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Upon arrival later that afternoon to our medical intensive care unit, his exam was notable for stable vital signs but persistently depressed mental status with fixed symmetric pupils. He weighed 100 kg. Admission labs (see Table 1 ) were notable for a persistent anion gap metabolic acidosis and an extremely elevated osmolar gap of > 200 mOsm/kg. Toxicology and nephrology were consulted. A toxic alcohol panel was drawn and additional IV fomepizole was administered with IV folate, thiamine, and pyridoxine. Vascular access for hemodialysis (HD) was placed in the right internal jugular vein (15-cm 12-French Power-Trialysis catheter, Bard Access Systems, Salt Lake City, UT). Computed tomography (CT) of the head revealed “symmetric hypoattenuation in the bilateral basal ganglia involving portion of the putamen and external capsule… suspicious for hypoxic-ischemic injury or potentially toxic-metabolic injury in the correct clinical setting.” The alcohol panel results obtained just prior to the initiation of HD revealed a methanol level above the upper limit of detection (> 156 mmol/L or > 500 mg/dL). The patient received three total HD sessions. His first treatment was interrupted due to poor function of his vascular access, which persisted despite the use of in-line heparin, ultimately requiring a second dialysis access to be placed (30-cm right femoral Power-Trialysis). The first two treatments were performed with the Tablo Hemodialysis System. The third treatment was performed with a conventional IHD machine (Gambro Phoenix, Baxter International, Deerfield, IL, USA) and was also interrupted due to circuit clotting. All dialysis treatments utilized a Revaclear™ dialyzer [Baxter International, polyarylethersulfone, membrane surface area 1.4 m 2 , K O A for urea 1170 mL/min at blood flow rate ( Qb ) of 300 mL/min and dialysate flow rate ( Qd ) of 500 mL/min, K UF 50 mL/h/mmHg]. See Table 2 and Fig. 1 for treatment sequence and serial methanol levels. Table 1 Labs upon admission to the medical ICU Lab Result Units WBC 21.2 (H) 10 9 /L Hemoglobin 146 g/L Hematocrit 0.49 MCV 9.2 10 −14 L/cell Platelets 263 10 9 /L INR 1.08 Sodium 139 mmol/L Potassium 5 mmol/L Chloride 107 mmol/L Total CO 2 7 (L) mmol/L BUN 4.6 mmol/L Creatinine 133 μmol/L Glucose 8.0 mmol/L Calcium 1.6 (L) mmol/L Phosphorus 1.3 mmol/L Magnesium 1.1 mmol/L Anion gap 25 (H) mmol/L Total protein 77 g/L Albumin 33 (L) g/L AST* 66 (H) unit/L ALT 43 unit/L Alkaline phosphatase 136 unit/L Total bilirubin 5.1 μmol/L Ammonia* 34 (H) μmol/L Serum osmolality 530 mOsm/kg Lactate 2.3 mmol/L Lipase* 988 (H) unit/L Troponin I < 0.017 μg/L Creatine kinase 637 (H) unit/L Ethanol ND mmol/L Acetaminophen < 2 μmol/L Salicylate < 2 mmol/L Ketones by urinalysis Small Urine amphetamine screen ND Urine barbiturate screen ND Urine benzodiazepine screen Positive Urine cannabinoid screen Positive Urine cocaine screen ND Urine methadone screen ND Urine opiate screen ND pH 7.23 (L) pCO 2 18 (L) mmHg pO 2 124 mmHg Calculated HCO 3 7 (L) mmol/L SaO 2 98 % Base deficit 19 (H) mEq/L FiO 2 40 % ICU , intensive care unit; ND , not detected. Abnormal numerical values are marked as high (H) or low (L). *Upper limit of normal for AST is 58 unit/L, for ammonia is 33 μmol/L, for creatine kinase is 242 unit/L, and for lipase is 360 unit/L Table 2 Treatment events including hemodialysis prescription Day Time Methanol levels (mmol/L) Events 1 11:35 Fomepizole given at local ED. 1 16:40 > 156 1 20:56 Treatment #1 started. Tablo® machine, Revaclear™ dialyzer, right IJ 15-cm 12-French Power-Trialysis™ catheter, lines reversed, Qb 350 mL/min, Qd 300 mL/min, UF 75 mL/h. 1 22:15 Circuit clotted. 1 22:44 Restarted with circuit lines changed and in-line heparin † added. Qb 300 mL/min, Qd 300 mL/min. 1 22:45 Fomepizole 950 mg IV. 1 23:05 Due to poor flows, Qb dropped further to 250 mL/min. 1 23:14 Treatment stopped again. Unable to aspirate from either line. New vascular access placed (right femoral 30-cm Power-Trialysis catheter). 2 0:45 Fomepizole 950 mg IV. 2 0:56 Treatment restarted using femoral line. Qb 350 mL/min, Qd 300 mL/min, UF 200 mL/h. 2 4:04 Treatment #1 completed. 2 7:51 64.9 2 9:19 Fomepizole 1500 mg IV. 2 10:45 Treatment #2 started. Tablo machine, Revaclear dialyzer, access 1-and-1 (right IJ arterial, right femoral venous return), Qb 350 mL/min, Qd 300 mL/min, UF 337 mL/h. 2 14:00 UF dropped to 117 mL/h. 2 14:45 7.2* *Level measured from the dialysis catheter during HD. 15:46 Fomepizole 1500 mg IV. 2 15:50 Treatment #2 completed. 2 22:36 15 3 0:50 Treatment #3 started. Gambro Phoenix™ machine, Revaclear dialyzer, Qb 350 mL/min, Qd 700 mL/min, UF 100 mL/h. 3 4:10 Circuit clotted; treatment stopped. 3 5:35 Treatment #3 restarted. Qb 350 mL/min, Qd 700 mL/min, UF 200 mL/h. 3 6:35 Treatment #3 completed. 3 8:54 3.4 3 10:25 3.1 3 12:42 2.2 4 4:00 ND ED , emergency department; HD , hemodialysis; IJ , internal jugular; K O A , product of the mass transfer coefficient and dialyzer membrane surface area; ND , not detected; Qb , blood flow rate; Qd , dialysate flow rate; UF , ultrafiltration rate. To convert methanol levels from mmol/L to mg/dL, multiply by 3.2. † Note that, though used in this case, the most recent EXTRIP guideline recommends avoiding systemic anticoagulation with hemodialysis due to reports of intracranial hemorrhage occurring in a substantial minority of patients with methanol poisoning Fig. 1 Methanol levels (measured and estimated) and treatment events. Included are measured methanol levels as well as estimated levels at the start and end of hemodialysis treatments #2 and #3. The drop in methanol levels during the Tablo treatment (HD#2) is highlighted in orange. The estimated methanol levels at the start and end of HD#2 and HD#3 were calculated assuming an endogenous methanol half-life (in the presence of ADH inhibition) of 52 h. ADH, alcohol dehydrogenase; ED, emergency department; HD, hemodialysis; UD, undetectable. To convert methanol levels from mmol/L to mg/dL, multiply by 3.2. *This level of 7.2 mmol/L (23 mg/dL) was drawn off of the dialysis catheter during treatment and is felt to be spurious. † Note that there was an 85-min interruption in HD#3 which is not graphically depicted
| 4.054688
| 0.944824
|
sec[1]/p[1]
|
en
| 0.999998
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34367669
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https://doi.org/10.1186/s41100-021-00362-8
|
[
"mmol",
"methanol",
"unit",
"hemodialysis",
"urine",
"screen",
"fomepizole",
"access",
"catheter",
"dialyzer"
] |
[
{
"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": "NE61&XM7KD9",
"title": "Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, methanol"
},
{
"code": "8A00.2Y",
"title": "Other specified secondary parkinsonism"
},
{
"code": "PD00&XM7KD9",
"title": "Intentional self-harm by exposure to or harmful effects of methanol"
},
{
"code": "PB30&XM7KD9",
"title": "Unintentional exposure to or harmful effects of methanol"
},
{
"code": "PH50&XM7KD9",
"title": "Exposure to or harmful effects of undetermined intent of methanol"
},
{
"code": "FB80.8",
"title": "Nonunion of fracture"
},
{
"code": "ED92.Z",
"title": "Disorders involving the apocrine follicular unit, unspecified"
}
] |
=== 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
[8A00.2Y] Other specified secondary parkinsonism
Also known as: Other specified secondary parkinsonism | Parkinsonism associated with hydrocephalus | Toxin-induced parkinsonism | secondary parkinsonism due to other external agents | Manganese-induced Parkinsonism
[FB80.8] Nonunion of fracture
Also known as: Nonunion of fracture | failed union fracture | false joint | pseudoarthrosis | pseudarthrosis
Excludes: Pseudarthrosis after fusion or arthrodesis
[ED92.Z] Disorders involving the apocrine follicular unit, unspecified
Also known as: Disorders involving the apocrine follicular unit, unspecified | Disorders involving the apocrine follicular unit
=== GRAPH WALKS ===
--- Walk 1 ---
[GB42.1] Albuminuria, Grade A3
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Gestational proteinuria without hypertension
--- Walk 2 ---
[GB42.1] Albuminuria, Grade A3
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Proteinuria
Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...
--- Walk 3 ---
[GB42.0] Albuminuria, Grade A2
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--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
--RELATED_TO--> [?] Neonatal hyperglycaemia
--- Walk 6 ---
[MA18.0Y] Other specified elevated blood glucose level
--PARENT--> [MA18.0] Elevated blood glucose level
--CHILD--> [MA18.00] Abnormal glucose tolerance test
Def: Greater than normal levels of glucose found in laboratory examination of the blood to check how the body breaks down (metabolizes) blood sugar. Positive findings may indicate diabetes or Cushing disea...
|
[
"[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension",
"[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...",
"[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --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 --RELATED_TO--> [?] Neonatal hyperglycaemia",
"[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.00] Abnormal glucose tolerance test\n Def: Greater than normal levels of glucose found in laboratory examination of the blood to check how the body breaks down (metabolizes) blood sugar. Positive findings may indicate diabetes or Cushing disea..."
] |
GB42.1
|
Albuminuria, Grade A3
|
[
{
"from_icd11": "FB80.8",
"icd10_code": "M841",
"icd10_title": ""
}
] |
M841
| |
The proband was referred to our hospital at the age of 41 due to progressive dyspnea on exertion over the last 3 months. Her medical history was remarkable for ischemic stroke attributed to paroxysmal atrial fibrillation. She was on oral anticoagulation (acenocumarol). Her electrocardiogram showed atrial fibrillation and her echocardiographic study revealed normal left ventricular (LV) dimensions with borderline contractile function (left ventricular ejection fraction [LVEF] 50%), severe biatrial dilatation and mild mitral regurgitation. Transmitral diastolic flow revealed monophasic flow (atrial fibrillation) with normal average maximal velocity (E) but shortened deceleration time (DT 110 ms), a finding consistent with restrictive LV filling (Table 1 ). Right heart catheterization demonstrated increased left atrial pressure (estimated through pulmonary capillary wedge pressure), pulmonary hypertension and restrictive diastolic filling pattern with characteristic dip-plateau morphology, confirming echocardiographic findings. Attempts to restore sinus rhythm were unsuccessful. Despite receiving appropriate treatment (metoprolol tartate, acenocoumarol, furosemide, amiloride) and achieving adequate rate control, the patient deteriorated during the following year and a new echocardiographic study revealed worsened LV systolic function (LVEF 35%, LV end-systolic diameter 34 mm), similar left and right atrial volumes, moderate mitral and tricuspid regurgitation and pericardial effusion, while right ventricular function was also impaired. Right heart catheterization confirmed hemodynamic deterioration and the patient was admitted to our center’s heart transplantation list. Due to further clinical aggravation, a pulsatile biventricular assist device was implanted as a bridge to transplant and two months later, successful heart transplantation was performed. The histology of the native heart revealed multiple foci of intestitial and pericellurar fibrosis with features of non-specific myocytic hypertrophy . Fig. 1 a The family pedigree is depicted. The proband (shown by arrow, II2) and her dizygotic twin sister (II3) were homozygous for the NM_000363.4:c.586G > C variant and displayed the phenotype of restrictive cardiomyopathy (RCM). Their brother (II1) also homozygous for the same variant displayed the phenotype of hypertrophic cardiomyopathy (HCM). Their children, with age range from 5 to 21 years old (III1: 5, III2: 13, III3 and III4: 21), remain unaffected along with the proband’s parents who were found heterozygous for the same mutation. Circle = female. Square = male. Filled symbols = affected individuals. b Electropherogram of the involved sequence fragment of the TNNI3 for the members of the family. The detected mutation is highlighted Table 1 Clinical, Electrocardiographic, and Doppler Echocardiographic Data of the proband and her family members. Approximate normal ranges of echocardiographic data according to published sources are shown in brackets Member of the family TNNI3 genetic status Current age/sex Age at symptom onset-examination Height (m)/ BSA (m 2 ) ECG, Arrhythmia LVEDD (mm) IVSd (mm) PWd (mm) LVESD (mm) LVEF % LAVi (ml/m 2 ) RAVi (ml/m 2 ) E (cm/s) A (cm/s) E/A DT (ms) Accompanying disease/habits (therapy) II1 Hom 49 M 42 1.75/2.01 SR, incomplete RBBB, LV strain 47 [42–58] 12 [6–10] 10 [6–10] 30 [25–40] 60 [52–72] 53.7 [16–34] 38.8 [11–39] 54 [40–104] 71 [32–92] 0.77 [0.60–1.84] 190 [81–293] HCM, NYHA II, presyncope, Dyslipidemia, smoker (acetylsalicylic acid, rosuvastatin) Proband II2 Hom 52F 41 1.60/1.49 AF, LVH, LV strain 45 [38–52] 7 [6–9] 7 [6–9] 31 [22–35] 50 [54–74] 127.5 [16–34] 100.7 [9–33] 60 [43–111] na (AF) na (AF) 110 [109–268] RCM, NYHA III-IV (acenocumarol, metoprolol tartate, furosemide, amiloride) II3 Hom 52F 45 1.60/1.59 SR, incomplete RBBB, LV strain 44 [38–52] 8 [6–9] 8 [6–9] 30 [22–35] 55 [54–74] 94.3 [16–34] 47.2 [9–33] 65 [43–111] 24 [35–91] 2.71 [0.4–2.12] 104 [109–268] RCM, NYHA II (furosemide) II4 Het 55F 1.65/1.79 SR 42 [38–52] 7 [6–9] 7 [6–9] 26 [22–35] 55 [54–74] 33.5 [16–34] 27.9 [9–33] 63 [43–111] 75 [35–91] 0.87 [0.4–2.12] 300 [109–268] Asymptomatic I1 Het 75 M 1.70/1.94 SR 46 [42–58] 10 [6–10] 10 [6–10] 27 [25–40] 65 [52–72] 23.2 [16–34] 23.7 [11–39] 60 [37–97] 75 [41–105] 0.80 [0.42–1.50] 280 [78–357] Asymptomatic Dyslipidemia (rosuvastatin) I2 Het 72F 1.70/2.00 SR 41 [38–52] 10 [6–9] 9 [6–9] 26 [22–35] 55 [54–74] 35 [16–34] 27.9 [9–33] 50 [38–106] 75 [44–108] 0.67 [0.37–1.61] 310 [90–313] Asymptomatic Increased apical trabeculations, AH, Dyslipidemia (olmesartan, rosuvastatin, acetylsalicylic acid) III2 Het 13F 1.61/1.45 SR 48 [38–52] 7 [6–10] 6 [6–10] 27 [22–35] 60 [54–74] 33.0 [18–34] 14.9 a [9.5–19.3] 100 [50–118] 70 [27–75] 1.43 [0.68–2.76] 190 [97–257] Asymptomatic III3 Het 21 M 1.78/1.97 SR 50 [42–58] 8 [6–10] 9 [6–10] 34 [25–40] 55 [52–72] 25.4 [16–34] 22.3 [11–39] 80 [51–107] 45 [24–76] 1.78 [0.65–2.73] 195 [87–273] Asymptomatic a for pediatric patient III2 Right Atrial Area is documented instead of RAVi A: maximal velocity of the late atrial component of transmitral blood flow, AF: Atrial Fibrillation, AH: Arterial Hypertension, BSA: Body Surface Area calculated with Mosteller formula, DT: Deceleration Timeof early transmitral flow (time from maximal velocity to zero), E: maximal early transmitral blood flow velocity, ECG: ElectroCardioGram, HCM: Hypertrophic Cardiomyopathy, Het: heterozygous, Hom: homozygous, IVSd: Interventricular Septum Diameter, LAVi: Left Atrial Volume indexed to BSA, LV: Left Ventricle, LVEDD: Left Ventricular End Diastolic Diameter, LVEF: LV Ejection Fraction, LVESD: Left Ventricular End Systolic Diameter, LVH: Left Ventricular Hypertrophy, na: not applicable, NYHA: New York Heart Association class, PWd: Posterior Wall Diameter, RAVi: Right Atrial Volume indexed to BSA, RBBB: Right Bundle Branch Block, RCM: Restrictive Cardiomyopathy, SR: Sinus Rhythm Abnormal values are shown in bold letters Fig. 2 The histology of the affected myocardium revealed multiple foci of intestitial and pericellurar fibrosis with features of non-specific myocytic hypertrophy. There was no evidence of inflammation or deposition of amyloid. (trichrome stain Χ100)
| 4.234375
| 0.907227
|
sec[1]/sec[0]/p[0]
|
en
| 0.999995
|
30953456
|
https://doi.org/10.1186/s12881-019-0793-z
|
[
"atrial",
"ventricular",
"heart",
"proband",
"echocardiographic",
"flow",
"diameter",
"asymptomatic",
"fibrillation",
"lvef"
] |
[
{
"code": "BC46&XA91S4",
"title": "Atrial thrombosis"
},
{
"code": "LA8Z",
"title": "Structural developmental anomaly of heart or great vessels, unspecified"
},
{
"code": "BC40.Z",
"title": "Acquired atrial abnormality, unspecified"
},
{
"code": "BC81.2Z",
"title": "Macro reentrant atrial tachycardia, unspecified"
},
{
"code": "LA8Y",
"title": "Other specified structural developmental anomaly of heart or great vessels"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease
[BC40.Z] Acquired atrial abnormality, unspecified
Also known as: Acquired atrial abnormality, unspecified | Acquired atrial abnormality
[BC81.2Z] Macro reentrant atrial tachycardia, unspecified
Also known as: Macro reentrant atrial tachycardia, unspecified | Macro reentrant atrial tachycardia | MRAT - [macro re-entrant atrial tachycardia] | intra-atrial re-entry tachycardia | Atrial flutter NOS
[LA8Y] Other specified structural developmental anomaly of heart or great vessels
Also known as: Other specified structural developmental anomaly of heart or great vessels | Congenital anomaly of position or spatial relationships of thoraco-abdominal organs | Usual atrial arrangement | atrial situs solitus | Abnormal atrial arrangement
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--PARENT--> [?] Structural developmental anomalies of the circulatory system
--- Walk 2 ---
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--CHILD--> [LA82] Total mirror imagery
Def: A congenital malformation in which there is complete mirror-imaged arrangement of the internal organs along the left-right axis of the body....
--- Walk 3 ---
[BC40.Z] Acquired atrial abnormality, unspecified
--PARENT--> [BC40] Acquired atrial abnormality
Def: A postnatal pathological change in form or function of one or both atriums....
--CHILD--> [BC40.0] Acquired interatrial communication
Def: A postnatal pathological hole or pathway between the atrial chambers....
--- Walk 4 ---
[BC40.Z] Acquired atrial abnormality, unspecified
--PARENT--> [BC40] Acquired atrial abnormality
Def: A postnatal pathological change in form or function of one or both atriums....
--RELATED_TO--> [?] Postprocedural residual or recurrent interatrial communication
Def: A persistent or recurrent hole or pathway between the atrial chambers, including intentional residual communications....
--- Walk 5 ---
[BC81.2Z] Macro reentrant atrial tachycardia, unspecified
--PARENT--> [BC81.2] Macro reentrant atrial tachycardia
Def: An atrial arrhythmia in which there is intra-atrial reentry or circus movement around a fixed or functional central obstacle. The central obstacle may consist of normal (e.g. valves) or abnormal (e.g....
--CHILD--> [BC81.22] Scar mediated macro reentrant atrial tachycardia
Def: A macro re-entrant atrial tachycardia in which the central obstacle and/or the zone of slow conduction sustaining the tachycardia is due to scar. In this context scar generally refers to surgical or i...
--- Walk 6 ---
[BC81.2Z] Macro reentrant atrial tachycardia, unspecified
--PARENT--> [BC81.2] Macro reentrant atrial tachycardia
Def: An atrial arrhythmia in which there is intra-atrial reentry or circus movement around a fixed or functional central obstacle. The central obstacle may consist of normal (e.g. valves) or abnormal (e.g....
--CHILD--> [BC81.20] Cavotricuspid isthmus dependent macroreentry tachycardia
Def: A macro re-entrant atrial tachycardia that rotates around the tricuspid annulus....
|
[
"[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --PARENT--> [?] Structural developmental anomalies of the circulatory system",
"[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --CHILD--> [LA82] Total mirror imagery\n Def: A congenital malformation in which there is complete mirror-imaged arrangement of the internal organs along the left-right axis of the body....",
"[BC40.Z] Acquired atrial abnormality, unspecified\n --PARENT--> [BC40] Acquired atrial abnormality\n Def: A postnatal pathological change in form or function of one or both atriums....\n --CHILD--> [BC40.0] Acquired interatrial communication\n Def: A postnatal pathological hole or pathway between the atrial chambers....",
"[BC40.Z] Acquired atrial abnormality, unspecified\n --PARENT--> [BC40] Acquired atrial abnormality\n Def: A postnatal pathological change in form or function of one or both atriums....\n --RELATED_TO--> [?] Postprocedural residual or recurrent interatrial communication\n Def: A persistent or recurrent hole or pathway between the atrial chambers, including intentional residual communications....",
"[BC81.2Z] Macro reentrant atrial tachycardia, unspecified\n --PARENT--> [BC81.2] Macro reentrant atrial tachycardia\n Def: An atrial arrhythmia in which there is intra-atrial reentry or circus movement around a fixed or functional central obstacle. The central obstacle may consist of normal (e.g. valves) or abnormal (e.g....\n --CHILD--> [BC81.22] Scar mediated macro reentrant atrial tachycardia\n Def: A macro re-entrant atrial tachycardia in which the central obstacle and/or the zone of slow conduction sustaining the tachycardia is due to scar. In this context scar generally refers to surgical or i...",
"[BC81.2Z] Macro reentrant atrial tachycardia, unspecified\n --PARENT--> [BC81.2] Macro reentrant atrial tachycardia\n Def: An atrial arrhythmia in which there is intra-atrial reentry or circus movement around a fixed or functional central obstacle. The central obstacle may consist of normal (e.g. valves) or abnormal (e.g....\n --CHILD--> [BC81.20] Cavotricuspid isthmus dependent macroreentry tachycardia\n Def: A macro re-entrant atrial tachycardia that rotates around the tricuspid annulus...."
] |
BC46&XA91S4
|
Atrial thrombosis
|
[
{
"from_icd11": "LA8Z",
"icd10_code": "Q248",
"icd10_title": "Other specified congenital malformations of heart"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q893",
"icd10_title": "Situs inversus"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q212",
"icd10_title": "Atrioventricular septal defect"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q249",
"icd10_title": "Congenital malformation of heart, unspecified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q246",
"icd10_title": "Congenital heart block"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q242",
"icd10_title": "Cor triatriatum"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q219",
"icd10_title": "Congenital malformation of cardiac septum, unspecified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q208",
"icd10_title": "Other congenital malformations of cardiac chambers and connections"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q897",
"icd10_title": "Multiple congenital malformations, not elsewhere classified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q209",
"icd10_title": "Congenital malformation of cardiac chambers and connections, unspecified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q218",
"icd10_title": "Other congenital malformations of cardiac septa"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q20",
"icd10_title": "Congenital malformations of cardiac chambers and connections"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q206",
"icd10_title": "Isomerism of atrial appendages"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q21",
"icd10_title": "Congenital malformations of cardiac septa"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q226",
"icd10_title": "Hypoplastic right heart syndrome"
}
] |
Q248
|
Other specified congenital malformations of heart
|
This case presents a 20-year-old German female patient diagnosed with a chronic wound infection caused by MFC following a traffic accident in Vietnam . The patient was travelling through Vietnam when she was involved in a motorbike accident in February 2019. She was taken to the emergency department of a hospital in Hanoi where she presented with a large wound on the right leg. At the time of admission, she was complaining of severe pain in her back and right foreleg, as well as headache and nausea. The patient reported no other pre-existing medical conditions. Radiograph of the lower leg did not show any signs of fracture, and cranio-encephalic traumatic lesions were excluded in the cranial computed tomography (CT) scan. However, a lumbosacral spine CT scan revealed stable fractures of the thoracic vertebrae (T4 / 5). The patient underwent surgical debridement and suture of the leg wound the next day and was treated with metronidazole and ceftriaxone over four days. She was discharged eight days after admission, transported to Germany and immediately admitted to a local hospital. At that time, her right lower leg was swollen, but lacked signs of surgical site infection. The patient was discharged three days afterwards, and dressing changes were subsequently performed in an outpatient-setting by her general practitioner and in local hospitals. Approximately five weeks after the accident, wound inflammation was observed for the first time, with redness and warmth around the suture site and dehiscent areas of the wound edges. However, no signs of systemic infection such as fever, increased leukocyte count, or C-reactive protein levels were apparent. Three days later, she was re-admitted to a local hospital with the diagnosis of wound infection. Surgeons described purulent exudate and a subcutaneous firm tumor measuring 2 × 4 cm in size with spontaneous drainage . The patient was discharged, and oral antibiotic treatment with amoxicillin / clavulanic acid was continued for two weeks on suspicion of soft tissue infection. In the next follow-up presentation, two new lesions with serous drainage were documented. Of note, several swabs failed to show growth of any pathogenic bacteria on standard microbiological examination. Magnetic resonance imaging (MRI) was performed, showing neither bone involvement, nor a remaining foreign body underlying the chronic infection. The patient was transferred to our university hospital where plastic surgical debridement was performed. On histopathological examination, chronic granulomatous purulent inflammation was documented. The lesion was covered by skin grafting and local flap surgery three days later, while intravenous antibiotic treatment with ampicillin / sulbactam was continued over ten days . However, the wound failed to heal, and persistent infected cutaneous lesions were noted on follow-up outpatient appointments . MFC could then be grown from a biopsy on Columbia agar on culture day two. Species identification via MALDI-TOF and subsequent genotypic identification using a DNA hybridization strip assay (GenoType Mycobacterium CM, Hain Lifescience / Bruker) was performed and Infectious Diseases specialist consultation was initiated. Minimal inhibitory concentration (MIC)-determination via broth microdilution revealed susceptibility to amikacin and fluoroquinolones, and intermediate sensitivity to imipenem, while the isolated strain exhibited resistance toward linezolid, doxycycline / minocycline, trimethoprim-sulfamethoxazole, clarithromycin, and cefoxitin . In addition, susceptibility testing for the second line antimycobacterial agents clofazimine, bedaquiline, and delamanid was performed (Table 1 ). Though official clinical breakpoints for susceptibility testing of NTM for those agents have not been defined yet , the results pointed towards resistance against delamanid and susceptibility for bedaquiline considering proposed European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints for Mycobacterium tuberculosis (version 10.0) and previous studies . Fig. 1 Timecourse of the antimicrobial treatments, surgical procedures, diagnostics and hospital admissions. Links to the respective photos depicted in Fig. 2 have been included. CT, computer tomography; d, day; GER, Germany; LH, local hospital; metron., metronidazole; MRI, magnet resonance imaging; UH, university hospital; US, ultrasound; Nov., November; w, weeks; XR, Xray Fig. 2 Serial images of the patient’s right foreleg. ( a ) Photograph taken four days after the traffic accident at a hospital in Hanoi following surgical debridement and suture of the wound. ( b , c ) Six weeks after the accident a firm subcutaneous nodule was noted ( b ), which drained spontaneously the next day ( c ). The soft tissue infection persisted despite four weeks of empiric antimicrobial treatment (sixth to tenth week after the accident) ( d ) leading to the decision to perform surgical debridement and subsequent skin grafting as well as local flap surgery 11 weeks after the trauma ( e ). ( f) A tissue biopsy was obtained 19 weeks after the accident when abscesses and nodules reappeared within a few weeks upon surgical debridement and intravenous empiric antibiotic therapy. ( g-i ) After 20 weeks, antimycobacterial treatment was initiated following susceptibility testing of the identified Mycobacterium fortuitum: Photographs show the status before ( g ), eight weeks after antimycobacterial therapy ( h ) and upon completion of the four-month therapy regimen ( i ). The patient was followed-up, continuous improvement was noticed nine months ( j ), 12 months ( k ) and 14 months after the initial accident ( l ) Table 1 Drug susceptibility results of the MFC isolate Substance MIC Interpretation Moxifloxacin 0.25 mg / L S Ciprofloxacin 0.5 mg / L S Amikacin 4.0 mg / L S Linezolid 32.0 mg / L R Clarithromycin 16.0 mg / L R Imipenem 8.0 mg / L I Cefoxitin 128 mg / L R Doxycycline 16.0 mg / L R Minocyclin 8.0 mg / L R Cotrimoxazol 8/152 mg / L R Tigecyclin 0.5 mg / L No breakpoints available Clofazimine 0.06 mg / L No breakpoints available Bedaquiline 0.015 mg / L No breakpoints available Delamanid > 0.5 mg / L No breakpoints available
| 3.865234
| 0.982422
|
sec[1]/p[0]
|
en
| 0.999997
|
32448204
|
https://doi.org/10.1186/s12879-020-05075-7
|
[
"wound",
"accident",
"infection",
"susceptibility",
"local",
"breakpoints",
"debridement",
"four",
"testing",
"available"
] |
[
{
"code": "MD11.5",
"title": "Dyspnoea"
},
{
"code": "NB32.3Z",
"title": "Injury of lung, unspecified"
},
{
"code": "NB91.1Z",
"title": "Injury of liver, unspecified"
},
{
"code": "NA01.Z&XA9T94",
"title": "Temporal wound"
},
{
"code": "ND56.1",
"title": "Open wound of unspecified body region"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "PA0Z",
"title": "Unintentional land transport traffic event injuring a user of unspecified land transport"
},
{
"code": "PA05",
"title": "Unintentional land transport traffic event injuring an occupant of a bus or coach"
},
{
"code": "PA20",
"title": "Unintentional land transport event unknown whether traffic or nontraffic injuring a pedestrian"
},
{
"code": "PA3Z",
"title": "Unintentional railway transport injury event of unspecified type"
}
] |
=== ICD-11 CODES FOUND ===
[MD11.5] Dyspnoea
Definition: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a presenting complaint of patients with a wide variety of medical diseases by multiple mechanisms.
Dyspnoea is considered acute when it lasts from hours up to 3 weeks, subacute from 3 weeks up to 8 weeks, and chronic dyspnoea lasts more than 8 weeks.
Also known as: Dyspnoea | difficulty breathing | respiration difficult | short of breath | winded
Includes: Orthopnoea
Excludes: Transient tachypnoea of newborn
[NB32.3Z] Injury of lung, unspecified
Also known as: Injury of lung, unspecified | Certain injuries of lung | injury of lung NOS | acute lung injury NOS | lung wound NOS
[NB91.1Z] Injury of liver, unspecified
Also known as: Injury of liver, unspecified | Injury of liver | liver wound NOS | liver fracture NOS | hepatocellular injury
[ND56.1] Open wound of unspecified body region
Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region
Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[PA0Z] Unintentional land transport traffic event injuring a user of unspecified land transport
Also known as: Unintentional land transport traffic event injuring a user of unspecified land transport | unintentional land transport injury event in road crash | unintentional land transport injury event on road | unintentional traffic accident | car accident NOS
[PA05] Unintentional land transport traffic event injuring an occupant of a bus or coach
Also known as: Unintentional land transport traffic event injuring an occupant of a bus or coach | Bus occupant injured in transport accident | Bus collision NOS, traffic | Bus accident NOS | Bus occupant injured in collision with pedestrian or animal
[PA20] Unintentional land transport event unknown whether traffic or nontraffic injuring a pedestrian
Also known as: Unintentional land transport event unknown whether traffic or nontraffic injuring a pedestrian | unintentional crash injuring a pedestrian, unknown whether on road | pedestrian accident NOS | pedestrian struck by motor vehicle | pedestrian struck by vehicle
[PA3Z] Unintentional railway transport injury event of unspecified type
Also known as: Unintentional railway transport injury event of unspecified type | train accident | train crash | Railway accident NOS | Occupant of railway train or railway vehicle injured in transport accident
=== GRAPH WALKS ===
--- Walk 1 ---
[MD11.5] Dyspnoea
Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres...
--EXCLUDES--> [?] Transient tachypnoea of newborn
Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth....
--PARENT--> [?] Respiratory distress of newborn
Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs....
--- Walk 2 ---
[MD11.5] Dyspnoea
Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres...
--EXCLUDES--> [?] Transient tachypnoea of newborn
Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth....
--PARENT--> [?] Respiratory distress of newborn
Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs....
--- Walk 3 ---
[NB32.3Z] Injury of lung, unspecified
--PARENT--> [NB32.3] Certain injuries of lung
--PARENT--> [NB32] Injury of other or unspecified intrathoracic organs
--- Walk 4 ---
[NB32.3Z] Injury of lung, unspecified
--PARENT--> [NB32.3] Certain injuries of lung
--CHILD--> [NB32.30] Contusion of lung
--- Walk 5 ---
[NB91.1Z] Injury of liver, unspecified
--PARENT--> [NB91.1] Injury of liver
Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity....
--CHILD--> [NB91.12] Laceration of liver, moderate
--- Walk 6 ---
[NB91.1Z] Injury of liver, unspecified
--PARENT--> [NB91.1] Injury of liver
Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity....
--RELATED_TO--> [?] Birth injury to liver
Def: Rupture or subcapsular haemorrhage into the liver parenchyma as a result of birth trauma usually seen in large for gestational age infants, those with hepatomegaly, those born by breech delivery; may ...
|
[
"[MD11.5] Dyspnoea\n Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres...\n --EXCLUDES--> [?] Transient tachypnoea of newborn\n Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth....\n --PARENT--> [?] Respiratory distress of newborn\n Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs....",
"[MD11.5] Dyspnoea\n Def: Dyspnoea is used to describe perceptions of difficulty or distress related to breathing and is recognised as symptomatic of disease when it occurs under inappropriate circumstances. Dyspnoea is a pres...\n --EXCLUDES--> [?] Transient tachypnoea of newborn\n Def: Transient tachypnoea of newborn is usually a benign self-limiting illness of term and near-term infants demonstrating increased respiratory rate and requiring supplementary oxygen after birth....\n --PARENT--> [?] Respiratory distress of newborn\n Def: A condition characterised by developmental insufficiency of surfactant associated proteins or surfactant production and structural immaturity in the lungs....",
"[NB32.3Z] Injury of lung, unspecified\n --PARENT--> [NB32.3] Certain injuries of lung\n --PARENT--> [NB32] Injury of other or unspecified intrathoracic organs",
"[NB32.3Z] Injury of lung, unspecified\n --PARENT--> [NB32.3] Certain injuries of lung\n --CHILD--> [NB32.30] Contusion of lung",
"[NB91.1Z] Injury of liver, unspecified\n --PARENT--> [NB91.1] Injury of liver\n Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --CHILD--> [NB91.12] Laceration of liver, moderate",
"[NB91.1Z] Injury of liver, unspecified\n --PARENT--> [NB91.1] Injury of liver\n Def: Damage inflicted on the liver as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --RELATED_TO--> [?] Birth injury to liver\n Def: Rupture or subcapsular haemorrhage into the liver parenchyma as a result of birth trauma usually seen in large for gestational age infants, those with hepatomegaly, those born by breech delivery; may ..."
] |
MD11.5
|
Dyspnoea
|
[
{
"from_icd11": "MD11.5",
"icd10_code": "R0603",
"icd10_title": "Acute respiratory distress"
},
{
"from_icd11": "MD11.5",
"icd10_code": "R0601",
"icd10_title": "Orthopnea"
},
{
"from_icd11": "MD11.5",
"icd10_code": "R0602",
"icd10_title": "Shortness of breath"
},
{
"from_icd11": "MD11.5",
"icd10_code": "R0600",
"icd10_title": "Dyspnea, unspecified"
},
{
"from_icd11": "MD11.5",
"icd10_code": "R0609",
"icd10_title": "Other forms of dyspnea"
},
{
"from_icd11": "MD11.5",
"icd10_code": "R060",
"icd10_title": "Dyspnea"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27321A",
"icd10_title": "Contusion of lung, unilateral, initial encounter"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27322A",
"icd10_title": "Contusion of lung, bilateral, initial encounter"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27331S",
"icd10_title": "Laceration of lung, unilateral, sequela"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27331A",
"icd10_title": "Laceration of lung, unilateral, initial encounter"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27329A",
"icd10_title": "Contusion of lung, unspecified, initial encounter"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27339A",
"icd10_title": "Laceration of lung, unspecified, initial encounter"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27391A",
"icd10_title": "Other injuries of lung, unilateral, initial encounter"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27391S",
"icd10_title": "Other injuries of lung, unilateral, sequela"
},
{
"from_icd11": "NB32.3Z",
"icd10_code": "S27321D",
"icd10_title": "Contusion of lung, unilateral, subsequent encounter"
}
] |
R0603
|
Acute respiratory distress
|
A 20-year-old male patient was admitted to our hospital complaining of dyspnea that persisted for 2 weeks (modified Medical Research Council dyspnea scale, 3). Two weeks prior, a cough accompanied by blood-tinged sputum was observed, along with exertional dyspnea. Upon his visit to the pulmonary clinic, the patient demonstrated a blood pressure of 150/100 mmHg, pulse rate of 102 beats/min, respiration rate of 20 breaths/min, and a body temperature of 36.8°C. His past medical history was free of tuberculosis, diabetes mellitus, hypertension, and renal diseases, aside from an obesity-related fatty liver. His family history was also free of kidney disease, including microscopic hematuria. The patient had a smoking history of 1 pack per year. Chest auscultation revealed reduced breathing sounds in both lung bases without inspiratory crackles. Physical examination revealed that the patient had no pretibial edema in the lower extremities or hepatosplenomegaly. Results of a peripheral blood test conducted on admission revealed counts of 9900/μL white blood cells (WBC, 74.2% neutrophils), 14.1 g/dL hemoglobin, and 364,000/μL platelets. Serum biochemistry test results were as follows: 9.9 mg/dL blood urea nitrogen (BUN), 0.8 mg/dL creatinine (Cr), 87 IU/L aspartate aminotransferase, 192 IU/L alanine aminotransferase, 7.5 g/dL total protein, 4.3 g/dL albumin, and 32.6 mg/L C-reactive protein (reference range, <5 mg/L). Results of arterial blood gas analysis performed in normal room air conditions were pH 7.461, PaCO 2 32.1 mmHg, PaO 2 75.4 mmHg, and 96.4% oxygen saturation. Urinalysis results were pH 5.5, 1+ occult blood, and trace albumin, and urine sediment examination revealed WBCs at 1–4/high-power field (HPF) and red blood cells (RBCs) at 5–10/HPF (dysmorphic 80%). The 24-hour urine volume was 1500 mL, with the urinary protein excretion level being 242.5 mg/day and Cr clearance being 95 mL/min/1.73m 2 . Blood coagulation profiles (prothrombin time, activated partial thromboplastin time, and fibrinogen) were all found to be within the normal range. Serum immunoglobulin (Ig) G, IgA, and IgM levels were all normal. Serum complement (C) 3 level was low at 86.2 mg/dL (reference range, 90–180 mg/dL), whereas C4 and CH50 levels were normal. Furthermore, serological examinations of rheumatoid factor and viral markers (hepatitis B surface antigen, anti-hepatitis C antibody, and anti-human immunodeficiency virus antibody) were all negative. Bilateral infiltrative lesions suspected of atypical bacterial pneumonia were detected in the lower lung fields through chest radiograph and chest computed tomography (CT), after which intravenous administration of antibiotics (ceftriaxone, levofloxacin) was initiated . However, gross hemoptysis persisted, and bronchoscopy was performed on the 3rd day of hospitalization, which revealed the presence of diffuse hemorrhage with no endobronchial lesions. The flexible bronchoscope was wedged into the lateral segment of the right middle lobe bronchus. Sequential broncho-alveolar lavage (BAL) showed progressively more hemorrhagic effluent. Analysis of BAL fluid revealed a CD4/CD8 ratio of 0.62 (reference range, 069–2.83), RBC levels of 578,470/μL, and WBC levels of 1500/μL. Bronchial secretion cultures were negative for bacteria, mycobacteria, and fungi. Transbronchial lung biopsies were not attempted because of the probable risk of profuse bleeding and respiratory distress. Nevertheless, an enzyme-linked immunosorbent assay (ELISA) of his serum revealed an anti-GBM antibody titer of 95.1 U/mL (reference range, <20 U/mL). The results of serologic tests for antinuclear antibody, anti-neutrophil cytoplasmic antibody, and cryoglobulin were all negative, excluding connective tissue disease and systemic vasculitis. Taken together, the patient was subsequently diagnosed with anti-GBM disease. Therefore, the authors opted for treatment with 500 mg intravenous methylprednisolone for 7 consecutive days, followed by daily administration of 80 mg oral prednisolone. Cyclophosphamide was also orally administered once a day (250 mg/day). Plasmapheresis was started on the 7th day of hospitalization due to continued pulmonary hemorrhage. Plasmapheresis was performed once a day for 6 days, after which there was a reduction in the serum level of anti-GBM antibody (2.2 U/mL). Ten days after completion of corticosteroid pulse therapy, interval improvement of pulmonary lesions was noted on the radiologic examinations . A human leukocyte antigen (HLA) test revealed the presence of both HLA-DR15 and HLA-DR04, which are linked to genetic susceptibility for anti-GBM disease. The size and shape of the kidneys appeared normal during abdominal ultrasonography. Fourteen days after admission, a percutaneous renal biopsy, under ultrasound guidance, was performed to assess glomerular abnormalities related to the presence of anti-GBM antibody. Light microscopic examination on a total of 13 glomeruli showed no pathological abnormalities, including lack of intravascular thrombosis and formed crescents. Furthermore, there were no indications of tubular atrophy, interstitial fibrosis, or inflammatory cell infiltrations . Immunofluorescence microscopy did not indicate immune deposits for immunoglobulins or complements . However, electron microscopy revealed diffuse thinning of the GBM to an average thickness of 220 nm; thus, a diagnosis of TBMN was made . No heterozygous mutations in the COL4A3 or COL4A4 genes were identified in the genotypic analysis. The patient was discharged with a marked resolution of respiratory symptoms after 32 days in the hospital. Two months after hospital discharge, follow-up chest radiograph and chest CT scans demonstrated complete recovery of the previous pulmonary lesions , and oral cyclophosphamide was discontinued. Currently, 12 months after discharge, a tapered dose of oral prednisolone (10 mg/day) was withdrawn without hemoptysis. His renal function was normal at BUN 19.4 mg/dL and serum Cr 0.9 mg/dL. Moreover, there were no notable changes in urinalysis with albumin 1+, RBC 5–10/HPF, and spot urine protein/Cr of 0.215 g/g, when compared to the initial findings at the time of kidney biopsy.
| 4.105469
| 0.972168
|
sec[1]/p[0]
|
en
| 0.999998
|
34011133
|
https://doi.org/10.1097/MD.0000000000026095
|
[
"blood",
"anti",
"antibody",
"serum",
"chest",
"range",
"pulmonary",
"protein",
"reference",
"lesions"
] |
[
{
"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": "JA86.Y",
"title": "Maternal care for other specified fetal problems"
},
{
"code": "MB23.1",
"title": "Antisocial behaviour"
},
{
"code": "3B4Z",
"title": "Coagulation defects, unspecified"
},
{
"code": "4A45.Z",
"title": "Antiphospholipid syndrome, unspecified"
},
{
"code": "4A43.Y",
"title": "Other specified overlap non-organ specific systemic autoimmune disease"
}
] |
=== ICD-11 CODES FOUND ===
[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
[JA86.Y] Maternal care for other specified fetal problems
Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS
[MB23.1] Antisocial behaviour
Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.
Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour
[3B4Z] Coagulation defects, unspecified
Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality
[4A45.Z] Antiphospholipid syndrome, unspecified
Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome
[4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease
Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Certain conditions originating in the perinatal period
Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--CHILD--> [?] Diseases of spleen
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.4Z] Haematuria, unspecified
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.41] Microscopic haematuria
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.2] Finding of hallucinogen in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --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 --CHILD--> [?] Diseases of spleen",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
A 64-year-old woman with acute myeloid leukemia received chemotherapy, first with adriamycin (AD), cytarabine arabinoside (cytarabine), and daunorubicin (AD 7 + 3), then with AD, cytarabine, and idarubicin (AI 7 + 3) . No consolidation chemotherapy was performed, because the patient had refused. Unfortunately, the disease relapsed as acute undifferentiated leukemia. She was treated with salvage chemotherapy of fludarabine, cytosine arabinoside, and granulocyte-colony stimulating factor (G-CSF) (FLAG) and achieved complete remission (CR). She was treated with one cycle of intermediate-dose Ara-C consolidation (IDAC). Then, she underwent a full match allogeneic peripheral blood stem cell transplant (Allo-PBSCT) from a male donor, registered in the Korea Marrow Donor Program. After approximately one month, she had a tendency to sleep and the deterioration of consciousness accelerated. Polymorphonuclear (PMN) leukocyte dominant pleocytosis had developed. Cerebrospinal fluid (CSF) examination revealed polymorphonuclear neutrophil (PMN)-dominant pleocytosis and increased protein level up to 135 g/dL (cf. normal range: 15–45 g/dL). Three months after transplantation, the patient’s consciousness deteriorated rapidly, but light reflexes were still intact. However, she could neither respond to painful stimuli nor communicate. Electroencephalography revealed generalized slow activity indicating diffuse cerebral dysfunction. T2-weighted magnetic resonance imaging (MRI) showed high signal intensity in the bilateral centrum semiovale and the optic pathway with a slightly decreased size of bilateral basal ganglia . Graft versus host disease (GVHD), toxic encephalopathy, metabolic encephalopathy, and autoimmune encephalitis were considered as the clinical differential diagnosis. The patient was treated with methylprednisolone (120 mg), intravenous immunoglobin (IVIG) (400 mg/kg) and intrathecal hydrocortisone under the assumption of CNS-GVHD. Autoimmune encephalitis could be ruled out by neurologists upon getting negative results of anti-aquaporin4 IgG Ab, anti-monosialoganglioside (GM1) Ab, and anti-ganglioside Ab IgG panel (anti-GQ1b IgM, anti-GD1 B IgM) tests from peripheral blood serum samples. Fig. 1 A Patient 1 was diagnosed with AML in 2016 and treated with standard induction chemotherapy of cytarabine arabinoside, and daunorubicin (AD 7 + 3), and further re-induction chemotherapy of cytarabine and idarubicin (AI 7 + 3). No consolidation chemotherapy was performed due to the patient’s refusal. Unfortunately, the patient’s disease relapsed as acute undifferentiated leukemia. She was treated with salvage chemotherapy of fludarabine, and cytosine arabinoside, and G-CSF (FLAG) and achieved complete remission (CR). She was treated with one cycle of intermediate-dose Ara-C consolidation (IDAC). Then she underwent an allogeneic peripheral blood stem cell transplant (Allo-PBSCT). After approximately one month, she had a tendency to sleep and deterioration of consciousness was accelerated. Polymorphonuclear (PMN) leukocyte dominant pleocytosis had developed. Under the clinical impression of CNS-GVHD, methylprednisolone (mPD, 120 mg), intravenous immunoglobulin (IVIG), and intrathecal hydrocortisone therapy were implemented. However, she showed drowsy mentality acutely and died of respiratory failure. It was only three months after she began to develop a tendency to sleep. B Patient 2 was diagnosed with myelodysplastic syndrome (MDS) and was treated with three cycles of azacytidine for 3 months. He received allogeneic peripheral blood stem cell transplant (Allo PBSCT). Approximately one month later, he developed motor dysfunction (general weakness, gait disability, and fecal and urinary incontinence). Then sleep tendency and disorientation developed. Under the clinical impression of CNS-GVHD, methylprednisolone (mPD) pulse plus IVIG, rituximab and ruxolitinib were implemented. These symptoms improved temporarily but got worse. He was given tacrolimus and mycophenolate mofetil (MMF) instead of mPd pulse and IVIG. However, the patient’s condition deteriorated rapidly, and within three months after dyskinesia, he died of pneumonia, septic shock, disseminated intravascular coagulopathy (DIC), and multiorgan failure Table 2 Clinicopathological findings of two cases with autopsy-proven chemobrains Case 1 Case 2 Age/Gender 64/F 63/M Active problem Loss of consciousness, sleep tendency, type I respiratory failure due to aspiration pneumonia and sepsis Disorientation, drowsy mentality, sleep tendency, coma Pneumonia, sepsis, & DIC, multiorgan failure Underlying disease Relapsed Acute undifferentiated myelogenous leukemia Myelodysplastic syndrome excess blast 1 (MDS-EB1) Chemotherapy-Regimen FLAG, IDAC Azacitidine #3 Transplant MUD-alloPBSCT MUD-alloPBSCT Autopsy finding Numerous axonal spheroid with vacuolar changes of the white matter and exogenous foamy macrophage (CD68-positive/TMEM119-negative) infiltration Beta-amyloid deposit in the degenerated axons of the optic tract of occipital and temporal lobes Numerous axonal spheroids with vacuolation of the white matter with exogenous foamy macrophage (CD68-positive/TMEM119-negative) infiltration Beta-amyloid deposit in the axons, extensively in the most white matter Main involving area The white matter of the occipital and temporal lobe The white matter of the occipital, temporal, and parietal lobe T- or B-lymphocytes Absent in the entire brain parenchyma Absent in the entire brain parenchyma Survival 3 months after alloPBSCT 4 months after alloPBSCT (about 3 months after onset of disorientation) FLAG (fludarabine, Ara-Cytarabine, granulocyte colony-stimulating factor), IDAC Intermediate-dose Ara-Cytarabine, MUD Matched unrelated donor, allPBSCT Allogeneic peripheral blood stem cell transplantation Fig. 2 A , B , C T2-weighted brain MRI of case 1 revealed multiple high signal intensity lesions (arrows) in the white matter with diffuse high signal intensity of the optic pathway and central pons (arrow). D , E , F T2-weighted image of case 2 showed high signal intensity lesions (arrows) in the white matter, the splenium of the corpus callosum (yellow arrow) and the pons (arrows)
| 4.066406
| 0.974121
|
sec[2]/sec[0]/p[0]
|
en
| 0.999996
|
PMC9347126
|
https://doi.org/10.1186/s12883-022-02818-8
|
[
"chemotherapy",
"cytarabine",
"treated",
"white",
"matter",
"tendency",
"sleep",
"blood",
"anti",
"leukemia"
] |
[
{
"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": "PL00",
"title": "Drugs, medicaments or biological substances associated with injury or harm in therapeutic use"
},
{
"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"
}
] |
=== 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
[PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use
Also known as: Drugs, medicaments or biological substances associated with injury or harm in therapeutic use | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Penicillins | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Cephalosporins or other beta-lactam antibiotics | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Chloramphenicol group
Excludes: Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm
[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
=== 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
--PARENT--> [?] Reasons for contact with the health services
--- Walk 2 ---
[QB97] Contact with health services for chemotherapy session for neoplasm
--PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices
--PARENT--> [?] Reasons for contact with the health services
--- Walk 3 ---
[QC05.Y] Other specified prophylactic measures
--PARENT--> [QC05] Need for certain specified other prophylactic measures
--EXCLUDES--> [?] Contact with health services for prophylactic surgery
--- 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
--CHILD--> [QB90] Contact with health services for ear piercing
--- 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--> [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 --PARENT--> [?] Reasons for contact with the health services",
"[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Reasons for contact with the health services",
"[QC05.Y] Other specified prophylactic measures\n --PARENT--> [QC05] Need for certain specified other prophylactic measures\n --EXCLUDES--> [?] Contact with health services for prophylactic surgery",
"[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 --CHILD--> [QB90] Contact with health services for ear piercing",
"[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--> [QB90] Contact with health services for ear piercing"
] |
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": "PL00",
"icd10_code": "Y40",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y400",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y401",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y402",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y403",
"icd10_title": ""
}
] |
Z5111
|
Encounter for antineoplastic chemotherapy
|
Leishmaniasis is an infectious protozoal disease caused by different Leishmania species and transmitted by a variety of sandflies from the Phlebotomus or Lutzomyia family . There are an estimated 0.6 to 1 million cases of CL annually and 50,000 to 90,000 cases of VL respectively according to the WHO . While VL and CL are well known conditions in old-world leishmaniasis, mucosal involvement has been described less frequently for L. infantum . Recently, a European multi-center study found higher rates of ML due to L. infantum than previously reported . MCL by New World Leishmania species and ML by Leishmania infantum are different in their clinical appearance. MCL typically has a more nasal than oral tropism and usually starts at the nostrils or lips. Features of MCL are characteristic destructive lesions of the nasal septum, lips and palate, which can lead to permanent deformity like so-called tapir-nose and result in life-threatening conditions . ML from L. infantum however rather occurs in oral (lips, cheeks, palate, gums, tongue), pharyngeal or upper airway locations including the larynx and vocal cords . ML with oral and lingual involvement has been described more frequent in immunocompromised, but also occasionally in immunocompetent patients . Different kinds of immunosuppressive conditions are known in ML , such as renal transplant , cancer and systemic or local immunosuppressive treatment including steroids and biologicals . Case series showed mainly elderly men are affected by ML . A previous history of possible or confirmed CL or VL is rare . Due to the scarcity of the disease, patients often are referred to oral surgery departments and evaluated for cancer . Diagnosis can be delayed and sometimes patients receive inappropriate treatments . Our case report describes localized mucosal leishmaniasis of the tongue in a patient with no underlying immunocompromising disease or treatment, which is a rare condition. There has been a debate, whether localized mucosal leishmaniasis by L. infantum represents the site of inoculation or is secondary to dissemination . As the amastigotes of Leishmania species can persist in macrophages for years after cutaneous inoculation, they can be reactivated in immunosuppressive condition and cause VL or ML subsequently . Reactivation of leishmaniasis by L. infantum in immunocompetent patients is rare but has been described recently . This case report supports the hypothesis of secondary dissemination due to reactivation of leishmaniasis. It could be demonstrated that the patient was suffering from a previous CL by L. donovani complex acquired in Spain, where L. infantum is the only species of Leishmania present. Hence the preceding CL likely was reactivated and caused the current manifestation as ML, where L. infantum could by identified by sequencing. However, the patient continued to travel to Spain annually after the first diagnosis of cutaneous leishmaniasis in 2015 and therefore periodically was exposed to the risk of re-infection in a low-endemicity setting while Germany is non-endemic for Leishmania species. Although the patient suffered from obstructive sleeping apnea syndrome, inoculation of the parasites into the oral mucosa by Phlebotomus flies is unlikely, as OSAS is common in the European population but cases of oral leishmaniasis by L. infantum are rare and additionally, the second lingual lesion developed in Germany with no exposure to an endemic setting. However, also inapparent re-infection on other locations cannot be ruled out in general due to the patient´s travel history. After confirming the diagnosis of a previous CL from dermatohistopathology, we assumed dissemination of the parasites. The patient did not show any clinical or laboratory signs of VL caused by L. infantum. In particular, there was no fever, hypergammaglobulinemia or other elevated laboratory inflammatory markers. This is particularly relevant as VL typically exhibits hypergammaglobulinemia, while isolated ML and CL generally do not. Therefore, we decided against bone marrow aspiration (BMA). In literature, detection of L. infantum from BMA in ML varied [ 4 , 7 – 9 , 19 ] and PCR from EDTA (ethylenediaminetetraacetic acid) blood often led to positive findings in healthy blood donors . In our case the kinetoplast-PCR proved more sensitive as molecular screening method, as previously described . However, the less sensitive complex-PCR has the advantage of narrowing down the pathogen to a complex in a single step . The strategy of management can be discussed critically in this case. Miltefosine and liposomal amphotericin B are the most favored treatment options of old-world ML in literature , but no evidence-based treatment option is available from randomized clinical trials. Miltefosine 150 mg/d for 28 days or liposomal amphotericin B (e.g. 3 mg/kg d1-5, 14, 21) have successfully been used for treatment of mucosal leishmaniasis due to L. Infantum . In literature, also successful systemic or intralesional treatment of mucosal lesions with pentavalent antimonials is mentioned . However, given the classification of the lesion as complex and considering the history of a previous CL, we opted strongly against intralesional injections. Systemic antimony formulations are not favorable because of toxicity especially in elderly patients. Relapse is possible in ML and described for all standard treatment regimens. However, higher cure rates are reported for oral miltefosine than liposomal amphotericin B . In our case, despite low evidence, we considered oral fluconazole as a reasonable option in an out-patient setting, because miltefosine has high treatment costs and liposomal amphotericin B usually requires an in-patient setting, which both could not be handled by the patient and his family. Treatment failure with fluconazole may also be attributed to underdosing and discontinuation of the therapy after stroke. When suspecting dissemination of Leishmania from a previous lesion, although there were no signs of VL, oral miltefosine or intravenous liposomal amphotericin B rather than fluconazole should have been chosen as the drug of choice in the first round of treatment in this patient.
| 4.433594
| 0.74707
|
sec[2]/p[0]
|
en
| 0.999996
|
39966762
|
https://doi.org/10.1186/s12879-025-10592-4
|
[
"infantum",
"leishmaniasis",
"oral",
"leishmania",
"however",
"species",
"mucosal",
"patients",
"miltefosine",
"liposomal"
] |
[
{
"code": "EH40.10",
"title": "Primary irritant napkin dermatitis"
},
{
"code": "1F01",
"title": "Roseola infantum"
},
{
"code": "EA12",
"title": "Infantile papular acrodermatitis"
},
{
"code": "1F54.0",
"title": "Visceral leishmaniasis"
},
{
"code": "1F54.Z",
"title": "Leishmaniasis, unspecified"
},
{
"code": "1F54.1",
"title": "Cutaneous leishmaniasis"
},
{
"code": "1F54.2",
"title": "Mucocutaneous leishmaniasis"
},
{
"code": "QA08.6",
"title": "Special screening examination for other protozoal diseases or helminthiases"
},
{
"code": "MD11.8Z",
"title": "Mouth breathing, unspecified"
},
{
"code": "DA01.00",
"title": "Oral leukoplakia"
}
] |
=== ICD-11 CODES FOUND ===
[EH40.10] Primary irritant napkin dermatitis
Definition: A type of irritant dermatitis seen most frequently in infants localised to the area in contact with a napkin (diaper) and occurring most often as a reaction to prolonged contact with urine, faeces, or retained soap or detergent.
Also known as: Primary irritant napkin dermatitis | Diaper dermatitis | Nappy rash | Diaper rash | Napkin dermatitis
Includes: Nappy rash | Diaper rash
[1F01] Roseola infantum
Definition: A disease caused by an infection with roseolovirus (human herpesvirus type 6 or 7). This disease is characterised by acute fever, followed by macular or maculopapular exanthem in some individuals. Transmission is by inhalation of infected respiratory secretions or direct contact.
Also known as: Roseola infantum | Exanthema subitum | Sixth disease | roseola
[EA12] Infantile papular acrodermatitis
Definition: Infantile papular acrodermatitis (Gianotti-Crosti syndrome) is a cutaneous reaction pattern to a range of infective agents affecting predominantly young children aged from six months to two years. Agents implicated include hepatitis B virus, Epstein-Barr virus and a number of enteroviruses. The rash consists in a profuse eruption of 5-10 mm diameter dull red flat-topped papules which appear first on the thighs and buttocks, then on the extensor aspects of the arms, and finally on the face. There
Also known as: Infantile papular acrodermatitis | Acrodermatitis papulosa infantum | Papular acrodermatitis of childhood | Gianotti-Crosti syndrome
Excludes: Acrodermatitis chronica atrophicans | Acrodermatitis continua of Hallopeau | Acrodermatitis enteropathica
[1F54.0] Visceral leishmaniasis
Definition: A disease caused by an infection with the protozoan parasite Leishmania. This disease is characterised by biphasic fever, hepatosplenomegaly, pancytopenia, wasting, darkening of the skin, or may be asymptomatic. Transmission is through the bite of an infected female phlebotomine sandfly. Confirmation is by identification of Leishmania from a tissue or blood sample, or detection of antibodies against Leishmania.
Also known as: Visceral leishmaniasis | Sahib disease | Ponos | Burdwan fever | Kala-azar
Includes: Kala-azar
[1F54.Z] Leishmaniasis, unspecified
Also known as: Leishmaniasis, unspecified | Leishmaniasis | leishmania | leishmania infection | leishmaniosis
[1F54.1] Cutaneous leishmaniasis
Definition: Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethiopia and Asia), where L. major, L. tropica, L. aethiopica and L. donovani infantum predominate. Other sandflies are responsible for transmitting the New World species, L. mexicana and L. brasiliensis. The commonest presentation is with one or more crusted nodules or ulcers on exposed sites which gra
Also known as: Cutaneous leishmaniasis | Old world cutaneous leishmaniasis | Lymphocutaneous leishmaniasis | cutaneous leishmaniasis with nodular lymphangitis | Disseminated cutaneous leishmaniasis
[1F54.2] Mucocutaneous leishmaniasis
Definition: Mucocutaneous leishmaniasis is a secondary infection of nasal and oral mucosae, predominantly by Leishmania braziliensis. It usually first manifests within two years of initial cutaneous infection but often after the latter has healed. It results from lymphatic or haematogenous spread of infection and can cause severe local tissue destruction.
Also known as: Mucocutaneous leishmaniasis | Espundia | American mucocutaneous leishmaniasis | Leishmania braziliensis infection | Nasopharyngeal leishmaniasis
Includes: Leishmania braziliensis infection
[QA08.6] Special screening examination for other protozoal diseases or helminthiases
Also known as: Special screening examination for other protozoal diseases or helminthiases | screening for helminthiasis | screening for protozoal disease | Filariasis screening | Leishmaniasis screening
Excludes: Protozoal intestinal infections
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[EH40.10] Primary irritant napkin dermatitis
Def: A type of irritant dermatitis seen most frequently in infants localised to the area in contact with a napkin (diaper) and occurring most often as a reaction to prolonged contact with urine, faeces, or...
--PARENT--> [EH40.1] Infantile napkin dermatoses
--RELATED_TO--> [?] Neonatal nutritional zinc deficiency
Def: An eruption clinically indistinguishable from acrodermatitis enteropathica but due to nutritional deficiency rather than a genetically-determined zinc malabsorption as in the former condition. It occu...
--- Walk 2 ---
[EH40.10] Primary irritant napkin dermatitis
Def: A type of irritant dermatitis seen most frequently in infants localised to the area in contact with a napkin (diaper) and occurring most often as a reaction to prolonged contact with urine, faeces, or...
--PARENT--> [EH40.1] Infantile napkin dermatoses
--RELATED_TO--> [?] Neonatal nutritional zinc deficiency
Def: An eruption clinically indistinguishable from acrodermatitis enteropathica but due to nutritional deficiency rather than a genetically-determined zinc malabsorption as in the former condition. It occu...
--- Walk 3 ---
[1F01] Roseola infantum
Def: A disease caused by an infection with roseolovirus (human herpesvirus type 6 or 7). This disease is characterised by acute fever, followed by macular or maculopapular exanthem in some individuals. Tra...
--PARENT--> [?] Viral infections characterised by skin or mucous membrane lesions
--CHILD--> [?] Infections due to poxvirus
--- Walk 4 ---
[1F01] Roseola infantum
Def: A disease caused by an infection with roseolovirus (human herpesvirus type 6 or 7). This disease is characterised by acute fever, followed by macular or maculopapular exanthem in some individuals. Tra...
--PARENT--> [?] Viral infections characterised by skin or mucous membrane lesions
--CHILD--> [?] Infections due to poxvirus
--- Walk 5 ---
[EA12] Infantile papular acrodermatitis
Def: Infantile papular acrodermatitis (Gianotti-Crosti syndrome) is a cutaneous reaction pattern to a range of infective agents affecting predominantly young children aged from six months to two years. Age...
--EXCLUDES--> [?] Acrodermatitis enteropathica
Def: Acrodermatitis enteropathica is an uncommon autosomal recessive disorder of intestinal zinc absorption. Signs usually appear within the first months of life with an exudative and crusted erythema loca...
--PARENT--> [?] Certain genetically-determined metabolic disorders with skin involvement
Def: Heredofamilial metabolic disorders with skin manifestations not listed elsewhere in this chapter....
--- Walk 6 ---
[EA12] Infantile papular acrodermatitis
Def: Infantile papular acrodermatitis (Gianotti-Crosti syndrome) is a cutaneous reaction pattern to a range of infective agents affecting predominantly young children aged from six months to two years. Age...
--EXCLUDES--> [?] Acropustulosis of Hallopeau
Def: An uncommon pustular form of psoriasis which may rarely eventuate into generalised pustular psoriasis. It is characterised by pustules and variable scaling occurring in and around the nails and nail-b...
--EXCLUDES--> [?] Palmoplantar pustulosis
Def: Palmoplantar pustulosis (PPP) is a chronic inflammatory skin condition characterised by crops of sterile pustules on the palms and soles which erupt repeatedly over months or years. The affected areas...
|
[
"[EH40.10] Primary irritant napkin dermatitis\n Def: A type of irritant dermatitis seen most frequently in infants localised to the area in contact with a napkin (diaper) and occurring most often as a reaction to prolonged contact with urine, faeces, or...\n --PARENT--> [EH40.1] Infantile napkin dermatoses\n --RELATED_TO--> [?] Neonatal nutritional zinc deficiency\n Def: An eruption clinically indistinguishable from acrodermatitis enteropathica but due to nutritional deficiency rather than a genetically-determined zinc malabsorption as in the former condition. It occu...",
"[EH40.10] Primary irritant napkin dermatitis\n Def: A type of irritant dermatitis seen most frequently in infants localised to the area in contact with a napkin (diaper) and occurring most often as a reaction to prolonged contact with urine, faeces, or...\n --PARENT--> [EH40.1] Infantile napkin dermatoses\n --RELATED_TO--> [?] Neonatal nutritional zinc deficiency\n Def: An eruption clinically indistinguishable from acrodermatitis enteropathica but due to nutritional deficiency rather than a genetically-determined zinc malabsorption as in the former condition. It occu...",
"[1F01] Roseola infantum\n Def: A disease caused by an infection with roseolovirus (human herpesvirus type 6 or 7). This disease is characterised by acute fever, followed by macular or maculopapular exanthem in some individuals. Tra...\n --PARENT--> [?] Viral infections characterised by skin or mucous membrane lesions\n --CHILD--> [?] Infections due to poxvirus",
"[1F01] Roseola infantum\n Def: A disease caused by an infection with roseolovirus (human herpesvirus type 6 or 7). This disease is characterised by acute fever, followed by macular or maculopapular exanthem in some individuals. Tra...\n --PARENT--> [?] Viral infections characterised by skin or mucous membrane lesions\n --CHILD--> [?] Infections due to poxvirus",
"[EA12] Infantile papular acrodermatitis\n Def: Infantile papular acrodermatitis (Gianotti-Crosti syndrome) is a cutaneous reaction pattern to a range of infective agents affecting predominantly young children aged from six months to two years. Age...\n --EXCLUDES--> [?] Acrodermatitis enteropathica\n Def: Acrodermatitis enteropathica is an uncommon autosomal recessive disorder of intestinal zinc absorption. Signs usually appear within the first months of life with an exudative and crusted erythema loca...\n --PARENT--> [?] Certain genetically-determined metabolic disorders with skin involvement\n Def: Heredofamilial metabolic disorders with skin manifestations not listed elsewhere in this chapter....",
"[EA12] Infantile papular acrodermatitis\n Def: Infantile papular acrodermatitis (Gianotti-Crosti syndrome) is a cutaneous reaction pattern to a range of infective agents affecting predominantly young children aged from six months to two years. Age...\n --EXCLUDES--> [?] Acropustulosis of Hallopeau\n Def: An uncommon pustular form of psoriasis which may rarely eventuate into generalised pustular psoriasis. It is characterised by pustules and variable scaling occurring in and around the nails and nail-b...\n --EXCLUDES--> [?] Palmoplantar pustulosis\n Def: Palmoplantar pustulosis (PPP) is a chronic inflammatory skin condition characterised by crops of sterile pustules on the palms and soles which erupt repeatedly over months or years. The affected areas..."
] |
EH40.10
|
Primary irritant napkin dermatitis
|
[
{
"from_icd11": "EH40.10",
"icd10_code": "L22",
"icd10_title": "Diaper dermatitis"
},
{
"from_icd11": "1F01",
"icd10_code": "B082",
"icd10_title": "Exanthema subitum [sixth disease]"
},
{
"from_icd11": "EA12",
"icd10_code": "L444",
"icd10_title": "Infantile papular acrodermatitis [Gianotti-Crosti]"
},
{
"from_icd11": "1F54.0",
"icd10_code": "B550",
"icd10_title": "Visceral leishmaniasis"
},
{
"from_icd11": "1F54.Z",
"icd10_code": "B559",
"icd10_title": "Leishmaniasis, unspecified"
},
{
"from_icd11": "1F54.Z",
"icd10_code": "B55",
"icd10_title": "Leishmaniasis"
},
{
"from_icd11": "1F54.1",
"icd10_code": "B551",
"icd10_title": "Cutaneous leishmaniasis"
},
{
"from_icd11": "1F54.2",
"icd10_code": "B552",
"icd10_title": "Mucocutaneous leishmaniasis"
},
{
"from_icd11": "QA08.6",
"icd10_code": "Z116",
"icd10_title": "Encounter for screening for other protozoal diseases and helminthiases"
},
{
"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"
}
] |
L22
|
Diaper dermatitis
|
A 50-year-old Filipino male with a history of hypertension developed a discoid, photosensitive, and hyperpigmented rash on sun-exposed areas of his face, arms, and legs in March 2012 shortly after starting lisinopril. Lisinopril was discontinued in April 2012 without resolution of the rash, prompting consultation with a dermatologist who suspected discoid lupus and ordered screening lupus labs. Complete blood count (CBC) was normal. Erythrocyte sedimentation rate (ESR) was 76 mm/hour, anti-nuclear antibody (ANA) 1 : 320 in a homogenous and fine speckled pattern, anti-histone and anti-RNP antibodies were positive, and complement C50, C3, and C4 were low. Anti-double-stranded DNA (anti-ds DNA) and anti-smith (anti-Sm) antibodies were negative. Initial impression was drug-induced lupus. In July 2012, he was admitted for recurrent falls. Neurological examination was notable for reduced degree of facial expression (hypomimia), weak and soft speech (hypophonia), and a mild shuffling gait. Muscle strength was normal (i.e., graded 5 in all muscle groups by Medical Research Council scale for motor strength). He denied feeling depressed. Cerebrospinal fluid (CSF) analysis revealed 0 WBC/uL, 3 RBC/uL, protein was 88 mg/dL, and glucose was 36 mg/dL. Contrast-enhanced brain MRI revealed symmetric confluent periventricular white matter hyperintensities on T2-weighted sequences associated with restricted diffusion on diffusion-weighted sequences and corresponding hypointense signal on Apparent Diffusion Coefficient map markedly more severe than the mild small-vessel ischemic changes which would be seen in a similarly aged individual with a history of hypertension (Figures 1(a) and 1(b) ). There was mild symmetric dural enhancement that was attributed to the lumbar puncture. Head MRA was normal. He was discharged but was readmitted two weeks later reporting progressive weakness. General physical examination revealed a discoid, hyperpigmented rash on sun-exposed areas of his face, arm, and legs. No oral ulcers were noted. His peripheral joints were normal. Lungs were clear to auscultation, and no friction rub was present. Neurological examination revealed an awake and alert individual who was oriented to person, place, and time with slowed mentation (bradyphrenia). He had marked hypomimia, hypophonia, symmetric bradykinesia, and cogwheel rigidity. No tremor was present. He was unable to arise from bed without maximal assistance and was unable to initiate a step despite normal motor strength. Part III, Unified Parkinson's Disease Rating Scale (UPDRS) was 47 (UPDRS range is 0 to 56, where 0 is normal and 56 is the most severe motor disability related to parkinsonism). CBC during this admission was notable for a white blood cell count that dropped to 2.7 × 10 9 /L × 10 9 /L, absolute lymphopenia of 0.59 × 10 9 /L (normal range 0.7–4.5 × 10 9 /L), and thrombocytopenia of 111 × 10 9 /L (normal range 150–450 × 10 9 /L). Repeat ESR was 91 mm/hr, ANA 1 : 640 in a homogenous pattern, anti-RNP and anti-histone antibodies positive, and complement C3 low. Repeat anti-ds and anti-sm antibodies were negative. Evaluation for toxic encephalopathies (urine toxicology, alcohol, toluene, arsenic, mercury, and lead levels), metabolic disorders (vitamin B12, folate, copper, ceruloplasmin, vitamin E, and TSH), autoimmune disorders (anti-SSA, anti-SSB, angiotensin converting enzyme, anti-neutrophil cytoplasmic antibodies (cytoplasmic and perinuclear), rheumatoid factor, phospholipid antibodies, beta-2 glycoprotein antibodies, lupus anticoagulant, immunofixation electrophoresis, cryoglobulin, TSH receptor, thyroid peroxidase, thyroglobulin antibodies, paraneoplastic antibodies, and NMDA antibodies), infections (human immunodeficiency virus, syphilis, lyme, human T-lymphotropic virus, JC virus, and hepatitis C virus), and inherited mitochondrial and metabolic disorders (CK, lactic acid, very long chain fatty acids, plasma and urine amino acids, urine organic acids, homocysteine, total cholesterol, total hexosaminidase, hexosaminidase A, and evaluation for lysosomal disorders) was negative. Repeat CSF analysis revealed 3 WBC/uL, 98 RBC/uL, protein being 61 mg/dL, and glucose being 41 mg/dL. Repeat contrast-enhanced brain MRI was unchanged from prior MRI. Chest, abdomen, pelvic CT, and scrotal ultrasound was normal. EEG revealed diffuse symmetric slowing without periodic triphasic waves. Repeat CBC during this admission revealed persistent leukopenia with a white blood cell count of 2.8 × 10 9 /L (normal range 3.8–11.2 × 10 9 /L). The patient met 4 of 11 criteria based on the 1997 American College of Rheumatology revised criteria for classification of SLE by the presence of an abnormal ANA titer, discoid rash, photosensitivity, and a hematologic disorder (leukopenia on at least two occasions) . Biopsy of a discoid skin lesion revealed superficial and deep perivascular dermatitis with focally increased dermal mucin highlighted by Alcian blue stain which suggested SLE versus Mixed Connective Tissue Disease (Figures 1(c) – 1(f) ). Patient was referred to rheumatology and was diagnosed with SLE with cutaneous and central nervous system involvement. He was started on intravenous methylprednisolone 120 mg (2 mg/kg/dose) daily for 3 days, then 80 mg daily for 3 days, and then 60 mg daily for 3 days. He was converted to oral prednisone and gradually tapered over the next 4 months to 10 mg of prednisone daily. No dopaminergic agents were used. Four months after his hospital discharge, his rash resolved and neurologic examination improved significantly. He had mild hypomimia, hypophonia, bradykinesia, and bilateral resting leg tremor with a normal gait. UPDRS (Part III) was 6. The leukopenia, thrombocytopenia, ESR, and hypocomplementemia normalized, although anti-histone antibodies were persistently elevated. There was marked radiologic improvement with resolution of the diffusion restriction (Figures 1(g) and 1(h) ). He continues to be alert, oriented to person, place, and time, ambulatory, and functionally independent with unchanged neurologic and UPDRS (Part III) examination 9 months after his hospital discharge on 10 mg of prednisone daily.
| 4.019531
| 0.978516
|
sec[1]/p[0]
|
en
| 0.999996
|
24369514
|
https://doi.org/10.1155/2013/367185
|
[
"anti",
"antibodies",
"discoid",
"rash",
"repeat",
"daily",
"lupus",
"symmetric",
"diffusion",
"updrs"
] |
[
{
"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": "LB30.61",
"title": "Fused pelvic kidney"
}
] |
=== 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
[LB30.61] Fused pelvic kidney
Definition: A condition caused by failure of the kidneys to correctly develop during the antenatal period. This condition is characterised by the presence of a single kidney, along the midline of the body. This condition may present with kidney stones, hydronephrosis, kidney infection, haematuria, or may be asymptomatic. Confirmation is through observation of a fused kidney by imaging.
Also known as: Fused pelvic kidney | Cake kidney | Pancake kidney | Lump kidney | Discoid kidney
=== GRAPH WALKS ===
--- Walk 1 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.0] Maternal care for red cell antibodies
Def: Maternal care for rhesus or other isoimmunization...
--- Walk 2 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--EXCLUDES--> [?] Placental transfusion syndromes
--- Walk 3 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--CHILD--> [MB23.1] 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
--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--> [JA86.0] Maternal care for red cell antibodies\n Def: Maternal care for rhesus or other isoimmunization...",
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Placental transfusion syndromes",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.1] 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 --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
| |
A right-handed 51-year-old man, who was an employee of a company, became more fastidious than before. When he was 52 years old, bizarre behaviors emerged, such as hoarding toilet paper and gum syrup and talking to his middle and high school sons as if they were toddlers. Difficulties in word comprehension were occasionally observed. At the age of 54, amnesia appeared, including forgetting yesterday’s events. He also developed a food preference for sweetness and a strictly fixed daily rhythm that looked like a timetable, such as going to a certain restaurant on the same day of the week at the same time of the day. At the age of 55, repetitive and obsessive checks of the power plug at home appeared. Disinhibitions such as spitting and loud monologues at work also worsened, and he was diagnosed with bipolar disorder at a nearby psychiatrist’s office. When he was 56, he was defrauded by an online scam worth over JPY 50 million. At the age of 57 years, he was admitted to a local psychiatric hospital for three months and discharged with multiple psychotropic medications. He began speaking strangely with prolonged endings. When his attending psychiatrist reduced his psychotropic medication, he began to lose control, talking late at night to his son, who was scheduled to take a college entrance exam. Therefore, he was referred to the psychiatry clinic of Osaka University Hospital, where an FTD-spectrum disorder was suspected during the initial examination. He was admitted to the psychiatric ward for a thorough examination. His wife said that his deceased, estranged father probably had young-onset dementia, although further family history details were unavailable. During the examination, the patient was highly distracted but cooperative. He lacked insight into his disease and had no sense of its seriousness. He exhibited agitation, indifference, disinhibition, abnormal motor behavior, disturbed sleep, and changes in eating behavior, which were scored using the neuropsychiatric inventory. His evaluation of the Stereotypy Rating Inventory provided points for eating behavior, roaming, speaking, and movements. Neurological examination revealed mild rigidity and bradykinesia in both upper extremities (no difference between the right and left extremities). A tendency to disuse the left hand and an imitation behavior were observed. Neuropsychological batteries were as follows: Mini-Mental State Examination, 22/30 (orientation -2, serial sevens -2, three-stage command -1, delayed recall -3); Frontal Assessment Battery 14/18, Addenbrooke’s Cognitive Examination-Revised (ACE-R) , 55/100 (attention and orientation, 14/18; memory, 7/26; fluency, 10/26; language, 14/26; visuospatial, 10/16); and the aphasia quotient of the Western Aphasia Battery, 92.1, revealing a memory deficit with relatively spared attention and language. He could remember daily episodes with ward staff, suggesting his memory impairments were not severe. He showed impairment in recognizing famous landscapes (examined with our original quantitative test of famous landscape) or famous figures (assessed using the Visual Perception Test for Agnosia Famous Faces Test version 2 (VPTA-FFT ver 2) ), and he could not point to them even when instructed to do so; therefore, he was found to have some degree of semantic memory impairment. Clinically, the patient’s prosopagnosia was mild because he was able to recognize ward staff members’ faces after many encounters. He scored 90/200 on the picture-naming task and 148/200 on the auditory word comprehension task as assessed by the Test of Lexical Processing in Aphasia (TLPA) , suggesting mild impairments in semantic memory. Surface dyslexia was also observed in the reading irregular words subtest of the ACE-R, suggesting an impairment in the semantic memory of language. However, the object knowledge qualitatively assessed during the naming test of ACE-R was not clearly impaired. His magnetic resonance imaging (MRI) scan revealed marked atrophy of the right-dominant medial temporal lobe, including the amygdala, extending to the temporal pole. Hippocampal atrophy was relatively mild compared to severe atrophy in the amygdala. Caudate was preserved. In addition, there was severe atrophy in the basal part of the right temporal lobe. No obvious atrophy was observed in the parietal lobe or cerebellum; however, mild atrophy was observed in the midbrain tegmentum . The 3D-SSP analysis of 123 I-IMP-SPECT showed reduced cerebral blood flow, predominantly from the right temporal pole to the mediobasal temporal lobe . 123 I-Ioflupane-SPECT (DaT Scan™) at age 57 revealed right-predominantly reduced standard binding ratio (SBR R = 3.11, L = 5.38, Asymmetry Index 53.3%) . Electroencephalogram study revealed 8–9 Hz of basic rhythms with amplitude of 20–30 μV. No evident epileptiform discharges were observed. Blood tests revealed no remarkable findings. Cerebrospinal fluid examination revealed a cell count of 0/μl, total protein 46 mg/dl, and the amyloid beta 42/40 ratio was 0.084 , suggesting that amyloid pathology is unlikely to be present; however, CSF phosphorylated (p)-tau181 was 54 pg/ml, which is slightly above the cut off (cut off > 50). The total CSF tau level was 338 pg/ml. Fig. 1 Clinical Images. a – d T1-weighted MR images at age 59. a Coronal image showing visible amygdala. Severe bilateral amygdala atrophy, predominantly on the right side, can be observed. White matter signal intensities in the left temporal lobe and right superior temporal gyrus are preserved, while those intensities in the right middle and inferior temporal gyri are attenuated. The third ventricle is enlarged. b Coronal image showing the hippocampal body. The hippocampus is mildly atrophic but relatively spared. c Axial image displaying predominantly enlarged right inferior horn of the lateral ventricle. Mild midbrain atrophy is noticeable. d Sagittal image revealing mild atrophy in the midbrain tegmentum area. e 3D-SSP image of 123 I-IMP-SPECT demonstrates predominant right medial temporal hypoperfusion at age 57. f 123I-Ioflupane-SPECT reveals reduced binding to the striatal dopamine transporter, predominantly on the right side, at age 57
| 4.050781
| 0.978027
|
sec[1]/p[0]
|
en
| 0.999995
|
37563653
|
https://doi.org/10.1186/s40478-023-01629-3
|
[
"atrophy",
"temporal",
"memory",
"lobe",
"predominantly",
"behavior",
"suggesting",
"famous",
"amygdala",
"spect"
] |
[
{
"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": "4A44.2",
"title": "Giant cell arteritis"
},
{
"code": "8B82.Z",
"title": "Disorders of trigeminal nerve, unspecified"
},
{
"code": "4A44.Y",
"title": "Other specified vasculitis"
},
{
"code": "NA0Z&XA9T94",
"title": "Temporal region injury"
},
{
"code": "NA01.Z&XA9T94",
"title": "Temporal wound"
}
] |
=== 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
[4A44.2] Giant cell arteritis
Definition: Arteritis, often granulomatous, usually affecting the aorta and/or its major branches, with a predilection for the branches of the carotid artery. Often involves the temporal artery. Onset usually in patients older than 50 and often associated with polymyalgia rheumatica.
Also known as: Giant cell arteritis | GCA - [giant cell arteritis] | temporal arteritis | cranial arteritis | Horton disease
[8B82.Z] Disorders of trigeminal nerve, unspecified
Also known as: Disorders of trigeminal nerve, unspecified | Disorders of trigeminal nerve | Disorders of 5th cranial nerve | disorders of the fifth cranial nerve | Gasserian ganglion lesion
[4A44.Y] Other specified vasculitis
Also known as: Other specified vasculitis | Large vessel vasculitis | Juvenile temporal arteritis | Medium-sized vessel vasculitis | Polyangiitis overlap syndrome
=== 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....
--RELATED_TO--> [?] Drug-induced myopathy
Def: Myopathy caused by drugs that ranges from mild myalgias with or without mild weakness to chronic myopathy with severe weakness, to massive rhabdomyolysis with acute renal failure. It could be due to s...
--- 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....
--EXCLUDES--> [?] Cramp or spasm
--- 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...
--RELATED_TO--> [?] Cerebrovascular diseases
Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi...
--- Walk 4 ---
[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 5 ---
[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 6 ---
[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
|
[
"[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--> [?] Drug-induced myopathy\n Def: Myopathy caused by drugs that ranges from mild myalgias with or without mild weakness to chronic myopathy with severe weakness, to massive rhabdomyolysis with acute renal failure. It could be due to s...",
"[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --EXCLUDES--> [?] Cramp or spasm",
"[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...",
"[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...",
"[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--> [?] Airway obstruction in the neonate due to airway abnormality"
] |
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": "4A44.2",
"icd10_code": "M316",
"icd10_title": "Other giant cell arteritis"
},
{
"from_icd11": "8B82.Z",
"icd10_code": "G508",
"icd10_title": "Other disorders of trigeminal nerve"
},
{
"from_icd11": "8B82.Z",
"icd10_code": "G509",
"icd10_title": "Disorder of trigeminal nerve, unspecified"
},
{
"from_icd11": "8B82.Z",
"icd10_code": "G50",
"icd10_title": "Disorders of trigeminal nerve"
}
] |
M6281
|
Muscle weakness (generalized)
|
A 24-year-old Japanese woman with one year history of active rheumatoid arthritis (RA) who complained in March 2007 with pain and swelling of bilateral wrists, elevation of the inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and matrix metalloproteinase-3 (MMP3). The blood examination showed anti-agalactosyl IgG antibody CARF positive, which is known as the early diagnosis marker for RA . X-ray imaging showed particular bone erosions in the carpal bones of the hands and partially ankylosis of the carpal bones . RA diagnosis was met with the 1987 Rheumatoid Arthritis Classification. The combination of MTX (6–8 mg/week) and PSL (3 mg/day) was selected as an initial therapy for RA in September 2007. After that, however, disease activity was increased up to DAS28-CRP 5.1 (over right fingers, bilateral knees, right index middle ring PIP, and right ankle) and x-ray showed rapid destructive joints and high disease activity progression to Steinbrocker stage classification 3 within half a year after RA diagnosis. Then, she was referred to Takatsuki Red Cross Hospital for administration of anti-TNF-α inhibitor. Screening test was examined by included laboratory data with ECG, chest x-ray for excluding tuberculosis (Tbe), hepatitis C viruses (HCV) and hepatitis B viruses (HBV). Immunological examinations were tested for rheumatoid factor (RF) 22 U/ml, MMP-3 654 ng/ml, CRP 7.65 mg/dl, and ESR 35 mm/h. In August 2008, ADA (40 mg every other week) was administrated with MTX (8 mg/week). Seven days after receiving first administration of ADA, she showed rapid progression of sore throat, high fever and general lymph nodes swelling. Laboratory tests showed an elevated white blood cell count (WBC) 31800 (20.6% neutrophils and 63.7% lymphocytes without atypical lymphocytes), high level of CRP (3.3 mg/dl) and elevated liver-function tests with alanine aminotransferase level (53 U/L), aspartate aminotransferase (65 U/L), and gamma-glutamyltransferase (138 U/L). Evaluation of diagnosis with computed tomography (CT) and ultrasonography showed cervical and mediastinal lymph node swelling, multiple nodules measuring up to 13 mm in diameter in the lungs and mild hepatosplenomegary . An inguinal lymph node biopsy staining with hematoxylin and eosin staining (H&E staining) showed proliferation of the lymphatic cells without tumor cell phenotype and immunohistological studies with this examined inguinal lymph node revealed the lympho-proliferative CD20 positive cells . H&E staining in high power filed showed the full range of mature lymphatic cells with polymorphous pattern and phagocytic macrophages included condensed small nuclear cells suggested apoptotic cell . Besides, many lymphatic cells in the inguinal lymph node were positive with cleaved caspase 3 staining . Moreover, EBV RNA in situ hybridization with the biopsy specimen revealed positive signals in the nucleus of large cells, and EBV DNA was detected by southern blot analysis (data not shown). Flow-cytometric analysis of infiltrating lymphocytes in lymph node showed an abundant population of CD38 positive B cell. In addition to routine blood test and urine cultures, the histories of infection were collected (e.g., HCV, HBV, tuberculosis, cytomegalovirus, parvovirus, varicella-zoster virus, HIV, EBV). The examinations for all these infections agents were negative except for high titers of anti-EBV antigen IgG (Table 1 ). Taken together these examinations, we diagnosed EB virus related B-cell LPD after the treatment with TNF-α inhibitor plus MTX, and that was in accordance with the 2008 WHO classification. Combination therapy with ADA plus MTX was terminated and pulse treatment with methylprednisolone was started. Steroid treatment for 7 days resulted in dramatic regression of LPD. Moreover, 10 days treatment with methylprednisolone reached to the complete remission of arthritis with below detection limits in ESR (3 ~ 11 mm/h), CRP (<0.3 mg/dl), and low level of MMP-3 (17.3 ~ 59.7 ng/ml) . After the improvement of clinical symptoms and laboratory data, the administration of PSL was tapered off. She achieved drug-free with the reduction of EBV VCA-IgG titers (160 U/ml) 12 months after the emergent admission, and delivered healthy baby 2 years after discharge. She has completely attained drug-free Boolean remission for 5 years. Figure 1 X-ray of bilateral fingers and wrists at the diagnosis: A) erosions with deformity of the carpal bones in the hands, B) Left wrist demonstrating bone erosion (black arrow) and joint narrowing partially ankylosis and subluxation of the carpal bones (white arrow). Figure 2 Computed tomography (CT) from cervical to abdomen: A) and B) cervical lymph nodes swelling ( arrows ), C) hepatosplenomegary ( arrow heads ). Figure 3 Immunohistochemistry of inguinal lymph node: A) Hematoxylin and eosin stain (H&E stain) ( × 40 magnification), B) Immunostaining shows positive with anti-CD 20 antibody ( × 400 magnification), C) H&E staining in high power field shows proliferations of the full range of diffuse lymphatic cells and phagocytic macrophages included condensed small nuclear cells ( arrows) suggested the presence of apoptotic cells ( × 400 magnification), D) Lymphatic cells are frequently positive with cleaved caspase 3 ( × 400 magnification). Table 1 Immunological test on admission Valuable Value HBsAg <1.0 HCV Ab <1.0 HIV Ab (−) SIR-2R 6658 VCA-IgG 320 VCA-IgM <10 EBV-EBNA <10 EBV-LQ-T 5 × 10 6 CMV-G/EI 25.9 HBsAg, hepatitis B surface antigen; HCV Ab, hepatitis C virus antibody; HIV Ab, human immunodeficiency virus antibody; SIR-2R, systemic inflammatory response-2 receptor; VCA-IgG, Epstein-Barr virus viral capsid antigen- Immunoglobulin G; VCA-IgM, Epstein-Barr virus viral capsid antigen- Immunoglobulin M; EBV-EBNA, Epstein-Barr virus nuclear antigen; EBV-LQ-T, Epstein-Barr virus LQTHIFAEV; CMV-G/EI, Cytomegalovirus antibody titer. Figure 4 Changes in inflammation and disease activity: A) CRP & ESR, B) MMP-3, Clinical course and the treatment showed that the inflammation and disease activity were improved after terminating of the MTX and ADA and administrating the steroid pulse treatment.
| 4.097656
| 0.970703
|
sec[1]/p[0]
|
en
| 0.999995
|
25694859
|
https://doi.org/10.1186/s40064-015-0798-9
|
[
"cells",
"lymph",
"virus",
"node",
"staining",
"antibody",
"cell",
"lymphatic",
"antigen",
"swelling"
] |
[
{
"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": "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 ===
[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
[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 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism
--- Walk 3 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Mucolipidosis type 4
Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...
--PARENT--> [?] Sphingolipidosis
--- Walk 4 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Mucolipidosis type 4
Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...
--PARENT--> [?] Mucolipidosis
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Sphingolipidosis",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Mucolipidosis",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch..."
] |
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": "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"
}
] |
D571
|
Sickle-cell disease without crisis
|
The proband (II:1), a 7-year-old male, was the third child of physically healthy non-consanguineous parents . He was born at full term with normal measurements . He was admitted to the Pediatric Endocrine Guangxi Zhuang Autonomous Region Women and Children Care Hospital due to severe intellectual disability and gait disturbance when he was 5 years old. He started to sit unsupported at 11 months and walked at 31 months, but continues to exhibit an unsteady gait. He currently has no meaningful language. He had mild facial dysmorphic features including a broad nasal bridge, low set malformed ears, and left-sided ptosis . He has Duane syndrome. He also suffered from congenital heart disease consisting of a repaired atrial septal defect and a ventricular septal defect. According to the Wechsler Intelligence Scale for Children at the age of 5, his Full Scale IQ was 45. He has recurrent stereotypical body rocking, hand flapping, and spinning. Brain magnetic resonance imaging at 4 years showed mild generalized brain atrophy. He does not have hearing problems. Growth parameters were also within the normal range (At 5 years of age: Height, 110.3 cm, 50%, 0.0SD; weight, 20.2 kg, + 0.4SD; head circumference, 50 cm, − 0.5SD). His karyotype was 46, XY. His 10-year-old sister was also found to have a similar phenotype in the form of severe psychomotor delay, mild craniofacial dysmorphism, and congenital heart defects. Full clinical details for each patient are shown in Table 1 . Table 1 Comparison of the clinical phenotype of patients with SMG9 mutation reported by other groups Patients clinical data Our patient Altuwaijri et al. Lemire et al. Shaheen et al. Lecoquierre et al. Rahikkala et al. (, 5 patients) Proband Affected sister Patient 1 Patient 2 Family I Family II-proband Family II-proband's first cousin Variants in SMG9 c.947A>G (p.His316Arg) and c.1318_1319delAG (p.Ser440*) c.701+4A>G (p.Tyr197Aspfs*10) c.1508G>C (p.Trp503Ser) c.520_521delCC (p.Pro174Argfs*12) c.701+4A>G (p.Tyr197Aspfs*10) c.1177C>T (p.Gln393*) c.551T>C (p.Val184Ala) Gender Male Female Male Female Female Female Female Female Female Male Age at last examination 5 year 10 years Died at 25 months Died at 1 h after birth 7 years Died at 7 weeks Died at 7 weeks 8 years 5 years ≥ 25 years in all the 5 patients Neurodevelopment Severe ID Severe ID Global developmental delay NA Severe ID NA Global developmental delay Global developmental delay Severe psychomotor developmental delay 1/5 mild ID, 3/5 moderate ID, 1/5 borderline mild/moderate ID Height, weight, head circumference 110.3 cm (50%, 0.0 SD), 20.2 kg (+ 0.4SD), 50 cm (− 0.5SD) 132.1 cm (10%, − 1.1SD), 31.2 kg (49.5%, 0.0SD) 74 cm (< 1%, − 3.7SD), 8.9 kg (< 1%, − 3.1SD), 44 cm (< 1%, − 3.2SD) NA 118.5 cm (30%), 25.1 kg (75%), 49.5 cm (25%) 44 cm (− 2.4SD), 2.130 kg (5%), 31.5 cm (− 2.2SD) 47 cm (15%, − 2.2SD), 2.26 kg, 32 cm (− 1.8SD) 69 cm (− 4.8SD), 6.3 kg (− 5.2SD), 39 cm (− 6SD) All three metrics were less than 3SD at the age of 2.5 years 3/5 short stature, 2/5 microcephaly Age of walking 31 months but continues to exhibit an unsteady gait 35 months but continues to exhibit an unsteady gait NA NA 7 years but walk with a walker and ankle foot orthosis NA NA Unstable to sit alone Inability to walk ≤ 20 month Development of speech and language skills No meaningful language Nonverbal NA NA Nonverbal NA NA Nonverbal Nonverbal Markedly delayed Behavioral anomalies Recurrent stereotypical body rocking, hand flapping and spinning Recurrent hand flapping NA Recurrent hand flapping and stereotypical body rocking Brain radiologic features Mild generalized brain atrophy hypomyelination, and small globus pallidus and putamen Not performed Brain atrophy, abnormally shaped lateral ventricles, thin corpus callosum, cerebellar and pontine atrophy with flattening of the pons ventral aspect, diffuse Not performed Normal Dandy–Walker malformation Brain atrophy, decreased myelination, and Dandy–Walker malformation Generalized brain atrophy, prominent ventricular system and thin corpus callosum Enlarged fourth ventricle with dysmorphism, a parieto-occipital junctional stroke, thin corpus callosum, a cavum septum pellucidum, and a Blake's pouch cyst 1/5 abnormal 2/5 normal Feeding difficulty Yes Yes Yes NA Yes Yes Yes Muscular hypotonia Yes Yes Yes NA Yes NA Yes Yes Yes 2/5 abnormal Ocular anomalies Duane syndrome Poor vision Bilateral sutural cataract NA Bilateral Duane syndrome type III, high hyperopia, and astigmatism Microphthalmia Microphthalmia Hypertelorism, ptosis, and bilateral cataracts 4/5 abnormal Cardiovascular Atrial septal defect and VSD VSD, hypoplastic tricuspid valve Interrupted inferior vena cava, a small ASD with left to right shunt Ectopia cordis ASD and a large perimembranous VSD Interrupted aortic arch, hypoplastic tricuspid and aortic valves, large muscular VSD Large VSD VSD VSD, aortic valve bicuspidy and aortic dilatation 1/5 abnormal 4/5 normal Infections No No Yes NA Yes Yes Yes Yes Facial dysmorphic fetaures Broad nasal bridge, low set malformed ears and left-sided ptosis, prominent forehead Broad nasal bridge, low set malformed ears, prominent forehead Microretrognathia, anteverted nares, and hypertelorism, unilateral ear malformation and bilateral external auditory canal stenosis NA Long and oval face, narrow mouth, bifrontal narrowing with frontal bossing, prominent nose with bulbous tip, and high anterior hairline Prominent forehead and occiput, low set malformed ears, wide anterior fontanelle, depressed nasal bridge and anteverted nares, high arched palate Narrow forehead, prominent metopic suture, posteriorly rotated ears with attached lobules, hypertelorism, small eyes, broad nasal bridge, full and everted lower lip, right-sided cleft lip Dysmorphic features Left cleft lip and palate, transient frontal white hair lock, bi-temporal retraction with frontal bossing, upslanting palpebral fissures with hypertelorism, broad nasal bridge, midface hypoplasia, low-set posteriorly rotated ears with attached lobules, Widow's peak Abnormal ID intellectual disability, SD standard deviation from the mean, ASD atrial septal defect, VSD ventricular septal defect, NA not available
| 4.210938
| 0.739258
|
sec[2]/sec[0]/p[0]
|
en
| 0.999996
|
PMC8943999
|
https://doi.org/10.1186/s12920-022-01217-9
|
[
"brain",
"nasal",
"bridge",
"ears",
"atrophy",
"prominent",
"broad",
"septal",
"defect",
"delay"
] |
[
{
"code": "8E7Y",
"title": "Other specified diseases of the nervous system"
},
{
"code": "LA05.Z",
"title": "Cerebral structural developmental anomalies, unspecified"
},
{
"code": "1D00.Z",
"title": "Infectious encephalitis, unspecified"
},
{
"code": "LA00.0Z",
"title": "Anencephaly, unspecified"
},
{
"code": "NA07.3Y",
"title": "Other specified diffuse brain injury"
},
{
"code": "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 ===
[8E7Y] Other specified diseases of the nervous system
Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis
[LA05.Z] Cerebral structural developmental anomalies, unspecified
Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS
[1D00.Z] Infectious encephalitis, unspecified
Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation
[LA00.0Z] Anencephaly, unspecified
Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence
[NA07.3Y] Other specified diffuse brain injury
Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion
[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 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--CHILD--> [?] Multiple sclerosis or other white matter disorders
Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....
--- Walk 2 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--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 ---
[LA05.Z] Cerebral structural developmental anomalies, unspecified
--PARENT--> [LA05] Cerebral structural developmental anomalies
Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....
--EXCLUDES--> [?] Encephalocele
--- Walk 4 ---
[LA05.Z] Cerebral structural developmental anomalies, unspecified
--PARENT--> [LA05] Cerebral structural developmental anomalies
Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies of the nervous system
Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....
--- Walk 5 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.1] Fungal encephalitis
--- Walk 6 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--PARENT--> [?] Non-viral and unspecified infections of the central nervous system
Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source....
|
[
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Multiple sclerosis or other white matter disorders\n Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....",
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --EXCLUDES--> [?] 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....",
"[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --EXCLUDES--> [?] Encephalocele",
"[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the nervous system\n Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --PARENT--> [?] Non-viral and unspecified infections of the central nervous system\n Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source...."
] |
8E7Y
|
Other specified diseases of the nervous system
|
[
{
"from_icd11": "LA05.Z",
"icd10_code": "Q048",
"icd10_title": "Other specified congenital malformations of brain"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q043",
"icd10_title": "Other reduction deformities of brain"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q049",
"icd10_title": "Congenital malformation of brain, unspecified"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q04",
"icd10_title": "Other congenital malformations of brain"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0490",
"icd10_title": "Encephalitis and encephalomyelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0491",
"icd10_title": "Myelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0430",
"icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0431",
"icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0439",
"icd10_title": "Other acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0481",
"icd10_title": "Other encephalitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0489",
"icd10_title": "Other myelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G04",
"icd10_title": "Encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G048",
"icd10_title": "Other encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "LA00.0Z",
"icd10_code": "Q000",
"icd10_title": "Anencephaly"
},
{
"from_icd11": "MA82.2",
"icd10_code": "R4921",
"icd10_title": "Hypernasality"
}
] |
Q048
|
Other specified congenital malformations of brain
|
A 53-year-old Chinese woman had ESDR secondary to obstructive kidney disease and was treated with haemodialysis three times a week regularly since October 2008. She received a living donor kidney graft in May 2008 that was lost 5 months later because of rejection. SHPT was diagnosed based on elevated PTH and hypercalcaemia in July 2014. Although she had taken a vitamin D analogue (calcitriol and caltrate) and phosphate binder (lanthanum carbonate), her PTH and serum calcium levels gradually increased. Since October 2015, the patient had constantly experienced generalized itching. The results of the laboratory tests were as follows (normal ranges in parentheses): serum PTH, 942 pg/mL (10–65); serum calcium, 2.64 mmol/L (2.03–2.54); serum phosphate, 3.17 mmol/L (0.87–1.45); serum alkaline phosphatase, 77 U/L (40–150). Four-dimensional computed tomography (4D-CT, which originates from the number of phases of imaging, typically 3, and the change over time, the fourth dimension) of the parathyroid demonstrated four enhanced nodules consistent with orthotopic parathyroid glands . No remarkable signs of ectopic or supernumerary parathyroid glands were observed. In November 2015, parathyroidectomy was performed to remove the four parathyroid glands, and the right inferior parathyroid gland was transplanted into the nondominant right forearm. On the first postoperative day, tests revealed PTH of 212 pg/mL, serum calcium of 2.43 mmol/L, and serum phosphate of 1.44 mmol/L, with alleviation of itching. Pathological findings showed parathyroid nodular hyperplasia without evidence of malignancy. Eighteen months after the surgery, she presented with recurred itching and bone pain. Serum calcium and PTH levels were 2.56 mmol/L and 1631 pg/mL, respectively. Planar 99m Tc-sestamibi ( 99m Tc-MIBI) scanning failed to localize the lesion. However, ultrasonography identified a remnant parathyroid gland in the left inferior thyroid, and she subsequently underwent percutaneous ethanol injection therapy (PEIT). On the third day of PEIT, her PTH and serum calcium levels decreased to 447 pg/mL and 2.15 mmol/L, respectively. In August 2019, the patient again experienced itching and bone pain and was admitted due to elevated serum calcium of 3.08 mmol/L and an elevated PTH level of 1593 pg/mL. Physical examination revealed a well-healed cervical surgical scar without a palpable mass. 99m Tc-MIBI single-photon emission computed tomography/computer tomography (SPECT/CT) indicated focal tracer uptake in the left inferior clavicle head , consistent with the findings of 4D-CT and ultrasonography. A right nodule without tracer uptake was located subcutaneously in the anterior sternocleidomastoid muscle, which was also identified by serial 4D-CT . A 99m Tc-MIBI planar scan also demonstrated focal tracer uptake in the autografted site in the early and delayed phases , accompanied by a hypoechoic mass on ultrasonography. Three nodules were identified during bilateral neck exploration and then removed (the right subcutaneous nodule, right inferior and left inferior clavicle head were 1.0 × 0.8 cm, 0.6 × 0.5 cm and 1.5 × 1.0 cm, respectively). On the first day after the operation, the PTH level in a blood specimen obtained from the right arm was 11,226 pg/mL, whereas it was 1029 pg/mL from the left arm. In September 2019, surgery to remove the nodules in the autografted site was performed. The next day, her PTH level had decreased to 6.9 pg/mL. Pathological results showed all four nodules to be hyperplastic parathyroid, with several small nodular foci of atypical hyperplastic parathyroid tissue in the fat adjacent to the right inferior remnant parathyroid . According to the clinical course and pathological findings, parathyromatosis and supernumerary parathyroid glands were confirmed. During 6 months of follow-up, her itching and bone pain improved, and she exhibited appropriate calcium (2.04–2.38 mmol/L) and PTH (84.4–145.0 pg/mL) levels under regular haemodialysis (Table 1 ). Fig. 1 Axial arterial-phase computer tomography images (A-C) demonstrate four enhanced orthotopic parathyroid glands (the arrows) located posterior or inferior to the thyroid gland Fig. 2 The 99m Tc-MIBI SPECT/CT image indicates a low-density lesion with high tracer uptake at the site of the inferior clavicle head (red arrows: A, axial image; B, SPECT; C, fusion image) Fig. 3 Serial arterial-phase axial 4D-CT of the parathyroid shows the growth of the right nodule (red arrows) located subcutaneously in the anterior sternocleidomastoid muscle (A, pre-operative; B, 18 months after surgery; C, 46 months after surgery). The 99m Tc-MIBI SPECT/CT image reveals the lesion without tracer uptake (red arrows: D, axial image; E, SPECT; F, fusion image) Fig. 4 99m Tc-MIBI planar early (A) and delayed (B) static images demonstrate focal tracer accumulation (red arrows) at the site of autograft Fig. 5 Histopathology (haematoxylin-eosin staining× 50) reveals hyperplastic parathyroid tissues composed of chief cells (A, red circles: microscopic nests of hypercellular parathyroid in the right inferior neck adipose tissue; B, supernumerary parathyroid gland; C nodule located in right forearm; D, subcutaneous nodule located anterior sternocleidomastoid muscle) Table 1 Changes in laboratory values in response to therapeutic interventions during the last 6 years Time Treatment Calcium Phosphorus Parathyroid hormone July 2014 Calcitriol + caltrate +lanthanum carbonate 2.43 1.58 171 October 2015 Before parathyroidectomy 2.64 3.17 942 November 2015 One day after parathyroidectomy + right forearm autograft 2.43 1.44 212 May 2017 Before percutaneous ethanal injection therapy 2.56 2.16 1631 Three days after percutaneous ethanal injection therapy 2.15 1.58 447 August 2019 Before bilateral neck exploration 3.08 2.68 1593 September 2019 Before right forearm autograft resection 2.58 1.68 11,226 (right arm) 1029 (left arm) One day after right forearm autograft resection and 2.17 1.25 6.9 During 6 months of follow-up regular haemodialysis 2.04–2.38 1.01–1.35 84.4–145.0 Calcium (mmol/L, normal 2.03–2.54); Phosphorus (mmol/L, normal 0.87–1.45); Parathyroid hormone (pg/mL, normal 10–65)
| 4.054688
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999997
|
32631272
|
https://doi.org/10.1186/s12882-020-01917-3
|
[
"parathyroid",
"serum",
"mmol",
"calcium",
"mibi",
"tracer",
"itching",
"four",
"glands",
"forearm"
] |
[
{
"code": "5A5Z",
"title": "Disorders of the parathyroids or parathyroid hormone system, unspecified"
},
{
"code": "5A51.0",
"title": "Primary hyperparathyroidism"
},
{
"code": "5A50.Z",
"title": "Hypoparathyroidism, unspecified"
},
{
"code": "5D42",
"title": "Postprocedural hypoparathyroidism"
},
{
"code": "NA21.0&XA1342",
"title": "Laceration of parathyroid gland"
},
{
"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 ===
[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified
Also known as: Disorders of the parathyroids or parathyroid hormone system, unspecified | parathyroidal disturbance | disorder of parathyroid gland | parathyroid gland disease | parathyroid disease
[5A51.0] Primary hyperparathyroidism
Definition: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperparathyroidism usually causes hypercalcaemia by enhanced PTH actions.
Also known as: Primary hyperparathyroidism | parathyroid enlargement | Familial primary hyperparathyroidism | Hereditary primary hyperparathyroidism | Familial isolated hyperparathyroidism
[5A50.Z] Hypoparathyroidism, unspecified
Also known as: Hypoparathyroidism, unspecified | Hypoparathyroidism | deficiency of parathyroid hormone | parathyroid gland insufficiency | parathyroid insufficiency
[5D42] Postprocedural hypoparathyroidism
Definition: This refers to a postprocedural decreased function of the parathyroid glands with underproduction of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping and twitching of muscles or tetany (involuntary muscle contraction), and several other symptoms.
Also known as: Postprocedural hypoparathyroidism | absence of parathyroid gland | postoperative tetany | Parathyroprival tetany
Includes: Parathyroprival tetany
[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 ---
[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified
--PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system
Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...
--CHILD--> [5A5Y] Other specified disorders of the parathyroids or parathyroid hormone system
--- Walk 2 ---
[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified
--PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system
Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...
--EXCLUDES--> [?] Hyperphosphataemic familial tumoural calcinosis
Def: This is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood, in a rare condition in which there is calcium deposition in the soft tissue in periarticular loc...
--- Walk 3 ---
[5A51.0] Primary hyperparathyroidism
Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...
--PARENT--> [5A51] Hyperparathyroidism
Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...
--CHILD--> [5A51.2] Familial hypocalciuric hypercalcaemia
Def: Familial Hypocalciuric Hypercalcaemia (FHH) or benign familial hypercalcaemia is an autosomal dominant disorder of calcium metabolism that is often asymptomatic and that is biologically characterised ...
--- Walk 4 ---
[5A51.0] Primary hyperparathyroidism
Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...
--PARENT--> [5A51] Hyperparathyroidism
Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...
--CHILD--> [5A51.1] Secondary hyperparathyroidism
Def: Secondary hyperparathyroidism is a condition with enhanced parathyroid hormone (PTH) secretion and high circulatory PTH level caused by metabolic changes such as hypocalcaemia, hyperphosphataemia and ...
--- Walk 5 ---
[5A50.Z] Hypoparathyroidism, unspecified
--PARENT--> [5A50] Hypoparathyroidism
Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...
--RELATED_TO--> [?] Transitory neonatal hypoparathyroidism
Def: Defined as hypocalcaemia, hyperphosphatemia and low serum parathyroid hormone that improves spontaneously but may last from weeks to months....
--- Walk 6 ---
[5A50.Z] Hypoparathyroidism, unspecified
--PARENT--> [5A50] Hypoparathyroidism
Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...
--EXCLUDES--> [?] Tetany
|
[
"[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified\n --PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system\n Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...\n --CHILD--> [5A5Y] Other specified disorders of the parathyroids or parathyroid hormone system",
"[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified\n --PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system\n Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...\n --EXCLUDES--> [?] Hyperphosphataemic familial tumoural calcinosis\n Def: This is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood, in a rare condition in which there is calcium deposition in the soft tissue in periarticular loc...",
"[5A51.0] Primary hyperparathyroidism\n Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...\n --PARENT--> [5A51] Hyperparathyroidism\n Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...\n --CHILD--> [5A51.2] Familial hypocalciuric hypercalcaemia\n Def: Familial Hypocalciuric Hypercalcaemia (FHH) or benign familial hypercalcaemia is an autosomal dominant disorder of calcium metabolism that is often asymptomatic and that is biologically characterised ...",
"[5A51.0] Primary hyperparathyroidism\n Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...\n --PARENT--> [5A51] Hyperparathyroidism\n Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...\n --CHILD--> [5A51.1] Secondary hyperparathyroidism\n Def: Secondary hyperparathyroidism is a condition with enhanced parathyroid hormone (PTH) secretion and high circulatory PTH level caused by metabolic changes such as hypocalcaemia, hyperphosphataemia and ...",
"[5A50.Z] Hypoparathyroidism, unspecified\n --PARENT--> [5A50] Hypoparathyroidism\n Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...\n --RELATED_TO--> [?] Transitory neonatal hypoparathyroidism\n Def: Defined as hypocalcaemia, hyperphosphatemia and low serum parathyroid hormone that improves spontaneously but may last from weeks to months....",
"[5A50.Z] Hypoparathyroidism, unspecified\n --PARENT--> [5A50] Hypoparathyroidism\n Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...\n --EXCLUDES--> [?] Tetany"
] |
5A5Z
|
Disorders of the parathyroids or parathyroid hormone system, unspecified
|
[
{
"from_icd11": "5A5Z",
"icd10_code": "E213",
"icd10_title": "Hyperparathyroidism, unspecified"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E212",
"icd10_title": "Other hyperparathyroidism"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E214",
"icd10_title": "Other specified disorders of parathyroid gland"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E215",
"icd10_title": "Disorder of parathyroid gland, unspecified"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E21",
"icd10_title": "Hyperparathyroidism and other disorders of parathyroid gland"
},
{
"from_icd11": "5A51.0",
"icd10_code": "E210",
"icd10_title": "Primary hyperparathyroidism"
},
{
"from_icd11": "5A50.Z",
"icd10_code": "E209",
"icd10_title": "Hypoparathyroidism, unspecified"
},
{
"from_icd11": "5A50.Z",
"icd10_code": "E208",
"icd10_title": "Other hypoparathyroidism"
},
{
"from_icd11": "5A50.Z",
"icd10_code": "E20",
"icd10_title": "Hypoparathyroidism"
},
{
"from_icd11": "5D42",
"icd10_code": "E892",
"icd10_title": "Postprocedural hypoparathyroidism"
},
{
"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"
}
] |
E213
|
Hyperparathyroidism, unspecified
|
Light microscopic studies showed mesangial cell proliferation and increased mesangial matrix with lobulation in almost all glomeruli. Endocapillary proliferation in the glomeruli and a few neutrophil infiltrations in the capillaries of the glomeruli were observed . Additionally, periodic acid-methenamine-silver staining showed some double contours of the glomerular basement membrane ; these are all characteristic findings of MPGN. The size of the glomeruli was within the normal range, and there were 2.6 glomeruli per square millimeter. The glomerular density of 13 minimal change nephrotic syndrome patients (mean 11.8 ± 3.6 years) with normal birth weight was 3.6 ± 1.1 / per square millimeter , indicating that the glomerular density of this patient was within the normal range or slightly lower. Immunofluorescent studies showed that deposits of IgA and C3 were dominantly detected in the mesangial regions, and were also slightly detected along the capillary walls. In addition, IgA deposits were stronger than those of C3 . IgA subclass staining revealed stronger staining for IgA2 stains than for IgA1 stains . Electron microscopic studies showed electron-dense deposits in the subendothelial, subepithelial, and paramesangial regions. Mesangial cell interposition was observed . The subepithelial deposits were not hump-like and podocytes were slightly sparse. No disease-specific glomerular deposit structures such as renal amyloidosis or monoclonal immunoglobulin deposition disease were observed on EM . Based on these aforementioned findings, we diagnosed this girl with IgA-dominant MPGN. Hypoalbuminemia was treated by intravenous infusion of albumin, and furosemide was also administered. After the biopsy, the patient was treated with three courses of methylprednisolone pulse therapy (MPT; one course; 30 mg/kg of methylprednisolone for three consecutive days), followed by oral prednisolone (1 mg/kg/day) and mizoribine (MZR). Lisinopril was used to treat hypertension and proteinuria. Although hypocomplementemia improved after the three courses of MPT, nephrotic-range proteinuria and hypoalbuminemia remained; therefore, two courses of MPT were additionally administered, and the immunosuppressant was changed from MZR to cyclosporine (CsA). The dose of CsA was initially started at 2 mg/kg/day. The CsA blood level target for single-point concentration 2 h post-dose was set at 600–700 ng/mL for approximately 2 months, after which the dosage was adjusted to 450–550 ng/mL. Subsequently, the urinary protein-creatinine ratio decreased from 4 to 0.8 g/gCr, and serum albumin tended to increase. She was discharged on the 155 th day of hospitalization. The dose of prednisolone was changed every other day and gradually decreased. Decreased urinary protein was detected 13 months after the treatment . A second renal biopsy was performed 22 months after the start of treatment, and improvement in glomerular lesions was found . Cyclosporine nephropathy was not observed. On the second biopsy, positive deposits of IgA were detected mainly in the mesangial regions and also slightly along the capillary walls. Deposits of C3 and IgA1 were not detected, but very slight deposits of IgA2 were present in the mesangial regions and along the capillary walls. . No deterioration of kidney function was observed after almost 2 years of treatment. The levels of C3 improved after three courses of methylprednisolone pulse therapy, and has remained normal since then. Posterior subcapsular cataract was considered as an adverse effect of steroids because no deterioration in visual acuity was observed during the follow-up period. Fig. 1 Pathological results of the first and second kidney biopsies. Light and electron microscopy Nikon ECLIPSE Ts2R and NIS Elements (Nikon Corporation, Japan) is used to capture the images. The images were obtained with eyepiece at 10X magnification and objective at 20X. The brightness and contrast were adjusted by using Phtoshop (adobe, Japan). No other downstream processing or averaging were applied to the images to enhance the resolution. a Periodic acid Schiff (PAS) staining of the first kidney biopsy showed mesangial cell proliferation and increased mesangial matrix with lobulation. Endocapillary proliferation in the glomeruli and a few neutrophil infiltrations in the capillaries of the glomeruli were observed (Magnification: × 200). b Periodic Acid-Methenamine-Silver staining of the first kidney biopsy showed some double contours of the glomerular basement membrane (Magnification: × 200). c Electron microscopy analysis showed electron-dense deposits in the subendothelial, subepithelial, and paramesangial regions . d Enlarged views of marked regions (black box) in corresponding Fig. 1-c image. Electron microscopy also showed that the subepithelial deposits were not hump-like and podocytes were partially sparse. e PAS staining of the second biopsy two years later showed mild proliferation of mesangial cells (Magnification: × 200) Fig. 2 Immunofluorescent studies of the first and second renal biopsies. Fluorescence microscope microscopy Nikon ECLIPSE Ts2R and NIS Elements (Nikon Corporation, Japan) is used to capture the images. The images were obtained with eyepiece at 10X magnification and objective at 20X. The brightness and contrast were adjusted by using Phtoshop (adobe, Japan). No other downstream processing or averaging were applied to the images to enhance the resolution. On the first biopsy ( a - d ), positive deposits of IgA ( a ) and C3 ( d ) were dominantly detected in the mesangial regions, and were also slightly detected along the capillary walls. In addition, IgA deposits were stronger than those of C3. IgA2 ( c ) staining was stronger than IgA1 ( b ) staining. On the second biopsy ( e – h ), positive deposits of IgA ( e ) were detected mainly in the mesangial regions and also slightly along the capillary walls. C3 ( h ) deposits were not detected. IgA1 ( f ) deposits were not found, and IgA2 ( g ) deposits were found in the mesangial region. (Magnification: × 200, a-h) Fig. 3 Urinary protein-creatinine ratio (U-P/Cr ratio) and serum albumin levels at 24 months from the start of treatment
| 4.304688
| 0.797363
|
sec[1]/p[1]
|
en
| 0.999996
|
PMC9639310
|
https://doi.org/10.1186/s12882-022-02983-5
|
[
"deposits",
"mesangial",
"staining",
"regions",
"biopsy",
"glomeruli",
"glomerular",
"slightly",
"electron",
"magnification"
] |
[
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "9A78.1",
"title": "Corneal pigmentations or deposits"
},
{
"code": "9A61.6",
"title": "Conjunctival or subconjunctival degenerations or deposits"
},
{
"code": "FB40.Y",
"title": "Other specified tenosynovitis"
},
{
"code": "9A77.Y",
"title": "Other specified corneal scars or opacities"
},
{
"code": "MF80",
"title": "Diffuse mesangial sclerosis"
},
{
"code": "MF8Y",
"title": "Other specified clinical findings in specimens from the urinary system"
},
{
"code": "GB4Z",
"title": "Glomerular diseases, unspecified"
},
{
"code": "GB40/MF8Y&XT8W",
"title": "Chronic nephritic syndrome : diffuse mesangial proliferative glomerulonephritis"
},
{
"code": "KD38",
"title": "Meconium staining"
}
] |
=== ICD-11 CODES FOUND ===
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[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
[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
[FB40.Y] Other specified tenosynovitis
Also known as: Other specified tenosynovitis | Other tenosynovitis or tendinitis | synovitis NOS | Bicipital tendinitis | biceps tendinitis
[9A77.Y] Other specified corneal scars or opacities
Also known as: Other specified corneal scars or opacities | Corneal infiltrate or haze | Surgically-induced corneal haze | Argentous corneal deposits | Corneal deposits in metabolic disorders
[MF80] Diffuse mesangial sclerosis
Definition: Diffuse mesangial sclerosis is a histological appearance which is characterised by diffuse thickening of basement membrane and massive enlargement of mesangial areas leading to contraction and sclerosis of the glomerular capillary tuft. It may be seen in children with early onset steroid resistant nephrotic syndrome due to a variety of genetic abnormalities, either as an isolated renal disease or as part of a multi-organ syndrome.
Also known as: Diffuse mesangial sclerosis
[MF8Y] Other specified clinical findings in specimens from the urinary system
Also known as: Other specified clinical findings in specimens from the urinary system | Glomerular disease with minor glomerular abnormality | Glomerular disease with minimal change disease | Secondary glomerular disease with minor glomerular abnormality | Glomerular disease with minor glomerular abnormality in diseases classified elsewhere
[GB4Z] Glomerular diseases, unspecified
Also known as: Glomerular diseases, unspecified | Glomerular disease classified by aetiology | Idiopathic glomerular disease | primary glomerular disease | Glomerular disease associated with secondary causes or systemic conditions
[KD38] Meconium staining
Definition: Green or yellowish appearing amniotic fluid, indicating presence of meconium. The newborn’s skin, nail beds or the umbilical cord may be stained.
Also known as: Meconium staining | meconium amniotic fluid | meconium staining of amniotic fluid
Excludes: Neonatal aspiration of meconium | Meconium passage during delivery
=== GRAPH WALKS ===
--- Walk 1 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--PARENT--> [?] Symptoms, signs or clinical findings involving the skin
--- Walk 2 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--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 3 ---
[9A78.1] Corneal pigmentations or deposits
--PARENT--> [9A78] Certain specified disorders of cornea
--CHILD--> [9A78.1] Corneal pigmentations or deposits
--- Walk 4 ---
[9A78.1] Corneal pigmentations or deposits
--PARENT--> [9A78] Certain specified disorders of cornea
--RELATED_TO--> [?] Injury of conjunctiva or corneal abrasion without mention of foreign body
--- Walk 5 ---
[9A61.6] Conjunctival or subconjunctival degenerations or deposits
Def: These are the conjunctival/subconjunctival accumulation of some materials and gradual deterioration with impairment or loss of function, caused by injury, disease, or aging....
--RELATED_TO--> [?] Vitamin A deficiency with conjunctival xerosis
Def: In conjunctival xerosis the epithelium of the conjunctiva is transformed from the normal columnar to the stratified squamous type, with a resultant loss of goblet cells, formation of a granular cell l...
--PARENT--> [?] Conjunctival xerosis, not elsewhere classified
Def: This term for conjunctival dry skin. It can have many different causes, including general dehydration, atopic dermatitis, Vitamin A deficiency, and possibly diabetes. It is also a side-effect of isotr...
--- Walk 6 ---
[9A61.6] Conjunctival or subconjunctival degenerations or deposits
Def: These are the conjunctival/subconjunctival accumulation of some materials and gradual deterioration with impairment or loss of function, caused by injury, disease, or aging....
--RELATED_TO--> [?] Vitamin A deficiency with conjunctival xerosis and Bitot's spots
Def: Generalised conjunctival xerosis suggests advanced vitamin A deficiency. The entire conjunctiva appears dry, roughened, and corrugated, sometimes skin-like. In some individuals keratin and saprophytic...
--PARENT--> [?] Conjunctival xerosis, not elsewhere classified
Def: This term for conjunctival dry skin. It can have many different causes, including general dehydration, atopic dermatitis, Vitamin A deficiency, and possibly diabetes. It is also a side-effect of isotr...
|
[
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the skin",
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [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....",
"[9A78.1] Corneal pigmentations or deposits\n --PARENT--> [9A78] Certain specified disorders of cornea\n --CHILD--> [9A78.1] Corneal pigmentations or deposits",
"[9A78.1] Corneal pigmentations or deposits\n --PARENT--> [9A78] Certain specified disorders of cornea\n --RELATED_TO--> [?] Injury of conjunctiva or corneal abrasion without mention of foreign body",
"[9A61.6] Conjunctival or subconjunctival degenerations or deposits\n Def: These are the conjunctival/subconjunctival accumulation of some materials and gradual deterioration with impairment or loss of function, caused by injury, disease, or aging....\n --RELATED_TO--> [?] Vitamin A deficiency with conjunctival xerosis\n Def: In conjunctival xerosis the epithelium of the conjunctiva is transformed from the normal columnar to the stratified squamous type, with a resultant loss of goblet cells, formation of a granular cell l...\n --PARENT--> [?] Conjunctival xerosis, not elsewhere classified\n Def: This term for conjunctival dry skin. It can have many different causes, including general dehydration, atopic dermatitis, Vitamin A deficiency, and possibly diabetes. It is also a side-effect of isotr...",
"[9A61.6] Conjunctival or subconjunctival degenerations or deposits\n Def: These are the conjunctival/subconjunctival accumulation of some materials and gradual deterioration with impairment or loss of function, caused by injury, disease, or aging....\n --RELATED_TO--> [?] Vitamin A deficiency with conjunctival xerosis and Bitot's spots\n Def: Generalised conjunctival xerosis suggests advanced vitamin A deficiency. The entire conjunctiva appears dry, roughened, and corrugated, sometimes skin-like. In some individuals keratin and saprophytic...\n --PARENT--> [?] Conjunctival xerosis, not elsewhere classified\n Def: This term for conjunctival dry skin. It can have many different causes, including general dehydration, atopic dermatitis, Vitamin A deficiency, and possibly diabetes. It is also a side-effect of isotr..."
] |
ME67
|
Skin disorder of uncertain or unspecified nature
|
[
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "9A78.1",
"icd10_code": "H18049",
"icd10_title": "Kayser-Fleischer ring, unspecified eye"
},
{
"from_icd11": "9A78.1",
"icd10_code": "H180",
"icd10_title": "Corneal pigmentations and deposits"
},
{
"from_icd11": "9A61.6",
"icd10_code": "H111",
"icd10_title": "Conjunctival degenerations and deposits"
},
{
"from_icd11": "MF80",
"icd10_code": "N00-N08",
"icd10_title": ""
},
{
"from_icd11": "GB4Z",
"icd10_code": "N08",
"icd10_title": "Glomerular disorders in diseases classified elsewhere"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N028",
"icd10_title": "Recurrent and persistent hematuria with other morphologic changes"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N022",
"icd10_title": "Recurrent and persistent hematuria with diffuse membranous glomerulonephritis"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N029",
"icd10_title": "Recurrent and persistent hematuria with unspecified morphologic changes"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N027",
"icd10_title": "Recurrent and persistent hematuria with diffuse crescentic glomerulonephritis"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N025",
"icd10_title": "Recurrent and persistent hematuria with diffuse mesangiocapillary glomerulonephritis"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N026",
"icd10_title": "Recurrent and persistent hematuria with dense deposit disease"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N023",
"icd10_title": "Recurrent and persistent hematuria with diffuse mesangial proliferative glomerulonephritis"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N02",
"icd10_title": "Recurrent and persistent hematuria"
},
{
"from_icd11": "GB4Z",
"icd10_code": "N020",
"icd10_title": "Recurrent and persistent hematuria with minor glomerular abnormality"
}
] |
L989
|
Disorder of the skin and subcutaneous tissue, unspecified
|
A 2.5-year-old boy with end-stage renal disease (ESRD) and familial focal segmental glomerulosclerosis (FSGS) presented with dysfunction of the peritoneal catheter, fever, and edema. Blood tests, urine tests, kidney ultrasound, and CT scan confirmed end-stage renal failure, while proteinuria, hyaline and broad waxy casts, histopathology findings, nephrotic syndrome, edema, fatigue, and loss of appetite indicated focal segmental glomerulosclerosis. A consultation with the general surgery department was conducted to evaluate the catheter's location, and subsequent catheter care was performed adequately. Additionally, an abdominal tap was performed, which revealed an infection. The ascites exam was completed one day after the onset of fever and peritoneal dialysis dysfunction. The initial tap of ascites revealed a total of 41,600 nucleated cells, with 96 % of them being polymorphonuclear cells (PMN). Subsequently, empirical treatment was started by prescribing intravenous cefepime. The initial laboratory results showed a white blood cell (WBC) count of 7.3 × 109 cells/L with 80 % neutrophils, a hemoglobin (Hb) level of 7.3 g/dL, a C-reactive protein (CRP) level of 113 mg/L, and an erythrocyte sedimentation rate (ESR) of 113 mm/h. Additionally, two consecutive peritoneal and blood cultures using the BACTEC system were positive for Acinetobacter . For this positive culture, empirically colistin was administered. However, successive BACTEC peritoneal and blood cultures results, after two weeks of hospitalization, showed enterococci. The contents of the BACTEC bottle were cultured in sheep blood agar medium and incubated overnight at 37 °C. Subsequently, non-hemolytic gray colonies were appeared after 24 h, and microbiological examination revealed gram-positive cocci arranged in chains in gram stain with catalase negative reaction, bacitracin and optochin resistant, and grew well on bile esculin agar. Indeed, during admission, the patient was taking dialysis peritoneal and because the cell counts of dialysis fluid had been increased, vancomycin was prescribed. Laboratory checkups for HIV Ab, HCV Ab, HBs Ag, Mycobacterium tuberculosis , and fungi demonstrated negative results. Although the catheter tip culture results showed heavy growth of enterococci, but the cell count of dialysis fluid had still been increased. It can be noted that during general surgery and hemodialysis for patients with underlying kidney diseases, especially for ESRD and FSGH cases, there is a risk of bloodstream infection with VRE. Moreover, Antibacterial Susceptibility Testing (AST) was performed by Kirby–Bauer disk diffusion method according to Clinical and Laboratory Standard Institute (CLSI) 2021 guidelines . According to the AST report, this isolate showed high resistance to tetracycline (30 μg), ciprofloxacin (5 μg), chloramphenicol (30 μg), meropenem (10 μg), ampicillin (10 μg), erythromycin (15 μg), penicillin (10 μg), and rifampin (5 μg). Furthermore, Minimal Inhibitory Concentration (MIC) for vancomycin was determined >256 μg/mL through the broth microdilution method according to CLSI 2021 guidelines . Based on the AST results, it was found that VRE was susceptible to linezolid. Therefore, the antibiotic therapy was switched to linezolid (600 mg PO/IV q12hr for 14 days). Fig. 1 displays some of the main phenotypic detection tests and AST results. Totally, in this case two blood cultures and one culture from the tip of the catheter were collected, and all showed the presence of VRE. General surgery consult was done and the dialysis peritoneal catheter was disconnected. Thereafter, the patient did not take dialysis for 4–5 days. During admission, potassium (K) had been raised and symptomatic treatment was performed. After a few days, permcath inserted and hemodialysis started. Indeed, during the admission the patient showed high blood pressure and amlodipine was ordered. In our case, the Acinetobacter bacteremia was found to be susceptible to colistin, so polymyxin was prescribed as treatment. After undergoing polymyxin treatment, there was a decrease in the number of nucleated cells in the ascites fluid. On the third day, the cell count was 70 with 50 % PMN, on the fourth day, it was 100 with 9 % PMN, and on the fifth day, it was 80 % PMN with a cell count of 78 %. However, on the sixth day, there was a significant increase with a cell count of 1000 and 85 % PMN. Despite this rebound in cell count, the fever responded well to the polymyxin treatment, and the levels of CRP and ESR decreased from the first measurement (ESR was 113 mm/h and CRP was 113 mg/L). The peritoneal catheter remained in place. Due to the rebound in the number of nucleated cells in the ascites, we decided to repeat both the blood and ascites cultures. From the second culture, Acinetobacter was again detected. In the third culture, Enterococcus was isolated. Besides, Echocardiography findings showed Schwachman-Diamond Syndrome (SDS), good left ventricular (LV) systolic function, left aortic arch, no coarctation of the aorta (COA), and good right ventricular systolic function. Also, TTE and TEE were performed to rule out infective endocarditis following VRE bacteremia, and mild pleural effusion was reported. On the other hand, results disclosed no pulmonary hypertension, left ventricular hypertrophy, mild left pleural effusion, mild mitral valve regurgitation (MR), and mild right pleural effusion. Finally, pleural effusion (disorder) was mentioned as a conclusion. The patient was dialyzed 3 times in week with a low amount of heparin and an ultrafiltration rate of 500 mL/h/m2. Fortunately, our patient successfully treated by linezolid and discharged from the hospital. After discharge, tip of catheter was removed and permcath was inserted for hemodialysis. The source of the VRE infection was the catheter, and there was no connection between the infection, other patients in the same room, or medical equipment. Fig. 1 Phenotypic detection such as positive BACTEC bottle culture, gram-positive cocci in gram stain, well growing on bile esculin agar and antibiotics susceptibility test results for Vancomycin-resistant E. faecium bacteremia. Fig. 1
| 4.234375
| 0.948242
|
sec[1]/p[0]
|
en
| 0.999995
|
PMC11357762
|
https://doi.org/10.1016/j.heliyon.2024.e36028
|
[
"catheter",
"blood",
"peritoneal",
"cell",
"dialysis",
"count",
"culture",
"ascites",
"cells",
"infection"
] |
[
{
"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"
},
{
"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 ===
[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
[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 ---
[QB62.Z] Attention to artificial openings, unspecified
--PARENT--> [QB62] Attention to artificial openings
--CHILD--> [QB62.0] Attention to tracheostomy
--- Walk 2 ---
[QB62.Z] Attention to artificial openings, unspecified
--PARENT--> [QB62] Attention to artificial openings
--EXCLUDES--> [?] Tracheostomy malfunction
--- Walk 3 ---
[QB30.5] Fitting or adjustment of urinary device
--PARENT--> [QB30] Adjustment or management of implanted devices
--CHILD--> [QB30.1] Adjustment or management of infusion pump
--- Walk 4 ---
[QB30.5] Fitting or adjustment of urinary device
--PARENT--> [QB30] Adjustment or management of implanted devices
--CHILD--> [QB30.1] Adjustment or management of infusion pump
--- Walk 5 ---
[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft
--- Walk 6 ---
[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter
--PARENT--> [PK93.1] Gastroenterology or urology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices
Def: A gastroenterology or urology device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task...
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
|
[
"[QB62.Z] Attention to artificial openings, unspecified\n --PARENT--> [QB62] Attention to artificial openings\n --CHILD--> [QB62.0] Attention to tracheostomy",
"[QB62.Z] Attention to artificial openings, unspecified\n --PARENT--> [QB62] Attention to artificial openings\n --EXCLUDES--> [?] Tracheostomy malfunction",
"[QB30.5] Fitting or adjustment of urinary device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.1] Adjustment or management of infusion pump",
"[QB30.5] Fitting or adjustment of urinary device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.1] Adjustment or management of infusion pump",
"[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft",
"[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter\n --PARENT--> [PK93.1] Gastroenterology or urology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices\n Def: A gastroenterology or urology device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task...\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm"
] |
QB62.Z
|
Attention to artificial openings, unspecified
|
[
{
"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"
},
{
"from_icd11": "PK93.10",
"icd10_code": "T83012A",
"icd10_title": "Breakdown (mechanical) of nephrostomy catheter, initial encounter"
},
{
"from_icd11": "PK93.10",
"icd10_code": "T83030A",
"icd10_title": "Leakage of cystostomy catheter, initial encounter"
}
] |
Z436
|
Encounter for attention to other artificial openings of urinary tract
|
A right adrenal mass was found on routine computed tomography (CT) in March 2007 and was diagnosed as a solitary right adrenal metastasis by 18 F-fluoro-2 deoxy-D-glucose (FDG)-positron emission tomography (PET). Although the patient had taken tegafur-uracil (UFT) at 4.0 g/day for three months, the metastasis continued to enlarge (40 mm in diameter by June 2007; Figure 1(a) ). The patient was therefore referred to our clinic for SBRT. Although other regimens of chemotherapy were considered, the patient wished to undergo SBRT as local intensive therapy. He showed a very positive and cheerful demeanor. During the SBRT planning sessions, the patient was trained in voluntary breath-holding during the inspiration phase using a respiratory indicator to minimize the adrenal respiratory motions during irradiation . Planning target volume (PTV) was determined as the gross tumor volume (GTV) of the right adrenal mass plus the personal internal margin, with an additional margin of 2 mm to compensate for intrasession reproducibility and to provide a safety margin. Precise reproducibility of tumor position in this patient under voluntary breath-holding was measured on repeated CT. Tumor position was adjusted to the planned position before every session using the CT on rails taken in the vicinity of the tumor. Ten different noncoplanar static beams were used for irradiation. The radiation port was made with dynamic sliding multileaves adjusted with 3 mm margins around the border of the PTV. Dose constraints of normal tissue were defined for the intestine and spinal cord. For the intestine, volumes with dose >52.5 Gy and >43.2 Gy in 10 fractions (biologically effective dose (BED) = 144.4 Gy and 105.0 Gy, resp., α / β = 3 Gy) were restricted within 10 mL and 100 mL, respectively. For the spinal cord, maximum dose was restricted to <36 Gy in 10 fractions (BED = 79.2 Gy, α / β = 3 Gy). These criteria represent a modification of the dose constraints provided in the protocol of the Japanese Clinical Oncology Group (JCOG)-0403 study, a prospective study of SBRT for stage I NSCLC. A total dose to the isocenter of 75 Gy in 25 fractions over 36 days was delivered using a 10-MV X-ray from June to July 2007. Isodose lines on CT are shown in Figure 1(b) . The reason for the middle fraction size (3 Gy) was to avoid serious toxicity affecting the duodenum, because the second portion was included in the high-dose area. Administration of UFT was stopped before the start of the SBRT. After completion of SBRT, daily oral administration of tegafur-gimeracil-oteracil potassium (TS-1) was initiated at 80 mg/body. The patient complained of mild epigastralgia in December 2007, and grade 1 duodenitis was observed under fiberscopy. Symptoms improved with administration of oral antacids. In February 2008, the right adrenal tumor had decreased in size sufficiently to meet the criteria for partial response (PR; Figure 1(c) ), but right para-aortic lymph node swelling (diameter, 30 mm; Figure 2(a) ) was found on CT. This lesion was considered to represent a new metastasis of lung cancer. At this point of time, we informed the patient that he had systemic multiple metastases and that complete cure might be difficult. However, he was elected to undergo further local treatment and a second course of SBRT was therefore performed for this new lesion. The method of the SBRT was similar to that for the right adrenal metastasis. A total dose to the isocenter of 60 Gy shown in Figure 2(b) in 20 fractions over 28 days was delivered. A small overlap of treated volumes was produced between the first and second courses of SBRT, affecting the second portion of the duodenum, but dose constraints were not exceeded. No toxicities in relation to the second course of SBRT were identified. Administration of TS-1 was stopped before the start of second SBRT and resumed after completion. In July 2008, the patient complained of acute hoarseness, and CT showed a new lymph node swelling in the left supraclavicular fossa (diameter, 25 mm; Figure 3(a) ) and a left upper lung nodule (diameter, 20 mm; Figure 4(a) ), although the right para-aortic lymph node lesion had decreased in size to represent PR ( Figure 2(c) ). Aspiration cytology was performed from the left supraclavicular fossa, revealing adenosquamous carcinoma cells. We considered that the condition of the patient at this time represented a more difficult stage and that the potential merits of local treatment were likely to be reduced. However, the patient again insisted on local radical treatment and we were persuaded by his eagerness. We first tried to control the left supraclavicular lesion. A total dose to the isocenter of 52.2 Gy in 29 fractions (shown in Figure 3(b) ; 1.8 Gy/fraction, twice a day, accelerated hyperfractionation) over 22 days was delivered to only the swollen left supraclavicular lymph node using conventional radiotherapy techniques. The reason why we did not use SBRT for the lesion was to avoid an adverse effect on the brachial plexus. Administration of TS-1 was continued during and after the sessions until February 2009. Hoarseness improved and FDG-PET-CT studies 1 month after this third course of radiotherapy showed marked reductions in size of the left supraclavicular lesion ( Figure 3(c) ) with no accumulation of FDG and no other abnormal accumulations. SBRT for left upper lobe metastases was then performed in September 2008. SBRT for the left upper lung lesion was performed using a similar method to the previous right adrenal and para-aortic lesions, but the prescribed dose was 48 Gy in four fractions over 4 days to cover 95% of the PTV ( Figure 4(b) ). The tumor decreased in size to PR ( Figure 4(c) ) and has not progressed since. No other metastases have been identified since the completion of these four sessions of radiotherapy, including 3 courses of SBRT. Although fracture of the left rib within the PTV of the SBRT for the left lung metastases and idiopathic right pneumothorax occurred in March 2011 and August 2011, respectively, the patient has remained very well without cancer recurrence and has enjoyed hobby (dancing) cheerfully as recently as June 2012.
| 4.207031
| 0.622559
|
sec[1]/p[2]
|
en
| 0.999996
|
23150822
|
https://doi.org/10.1155/2012/713073
|
[
"sbrt",
"adrenal",
"lesion",
"tumor",
"this",
"fractions",
"using",
"administration",
"that",
"supraclavicular"
] |
[
{
"code": "5A76.Y",
"title": "Other specified disorders of adrenal gland"
},
{
"code": "5A7Z",
"title": "Disorders of the adrenal glands or adrenal hormone system, unspecified"
},
{
"code": "5A74.Z",
"title": "Adrenocortical insufficiency, unspecified"
},
{
"code": "5A74.Y",
"title": "Other specified adrenocortical insufficiency"
},
{
"code": "LC8Z",
"title": "Structural developmental anomalies of the adrenal glands, unspecified"
},
{
"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 ===
[5A76.Y] Other specified disorders of adrenal gland
Also known as: Other specified disorders of adrenal gland | Suprarenal gland abscess | Suprarenal abscess | Adrenal gland inflammation | adrenal glandular inflammation
[5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified
Also known as: Disorders of the adrenal glands or adrenal hormone system, unspecified | Adrenal gland disease, not elsewhere classified | adrenal cortex disease | adrenal cortical disease | adrenal glandular disease
[5A74.Z] Adrenocortical insufficiency, unspecified
Also known as: Adrenocortical insufficiency, unspecified | Adrenocortical insufficiency | adrenal failure NOS | Hypoadrenocorticism | adrenocortical hypofunction
[5A74.Y] Other specified adrenocortical insufficiency
Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism
[LC8Z] Structural developmental anomalies of the adrenal glands, unspecified
Also known as: Structural developmental anomalies of the adrenal glands, unspecified | adrenal anomaly | adrenal gland anomaly | congenital anomaly of adrenal gland | congenital malformation of adrenal gland
[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 ---
[5A76.Y] Other specified disorders of adrenal gland
--PARENT--> [5A76] Certain specified disorders of adrenal gland
--CHILD--> [5A76.0] Premature adrenarche
Def: Premature development of pubic and/or axillary hair without central or peripheral precocious puberty. Children show premature clinical and/or laboratory signs of androgen action without estrogen actio...
--- Walk 2 ---
[5A76.Y] Other specified disorders of adrenal gland
--PARENT--> [5A76] Certain specified disorders of adrenal gland
--CHILD--> [5A76.0] Premature adrenarche
Def: Premature development of pubic and/or axillary hair without central or peripheral precocious puberty. Children show premature clinical and/or laboratory signs of androgen action without estrogen actio...
--- Walk 3 ---
[5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified
--PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system
--CHILD--> [5A72] Hyperaldosteronism
--- Walk 4 ---
[5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified
--PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system
--RELATED_TO--> [?] Gonadotropin deficiency
Def: Deficiency of Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH) resulting in hypogonadism (male and female). Includes deficiency of Gonadotropin Releasing Hormone (GnRH, LHRH)....
--- Walk 5 ---
[5A74.Z] Adrenocortical insufficiency, unspecified
--PARENT--> [5A74] Adrenocortical insufficiency
Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...
--RELATED_TO--> [?] X-linked adrenoleukodystrophy
Def: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disease characterised by progressive demyelinisation of the central nervous system (CNS) (brain and/or spinal cord) and peripheral adrenal insuff...
--- Walk 6 ---
[5A74.Z] Adrenocortical insufficiency, unspecified
--PARENT--> [5A74] Adrenocortical insufficiency
Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...
--RELATED_TO--> [?] Neonatal haemorrhage originating in adrenal gland
Def: A condition characterised by bleeding into the adrenal glands in a newborn....
|
[
"[5A76.Y] Other specified disorders of adrenal gland\n --PARENT--> [5A76] Certain specified disorders of adrenal gland\n --CHILD--> [5A76.0] Premature adrenarche\n Def: Premature development of pubic and/or axillary hair without central or peripheral precocious puberty. Children show premature clinical and/or laboratory signs of androgen action without estrogen actio...",
"[5A76.Y] Other specified disorders of adrenal gland\n --PARENT--> [5A76] Certain specified disorders of adrenal gland\n --CHILD--> [5A76.0] Premature adrenarche\n Def: Premature development of pubic and/or axillary hair without central or peripheral precocious puberty. Children show premature clinical and/or laboratory signs of androgen action without estrogen actio...",
"[5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system\n --CHILD--> [5A72] Hyperaldosteronism",
"[5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system\n --RELATED_TO--> [?] Gonadotropin deficiency\n Def: Deficiency of Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH) resulting in hypogonadism (male and female). Includes deficiency of Gonadotropin Releasing Hormone (GnRH, LHRH)....",
"[5A74.Z] Adrenocortical insufficiency, unspecified\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --RELATED_TO--> [?] X-linked adrenoleukodystrophy\n Def: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disease characterised by progressive demyelinisation of the central nervous system (CNS) (brain and/or spinal cord) and peripheral adrenal insuff...",
"[5A74.Z] Adrenocortical insufficiency, unspecified\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --RELATED_TO--> [?] Neonatal haemorrhage originating in adrenal gland\n Def: A condition characterised by bleeding into the adrenal glands in a newborn...."
] |
5A76.Y
|
Other specified disorders of adrenal gland
|
[
{
"from_icd11": "5A7Z",
"icd10_code": "E2740",
"icd10_title": "Unspecified adrenocortical insufficiency"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E2749",
"icd10_title": "Other adrenocortical insufficiency"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E279",
"icd10_title": "Disorder of adrenal gland, unspecified"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E27",
"icd10_title": "Other disorders of adrenal gland"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E274",
"icd10_title": "Other and unspecified adrenocortical insufficiency"
},
{
"from_icd11": "LC8Z",
"icd10_code": "Q891",
"icd10_title": "Congenital malformations of adrenal gland"
},
{
"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"
}
] |
E2740
|
Unspecified adrenocortical insufficiency
|
A 34-year-old male patient was diagnosed with acute lymphoblastic leukemia in June 2015. The bone marrow morphology showed 93% lymphoblasts and prolymphocytes. The bone marrow immunophenotype showed that the primitive region cells accounted for 36.2% of the nucleated cells. CD19, CD10, and HLA-DR were completely expressed and cCD79a was partially expressed. cMPO, cCD3, CD7, CD117, CD14, CD64, CD11c, CD15, CD34, CD16, CD13, CD11b, CD20, CD4, CD56, and CD33 were not expressed and E2A-PBX1 was positive. On July 2, 2015, VTCLP induction chemotherapy was administered . After treatment, a bone marrow examination showed complete remission (CR). On August 9, 2015, a consolidation therapy CAM regimen was given (cyclophosphamide 1.2 g on days 1 and 8; cytarabine 160 mg on days 1–3 and 8–10; 6-mercaptopurine 100 mg on days 1–7). Eight cycles of consolidation therapy were given between September 2015 and June 2016. The bone marrow biopsies performed during that period all indicated CR. Then, the patient was given a maintenance treatment of oral methotrexate and 6-mercaptopurine. In May 2017, the patient had right hip pain again and low fever without obvious causes. On June 1, 2017, the bone marrow biopsy showed 24% lymphoblasts and prolymphocytes, suggesting leukemia relapse. On June 3, HyperCVAD A chemotherapy was administered . On June 30, a bone marrow examination showed CR. A hyper CVAD B regimen was given during July 2017. Lumbar intrathecal chemotherapy was performed 12 times during the treatment period; the cerebrospinal fluid examination showed no abnormality, and the last intrathecal injection was in July 2017. On September 23, 2017, a bone marrow biopsy showed 90% lymphoblasts and prolymphocytes, suggesting leukemia relapse. On September 28, the patient was admitted into our hospital and enrolled in a clinical trial to be treated with CAR-T cell. Informed consent was obtained from the patient for the purpose of publication of this case report. The protocol was approved by the Human Ethics Committees of the Chinese Navy General Hospital. This trial was registered at ClinicalTrials.gov . On October 11, the peripheral blood mononuclear cells were collected and subjected to CAR-T cell culture and amplification. Between October 14 and October 16, the patient was pretreated with an FC regimen (fludarabine phosphate 50 mg qd on days 1–3; cyclophosphamide 0.4 g qd on days 1–3). Then, 2 × 10 5 /kg and 1 × 10 5 /kg of CAR-T cells were respectively infused on October 19 and October 20. The frequency of CD19 + CAR-T in the product was 95.9%. The infused CAR-T cells were dominantly CD45RA + CCR7 + and CD45RA - CCR7 + phenotypes . After the cell infusion, the CD19+ cell and CAR-T cell in peripheral blood were monitored by flow cytometry and real-time quantitative polymerase chain reaction (qPCR) . The copy number of CAR gene detected by qPCR showed the continuous expansion of CAR-T cells. But CAR-T cells were not detected in blood by flow cytometry until day 15 after cell infusion. However, the frequency of CAR-T cells in peripheral blood lymphocytes (PBL) reaches 70%, suggesting a violent expansion of CAR-T cells in these 2 days. Then CAR-T cells remained 60% of PBL. The ratio of CD19+ cells in PBL detected by flow cytometry began to decrease on day 10 after cell infusion, and became undetectable on day 18, when the CAR-T expansion reached its peak. On October 23 the patient began to show muscle soreness. A pain killer was given, but with poor effect. On the early morning of October 25, the patient had a fever of 38.9°C, and it was accompanied by bilateral wrist, hip, knee, and ankle joint swelling and pain. The pain was especially excruciating in the right wrist, both knees, and the left ankle. The patient was treated with imipenem, an anti-inflammatory medication, but the temperature did not fall. Based on the evidence below: fever occurred 5 days after CAR-T cells infusion, highly increased serum level of IL-6, multiple arthritis, the patient was diagnosed as CRS. On October 26, tacilizumab (400 mg) was infused and the temperature was back to normal within 1 hour, which confirmed the CRS diagnosis. The pain in the knees, ankles, and wrists was progressively aggravated. The patient was unable to move his knee and ankle joints. An ultrasound indicated effusion in the large joints. Oral administration of oxycodone sustained-release tablets and external use of fentanyl patches and diclofenac diethylamine emulgel did not lead to any improvement. On October 28, the pain was alleviated with continuous intravenous analgesic drugs (hydromorphone and sufentanil), but the swelling was still there and the left ankle joint swelling continued to worsen. Another dose of tacilizumab (240 mg) was given on November 01, and on November 03, blood tests showed that: IgG was 3.06 g/L, IgA was 0.28 g/L, and IgM was 0.06 g/L, all of which were significantly decreased. Then, immunoglobulin was given. During the night of November 4, the patient had another fever of 38.6°C, and pulse oxygen saturation of 90%. The acute arterial blood gas analysis showed: PO 2 54 mm Hg, PCO 2 34 mm Hg, pH 7.53, and Lac 2.8 mmol /L, suggesting type 1 respiratory failure. Imipenem and cotrimoxazole were given, as well as ethylprednisolone (1 mg/kg). The bedside chest radiograph showed multiple lung infections. On November 7, a chest computerized tomography scan was taken and it showed bilateral multiple lung lesions (multiple patches and strips of blurry shadows). The antibiotics were changed from cotrimoxazole to amphotericin B, which is an antifungal. The joint pain was alleviated, and the knees and ankles were moveable after methylprednisolone treatment. During the process of clinical treatment, we monitored the level of plasma ferritin and IL-6 , which were significantly increased after CAR-T cell infusion but decreased after tocilizumab treatment. On November 12, the patient was diagnosed as severe pulmonary infection with wheezing, coughing, and expectorating dark red bloody sputum. The situation became progressively worse. At 8:00 pm , the patient had a sudden increase in difficulty breathing, which was persistent, and he died.
| 4.097656
| 0.961914
|
sec[1]/p[0]
|
en
| 0.999997
|
29668614
|
https://doi.org/10.1097/MD.0000000000010455
|
[
"cells",
"october",
"cell",
"bone",
"marrow",
"pain",
"blood",
"june",
"infusion",
"which"
] |
[
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "FB84.Z",
"title": "Osteomyelitis or osteitis, unspecified"
},
{
"code": "FB80.Z",
"title": "Disorder of bone density or structure, unspecified"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "FB86.1Z",
"title": "Bone hyperplasias, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS
[FB84.Z] Osteomyelitis or osteitis, unspecified
Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease
[FB80.Z] Disorder of bone density or structure, unspecified
Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[FB86.1Z] Bone hyperplasias, unspecified
Also known as: Bone hyperplasias, unspecified | Bone hyperplasias
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] 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--> [?] Inborn errors of amino acid or other organic acid metabolism
--- Walk 3 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Mucolipidosis type 4
Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...
--PARENT--> [?] Mucolipidosis
--- Walk 4 ---
[5C56.20] Mucolipidosis
--EXCLUDES--> [?] Sialidosis
--CHILD--> [?] Sialidosis type 1
Def: Type 1 sialidosis, also called normomorphic or 'cherry-red-spot, myoclonus' syndrome is a form of sialidosis, a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinos...
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.0] Sickle cell trait
Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] 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--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Mucolipidosis",
"[5C56.20] Mucolipidosis\n --EXCLUDES--> [?] Sialidosis\n --CHILD--> [?] Sialidosis type 1\n Def: Type 1 sialidosis, also called normomorphic or 'cherry-red-spot, myoclonus' syndrome is a form of sialidosis, a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinos...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.0] Sickle cell trait\n Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ..."
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "FC0Z",
"icd10_code": "XIII",
"icd10_title": ""
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86672",
"icd10_title": "Other chronic osteomyelitis, left ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86172",
"icd10_title": "Other acute osteomyelitis, left ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86171",
"icd10_title": "Other acute osteomyelitis, right ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86671",
"icd10_title": "Other chronic osteomyelitis, right ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X7",
"icd10_title": "Other osteomyelitis, ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X8",
"icd10_title": "Other osteomyelitis, other site"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X6",
"icd10_title": "Other osteomyelitis, lower leg"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X9",
"icd10_title": "Other osteomyelitis, unspecified sites"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M8668",
"icd10_title": "Other chronic osteomyelitis, other site"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86662",
"icd10_title": "Other chronic osteomyelitis, left tibia and fibula"
}
] |
D571
|
Sickle-cell disease without crisis
|
A 63-year-old male patient had been suffering from long-term neck pain and limb numbness. The dynamic flexion-extension view revealed the C1-C2 instability, and magnetic resonance imaging (MRI) of the cervical spine revealed hypertrophic ossification at the odontoid process, resulting in tight stenosis at C1 level and spinal cord edema . C1 laminectomy and OC fixation using the screw-rod system were performed by an orthopedic surgeon in another hospital. To avoid the risk of VA injury, the surgeon chose occipito-C3-C4 fixation instead of C1-C2 fixation. The patient was discharged after 1 week, but a few days later, he began to experience persistent intolerable dizziness and vomiting. He went to the emergency department of our hospital. Physical examination revealed that his consciousness was clear and alert and had no change in muscle power compared to the status before surgery. He had no fever. However, the blood test showed a slight increase in leukocytosis (11,800 per mm 3 ) and C-reactive protein level (< 5 mg/dl), indicating that the infection was in the early stage. Furthermore, the patient has symptoms of unsteady gait and right-sided dysmetria, suggesting that the patient may have a cerebellar lesion. Computed tomography (CT) further revealed a significant signal enhancement around the occipital screw and a hypodense lesion in right cerebellar hemisphere . Although the presence of the screw interfered with CT image, it is still found that the position of the screw was the origin of brain abscess. In addition, the screw of inappropriate length were observed to penetrate through the occipital bone . Since the CT image showed only a mild patchy enhancement, the lesion is more likely to be a cerebritis rather than a neoplasm. Therefore, we speculated that it should be a central nervous system (CNS) infection, and the patient was initially prescribed broad-spectrum antibiotics, including Vancomycin and Ceftazidime. Although the local metallic implants interfered with the interpretation of MRI, subsequent MRI confirmed the lesion as a 2.5 cm faint ring-enhanced cerebellar abscess based on the T1-weighted images with contrast medium and on the diffusion weighted imaging sequences . A few days later, the patient became drowsier, so we decided to perform emergent external ventricular drainage (EVD) first to divert CSF and release intracranial pressure. When the wall of abscess is firmly formed, a second stage of suboccipital craniectomy will be performed to drain the brain abscess, and the implants will also be readjusted at the same time. One week after EVD surgery, the patient underwent an elective operation to drain the cerebellar abscess, debride the necrotic tissue, and inspect and readjust the hardware. Preoperative CT angiography (CTA) was conducted to evaluate the relationship between the VA and the planned trajectory, and it excluded a high-riding VA, demonstrating a safe trajectory for bilateral C2 transpedicular screws. In addition, the CTA scan also revealed that additional surgical changes in the positions of the left C3 and C4 screws may not be appropriate as it may breach the transverse foramen and damage the VA . Moreover, the CT sagittal images further showed dislodgement of the occipital screw and oversized diameter of the screw hole , indicating the failure of the instruments. Considering that the infectious status was limited to only around the occipital and cerebellar area and the persistent C1-C2 instability, therefore, in addition to the debridement and drainage of the abscess, the next step is to remove the previous hardware and reintroduce the C1 lateral mass and C2 transpedicular screws. In order to avoid the risk of VA injury when removing C3 and C4 screws, we left these screws in position. Next, we enlarged the hole of the right occipital screw and confirmed the abscess by echography. No purulent discharge was found, but necrotic tissue was found and debrided. The C1 lateral mass and C2 transpedicular screws were safely introduced under fluoroscopic guidance without VA damage . The postoperative course was uneventful, and the symptoms of dizziness, unsteady gait, and dysmetria improved gradually. A few days later, the EVD was removed. No pathogens were detected from the final tissue and CSF cultures, antibiotics were prescribed for the patient for 8 weeks, and the patient was discharged uneventfully. An MRI examination at 3 months postoperatively revealed that the cerebellar abscess almost completely subsided . Fig. 1 MRI image of hypertrophic ossification at the odontoid process, tight stenosis at the C1, and edematous changes at the spinal cord Fig. 2 The axial images of four continuous CT of the patient with cerebellar abscess. The four continuous CT images from a to d represented continuous section from the base of the skull to top. The arrow in ( a ) indicated the position where the screw penetrates the dura mater. Circled area was indicated as brain abscess Fig. 3 The appearance of cerebellar abscess at MRI image. MRI confirmed the diagnosis of a 2.5 cm of a faint ring-enhanced cerebellar abscess based on T1-weighted images with contrast medium. Circled area was represented as brain abscesses Fig. 4 Possible VA injury by C3 screw. The arrow indicated that the C3 screw has been inserted into the transverse foramen, which may cause VA injury Fig. 5 CT sagittal images of the failure of the OC fusion instruments. ( a ) The arrow showed the dislodgement of the occipital screw and the screw hole. The screw was loose and not in their original position. ( b ) The arrow indicated the oversized diameter of the screw hole. The diameter of the screw hole is much larger than the size of the screw, indicating that the screw has no fixing effect Fig. 6 CT image after C1-C2 instrumentation. The white arrows indicated the newly operated C1-C2 instruments, and the black arrow indicated the original occipito-C3-C4 fixation instruments Fig. 7 MRI image of cerebellar abscess resolution after surgery.MRI image showed that abscess in the right cerebellum was almost completely resolved 3 months after surgery. The arrow indicated the abscesses that has not resolved
| 3.880859
| 0.979004
|
sec[1]/p[0]
|
en
| 0.999999
|
32111221
|
https://doi.org/10.1186/s12891-020-3157-0
|
[
"screw",
"abscess",
"that",
"cerebellar",
"occipital",
"screws",
"arrow",
"hole",
"fixation",
"injury"
] |
[
{
"code": "QB84",
"title": "Follow-up care involving removal of fracture plate or other internal fixation device"
},
{
"code": "DA21.20",
"title": "Hypertensive peristalsis"
},
{
"code": "PK99.3",
"title": "Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices"
},
{
"code": "1B75.3",
"title": "Pyogenic abscess of the skin"
},
{
"code": "FB30",
"title": "Infectious myositis"
},
{
"code": "FA10.Z",
"title": "Direct infections of joint, unspecified"
},
{
"code": "FB84.Y",
"title": "Other specified osteomyelitis or osteitis"
},
{
"code": "FB40.0",
"title": "Infectious tenosynovitis"
},
{
"code": "8A80.Z",
"title": "Migraine, unspecified"
},
{
"code": "QA76",
"title": "Medication or substance that is known to be an allergen without injury or harm"
}
] |
=== 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
[DA21.20] Hypertensive peristalsis
Definition: This is a motility disorder of oesophagus characterised by hypertensive peristalsis. This motility abnormality includes nutcracker oesophagus that has been reported in association with dysphagia, non-cardiac chest pain, and heartburn.
Also known as: Hypertensive peristalsis | Bársony-Polgár Syndrome II | corkscrew oesophagus | curling of oesophagus | Nutcracker oesophagus
[PK99.3] Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices
Definition: Orthopaedic related surgical instruments like materials and devices (including sutures) were involved in an adverse related incident
Also known as: Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices | Orthopaedic devices associated with injury or harm, suture material | Orthopaedic devices associated with injury or harm, scalpel | Orthopaedic devices associated with injury or harm, cautery device | Orthopaedic devices associated with injury or harm, laser
Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
[1B75.3] Pyogenic abscess of the skin
Definition: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermoid cyst or around foreign bodies such as surgical sutures.
Also known as: Pyogenic abscess of the skin | abscess NOS
[FB30] Infectious myositis
Definition: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infection, is an important predisposing factor.
Also known as: Infectious myositis | Bacterial myositis | Bacterial pyomyositis | Tropical muscle abscess | Tropical pyomyositis
[FA10.Z] Direct infections of joint, unspecified
Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection
[FB84.Y] Other specified osteomyelitis or osteitis
Also known as: Other specified osteomyelitis or osteitis | Other chronic osteomyelitis | Garre's disease | chronic or old osteomyelitis with or without mention of periostitis | chronic bone abscess
[FB40.0] Infectious tenosynovitis
Also known as: Infectious tenosynovitis | Bacterial infection of tendon sheath | Fungal infection of tendon sheath | Mycobacterial infection of tendon sheath | Parasitic infection of tendon sheath
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[QB84] Follow-up care involving removal of fracture plate or other internal fixation device
--PARENT--> [?] Contact with health services for specific surgical interventions
--CHILD--> [QB82] Contact with health services for routine or ritual circumcision
--- Walk 2 ---
[QB84] Follow-up care involving removal of fracture plate or other internal fixation device
--PARENT--> [?] Contact with health services for specific surgical interventions
--EXCLUDES--> [?] Contact with health services for purposes of examination or investigation
--- Walk 3 ---
[DA21.20] Hypertensive peristalsis
Def: This is a motility disorder of oesophagus characterised by hypertensive peristalsis. This motility abnormality includes nutcracker oesophagus that has been reported in association with dysphagia, non-...
--PARENT--> [DA21.2] Disorder of oesophageal peristalsis
Def: Disorder of oesophageal peristalsis is part of a spectrum of motility disorders in the thoracic oesophagus characterised by dysphagia and chest pain due to incoordination of oesophageal peristaltic co...
--EXCLUDES--> [?] Gastro-oesophageal reflux disease
Def: A condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications...
--- Walk 4 ---
[DA21.20] Hypertensive peristalsis
Def: This is a motility disorder of oesophagus characterised by hypertensive peristalsis. This motility abnormality includes nutcracker oesophagus that has been reported in association with dysphagia, non-...
--PARENT--> [DA21.2] Disorder of oesophageal peristalsis
Def: Disorder of oesophageal peristalsis is part of a spectrum of motility disorders in the thoracic oesophagus characterised by dysphagia and chest pain due to incoordination of oesophageal peristaltic co...
--EXCLUDES--> [?] Gastro-oesophageal reflux disease
Def: A condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications...
--- Walk 5 ---
[PK99.3] Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices
Def: Orthopaedic related surgical instruments like materials and devices (including sutures) were involved in an adverse related incident...
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm
Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....
--- Walk 6 ---
[PK99.3] Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices
Def: Orthopaedic related surgical instruments like materials and devices (including sutures) were involved in an adverse related incident...
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--CHILD--> [?] Functional device failure without injury or harm
Def: A device not working or operating correctly, or that has stopped functioning after a period of function, but without documented injury or harm to the patient....
|
[
"[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions\n --CHILD--> [QB82] Contact with health services for routine or ritual circumcision",
"[QB84] Follow-up care involving removal of fracture plate or other internal fixation device\n --PARENT--> [?] Contact with health services for specific surgical interventions\n --EXCLUDES--> [?] Contact with health services for purposes of examination or investigation",
"[DA21.20] Hypertensive peristalsis\n Def: This is a motility disorder of oesophagus characterised by hypertensive peristalsis. This motility abnormality includes nutcracker oesophagus that has been reported in association with dysphagia, non-...\n --PARENT--> [DA21.2] Disorder of oesophageal peristalsis\n Def: Disorder of oesophageal peristalsis is part of a spectrum of motility disorders in the thoracic oesophagus characterised by dysphagia and chest pain due to incoordination of oesophageal peristaltic co...\n --EXCLUDES--> [?] Gastro-oesophageal reflux disease\n Def: A condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications...",
"[DA21.20] Hypertensive peristalsis\n Def: This is a motility disorder of oesophagus characterised by hypertensive peristalsis. This motility abnormality includes nutcracker oesophagus that has been reported in association with dysphagia, non-...\n --PARENT--> [DA21.2] Disorder of oesophageal peristalsis\n Def: Disorder of oesophageal peristalsis is part of a spectrum of motility disorders in the thoracic oesophagus characterised by dysphagia and chest pain due to incoordination of oesophageal peristaltic co...\n --EXCLUDES--> [?] Gastro-oesophageal reflux disease\n Def: A condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications...",
"[PK99.3] Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices\n Def: Orthopaedic related surgical instruments like materials and devices (including sutures) were involved in an adverse related incident...\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm\n Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....",
"[PK99.3] Orthopaedic devices associated with injury or harm, surgical instruments, materials or devices\n Def: Orthopaedic related surgical instruments like materials and devices (including sutures) were involved in an adverse related incident...\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Functional device failure without injury or harm\n Def: A device not working or operating correctly, or that has stopped functioning after a period of function, but without documented injury or harm to the patient...."
] |
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": "DA21.20",
"icd10_code": "K224",
"icd10_title": "Dyskinesia of esophagus"
},
{
"from_icd11": "PK99.3",
"icd10_code": "T84114A",
"icd10_title": "Breakdown (mechanical) of internal fixation device of right femur, initial encounter"
},
{
"from_icd11": "PK99.3",
"icd10_code": "T84125A",
"icd10_title": "Displacement of internal fixation device of left femur, initial encounter"
},
{
"from_icd11": "PK99.3",
"icd10_code": "T84197A",
"icd10_title": "Other mechanical complication of internal fixation device of bone of left lower leg, initial encounter"
}
] |
Z4733
|
Aftercare following explantation of knee joint prosthesis
|
A 34-year-old woman was admitted to the hospital on April 29, 2021, due to cough for 20 days. Twenty days before admission, the patient developed a cough, which was a dry and severe cough, but the patient had no fever, dyspnea, or hemoptysis. The patient was diagnosed with “ulcerative colitis” 5 years prior and was intermittently treated with “mesalazine,” which had a good effect. The patient complained of spontaneous relief of loose stools after pregnancy 2 years prior, and mesalazine was discontinued. 1 month before admission, her symptoms recurred, and “mesalazine” was used again to resolve the diarrhea. The patient was born and living in Sichuan, China, and denied a history of eating raw shrimp and crabs. The physical examination at admission revealed the following: T, 36.7°C; P, 78 bpm; R20, bpm; BP, 101/60 mm Hg; and SpO 2 , 97% (without oxygen inhalation). Her breathing was still steady, and her answers were pertinent. There was no ecchymosis or petechiae on the skin, no palpable enlarged lymph nodes, and no dry–wet rales in either lung. Her heart rhythm was normal, there was no murmur in the valve areas, and her abdomen was soft with no tenderness, rebound pain, or muscle tension. There was no pain in the liver or kidney, the muscle strength or muscle tone of the extremities was normal, and there was no edema in the lower limbs. Routine blood tests at admission revealed a white blood cell count of 7.68 × 10 9 /L, an eosinophil count of 0.87 × 10 9 /L↑, an eosinophil percentage of 11.3%↑, and a CRP level of 35.62 mg/L↑. The erythrocyte sedimentation rate was 71 mm/h↑, the results of routine urine and stool tests were normal, the results of urine and stool occult blood tests were negative, the PCT results were normal, and liver and kidney function, electrolytes, blood lipids, uric acid, and coagulation function were normal. Serum G and GM antigen tests, serum cryptococcal capsular antigen, tuberculosis antibody, PPD test (−), Mycoplasma pneumoniae , chlamydia antibody, and serum tumor markers were negative. CT of the chest revealed multiple patchy opacities in both lungs . Empirical anti-infective treatment with cefotaxime was given. After treatment, the patient’s cough symptoms were not relieved, and routine blood reexamination on August 8, 2021, revealed a white blood cell count of 6.22 × 10 9 /L, an eosinophil count of 1.04 × 10 9 /L↑, an eosinophil percentage of 16.7%↑, and a CRP level of 13.64 mg/L↑. Her eosinophil count was greater than that at admission, and CT reexamination revealed that the scope of the patchy shadow in the lung was enlarged. Serum antinuclear antibody spectrum, ANCA and IgG4 were negative, and sinus CT showed no obvious abnormalities. There was no obvious abnormality on bronchoscopy, and the bacteria and fungi smear and culture of the lavage fluid were negative. The TB-DNA and GM tests of the lavage fluid were negative, and the exfoliative cytology of the lavage fluid was normal. mNGS of the lavage fluid was negative. On May 13, 2021, routine blood tests revealed white blood cells of 8.16 × 10 9 /L, eosinophils of 1.62 × 10 9 /L↑, eosinophils of 19.8%↑, and CRP of 32.35 mg/L↑. Her eosinophil count was greater than that at admission, and a repeat CT scan revealed further expansion of the patchy lung shadow . No enlarged lymph nodes were found by color Doppler ultrasound of superficial lymph nodes in the whole body, and no definite masses were found by head, chest or abdomen enhanced CT. Gastroscopy revealed no definite abnormalities. Pulmonary function tests revealed an FVC of 2.55 L, an FVC of 76.9%, an FEV1/FVC of 94.29%, a DLCO of 101.9%, and increased airway resistance. CT-guided percutaneous lung biopsy was performed, and pathological examination revealed extensive eosinophil infiltration in the alveolar space and alveolar interstitium , and acid-quickly, hexamine silver, and PAS staining was negative. Immunohistochemical analysis revealed CD20(+)p, CD3(+)p, Mum1(+), CD138(+), IgG4(less+, 10/HPF), S-100(−), CD1a(−), and Langerin(−) in plasma cells. Lymphocytes were negative for EBER1/2-ISH. EPD was considered. Prednisone 40 mg/d (0.75 mg/kg/d) was administered, the lung lesions were completely absorbed after 10 days of glucocorticoid treatment , and the peripheral blood eosinophil counts returned to normal. The patient took oral glucocorticoids, and the dose was slowly reduced. During treatment with oral glucocorticoids, the patient’s ulcerative colitis did not flare, and mesalazine was not used. After 4 months of oral corticosteroid treatment, chest CT, routine blood tests and erythrocyte sedimentation rates were normal, and prednisone was discontinued. When the patient discontinued corticosteroids, her symptoms of mucopurulent and bloody stool recurred. Mesalazine was used again, and the symptoms were relieved. 3 months after drug withdrawal, the patient developed a cough again, a dry cough without sputum, accompanied by stool with no mucus, no chills, no dyspnea, and no hemoptysis. Routine blood examination showed that her eosinophil levels had increased again, chest CT showed bilateral patchy shadows in the lung, and the lesions were basically the same as those 6 months prior . There were no abnormal findings on breast ultrasound or superficial lymph node ultrasound. A colonoscopy revealed a small superficial ulcer , and a colonoscopy biopsy revealed chronic active inflammation of the ileocecal mucosa with focal hemorrhage in the superficial stroma. There was chronic active inflammation of the sigmoid colon mucosa with adenomatous hyperplasia in some glands; there was chronic active inflammation of the rectal mucosa with lymphoid follicle formation . The possibility of recurrence of chronic eosinophilic pneumonia was considered. Oral glucocorticoids were given again, starting with 40 mg/d prednisone. After 2 weeks of treatment, chest CT reexamination revealed that the lesions were completely absorbed and resolved. The dose of prednisone was gradually reduced over a total of 6 months. In December 2022, she was followed up, and she did not have any coughing and was intermittently treated with mesalazine for ulcerative colitis.
| 3.857422
| 0.983398
|
sec[1]/p[0]
|
en
| 0.999997
|
38669413
|
https://doi.org/10.1097/MD.0000000000037851
|
[
"blood",
"eosinophil",
"cough",
"mesalazine",
"lung",
"routine",
"count",
"chest",
"that",
"lymph"
] |
[
{
"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": "2B31.2Y",
"title": "Other specified Langerhans cell histiocytosis"
},
{
"code": "4B0Z",
"title": "Immune system disorders involving white cell lineages, unspecified"
},
{
"code": "EF40.20",
"title": "Granuloma faciale"
},
{
"code": "CB02.Z",
"title": "Pulmonary eosinophilia, unspecified"
},
{
"code": "DA60.4",
"title": "Eosinophilic gastric ulcer"
}
] |
=== 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
[2B31.2Y] Other specified Langerhans cell histiocytosis
Also known as: Other specified Langerhans cell histiocytosis | Eosinophilic granuloma | unifocal Langerhans-cell histiocytosis | Hashimoto-Pritzker syndrome | Hashimoto-Pritzker histiocytosis
Includes: Eosinophilic granuloma
[4B0Z] Immune system disorders involving white cell lineages, unspecified
Also known as: Immune system disorders involving white cell lineages, unspecified
[EF40.20] Granuloma faciale
Also known as: Granuloma faciale | Granuloma, eosinophilic, skin
[CB02.Z] Pulmonary eosinophilia, unspecified
Also known as: Pulmonary eosinophilia, unspecified | Pulmonary eosinophilia | eosinophilic lung infiltrate | Weingarten's syndrome
[DA60.4] Eosinophilic gastric ulcer
Definition: Gastric ulcer caused by eosinophilic gastritis.
Also known as: Eosinophilic gastric ulcer
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Pregnancy, childbirth or the puerperium
Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.41] Microscopic haematuria
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.4Z] Haematuria, unspecified
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
The patient consulted his general practitioner about a large, painful lump, loss of motor function in the right shoulder, and asthenia. Auscultation of the mass revealed a continuous murmur. The medical history included hypertension, type-2 diabetes, and a transient ischemic attack four years previously. A thirteen-centimetre tissue lesion with extensive osteolysis of the right scapula invading the soft tissue and the glenohumeral capsule was discovered using magnetic resonance imaging (MRI) . Two microbiopsies of the scapular mass revealed a tumour proliferation of medium-sized, quadrangular cells with clear cytoplasm, typical of RCC. Positron emission tomography (PET) unveiled a large mass (measuring 15*9*12 cm) involving the antero-inferior lobe of the right kidney, nodules of peritoneal carcinomatosis in the left paracolic gutter and near the spleen, a mass invading the left lateral pedicle of the sixth cervical vertebra, and the right scapular mass invading the shoulder girdle . In line with the current recommendations , the multidisciplinary consultation meeting validated a therapeutic strategy including radiotherapy focused on the right scapula and the spinal cord (twenty gray in thirteen sessions) as well as systemic treatment with axitinib plus pembrolizumab. After initial destabilization, we were able to equilibrate the patient's blood pressure . However, six weeks later, the patient developed ankle swelling and fatigue while gaining ten kilograms within a few days. Ordinary activities were resulting in undue breathlessness, limiting the activities of daily life (class III of the New York Heart Association's functional classification). Self-blood pressure monitoring found daily systolic blood pressures between 130 and 140 mmHg. Pulmonary crackles were bilaterally perceived on pulmonary auscultation. The right scapular mass was still prominent and very painful . Blood and urinary tests showed normal serum albumin, normal creatinine levels, normal liver function tests, and no proteinuria. N-terminal pro-B-type natriuretic peptides (NT-proBNP) were 665 ng/l and troponins were 0.07 μg/L (normal: less than 0.6 μg/L). The electrocardiogram (ECG) was normal, with a heart rate of 91 bpm and a normal cardiac rhythm. A transthoracic echocardiogram (TTE) depicted a non-dilated, non-hypertrophic left ventricle with excellent overall and segmental kinetics (Additional file 1: Video 1), an estimated ejection fraction of 60%, a dilated left atrium of 24 cm 2 , elevated left ventricular filling pressures, a dilated and non-compliant inferior vena cava, and an estimated systolic pulmonary artery pressure of 40–50 mmHg. The cardiac output was 9.8 L/min (normal range 4–6 L/min) and the cardiac index was 5.1 L/min/m 2 (normal range 2.6–4 L/min/m 2 ) . These findings were consistent with a state of high-output HF. Doppler US examination of the right scapular mass showed a well-delineated mass with a 14-cm long axis, containing numerous arteriovenous shunts predominantly in the upper-region of the lesion . Spectral Doppler analysis of the arteries of the upper limbs was highly asymmetrical, given the systolic diastolic run-off and elevated velocities in the subclavian artery and the axillar artery of the right upper limb. Furthermore, widened dorsal scapular and circumflex scapular arteries were seen at the axillobrachial junction, and the velocities within their lumen were very high. The Doppler velocity waveform was physiological in the downstream brachial artery and symmetrical to the left brachial artery. Right axillary artery flow was measured at 2.35 L/min at the middle of its course , while proximal brachial artery flow was normal at 51 ml/min, suggesting a blood flow shunt of 2.3 L/min between the right axillary artery and the downstream brachial artery. Also, there was no arterialized flow in the right axillary vein, inferior vena cava, or right renal vein. Considering that right axillary artery flow accounted for 24% of cardiac output, normal blood pressure, and the absence of any other identified cause, we attributed the condition of high-output HF-and subsequent cardiac overload-to the hypervascularity of the right scapular metastasis. Axitinib was discontinued due to its potential cardiovascular adverse effects, and furosemide was introduced at a dose of 40 mg per day . Ongoing diuretic treatment successfully reduced breathlessness and peripheral oedema. The patient completed the thirteen planned radiotherapy sessions. A half-dose of axitinib was reintroduced three months after it was discontinued, and the dose of furosemide was reduced by half . The patient reported feeling better, with no dyspnea, less pain, and improved motor function in the right arm. The pulmonary auscultation returned to normal. The NT-proBNP level decreased to 411 ng/L. Additional Doppler US examination highlighted a right-arm axillary outflow estimated at 1.40 L/min and a dramatically depressed diastolic component. The mass was still 14 cm in diameter, but the arteriovenous shunts were reduced . A second TTE showed normal left ventricular filling pressure with a measured cardiac output of 8.6 L/min and a cardiac index of 4.3 L/min/m 2 . The second PET revealed a significant reduction in right scapular hypermetabolism. Fifteen days later, the furosemide treatment was completely stopped. The symptoms of HF never recurred. Fig. 1 Magnetic resonance imaging of the right scapular mass Fig. 2 Positron emission tomography images of the right scapular mass Fig. 3 Information from this case report organized into a timeline figure Fig. 4 Clinical aspect of the right scapular mass Fig. 5 Transthoracic echocardiogram image: cardiac output measured at 9.8 L/min in two-dimensional imaging (stroke volume multiplied by heart rate) Fig. 6 Doppler ultrasound image of numerous arteriovenous shunts within the right scapular mass Fig. 7 Systolo-diastolic Doppler velocity waveform in the right axillary artery with estimated flow of 2.35 L/min Fig. 8 Doppler ultrasound image of the right scapular mass after thirteen sessions of lesion-focused radiotherapy showing less intra-metastatic arteriovenous shunts
| 4.105469
| 0.971191
|
sec[1]/p[0]
|
en
| 0.999995
|
PMC8981953
|
https://doi.org/10.1186/s12872-022-02588-8
|
[
"scapular",
"artery",
"cardiac",
"doppler",
"blood",
"output",
"axillary",
"flow",
"pressure",
"thirteen"
] |
[
{
"code": "NC12.1Z",
"title": "Fracture of scapula, unspecified"
},
{
"code": "NC1Z&XA3WD7",
"title": "Injury of scapular region, unspecified"
},
{
"code": "FB84.Y",
"title": "Other specified osteomyelitis or osteitis"
},
{
"code": "NC12.1Y",
"title": "Other specified fracture of scapula"
},
{
"code": "NC10.Y&XA3WD7",
"title": "Superficial injury of scapular region"
},
{
"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 ===
[NC12.1Z] Fracture of scapula, unspecified
Also known as: Fracture of scapula, unspecified | Fracture of scapula | fracture of shoulder blade | scapular fracture
[FB84.Y] Other specified osteomyelitis or osteitis
Also known as: Other specified osteomyelitis or osteitis | Other chronic osteomyelitis | Garre's disease | chronic or old osteomyelitis with or without mention of periostitis | chronic bone abscess
[NC12.1Y] Other specified fracture of scapula
Also known as: Other specified fracture of scapula | Fracture of body of scapula | fracture of scapular body | Fracture of acromial process | acromion process fracture
Includes: Fracture of body of scapula | Fracture of acromial process | Fracture of glenoid cavity of scapula
[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 ---
[NC12.1Z] Fracture of scapula, unspecified
--PARENT--> [NC12.1] Fracture of scapula
Def: A break in one or both of the scapulae....
--CHILD--> [NC12.10] Multiple fractures of scapula
--- Walk 2 ---
[NC12.1Z] Fracture of scapula, unspecified
--PARENT--> [NC12.1] Fracture of scapula
Def: A break in one or both of the scapulae....
--CHILD--> [NC12.10] Multiple fractures of scapula
--- Walk 3 ---
[FB84.Y] Other specified osteomyelitis or osteitis
--PARENT--> [FB84] Osteomyelitis or osteitis
--EXCLUDES--> [?] Inflammatory conditions of jaws
--- Walk 4 ---
[FB84.Y] Other specified osteomyelitis or osteitis
--PARENT--> [FB84] Osteomyelitis or osteitis
--CHILD--> [FB84.0] Acute haematogenous osteomyelitis
--- Walk 5 ---
[NC12.1Y] Other specified fracture of scapula
--PARENT--> [NC12.1] Fracture of scapula
Def: A break in one or both of the scapulae....
--CHILD--> [NC12.1Y] Other specified fracture of scapula
--- Walk 6 ---
[NC12.1Y] Other specified fracture of scapula
--PARENT--> [NC12.1] Fracture of scapula
Def: A break in one or both of the scapulae....
--PARENT--> [NC12] Fracture of shoulder or upper arm
|
[
"[NC12.1Z] Fracture of scapula, unspecified\n --PARENT--> [NC12.1] Fracture of scapula\n Def: A break in one or both of the scapulae....\n --CHILD--> [NC12.10] Multiple fractures of scapula",
"[NC12.1Z] Fracture of scapula, unspecified\n --PARENT--> [NC12.1] Fracture of scapula\n Def: A break in one or both of the scapulae....\n --CHILD--> [NC12.10] Multiple fractures of scapula",
"[FB84.Y] Other specified osteomyelitis or osteitis\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Inflammatory conditions of jaws",
"[FB84.Y] Other specified osteomyelitis or osteitis\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --CHILD--> [FB84.0] Acute haematogenous osteomyelitis",
"[NC12.1Y] Other specified fracture of scapula\n --PARENT--> [NC12.1] Fracture of scapula\n Def: A break in one or both of the scapulae....\n --CHILD--> [NC12.1Y] Other specified fracture of scapula",
"[NC12.1Y] Other specified fracture of scapula\n --PARENT--> [NC12.1] Fracture of scapula\n Def: A break in one or both of the scapulae....\n --PARENT--> [NC12] Fracture of shoulder or upper arm"
] |
NC12.1Z
|
Fracture of scapula, unspecified
|
[
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42121A",
"icd10_title": "Displaced fracture of acromial process, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42131A",
"icd10_title": "Displaced fracture of coracoid process, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42102A",
"icd10_title": "Fracture of unspecified part of scapula, left shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42111A",
"icd10_title": "Displaced fracture of body of scapula, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42142A",
"icd10_title": "Displaced fracture of glenoid cavity of scapula, left shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42112A",
"icd10_title": "Displaced fracture of body of scapula, left shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42109D",
"icd10_title": "Fracture of unspecified part of scapula, unspecified shoulder, subsequent encounter for fracture with routine healing"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42141A",
"icd10_title": "Displaced fracture of glenoid cavity of scapula, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42101A",
"icd10_title": "Fracture of unspecified part of scapula, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42132A",
"icd10_title": "Displaced fracture of coracoid process, left shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42191A",
"icd10_title": "Fracture of other part of scapula, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42145A",
"icd10_title": "Nondisplaced fracture of glenoid cavity of scapula, left shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42152A",
"icd10_title": "Displaced fracture of neck of scapula, left shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42151A",
"icd10_title": "Displaced fracture of neck of scapula, right shoulder, initial encounter for closed fracture"
},
{
"from_icd11": "NC12.1Z",
"icd10_code": "S42101D",
"icd10_title": "Fracture of unspecified part of scapula, right shoulder, subsequent encounter for fracture with routine healing"
}
] |
S42121A
|
Displaced fracture of acromial process, right shoulder, initial encounter for closed fracture
|
Unfortunately, after 3 months of follow-up, the patient discontinued all medications due to inaccessibility of the drugs. He returned to our hospital after discontinuing medication for six months, with a complaint of poor appetite for the past 10 days. Elevated liver enzymes were observed, with an alanine aminotransferase level of 295 IU/L (normal range: 0–40 IU/L) and a total bilirubin(TBIL) level of 1.8 mg/dL (normal range: 0–1 mg/dL). His HBV viral load increased to 5.5 × 10 9 copies/ml. Considering the liver impairment, elevated HBV-DNA and the incomplete anti-tuberculosis treatment regimen , we discontinued pyrazinamide and initiated treatment with linezolid, cycloserine, levofloxacin, and ethambutol for anti-tuberculosis therapy, along with BIC/TAF/FTC for HIV and HBV antiviral treatment. Additionally, enhanced liver protection and supportive management were provided, involving hepatoprotective effects of medications such as glutathione, magnesium isoglycyrrhizinate, and bicyclol. However, the patient’s TBIL levels continued to rise progressively, reaching 4.4 mg/dL on day 10 . Suspecting drug-related factors, we discontinued all anti-tuberculosis medications while maintaining BIC/TAF/FTC for antiviral therapy, the patient’s TBIL levels continued to rise persistently. We ruled out other viral hepatitis and found no significant evidence of obstructive lesions on magnetic resonance cholangiopancreatography. Starting from the day 19, due to the patient’s elevated TBIL levels of 12.5 mg/dL, a decrease in prothrombin activity (PTA) to 52% , and the emergence of evident symptoms such as abdominal distension and poor appetite, we initiated aggressive treatment methods. Unfortunately, on day 38, his hemoglobin level dropped to 65 g/L , and his platelet count decreased to 23 × 10 9 /L . Based on a score of 7 on the Naranjo Scale, it was highly suspected that “Linezolid” was the cause of these hematological abnormalities. Therefore, we had to discontinue Linezolid for the anti-tuberculosis treatment. Subsequently, on day 50, the patient developed recurrent fever, a follow-up chest CT scan revealed enlarged nodules in the lungs . The patient also reported mild dizziness and a worsening cough. On day 61, the previous blood culture results reported the growth of Cryptococcus. A lumbar puncture was performed on the same day, and the cerebrospinal fluid (CSF) opening pressure was measured at 130 mmH 2 O. India ink staining of the CSF showed typical encapsulated yeast cells suggestive of Cryptococcus. Other CSF results indicated mild leukocytosis and mildly elevated protein levels, while chloride and glucose levels were within normal limits. Subsequently, the patient received a fungal treatment regimen consisting of liposomal amphotericin B (3 mg/kg·d −1 ) in combination with fluconazole(600 mg/d). After 5 days of antifungal therapy, the patient’s fever symptoms were well controlled. Despite experiencing bone marrow suppression, including thrombocytopenia and worsening anemia, during this period, proactive symptom management, such as the use of erythropoietin, granulocyte colony-stimulating factor, and thrombopoietin, along with high-calorie dietary management, even reducing the dosage of liposomal amphotericin B to 2 mg/kg/day for 10 days at the peak of severity, successfully controlled the bone marrow suppression. However, within the following week, the patient experienced fever again, accompanied by a worsened cough, increased sputum production, and dyspnea. Nevertheless, the bilirubin levels did not show a significant increase. On day 78 the patient’s lung CT revealed patchy infiltrates and an increased amount of pleural effusion . The CD4 + T-cell count was 89/μL (normal range: 500–700/μL), indicating a significant improvement in immune function compared to the previous stage, and C-reactive protein was significantly elevated, reflecting the inflammatory state, other inflammatory markers such as IL-6 and γ-IFN were also significantly elevated. On day 84, Considering the possibility of IRIS, the patient began taking methylprednisolone 30 mg once a day as part of an effort to control his excessive inflammation. Following the administration of methylprednisolone, the man experienced an immediate improvement in his fever. Additionally, symptoms such as cough, sputum production, dyspnea, and poor appetite gradually subsided over time. A follow-up lung CT showed significant improvement, indicating a positive response to the treatment. After 28 days of treatment with liposomal amphotericin B in combination with fluconazole, liposomal amphotericin B was discontinued, and the patient continued with fluconazole to consolidate the antifungal therapy for Cryptococcus. Considering the patient’s ongoing immunodeficiency, the dosage of methylprednisolone was gradually reduced by 4 mg every week. After improvement in liver function, the patient’s anti-tuberculosis treatment regimen was adjusted to include bedaquiline, contezolid, cycloserine, moxifloxacin, and ethambutol. The patient’s condition was well controlled, and a follow-up lung CT on day 117 indicated a significant improvement in lung lesions . Fig. 2 Upon second hospitalization admission ( A ), nodular lesions were already present in the lungs, and their size gradually increased after the initiation of ART ( B , C ). Notably, the lung lesions became more pronounced following the commencement of anti-cryptococcal therapy, coinciding with the occurrence of pleural effusion ( C ). However, with the continuation of antifungal treatment and the addition of glucocorticoids, there was a significant absorption and reduction of both the pleural effusion and pulmonary nodules ( D ) Fig. 3 During the patient's second hospitalization, as the anti-tuberculosis treatment progressed and liver failure developed, the patient’s HGB levels gradually decreased ( A ), while TBIL levels increased ( B ). Additionally, there was a gradual decrease in PLT count ( C ) and a reduction in prothrombin activity (PTA) ( D ), indicating impaired clotting function. Moreover, myelosuppression was observed during the anti-cryptococcal treatment ( C )
| 3.966797
| 0.97168
|
sec[1]/p[1]
|
en
| 0.999998
|
PMC11129448
|
https://doi.org/10.1186/s12879-024-09431-9
|
[
"anti",
"tuberculosis",
"liver",
"tbil",
"lung",
"improvement",
"discontinued",
"lesions",
"fever",
"liposomal"
] |
[
{
"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": "1B1Z",
"title": "Tuberculosis, unspecified"
},
{
"code": "1B1Y",
"title": "Other specified tuberculosis"
},
{
"code": "KA61.0",
"title": "Congenital tuberculosis"
},
{
"code": "1B12.40",
"title": "Tuberculosis of bones or joints"
},
{
"code": "1B10.Z",
"title": "Respiratory tuberculosis, without mention of bacteriological or histological confirmation"
}
] |
=== ICD-11 CODES FOUND ===
[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
[1B1Z] Tuberculosis, unspecified
Also known as: Tuberculosis, unspecified | Infections due to Mycobacterium tuberculosis and Mycobacterium bovis | TB - [tuberculosis] | Tuberculosis infection | TBC - [tuberculosis]
[1B1Y] Other specified tuberculosis
Also known as: Other specified tuberculosis | Disorders of kidney or ureter in tuberculosis
[KA61.0] Congenital tuberculosis
Definition: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission.
Also known as: Congenital tuberculosis | congenital tuberculous gangrene | congenital tuberculous degeneration | congenital necrotic tuberculosis | congenital tuberculous infection
[1B12.40] Tuberculosis of bones or joints
Definition: A disease of the bones and joints, caused by an infection with the bacteria Mycobacterium tuberculosis. This disease commonly presents with bone pain, joint inflammation, loss of movement or feeling in the affected bone or joint, and weak bones prone to fracture. Transmission is through haematogenous spread to the bones and joints after inhalation of infected respiratory secretions. Confirmation is by identification of Mycobacterium tuberculosis in biopsy samples of the affected site.
Also known as: Tuberculosis of bones or joints | tuberculous cartilage | tuberculosis of bone | tuberculosis of joint | tuberculous bone
[1B10.Z] Respiratory tuberculosis, without mention of bacteriological or histological confirmation
Also known as: Respiratory tuberculosis, without mention of bacteriological or histological confirmation | Tuberculosis of the respiratory system | respiratory tuberculosis | pulmonary tuberculosis | pulmonary TB
=== GRAPH WALKS ===
--- Walk 1 ---
[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....
--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
--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
--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--> [?] Haemorrhagic diseases due to acquired coagulation factor defects
Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood....
|
[
"[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 --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 --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 --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--> [?] Haemorrhagic diseases due to acquired coagulation factor defects\n Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood...."
] |
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": "1B1Z",
"icd10_code": "A15-A19",
"icd10_title": ""
}
] |
O26841
| |
The girl is the second child of German, non-consanguineous parents. She was a newborn of 39 weeks of gestational age, weighted 3690 g, and had a birth length of 54 cm. Already in the first weeks of her life, the girl showed signs of hyperphagia by crying regularly after the end of a meal and only calmed down after further food intake. A perceptible feeling of satiety did not occur even after extensive food intake. Excessive weight gain within the first year of life led to a body weight of 18 kg (BMI 28.1 kg/m 2 , BMI SDS 6.2) . Despite numerous diagnostic examinations, no causal diagnosis could be found for the extreme early-onset obesity (Table 1 ). The persistent desire for food and the continuous weight gain played a major role in daily family life and massively distressed the girl and her family. Negative social experiences at school (e.g. bullying and teasing) led to social isolation. Intensive, interdisciplinary, behavioural treatments to reduce weight were unsuccessful in the long term (Table 2 ). Repeated setbacks after frustrating weight loss attempts caused a deep depression with suicidal thoughts, but no drug treatment was required. After exhaustion of common therapeutic approaches, she finally decided to undergo bariatric surgery at the age of 18 years. At this time, she weighed 188 kg (BMI 67.7 kg/m 2 ). As a result, she lost 38 kg within 1 year followed by rapid weight regain of 22 kg within 8 months . However, hypogonadotropic hypogonadism diagnosed at the age of 17 resolved one year after bariatric surgery. Fig. 1 Body mass index (BMI) trajectories from birth to diagnosis of leptin receptor deficiency in patient 1 ( a ) and patient 2 ( b ). Previous therapy approaches to treat obesity are marked in red (A–F) and can be seen in Table 2 Table 1 Chronology of diagnostic examinations performed in the two patients to exclude endocrine and syndromic diseases causing severe, early-onset obesity Age, year (y) month (m) Suspected diagnoses Methods Patient 1 0 y 9 m Hypercortisolism Cortisol profile and dexamethasone suppression test Hypothyroidism Thyrotropin-releasing hormone stimulation test Growth hormone deficiency Insulin hypoglycaemia test and radiography Brain tumour/brain malformation Sonography 1 y 10 m Prader-Willi syndrome MS-MLPA Chromosome aberrations Chromosome analysis Congenital leptin deficiency Leptin ELISA 2 y 6 m Brain tumour/brain malformation MRI Pituitary tumour MRI Hypercortisolism Urinary cortisol profile Disorder of the adipocyte differentiation In vitro functional examination Adrenal insufficiency Adrenocorticotropic hormone test Adrenal gland tumour CT Congenital leptin deficiency Leptin ELISA Prohormone convertase deficiency Oral glucose tolerance test, proinsulin ELISA Patient 2 1 y 11 m Hypercortisolism Cortisol profile Hypothyroidism Laboratory Chromosome aberrations Chromosome analysis Insulinoma Blood glucose profile Prader-Willi syndrome MS-MLPA Pseudohypoparathyroidism Laboratory values and radiography Brain tumour/brain malformation CT Glycogenosis type I Clinical examinations 2 y 9 m Brain tumour/brain malformation MRI Hypothalamus tumour MRI Prader-Willi syndrome MS-MLPA 5 y 6 m Eating disorders Psychological examinations 8 y 11 m Growth hormone deficiency l -Arginine and insulin-tolerance tests 9 y 3 m Anterior pituitary insufficiency Corticotropin-releasing hormone stimulation test and thyrotropin-releasing hormone stimulation test Brain tumour/brain malformation MRI 11 y 9 m Pituitary tumour MRI 12 y 2 m Disorder of the hypothalamic-pituitary-adrenal axis Combined pituitary stimulation test Adrenal insufficiency Adrenocorticotropin stimulation test CT computer tomography, ELISA enzyme-linked immunosorbent assay, MS-MLPA methylation-specific multiplex ligation-dependent probe amplification, MRI magnetic resonance imaging Table 2 Measures for treatment of obesity from birth to the age at diagnosis of leptin receptor deficiency in the two patients Age, year (y) month (m) Measures for treatment of obesity Impact on weight Patient 1 Ongoing Restrictive food intake and motivation for physical activity None 0 y 9 m 9 days stay in a paediatric clinic with caloric restriction to 600 kcal per day a None 3 y 21 days stay in a specialised clinic for metabolic disorders and Prader-Willi syndrome b None 4 y 2 m 14 days stay in a specialised clinic for Tomatis Listening Therapy c None 10 y 4 m 2 years outpatient psychotherapy for mother and child None 11 y 5 m 6 weeks stay in a rehabilitation clinic focusing obesity d − 10.7 kg (− 9.86%), followed by weight regain 14 y 7 m 6 months stay in a rehabilitation clinic with obesity long-term therapy e − 15.6 kg (− 6.41%), followed by 9.3 kg weight regain within 1 month 18 y 1 m Leaving the parental home and moving into an assisted living community − 8 kg (+ 4.26%) 18 y 3 m 2 years outpatient psychotherapy None 18 y 4 m Bariatric surgery: sleeve gastrectomy f − 38 kg (− 20.13%), followed by weight regain (overall weight reduction, 16 kg (− 8.47%)) Patient 2 Ongoing Restrictive food intake and motivation for physical activity None 1 y 11 m 15 days stay in a paediatric clinic with daily 800 kcal caloric restriction a None 2 y 9 m 7 weeks stay in a paediatric clinic with daily 400 kcal caloric restriction b − 4 kg (− 12.05%) 3 y 10 m 1.5 years outpatient psychotherapy None 5 y 6 m 1 year inpatient psychotherapy c − 14 kg (− 29.79%), followed by slow weight regain 6 y 5 m 3 years outpatient psychotherapy None 9 y 5 m 3 years growth hormone treatment due to short stature and growth hormone deficiency + 59 kg (+ 38.8%) 12 y 7 m 4 months stay in a rehabilitation clinic with obesity long-term therapy d + 4 kg (+ 4.0%) 12 y 11 m Regular advice and support from the youth welfare department, psychological care and medical weight control None 14 y 3 m Bariatric surgery: gastric banding e − 49 kg (− 33.84%) 14 y 4 m 28 days stay in a child and adolescent psychiatry after gastric banding − 5 kg (− 3.72%) 25 y 0 m Removal of gastric banding due to band migration f + 15 kg (+ 14.8%) within 4 years a–f Refer to Fig. 1 and display the time points of interventions and their impact on weight
| 4.210938
| 0.84668
|
sec[1]/sec[0]/p[0]
|
en
| 0.999997
|
33140236
|
https://doi.org/10.1186/s40348-020-00107-3
|
[
"weight",
"none",
"brain",
"tumour",
"stay",
"obesity",
"deficiency",
"hormone",
"clinic",
"leptin"
] |
[
{
"code": "MG43.5",
"title": "Excessive weight loss"
},
{
"code": "MG43.6",
"title": "Excessive weight gain"
},
{
"code": "MG44.11",
"title": "Failure to thrive in infant or child"
},
{
"code": "5B80.0Z",
"title": "Overweight, unspecified"
},
{
"code": "JA65.2",
"title": "Excessive weight gain in pregnancy"
},
{
"code": "MB20.1",
"title": "Coma"
},
{
"code": "8E7Y",
"title": "Other specified diseases of the nervous system"
},
{
"code": "LA05.Z",
"title": "Cerebral structural developmental anomalies, unspecified"
},
{
"code": "1D00.Z",
"title": "Infectious encephalitis, unspecified"
},
{
"code": "LA00.0Z",
"title": "Anencephaly, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[MG43.5] Excessive weight loss
Definition: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health.
Also known as: Excessive weight loss | abnormal decrease in weight | abnormal weight loss | unintended weight loss | weight loss NOS
[MG43.6] Excessive weight gain
Definition: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantity or rate to create risk to the individual’s health.
Also known as: Excessive weight gain | abnormal increase in weight | abnormal weight gain | unintended weight gain
Excludes: Obesity
[MG44.11] Failure to thrive in infant or child
Definition: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender.
Also known as: Failure to thrive in infant or child | failure to gain weight | failure to thrive NOS | FTT - [failure to thrive] syndrome
Excludes: Failure to thrive in newborn | Anorexia Nervosa | Avoidant-restrictive food intake disorder
[5B80.0Z] Overweight, unspecified
Also known as: Overweight, unspecified | Overweight
[JA65.2] Excessive weight gain in pregnancy
Definition: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy.
Also known as: Excessive weight gain in pregnancy | excessive weight gain in pregnancy, unspecified trimester | maternal obesity syndrome | maternal obesity without hypertension | abnormal weight gain in pregnancy
Excludes: Gestational oedema without hypertension
[MB20.1] Coma
Definition: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Motor responses to noxious stimulation are limited to reflexive behaviour. Etiologies include but are not limited to traumatic, anoxic, infectious, neoplastic, vascular, inflammatory and metabolic brain injuries.
Also known as: Coma | comatose | exanimation | Coma, NOS | Unconsciousness, NOS
Excludes: Diabetic coma | Hepatic coma | Neonatal coma
[8E7Y] Other specified diseases of the nervous system
Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis
[LA05.Z] Cerebral structural developmental anomalies, unspecified
Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS
[1D00.Z] Infectious encephalitis, unspecified
Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation
[LA00.0Z] Anencephaly, unspecified
Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence
=== GRAPH WALKS ===
--- Walk 1 ---
[MG43.5] Excessive weight loss
Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health....
--PARENT--> [MG43] Symptoms or signs concerning food or fluid intake
Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f...
--EXCLUDES--> [?] Feeding or eating disorders
Def: Feeding and Eating Disorders involve abnormal eating or feeding behaviours that are not explained by another health condition and are not developmentally appropriate or culturally sanctioned. Feeding ...
--- Walk 2 ---
[MG43.5] Excessive weight loss
Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health....
--PARENT--> [MG43] Symptoms or signs concerning food or fluid intake
Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f...
--CHILD--> [MG43.0] Polydipsia
--- Walk 3 ---
[MG43.6] Excessive weight gain
Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit...
--EXCLUDES--> [?] Obesity
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--> [?] Obesity hypoventilation syndrome
Def: Obesity hypoventilation syndrome is characterised by obesity (in adults, Body-Mass-Index > 30 kg/m²) and daytime hypercapnia indicated by arterial partial pressure of carbon dioxide (PaCO2) > 45 mm Hg...
--- Walk 4 ---
[MG43.6] Excessive weight gain
Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit...
--RELATED_TO--> [?] Excessive weight gain in pregnancy
Def: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy....
--PARENT--> [?] Maternal care for other conditions predominantly related to pregnancy
Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....
--- Walk 5 ---
[MG44.11] Failure to thrive in infant or child
Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....
--EXCLUDES--> [?] Failure to thrive in newborn
Def: When newborn’s current weight or rate of weight gain is significantly below that of other newborns of similar age and gender....
--PARENT--> [?] Feeding problems of newborn
Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn....
--- Walk 6 ---
[MG44.11] Failure to thrive in infant or child
Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....
--EXCLUDES--> [?] Failure to thrive in newborn
Def: When newborn’s current weight or rate of weight gain is significantly below that of other newborns of similar age and gender....
--PARENT--> [?] Feeding problems of newborn
Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn....
|
[
"[MG43.5] Excessive weight loss\n Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health....\n --PARENT--> [MG43] Symptoms or signs concerning food or fluid intake\n Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f...\n --EXCLUDES--> [?] Feeding or eating disorders\n Def: Feeding and Eating Disorders involve abnormal eating or feeding behaviours that are not explained by another health condition and are not developmentally appropriate or culturally sanctioned. Feeding ...",
"[MG43.5] Excessive weight loss\n Def: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health....\n --PARENT--> [MG43] Symptoms or signs concerning food or fluid intake\n Def: Symptoms or signs concerning food and fluid intake include anorexia, polydipsia, polyphagia, feeding difficulties or mismanagement, abnormal weight loss, abnormal weight gain, insufficient intake of f...\n --CHILD--> [MG43.0] Polydipsia",
"[MG43.6] Excessive weight gain\n Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit...\n --EXCLUDES--> [?] Obesity\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--> [?] Obesity hypoventilation syndrome\n Def: Obesity hypoventilation syndrome is characterised by obesity (in adults, Body-Mass-Index > 30 kg/m²) and daytime hypercapnia indicated by arterial partial pressure of carbon dioxide (PaCO2) > 45 mm Hg...",
"[MG43.6] Excessive weight gain\n Def: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantit...\n --RELATED_TO--> [?] Excessive weight gain in pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy....\n --PARENT--> [?] Maternal care for other conditions predominantly related to pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....",
"[MG44.11] Failure to thrive in infant or child\n Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....\n --EXCLUDES--> [?] Failure to thrive in newborn\n Def: When newborn’s current weight or rate of weight gain is significantly below that of other newborns of similar age and gender....\n --PARENT--> [?] Feeding problems of newborn\n Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn....",
"[MG44.11] Failure to thrive in infant or child\n Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....\n --EXCLUDES--> [?] Failure to thrive in newborn\n Def: When newborn’s current weight or rate of weight gain is significantly below that of other newborns of similar age and gender....\n --PARENT--> [?] Feeding problems of newborn\n Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn...."
] |
MG43.5
|
Excessive weight loss
|
[
{
"from_icd11": "MG43.5",
"icd10_code": "R634",
"icd10_title": "Abnormal weight loss"
},
{
"from_icd11": "MG43.6",
"icd10_code": "R635",
"icd10_title": "Abnormal weight gain"
},
{
"from_icd11": "5B80.0Z",
"icd10_code": "E669",
"icd10_title": "Obesity, unspecified"
},
{
"from_icd11": "JA65.2",
"icd10_code": "O2603",
"icd10_title": "Excessive weight gain in pregnancy, third trimester"
},
{
"from_icd11": "JA65.2",
"icd10_code": "O2601",
"icd10_title": "Excessive weight gain in pregnancy, first trimester"
},
{
"from_icd11": "JA65.2",
"icd10_code": "O2602",
"icd10_title": "Excessive weight gain in pregnancy, second trimester"
},
{
"from_icd11": "JA65.2",
"icd10_code": "O260",
"icd10_title": "Excessive weight gain in pregnancy"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402142",
"icd10_title": "Coma scale, eyes open, spontaneous, at arrival to emergency department"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402362",
"icd10_title": "Coma scale, best motor response, obeys commands, at arrival to emergency department"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402252",
"icd10_title": "Coma scale, best verbal response, oriented, at arrival to emergency department"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402412",
"icd10_title": "Glasgow coma scale score 13-15, at arrival to emergency department"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R4020",
"icd10_title": "Unspecified coma"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402141",
"icd10_title": "Coma scale, eyes open, spontaneous, in the field [EMT or ambulance]"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402361",
"icd10_title": "Coma scale, best motor response, obeys commands, in the field [EMT or ambulance]"
},
{
"from_icd11": "MB20.1",
"icd10_code": "R402251",
"icd10_title": "Coma scale, best verbal response, oriented, in the field [EMT or ambulance]"
}
] |
R634
|
Abnormal weight loss
|
A 57-year-old male was admitted to the General Internal Medicine Department of Padova University Hospital for acute massive haematoma of the left lower extremity associated with macrohaematuria. The patient reported no family or personal history of spontaneous bleeding and haemorrhagic complications, and he was taking no medications at the time of admission. A physical examination confirmed a large haematoma in the left leg and calf extending to the entire limb. A complete blood count revealed only mild normocytic anaemia (haemoglobin 9.3 g/dl; mean corpuscular volume 82.7 fl), with normal leukocytes and platelet count (6.65 × 10 9 /L and 232 × 10 9 /L, respectively). Coagulation parameters at time of admission, performed with fresh citrate plasma, revealed a prolongation of prothrombin time (PT) (21.4 s, n.v. 9.5–13.8), activated partial thromboplastin time (aPTT) (52 s, n.v. 22–32), thrombin time (TT) (34.2 s, n.v. <21) and reptilase time (RT) (60 s, n.v. <21). PT, aPTT and TT were corrected with mixing tests after incubation for two hours (PT mixing test 10.2 s, aPTT mixing test 26 s, and TT mixing test 16 s). The Clauss fibrinogen assay revealed that fibrinogen level, antigen level and activity were 46 mg/dl (n.v. 150–450), 0.70 g/L (n.v. 1.5–4.5) and 26% (n.v. 80–120), respectively. Antithrombin (87%) and von Willebrand factor (vWF:Ag 105 UI/dL) levels, as well as intrinsic (FXII 94%, FXI 113%, FIX 107%, FVIII 92%), extrinsic (FVII 101%) and common (FX 108%, FII 97%) factors of blood coagulation were all within the normal range. Moreover, plasminogen (106%) and α2-antiplasmin (99%) were normal. We used multiple electrode aggregometry (Multiplate® analyzer, Roche Diagnostics, Rotkreuz, Switzerland) to assess platelet function in whole blood, and rotational thromboelastometry (ROTEM® apparatus, Werfen, Bedford, MA, USA) to assess clot formation, strength and lysis in whole blood. In our patient, platelet function was within the normal range and the thromboelastometry profile was compatible with severe hypofibrinogenemia without hyperfibrinolysis . In particular, FIBTEM assay which evaluates the contribution of fibrinogen to blood clotting after inhibition of platelet aggregation by cytochalasin D, showed markedly prolonged clotting time (CT 321 s; normal range 38–62 s) which corresponds to the initiation phase of the clotting process; and significantly reduced maximum clot firmness (A10 3 mm; MCF 5 mm, normal range 9–25 mm) which is the maximum amplitude reached in the thromboelastogram. Thrombin generation (ST Genesia, Diagnostica Stago, Asnières-sur-Seine, France) measured in platelet poor plasma showed increased endogenous thrombin potential (ETP 1.31 nM*min, reference range 1.03–1.25). Due to the persistently elevated (mean ± standard deviation) D-dimer levels (2,455 ± 3,467 µg/L, peak 11.701 µg/L, n.v. <250) during hospitalization, the patient underwent venous Doppler ultrasound on the upper and lower extremities which excluded the presence of deep venous thrombosis in both the proximal and distal circulations. Furthermore, a chest computer tomography (CT) scan with and without contrast medium excluded the presence of signs indicative of pulmonary embolism. The results of serum protein electrophoresis were normal, thus excluding the presence of monoclonal gammopathy; Bence-Jones protein was negative. Finally, liver function tests were normal: alanine aminotransferase (ALT) 44 U, n.v. 10–50; aspartate aminotransferase (AST) 25 U, n.v. 10–45; coagulation factor V 105%, n.v. 80–120; albumin 41 g/L, n.v. 35–55; and no underlying infection was detected. The patient was initiated on tranexamic acid 1,000 mg intravenous (Lusofarmaco, Milan, Italy) three times daily and human fibrinogen concentrate (RiaSTAP®, CSL Behring GmbH, Marburg, Germany) 50 mg/kg body weight once daily (tot. 3 gr per day). We observed no improvement of the bleeding symptoms within 5 days of the initiation of fibrinogen replacement therapy at a dosage of 3 gr per day. In particular, two new haematomas appeared on the skin of the back (12 cm and 8 cm in diameter, respectively) and mild haematuria persisted. After administering RiaSTAP®, we observed a rapid increase in plasma fibrinogen levels, albeit followed immediately by a rapid decrease . Given that the chest x-rays findings at the time of admission showed a widening of the mediastinum, especially towards the left with blurring and poor recognition of the aortic profile, the patient underwent a positron emission tomography–magnetic resonance imaging (PET-MRI) scan that showed pathological F-fluorodeoxyglucose (FDG) uptake (maximum standardised uptake value, SUV Max 19) in adrenal glands (left 74 × 90 mm, right 65 × 35 mm), a bulky lesion in the superior-anterior mediastinum (10 cm × 5 cm with a SUV Max 19) and in one right inguinal lymph node (SUV Max 5.2) . Immediately after fibrinogen supplementation, a biopsy of the anterior mediastinum showed a population of immature T-lineage cells, consistent with early T-precursor (ETP) lymphoblastic leukaemia/lymphoma (blasts expressed CD3, CD4, CD7, CD117 and lacked CD2, CD1a, CD5, CD8, CD10, CD20, CD30, CD33, CD34, TdT, with a MIB1 70%–80%) . Bone marrow biopsy was negative for immature cells. This diagnosis prompted admission to the Haematology Unit wherein the patient underwent a lineage-targeted risk-oriented chemotherapy regimen with 5 anti-ALL drugs: induction with vincristine, idarubicin, dexamethasone, cyclophosphamide and pegylated asparaginase according to standard protocols. Pegylated asparaginase was not administered initially due to low plasma fibrinogen levels. The coagulopathy subsided subsequently with normal fibrinogen activity restored a few days after the initiation of induction chemotherapy . No toxicity related to pegylated asparaginase was observed. The patient tolerated post-induction chemotherapy without any further bleeding symptoms or evidence of hypofibrinogenemia. Notably, plasma fibrinogen levels remained consistently within the normal range 6 months after initiating chemotherapy concomitantly with clinical remission of the haematological malignancy.
| 4.261719
| 0.753906
|
sec[1]/p[0]
|
en
| 0.999995
|
38259312
|
https://doi.org/10.3389/fcvm.2023.1335296
|
[
"fibrinogen",
"time",
"range",
"blood",
"platelet",
"plasma",
"mixing",
"within",
"which",
"chemotherapy"
] |
[
{
"code": "3B14.0",
"title": "Hereditary deficiency of factor I"
},
{
"code": "PL13.52",
"title": "Incorrect timing of drug or medicament, as mode of injury"
},
{
"code": "QF2A",
"title": "Difficulty or need for assistance with community participation"
},
{
"code": "MF50.1",
"title": "Pollakiuria"
},
{
"code": "JA25.3",
"title": "Eclampsia, time period unspecified"
},
{
"code": "KD3B.Z",
"title": "Unspecified time of fetal death, cause not specified"
},
{
"code": "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"
}
] |
=== ICD-11 CODES FOUND ===
[3B14.0] Hereditary deficiency of factor I
Definition: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen. Afibrinogenaemia (complete absence of fibrinogen) and hypofibrinogenaemia (reduced plasma fibrinogen concentration) correspond to quantitative anomalies of fibrinogen while dysfibrinogenaemia corresponds to a functional anomaly of fibrinogen. Hypo- and dysfibrinogenaemia may be frequently combined
Also known as: Hereditary deficiency of factor I | Deficiency of factor 1 | Hereditary fibrinogen deficiency | Deficiency of fibrinogen | congenital fibrinogenopenia
[PL13.52] Incorrect timing of drug or medicament, as mode of injury
Also known as: Incorrect timing of drug or medicament, as mode of injury | wrong timing of drug | timing error in giving drug | timing mistake in administration of drug | administration error involving timing of drug
Excludes: Problem with delayed treatment | Overdose of substance, as mode of injury or harm
[QF2A] Difficulty or need for assistance with community participation
Also known as: Difficulty or need for assistance with community participation | difficulty with community participation | need for assistance with community participation | need for assistance with community, social and civic life | difficulty with community, social and civic life
Includes: Lack of relaxation or leisure
[MF50.1] Pollakiuria
Also known as: Pollakiuria | pollakisuria | Daytime frequency of micturition
[JA25.3] Eclampsia, time period unspecified
Definition: Onset of convulsions in a woman with pre-eclampsia not attributable to other causes without a specific onset time.
Also known as: Eclampsia, time period unspecified | Eclampsia NOS | eclamptic coma | eclamptic toxaemia | toxaemia with convulsions
[KD3B.Z] Unspecified time of fetal death, cause not specified
Also known as: Unspecified time of fetal death, cause not specified | Fetal death, cause not specified | stillbirth NOS | stillborn NOS | intrauterine fetal demise
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[3B14.0] Hereditary deficiency of factor I
Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....
--PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency
Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...
--PARENT--> [?] 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 2 ---
[3B14.0] Hereditary deficiency of factor I
Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....
--PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency
Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...
--CHILD--> [3B14.2] Combined deficiency of vitamin K-dependent clotting factors
Def: Hereditary combined vitamin K-dependent clotting factors deficiency (VKCFD) is a congenital bleeding disorder resulting from variably decreased levels of coagulation factors II, VII, IX and X, as well...
--- Walk 3 ---
[PL13.52] Incorrect timing of drug or medicament, as mode of injury
--EXCLUDES--> [?] Delayed treatment
--EXCLUDES--> [?] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--- Walk 4 ---
[PL13.52] Incorrect timing of drug or medicament, as mode of injury
--EXCLUDES--> [?] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--EXCLUDES--> [?] Intentional self-harm by exposure to or harmful effects of drugs, medicaments or biological substances
--- Walk 5 ---
[QF2A] Difficulty or need for assistance with community participation
--PARENT--> [?] Difficulty or need for assistance with activities
Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....
--CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management
--- Walk 6 ---
[QF2A] Difficulty or need for assistance with community participation
--PARENT--> [?] Difficulty or need for assistance with activities
Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....
--EXCLUDES--> [?] Dependence on enabling machines or devices
|
[
"[3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --PARENT--> [?] 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...",
"[3B14.0] Hereditary deficiency of factor I\n Def: Congenital deficiencies of fibrinogen are coagulation disorders characterised by bleeding symptoms ranging from mild to severe resulting from reduced quantity and/or quality of circulating fibrinogen....\n --PARENT--> [3B14] Other inherited coagulation factor deficiency with bleeding tendency\n Def: Any disease caused by genetically inherited mutations leading to lack of coagulation factors in the blood not elsewhere classified. These diseases are characterised by increased haemorrhaging and brui...\n --CHILD--> [3B14.2] Combined deficiency of vitamin K-dependent clotting factors\n Def: Hereditary combined vitamin K-dependent clotting factors deficiency (VKCFD) is a congenital bleeding disorder resulting from variably decreased levels of coagulation factors II, VII, IX and X, as well...",
"[PL13.52] Incorrect timing of drug or medicament, as mode of injury\n --EXCLUDES--> [?] Delayed treatment\n --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...",
"[PL13.52] Incorrect timing of drug or medicament, as mode of injury\n --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...\n --EXCLUDES--> [?] Intentional self-harm by exposure to or harmful effects of drugs, medicaments or biological substances",
"[QF2A] Difficulty or need for assistance with community participation\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management",
"[QF2A] Difficulty or need for assistance with community participation\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --EXCLUDES--> [?] Dependence on enabling machines or devices"
] |
3B14.0
|
Hereditary deficiency of factor I
|
[
{
"from_icd11": "3B14.0",
"icd10_code": "D682",
"icd10_title": "Hereditary deficiency of other clotting factors"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z7389",
"icd10_title": "Other problems related to life management difficulty"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z7382",
"icd10_title": "Dual sensory impairment"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z73",
"icd10_title": "Problems related to life management difficulty"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z732",
"icd10_title": "Lack of relaxation and leisure"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z738",
"icd10_title": "Other problems related to life management difficulty"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z739",
"icd10_title": "Problem related to life management difficulty, unspecified"
},
{
"from_icd11": "MF50.1",
"icd10_code": "R351",
"icd10_title": "Nocturia"
},
{
"from_icd11": "MF50.1",
"icd10_code": "R358",
"icd10_title": "Other polyuria"
},
{
"from_icd11": "MF50.1",
"icd10_code": "R35",
"icd10_title": "Polyuria"
},
{
"from_icd11": "JA25.3",
"icd10_code": "O159",
"icd10_title": "Eclampsia, unspecified as to time period"
},
{
"from_icd11": "KD3B.Z",
"icd10_code": "P95",
"icd10_title": "Stillbirth"
},
{
"from_icd11": "3B63.1Z",
"icd10_code": "D473",
"icd10_title": "Essential (hemorrhagic) thrombocythemia"
},
{
"from_icd11": "MA14.1C",
"icd10_code": "R760",
"icd10_title": "Raised antibody titer"
}
] |
D682
|
Hereditary deficiency of other clotting factors
|
Regarding the clinical manifestations, our patient showed an increase in proteinuria with the disproportion between her UACR and UPCR associated with AKI, and the results of the immunological study (viral serology, autoimmunity study, paraproteinemia, etc.) initially did not allow us to discard the presence of an overlapping systemic autoimmune disease such as SLE on SS versus MGRS. However, the patient did not meet the criteria according to the 2019 EULAR/ACR classification for SLE , and the IF on her RB reasonably discarded lupus nephritis (no full house staining, no strong staining for C1q). As for other drug-related nephrotoxicities apart from DIP, her usual medication, as well as HCQ, have not been associated with secondary NM, and the tubulo-interstitial involvement was too scarce and non-specific to suggest drug-related tubulo-interstitial nephritis. Our view is that the fact that the patient had SS is not related to her renal involvement or to the development of renal PLD. First, our patient was diagnosed with SS with positivity for anti-centromere antibodies and ANA, which is less related to renal involvement; there was no involvement of other organs such as the lungs or heart; and there was no suspicion of scleroderma renal crisis (SRC) in the absence of hypertension and vascular involvement in the RB . We could not to find any association between DIP, SS and GMSR in the literature, so we think that their relationship has a casual rather than causal effect. However, paraneoplastic scleroderma-like disorders, which have been described in the context of certain plasma cell dyscrasias, could not be discarded as a possible association with MGRS . Therefore, after the diagnosis of MGRS, a chemotherapy treatment directed at the pathological clone was initiated, without clinical or analytical improvement. Despite this, our patient presented with other more than notable respiratory complications. The renal and extra-renal complications of autoimmune or onco-hematologic diseases can be triggered by poor control of the disease or be related to its treatment. In our case report, the ultrastructural study of the patient’s EM showed findings of renal PLD, a disease characterized by abnormal lipid storage. Some cases of AKI by renal PLD induced by CADs have been described , but, in general, there is no clear association between renal PLD and negative consequences for renal function . It is important to mention that the patient’s GFR remained stable while she was taking amiodarone, which she had since 2016, and only worsened 4 weeks after initiating the treatment with HCQ. The functional consequence of renal PLD and its association with toxicity are still poorly understood . CADs (i.e., amiodarone, chloroquine and aminoglycosides) are the main causes of PLD . To date, 13 cases of chloroquine or HCQ-induced renal PLD have been reported in the literature, most of them in the context of autoimmune diseases such as systemic lupus erythematosus and Sjogren’s syndrome . All cases occurred in women with an age range between 14 and 70 years. A total of 76% of the cases received HCQ at an average dose of 400 mg/day, while the rest of the cases received chloroquine . The data agree with the clinical history of our patient. However, reported cases of amiodarone-induced renal PLD are rare; Pintavorn et al. reported one case of a 71-year-old African American woman with CKD (SCr 1.6 mg/dL) who began treatment with amiodarone for a cardiac arrhythmia diagnosed 4 months earlier during a hospital admission for interstitial pneumonia of unknown etiology. The analysis highlighted a significant AKI (SCr 3.5 mg/dL), so an RB was performed, in which the presence of ZBs was evident in the ultrastructural study. Given the suspicion of FD, an enzymatic and genetic study of α-GLA was carried out, finding no mutations associated with this disease. The patient did not have symptoms nor a family history of FD, except for the presence of cornea verticillata. During questioning, it was discovered that the patient had been mistakenly taking a high dose of amiodarone. The final diagnosis was amiodarone-associated renal and corneal PLD mimicking FD. After the discontinuation of amiodarone after 3 months, her SCr improved to 2.4 mg/dL. A study in male rats treated with amiodarone for weeks observed the accumulation of PLs in lung, kidney and skeletal muscle, and, in the long term, in other organs such as the heart, observing a significant correlation between increased phospholipids and decreased thyroid function due to amiodarone . Amiodarone has been shown to be a phospholipase A1 and A2 inhibitor, by inhibiting the electrostatic charge interactions between hydrolase and anionic phospholipids . Oikawa et al. reported the case of an 85-year-old male with liver cirrhosis under treatment with therapeutic doses of amiodarone and whose liver biopsy showed numerous lysosomes with dense lamellar inclusions. The discontinuation of amiodarone led to a slight improvement in his serum aminotransferase levels. However, to date, there are no cases of renal PLD induced by the combination of amiodarone and HCQ, except for our case report. There are some things that are not clear in our patient; one of them is the exposure time for the development of renal PLD induced by HCQ. Most case reports refer to several years of exposure, while in the case of amiodarone, the case described by Pintavorn et al. mentions short times and high doses, data that do not agree with our patient, who was treated with amiodarone for a long period and, on the contrary, with HCQ for a short time (only 4 weeks before the onset of kidney disease intervention). It is difficult to be sure that the synergism of both CADs (HCQ and amiodarone) is the cause of the formation of MBs/ZBs/LBs or, on the contrary, whether it is only in relation to amiodarone. We hypothesize that both CADs may have reached high concentrations within the lysosome, inhibiting phospholipase at concentrations significantly higher than those associated with their therapeutic activity, promoting the formation of inclusions in the kidney tissue.
| 4.261719
| 0.869141
|
sec[2]/p[2]
|
en
| 0.999996
|
38804381
|
https://doi.org/10.3390/medsci12020025
|
[
"amiodarone",
"renal",
"that",
"cases",
"associated",
"related",
"involvement",
"induced",
"however",
"which"
] |
[
{
"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 ...
--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 ---
[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 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--> [LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or 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--> [NB92.00] Contusion of kidney, minor
--- Walk 6 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--PARENT--> [NB92] Injury of urinary or pelvic organs
|
[
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --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....",
"[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",
"[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--> [LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or 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--> [NB92.00] Contusion of kidney, minor",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --PARENT--> [NB92] Injury of urinary or pelvic organs"
] |
GC2Z&XA6KU8
|
Disease of kidney, not elsewhere classified
|
[
{
"from_icd11": "GB6Z",
"icd10_code": "N19",
"icd10_title": "Unspecified kidney failure"
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17-N19",
"icd10_title": ""
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17",
"icd10_title": "Acute kidney failure"
},
{
"from_icd11": "LB30.1",
"icd10_code": "Q614",
"icd10_title": "Renal dysplasia"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q632",
"icd10_title": "Ectopic kidney"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q63",
"icd10_title": "Other congenital malformations of kidney"
},
{
"from_icd11": "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 20-year-old man was diagnosed with acute B-lymphocytic leukemia in June 2016. The bone marrow morphology studies indicated that the disease had been in remission after the induction therapy provided on July 5, 2016, while the flow cytometry results remained positive. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) was performed on November 3, 2016, with his elder sister as the fully human leukocyte antigen (HLA) 10/10- and blood type A-matched sibling donor. Leukocytes and platelets were successfully implanted at days +14. The implantation survival identification at days +28 was as follows: morphology in remission, negative flow cytometry results, complete donor type in the bone marrow, and peripheral blood chimerism. The re-examination of the bone marrow morphology in November 2017 showed the presence of 15% naïve lymphocytes, suggesting hematological relapse. Positron emission tomography/computed tomography (PET/CT) showed extramedullary relapse. After fluorine pyrimidine and carboplatin regimen chemotherapy, the re-examination showed bone marrow remission, without abnormalities in the cerebrospinal fluid. On January 3, 2018, 1 × 10 5 /kg of CD19-chimeric antigen receptor T-cell immunotherapy cells were re-infused into the patient, and the re-examination showed bone marrow remission. The bone marrow and cerebrospinal fluid of the patient continued to be in remission after re-infusion of 2 × 10 5 /kg of CD22-chimeric antigen receptor T-cell immunotherapy cells on July 10, 2018. The patient presented a small nodule on the left foot sole without pain or local erythema, in December 2019. Pathological biopsy of the plantar mass revealed a small round cell malignancy, considered to be leukemic cell infiltration. Flow cytometry showed that 88.43% of the analyzable CD19+/CD45- cells were naïve B lymphocytes with abnormal phenotypes, expressing CD34, CD10bright, CD22, CD81dim, CD58, and HLA-DR. In January 2020, PET–CT re-examination suggested multiple extramedullary leukemic infiltrates, and CD22 monoclonal antibody was successively administered twice. On May 6, 2020, PET–CT of the lower extremities showed incomplete remission of extramedullary lesions. A second allo-HSCT was initiated on May 9, 2020, with a haploidentical HLA 6/10-matched maternal donor and donor and recipient blood types O and A, respectively. The pretreatment protocol was cytarabine/fludarabine/thiotepa/anti-thymus immunoglobulin/ N -(2-chloroethyl)- N ′-(4-methylcyclohexyl)- N -nitrosourea, and the procedure went well. Leukocytes and platelets were viable at days +11 and +16, respectively. The re-examination by bone marrow puncture biopsy 1 month after the transplantation revealed that the primary disease was relieved, and bone marrow and peripheral blood were of full donor chimera. The re-examination 2 months after the transplantation showed complete remission of the bone marrow and cerebrospinal fluid. PET–CT showed that the extensive multiple hypermetabolic foci in both lower extremities and feet had partially reduced compared with those in the previous examination. Considering that the leukemic infiltrate-related results had partially improved and the residual tumor metabolic activity was still significant, local radiotherapy was provided to the lower legs and soles of the feet. In mid-November 2020 (+6 months after transplantation), a follow-up visit at another hospital showed hyperthermia without any obvious cause, with cough but without phlegm. The maximum temperature was 39.8 °C, and the minimum blood oxygen saturation was 85%. No positive signs were found on the chest during physical examination. The results of the routine blood tests were as follows: white blood cell count, 7.8 × 10 9 /L; neutrophil count, 5.68 × 10 9 /L; lymphocyte count, 1.06 × 10 9 /L; C-reactive protein, 268.69 mg/L (reference range: 0–10); and procalcitonin, 0.35 ng/mL (reference range: 0–0.07). The results of the G-test, GM-test, and TSPOT, as well as those of the tests for Mycoplasma pneumoniae antibody Immunoglobulin M (IgM), Chlamydia pneumoniae antibody IgM, influenza A virus antibody IgM, influenza B virus antibody IgM, parainfluenza virus antibody IgM, respiratory syncytial virus and influenza virus antibody IgM, adenovirus antibody IgM, coxsackie B virus antibody IgM, Legionella pneumophila antibody IgM, novel coronavirus antibody IgM, novel coronavirus antibody IgG, peripheral blood Epstein-Barr virus, cytomegalovirus virus, and novel coronavirus nucleic acid copy number, were negative. A mass shadow could be detected on the chest CT . No positive pathogens were detected by metagenomic next-generation sequencing (mNGS, DNA+RNA) in the peripheral blood specimens. The pharyngeal swab mNGS detected 10 Streptococcus pneumoniae -specific sequences, 2 Enterococcus faecalis -specific sequences, and 3 Aspergillus flavus -specific sequences and common upper respiratory flora in the DNA library; in the RNA library, 28,636 HCoV-NL63-specific sequences and common respiratory flora were detected. The coverage of HCoV-NL63 was 96.4%, the average depth was 75.8X, and the relative abundance was 99.4%, which satisfied the quality control requirements, and the test results were in full agreement with the clinical features. The final diagnosis was established as HCoV-NL63 viral pneumonia. Intravenous infusion of foscarnet sodium 60 mg/kg q12 h and methylprednisolone 40 mg qd, as well as oral antiviral therapy with Arbidol 200 mg tid, were administered, with gradual reduction after 7 days. Furthermore, gamma globulin 0.4 g/kg was administered for 5 days as an immunoregulatory therapy . As a result, the symptoms of the patient improved significantly: the body temperature decreased to normal, no fever peak appeared, and blood oxygen was stably maintained at 97% to 99% without nasal cannula oxygenation. The chest CT showed significant and slightly more resorbed lesions than before . Multiple re-examinations of cytokines during the onset and treatment period showed that as the body temperature decreased, the cough symptoms improved. The patient showed improvement and was discharged.
| 4.183594
| 0.963379
|
sec[1]/p[0]
|
en
| 0.999997
|
34160438
|
https://doi.org/10.1097/MD.0000000000026446
|
[
"antibody",
"blood",
"bone",
"marrow",
"virus",
"remission",
"that",
"cell",
"donor",
"without"
] |
[
{
"code": "JA86.Y",
"title": "Maternal care for other specified fetal problems"
},
{
"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": "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 ===
[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
[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
[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 ---
[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....
--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 ---
[MA14.14] Anti-nuclear antibody positive
--PARENT--> [MA14.1] Certain specified immunological findings
--PARENT--> [MA14] Immunological findings in blood, blood-forming organs, or the immune system
--- Walk 4 ---
[MA14.14] Anti-nuclear antibody positive
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.12] Anticitrullinated protein antibody positive
--- Walk 5 ---
[MA14.13] Anti-nuclear antibody negative
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.10] Abnormal reaction to tuberculin test
--- Walk 6 ---
[MA14.13] Anti-nuclear antibody negative
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.10] Abnormal reaction to tuberculin test
|
[
"[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 --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...",
"[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --PARENT--> [MA14] Immunological findings in blood, blood-forming organs, or the immune system",
"[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.12] Anticitrullinated protein antibody positive",
"[MA14.13] Anti-nuclear antibody negative\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.10] Abnormal reaction to tuberculin test",
"[MA14.13] Anti-nuclear antibody negative\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.10] Abnormal reaction to tuberculin test"
] |
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": "JA86.0",
"icd10_code": "O360930",
"icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360920",
"icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360130",
"icd10_title": "Maternal care for anti-D [Rh] antibodies, third trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360932",
"icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, fetus 2"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360922",
"icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, fetus 2"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360990",
"icd10_title": "Maternal care for other rhesus isoimmunization, unspecified trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360110",
"icd10_title": "Maternal care for anti-D [Rh] antibodies, first trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360120",
"icd10_title": "Maternal care for anti-D [Rh] antibodies, second trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360910",
"icd10_title": "Maternal care for other rhesus isoimmunization, first trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360",
"icd10_title": "Maternal care for rhesus isoimmunization"
},
{
"from_icd11": "MA14.1C",
"icd10_code": "R760",
"icd10_title": "Raised antibody titer"
}
] |
O26841
| |
The neurologic manifestations of B 12 deficiency, including myelopathy, neuropathy, dementia , and rarely cerebellar ataxia and movement disorders, are difficult to diagnose. In fact, the neurological abnormalities caused by cobalamin deficiency could take place without any hematological or gastrointestinal context , and in the absence of anemia or an elevated mean cell volume . The severity of neurological complications may be reversed only by an early treatment after onset, so a timely diagnosis is important. Despite the rapid correction of vitamin B 12 levels by prompt therapy and early clinical improvement, the recovery of polyneuropathy on nerve conduction could be slow. Deficiency of vitamin B 12 , mostly in vegetarians was found to be associated with depression and adverse neurological function. Berkins points out that the dietary intake of vitamin B 12 and vitamin B 6 might have an effect on brain structure. Ralapanawa et al. reported a strict vegetarian 66-year-old female case with demyelinating polyneuropathy without features of anemia (Hb concentration of 12.1 g/dL, RBCs count of 4.39/mm 3 , MCV of 83.3 fL), but very low serum vitamin B 12 levels (84.90 pg/mL reference range 208–963 pg/mL). To reverse neurological manifestations, after three months of therapy with intramuscular hydroxycobalamine 1000 μg for seven days, weekly for six weeks and thereafter three monthly, the patient showed clinical improvement, with repeated B 12 levels being elevated up to 308.6 pg/mL. At one- and three-year follow up for nerve conduction study previously absent, early clinical improvement was demonstrated, with a slow recovery of polyneuropathy on nerve conduction studies. Even though vitamin B 12 deficiency neuropathy is a rare debilitating disease that affects mostly the elderly, young adults with neuropathic symptoms warrant a high index of suspicion. The cause of neurological symptoms resulting from vitamin B 12 deficiency could be due to the role of methylcobalamin in myelin synthesis. The lack of cobalamin could induce the destruction of myelin sheaths or incorporation of abnormal fatty acids in myelin sheaths, thus leading to impaired neural function and/or transmission. The diagnosis of Vitamin B 12 deficiency is challenging in resource limited-settings due to limited access to diagnostic tools and unfamiliarity with the disease, owing to its rarity especially in young people. This is the case reported by Ekabe et al. . A 28-year-old sub-Saharan female, presenting peripheral neuropathic symptoms, was treated with oral vitamin B 12 tablets at doses of 2 mg per day for three months. A diagnosis of vitamin B 12 deficiency related peripheral neuropathy was made based on her symptoms, ovalo-macrocytosis and hyper-segmented neutrophils on peripheral blood smear. After one month of therapy, an improvement in neurological symptoms was recorded. The authors highlighted the pivotal role of basic investigations like peripheral blood smear for the timely detection and management of vitamin B 12 associated neurological disease in resource-limited settings. A case of sub-acute combined degeneration (SCD), the most common neurological disorder, in a 33-year-old woman without anemia or macrocytosis leading was diagnosed by Maamar et al. as suspected vitamin B 12 deficiency, subsequently confirmed by a low serum cobalamin. First investigations revealed Hb 12.1 g/100 mL, MCV 91 fL, other biochemical parameters were within normal limits, while magnetic resonance (MR) imaging of the spine revealed intramedullary hyperintensity in the posterior column of the cervico-dorsal spinal cord, highly suggestive of subacute combined degeneration (SCD). In fact, the patient’s vitamin B 12 serum level was low (30 pg/mL; reference range 200–700 pg/mL) while serum folate was within the normal range (26 ng/mL; reference range 18–30 ng/mL). Intramuscular administration of B 12 resulted in correction of the neurological signs (paresthesis and sphincter disorders). At a seven-year follow-up, while still receiving intramuscular vitamin B 12 monthly, the patient was found to be functionally independent with no neurological deficits. Early spinal MR imaging could support the early diagnosis of SCD of the spinal cord due to Vitamin B 12 deficiency as reported in the case of a 57-year-old man by Senol et al. . Following clinical and laboratory examinations, the patient was evaluated as cervical myelopathy due to Vitamin B 12 deficiency (60 pg/mL (reference range 189–883 pg/mL). The symptoms totally disappeared two months after intramuscular supplementation of vitamin B 12 and the MR imaging abnormalities significantly improved. The same diagnosis of SCD was considered and confirmed by laboratory findings in a 56-year-old man by Srikanth et al. . The patient presented an acute onset of paresthesia involving both hands and feet of 15 days duration, difficulty in walking, and inability to feel the ground for the same period. Neurological examination revealed impairment of sensation of fine touch, pinprick, joint position, and vibration in both hands and feet bilaterally. All the deep tendon reflexes were exaggerated, more so in the lower limbs, with no evidence of motor weakness. Gastric endoscopy and biopsy revealed changes of atrophic gastritis and folic acid and vitamin B 12 levels in the serum were 7 micrograms and 75 picograms, respectively. Cervical MR image findings were consistent with SCD. MR imaging lesion was completely resolved treating the patient with parenteral administration of vitamin B 12 and oral folic acid. In summary, SCD is clinically characterized by predominant involvement of the dorsal columns and the lateral columns of the spinal cord, resulting in sensory deficits, paresthesia, weakness, ataxia, and gait disturbance. In some patients, MR imaging shows abnormalities of the spinal cord, indicating demyelination of the posterior column. Early diagnosis and treatment play an important role in the reversibility of neurological deficits. Delayed treatment results in irreversible disabling neurological impairment, such as spasticity and paraplegia.
| 4.457031
| 0.541504
|
sec[2]/p[0]
|
en
| 0.999997
|
34575856
|
https://doi.org/10.3390/ijms22189694
|
[
"vitamin",
"neurological",
"deficiency",
"serum",
"range",
"imaging",
"spinal",
"improvement",
"reference",
"three"
] |
[
{
"code": "5B7Z",
"title": "Unspecified undernutrition"
},
{
"code": "5B90.Z",
"title": "Unspecified vitamin excesses"
},
{
"code": "5B55.Z",
"title": "Vitamin A deficiency, unspecified"
},
{
"code": "6C4H.1Z",
"title": "Harmful pattern of use of non-psychoactive substances, unspecified"
},
{
"code": "5B90.Y",
"title": "Other specified vitamin excess"
},
{
"code": "QF10",
"title": "Limited function or disability of body organ or system"
},
{
"code": "6B60.Z",
"title": "Dissociative neurological symptom disorder, with unspecified symptoms"
},
{
"code": "8D43.Z",
"title": "Neurological disorders due to toxicity, unspecified"
},
{
"code": "8D43.Y",
"title": "Other specified neurological disorders due to toxicity"
},
{
"code": "MD93",
"title": "Dysphagia"
}
] |
=== ICD-11 CODES FOUND ===
[5B7Z] Unspecified undernutrition
Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS
[5B90.Z] Unspecified vitamin excesses
Also known as: Unspecified vitamin excesses | Vitamin excesses
[5B55.Z] Vitamin A deficiency, unspecified
Also known as: Vitamin A deficiency, unspecified | Vitamin A deficiency | Hypovitaminosis A
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies
[5B90.Y] Other specified vitamin excess
Also known as: Other specified vitamin excess
[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
[6B60.Z] Dissociative neurological symptom disorder, with unspecified symptoms
Also known as: Dissociative neurological symptom disorder, with unspecified symptoms | Dissociative neurological symptom disorder | Functional neurological disorders | Functional neurological symptom disorder | Conversion disorder
[8D43.Z] Neurological disorders due to toxicity, unspecified
Also known as: Neurological disorders due to toxicity, unspecified | Neurological disorders due to toxicity
[8D43.Y] Other specified neurological disorders due to toxicity
Also known as: Other specified neurological disorders due to toxicity | Certain specified neurological disorders due to toxicity | Neurological disorder due to insect bite | Neurological disorder due to reptile bite | Encephalomyelopathy due to toxicity
[MD93] Dysphagia
Definition: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the pharynx and upper oesophageal sphincter; and oesophageal dysphagia due to malfunction of the oesophagus.
Also known as: Dysphagia | Difficulty in swallowing | difficulty swallowing | difficulty in swallowing NOS | swallowing problem
Includes: Difficulty in swallowing
Excludes: Functional swallowing disorder
=== GRAPH WALKS ===
--- Walk 1 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--RELATED_TO--> [?] Fetal intrauterine malnutrition without mention of small for gestational age
Def: Neonate, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin or loss of subcutaneous tissue....
--- Walk 2 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--RELATED_TO--> [?] Malnutrition in pregnancy
Def: A condition caused by ingestion of a diet in which the nutrients are lacking or are in excess....
--- Walk 3 ---
[5B90.Z] Unspecified vitamin excesses
--PARENT--> [5B90] Vitamin excesses
--CHILD--> [5B90.1] Hypercarotenaemia
Def: Excessive intake of carotenoids is not associated with toxicity but can cause yellow coloration of the skin that disappears when intake is reduced. This disorder is especially likely to occur in child...
--- Walk 4 ---
[5B90.Z] Unspecified vitamin excesses
--PARENT--> [5B90] Vitamin excesses
--CHILD--> [5B90.0] Hypervitaminosis A
Def: Because vitamin A is fat soluble and can be stored, primarily in the liver, routine consumption of large amounts of vitamin A over a period of time can result in toxic symptoms, including liver damage...
--- Walk 5 ---
[5B55.Z] Vitamin A deficiency, unspecified
--PARENT--> [5B55] Vitamin A deficiency
Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...
--CHILD--> [5B55.1] Vitamin A deficiency with conjunctival xerosis
Def: In conjunctival xerosis the epithelium of the conjunctiva is transformed from the normal columnar to the stratified squamous type, with a resultant loss of goblet cells, formation of a granular cell l...
--- Walk 6 ---
[5B55.Z] Vitamin A deficiency, unspecified
--PARENT--> [5B55] Vitamin A deficiency
Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...
--RELATED_TO--> [?] Acquired vitamin A deficiency anaemia
|
[
"[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Fetal intrauterine malnutrition without mention of small for gestational age\n Def: Neonate, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin or loss of subcutaneous tissue....",
"[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --RELATED_TO--> [?] Malnutrition in pregnancy\n Def: A condition caused by ingestion of a diet in which the nutrients are lacking or are in excess....",
"[5B90.Z] Unspecified vitamin excesses\n --PARENT--> [5B90] Vitamin excesses\n --CHILD--> [5B90.1] Hypercarotenaemia\n Def: Excessive intake of carotenoids is not associated with toxicity but can cause yellow coloration of the skin that disappears when intake is reduced. This disorder is especially likely to occur in child...",
"[5B90.Z] Unspecified vitamin excesses\n --PARENT--> [5B90] Vitamin excesses\n --CHILD--> [5B90.0] Hypervitaminosis A\n Def: Because vitamin A is fat soluble and can be stored, primarily in the liver, routine consumption of large amounts of vitamin A over a period of time can result in toxic symptoms, including liver damage...",
"[5B55.Z] Vitamin A deficiency, unspecified\n --PARENT--> [5B55] Vitamin A deficiency\n Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...\n --CHILD--> [5B55.1] Vitamin A deficiency with conjunctival xerosis\n Def: In conjunctival xerosis the epithelium of the conjunctiva is transformed from the normal columnar to the stratified squamous type, with a resultant loss of goblet cells, formation of a granular cell l...",
"[5B55.Z] Vitamin A deficiency, unspecified\n --PARENT--> [5B55] Vitamin A deficiency\n Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...\n --RELATED_TO--> [?] Acquired vitamin A deficiency anaemia"
] |
5B7Z
|
Unspecified undernutrition
|
[
{
"from_icd11": "5B7Z",
"icd10_code": "E43",
"icd10_title": "Unspecified severe protein-calorie malnutrition"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E538",
"icd10_title": "Deficiency of other specified B group vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E569",
"icd10_title": "Vitamin deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E638",
"icd10_title": "Other specified nutritional deficiencies"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E639",
"icd10_title": "Nutritional deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E41",
"icd10_title": "Nutritional marasmus"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E539",
"icd10_title": "Vitamin B deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E568",
"icd10_title": "Deficiency of other vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E649",
"icd10_title": "Sequelae of unspecified nutritional deficiency"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E618",
"icd10_title": "Deficiency of other specified nutrient elements"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E40-E46",
"icd10_title": ""
},
{
"from_icd11": "5B7Z",
"icd10_code": "E50-E64",
"icd10_title": ""
},
{
"from_icd11": "5B7Z",
"icd10_code": "E53",
"icd10_title": "Deficiency of other B group vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E56",
"icd10_title": "Other vitamin deficiencies"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E61",
"icd10_title": "Deficiency of other nutrient elements"
}
] |
E43
|
Unspecified severe protein-calorie malnutrition
|
Takayasu’s Arteritis (TA) is a chronic inflammatory large vessel vasculitis of unknown origin, predominantly affecting aorta and its major branches. It is also called Aortic arch syndrome, Pulse less disease, Occlusive thromboaortopathy, Martorell syndrome . The first scientific description of Takayasu’s Arteritis was given by Mikito Takaysu, Professor of Opthalmology at Kanazawa University, Japan, in 1905 at 12th Annual conference of Japanese Ophthalmology Society . He presented a 21year old woman with a peculiar form of arteriovenus anastomoses at optic fundi. K Onishi and T Kagosha also contributed with their patients of absent radial pulse in the same conference . But the first ever documented description of this arteritis dates back to 1830. Rokushu Yamamoto who practiced Japanese oriental medicine, described a case of 45 years old man presenting with absent pulse in one upper limb and feeble pulse in another one following a year long history of high grade fever. During the period of follow up the patient subsequently became emaciated, dyspnoeic and died suddenly after 11 years . The world wide prevalence of Takayasu’s disease is 3.3/million. The disease is more common in East Asia and in Asian descendants in other countries . TA commonly presents in 2nd or 3rd decade of life, with a high female preponderance. But the female to male ratio declines from Eastern Asia to the West . TA may manifest as asymptomatic pulseless disease to catastrophic neurological impairements. The disease may present in two phase, a prepulseless phase of nonspecific inflammatory signs, followed by a chronic phase of vascular insufficiency . Presentation of TA varies among the races. Japanese patients are predominantly female, presents with pulslessness, dizziness, vertigo, aortic regurgitation, inflammatory process commonly affecting the arch and its major branches, whereas Indian patients are male dominant. Indian cases present with more hypertension, headache, LV hypertrophy and vasculitic involvement of abdominal aorta and renal arteries . Diminished or absent pulse along with upper limb claudication and blood pressure difference is found in 84–96% of cases . Vascular bruits involving carotid, subclavian and abdominal vessels are also common (80–94%) . Hypertension is associated with 33–83% patients of TA . Our index case was also a young girl with feeble femoral pulse and absent other peripheral pulses in lower limb, blood pressure discrepancy between arms, bruits over multiple areas of chest and neck and hypertension. The blood pressure discrepancy of 50/40 mm of Hg is probably due to the difference in percentage of stenosis among the brachiocephalic (70–80% stenosis) and left subclavian vessels (50–60% stenosis). Retinopathy, aortic regurgitation, congestive heart failure, cardiomyopathy, myocardial ischemia, headache, dizziness, seizure are less common association of TA. From common findings of TA, American College of Rheumatology has devised some diagnostic criteria for TA in 1990. Angiography remains the gold standard investigation for diagnosis. The main differential diagnosis include other causes of large vessel vasculitis eg inflammatory vasculitis (Syphilis, Tuberculosis, Behchets, SLE); development abnormalities (Coarctation of aorta, Marfans syndrome) and neurofibromatosis. TA has been classified on the basis of angiographic findings. The new classification was described at Takayasu Arteritis Conference in 1994 based on vessel involvement. Type-I involving branches from aortic arch, Type-IIa denoting ascending aorta, aortic arch and its branches, Type-IIb including Type-Ia plus descending thoracic aorta. Type-III means descending thoracic aorta, abdominal aorta and/ or renal arteries. Type-IV involves abdominal aorta and/ or renal arteries. Type-V is combined features of Type-IIb and Type-IV . Ishikawa classified different clinical groups based on natural history and complications. He described Group-I as uncomplicated disease with or without pulmonary artery involvement, Group-IIA as mild/moderate single complication together with uncomplicated disease, Group-IIB as severe single complication together with uncomplicated disease, Group-III as two or more complications together with uncomplicated disease . Ishikawa defined Takayasu retinopathy, Secondary hypertension, Aortic regurgitation, Aneurysm formation as four most important complications. Our index case met the angiographic criteria of Type-IV Takayasu Arteritis class and Group-III of Ishikawa class . Ishikawa class caries a prognostic significance not only for the Japanese patients but also for the Indians. The overall five year survival rate is 83%. The survival rate is 100% in Group-I and 70% in Group-IIb and Group-III. The most common cause of mortality is cerebrovascular disease and cardiac failure. Regarding treatment strategy steroid had been the mainstay of treatment. Shelhamer et al. showed half of the TA patients on steroid won’t respond . Kerr et al. showed overall remission rate of 33% with immunosuppressive drugs in steroid unresponsive patients . Methotrexate though not more efficacious than others, became popular due to its well tolerability . The combination of steroid and methotrexate demonstrated a remission rate of 81% in steroid unresponsive patients . Treatment of hypertension and prevention of thrombosis are also important aspects of therapy. Treatment of hypertension with ACE inhibitors requires careful monitoring for renal artery stenosis. Surgery may be needed in patients with critical renal artery stenoses, limb claudication limiting the daily activities, stenosis of three or more cerebral vessels, moderate aortic regurgitation. Stenoses of renal artery are best treated by Percutaneous Transluminal Angioplasty . Stent placement following angioplasty is a safe and effective procedure . Takayasu’s Arteritis is a chronic progressive vasculopathy. So long term follow up is recommended. Markers of acute phase response are unreliable during follow up. Doppler studies and MRA are can help to determine the vessel wall thickness and lumen configuration.
| 4.347656
| 0.427734
|
sec[1]/p[3]
|
en
| 0.999995
|
23194278
|
https://doi.org/10.1186/1756-0500-5-659
|
[
"type",
"patients",
"aorta",
"group",
"takayasu",
"aortic",
"arteritis",
"pulse",
"hypertension",
"renal"
] |
[
{
"code": "9C82.4",
"title": "Oculomotor apraxia"
},
{
"code": "ED50.Z",
"title": "Ichthyosis of unspecified type"
},
{
"code": "EH6Z",
"title": "Drug eruption of unspecified type"
},
{
"code": "5C51.3",
"title": "Glycogen storage disease"
},
{
"code": "LD20.1",
"title": "Syndromes with lissencephaly as a major feature"
},
{
"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 ===
[9C82.4] Oculomotor apraxia
Also known as: Oculomotor apraxia | Congenital ocular motor apraxia | Cogan’s congenital ocular motor apraxia | Saccadic palsy | Head thrust movement
[ED50.Z] Ichthyosis of unspecified type
Also known as: Ichthyosis of unspecified type | Ichthyoses
[EH6Z] Drug eruption of unspecified type
Also known as: Drug eruption of unspecified type | Drug-induced eruptions | drug eruption or rash of unspecified type | rash due to drug NOS | drug rash
[5C51.3] Glycogen storage disease
Definition: The term Glycogen storage disease characterises a group of heterogeneous diseases resulting from defects in the process of glycogen synthesis or breakdown within muscles, liver, and other cell types.
Also known as: Glycogen storage disease | Glycogenosis | GSD - [Glycogen storage disease] | glycogen thesaurismosis | diffuse glycogenosis
Includes: Glycogen storage disease due to LAMP-2 deficiency | Glycogen storage disease due to glycogen debranching enzyme deficiency | Glycogen storage disease due to muscle glycogen phosphorylase deficiency
[LD20.1] Syndromes with lissencephaly as a major feature
Definition: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) associated with abnormal organisation of the cortical layers as a result of neuronal migration defects during embryogenesis. Children with lissencephaly have feeding and swallowing problems, muscle tone anomalies (early hypotonia and subsequently limb hypertonia), seizures (in particular, infantile spas
Also known as: Syndromes with lissencephaly as a major feature | Pachygyria | Agyria | Classic lissencephaly | Lissencephaly type 1
Includes: Agyria | Pachygyria
[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 ---
[9C82.4] Oculomotor apraxia
--PARENT--> [9C82] Disorders of extraocular muscles
--CHILD--> [9C82.1] Muscular dystrophy affecting extraocular muscle
Def: Non-specific term that is used to describe a range of primary myopathies that affect the extraocular muscles....
--- Walk 2 ---
[9C82.4] Oculomotor apraxia
--PARENT--> [9C82] Disorders of extraocular muscles
--CHILD--> [9C82.1] Muscular dystrophy affecting extraocular muscle
Def: Non-specific term that is used to describe a range of primary myopathies that affect the extraocular muscles....
--- Walk 3 ---
[ED50.Z] Ichthyosis of unspecified type
--PARENT--> [ED50] Ichthyoses
Def: Genetically-determined and acquired disorders of epidermal keratinization characterised by diffuse scaling and/or thickening of the stratum corneum....
--RELATED_TO--> [?] Syndromic ichthyosis
Def: Hereditary disorders in which ichthyosis is associated with significant other abnormalities....
--- Walk 4 ---
[ED50.Z] Ichthyosis of unspecified type
--PARENT--> [ED50] Ichthyoses
Def: Genetically-determined and acquired disorders of epidermal keratinization characterised by diffuse scaling and/or thickening of the stratum corneum....
--RELATED_TO--> [?] Non-syndromic ichthyosis
Def: Hereditary ichthyoses with clinical manifestations limited to the integument....
--- Walk 5 ---
[EH6Z] Drug eruption of unspecified type
--PARENT--> [?] Drug eruptions
--CHILD--> [EH61] Drug-induced urticaria, angioedema or anaphylaxis
Def: Adverse reaction to drugs due to release of histamine or vasoactive kinins....
--- Walk 6 ---
[EH6Z] Drug eruption of unspecified type
--PARENT--> [?] Drug eruptions
--CHILD--> [EH61] Drug-induced urticaria, angioedema or anaphylaxis
Def: Adverse reaction to drugs due to release of histamine or vasoactive kinins....
|
[
"[9C82.4] Oculomotor apraxia\n --PARENT--> [9C82] Disorders of extraocular muscles\n --CHILD--> [9C82.1] Muscular dystrophy affecting extraocular muscle\n Def: Non-specific term that is used to describe a range of primary myopathies that affect the extraocular muscles....",
"[9C82.4] Oculomotor apraxia\n --PARENT--> [9C82] Disorders of extraocular muscles\n --CHILD--> [9C82.1] Muscular dystrophy affecting extraocular muscle\n Def: Non-specific term that is used to describe a range of primary myopathies that affect the extraocular muscles....",
"[ED50.Z] Ichthyosis of unspecified type\n --PARENT--> [ED50] Ichthyoses\n Def: Genetically-determined and acquired disorders of epidermal keratinization characterised by diffuse scaling and/or thickening of the stratum corneum....\n --RELATED_TO--> [?] Syndromic ichthyosis\n Def: Hereditary disorders in which ichthyosis is associated with significant other abnormalities....",
"[ED50.Z] Ichthyosis of unspecified type\n --PARENT--> [ED50] Ichthyoses\n Def: Genetically-determined and acquired disorders of epidermal keratinization characterised by diffuse scaling and/or thickening of the stratum corneum....\n --RELATED_TO--> [?] Non-syndromic ichthyosis\n Def: Hereditary ichthyoses with clinical manifestations limited to the integument....",
"[EH6Z] Drug eruption of unspecified type\n --PARENT--> [?] Drug eruptions\n --CHILD--> [EH61] Drug-induced urticaria, angioedema or anaphylaxis\n Def: Adverse reaction to drugs due to release of histamine or vasoactive kinins....",
"[EH6Z] Drug eruption of unspecified type\n --PARENT--> [?] Drug eruptions\n --CHILD--> [EH61] Drug-induced urticaria, angioedema or anaphylaxis\n Def: Adverse reaction to drugs due to release of histamine or vasoactive kinins...."
] |
9C82.4
|
Oculomotor apraxia
|
[
{
"from_icd11": "9C82.4",
"icd10_code": "H518",
"icd10_title": "Other specified disorders of binocular movement"
},
{
"from_icd11": "EH6Z",
"icd10_code": "L270",
"icd10_title": "Generalized skin eruption due to drugs and medicaments taken internally"
},
{
"from_icd11": "EH6Z",
"icd10_code": "L27",
"icd10_title": "Dermatitis due to substances taken internally"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7401",
"icd10_title": "von Gierke disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7404",
"icd10_title": "McArdle disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7402",
"icd10_title": "Pompe disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7403",
"icd10_title": "Cori disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7409",
"icd10_title": "Other glycogen storage disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7400",
"icd10_title": "Glycogen storage disease, unspecified"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E740",
"icd10_title": "Glycogen storage disease"
},
{
"from_icd11": "LD20.1",
"icd10_code": "Q043",
"icd10_title": "Other reduction deformities of brain"
},
{
"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": ""
}
] |
H518
|
Other specified disorders of binocular movement
|
There are 6 main genotypes of HCV with different responses to treatment. Genotype 1 (HCV-1) is the most common genotype in the world, as well as in China, accounting for 60% of all cases worldwide. Infection with HCV is usually asymptomatic, with only a minority of patients presenting with symptomatic AHC. Herein, we report a rare case of a patient with decompensated cirrhosis induced by autoimmune liver disease–infected AHC. HCV infection is predominantly transmitted by exposure to blood or body fluids. The incubation period of AHC infection after blood transfusion is 2 to 16 weeks (average, 7 weeks). This patient received red blood cell transfusions on 2 separate occasions to address her anemia due to digestive tract hemorrhage. However, the patient was tested for anti-HCV antibody and HCV-RNA after the second red blood cell transfusion in December 2014, with negative results for both. The anti-HCV antibody test result was also negative in March 2015 and August 2015. Thus, we thought that AHC was not transmitted by blood transfusion. HCV can also be transmitted through broken skin and mucosa. To our knowledge, the patient did not inject drugs or undergo contaminated medical procedures. No other routes of infection were found. Notably, the patient who was undergoing treatment with phototherapy, compound glycyrrhizin tablets, and vitamins had psoriasis of 22 years with severely broken skin. She had hot-spring baths (with a water temperature of about 45°C) once or twice per week with her friend who had a chronic HCV infection from August 2015 to September 2015. Therefore, we thought that HCV might have been transmitted through broken skin. In this case, when acute exacerbation of hepatic damage occurred, we believed that it was appropriate initially to consider the progression of autoimmune liver disease. From September 2013 to August 2015, the ANA titer fluctuated between 1:1000 and 1:3200, and AMA-M2 fluctuated between (+) and (++). The highest levels of ANA and AMA-M2 were 1:3200 and (++), respectively, but the liver dysfunction was mild throughout therapy, including treatment with ursodeoxycholic acid and glycyrrhizinate. In September 2015, liver function dramatically worsened. The ANA titer was 1:3200 and AMA-M2 was (+), both of which did not exceed the prior level. After comprehensive medicine treatment for 1 week, the patient's condition continued to worsen. Thereafter, the patient began antiviral therapy based on the previously administered medicine with the same dosage. No glucocorticoid or immunosuppressant was used, which is necessary in acute exacerbation of autoimmune liver disease. After antiviral therapy for 1 week, the patient's symptoms and liver function improved. Following the reduction of viral load, liver function correspondingly improved. The clinical course did not match the pathological characteristics of acute exacerbation of autoimmune liver disease. No hepatitis A, B, D, or E virus or HIV infection was found. Other possible causes of acute hepatitis, such as drugs, toxic, alcohol, and infection with other pathogens, were also not found. After ruling out other possible causes of acute hepatitis and observing the therapeutic effect of antiviral medication, we concluded that the primary reason of the dramatic deterioration of liver function involved mass liver cell necrosis caused by AHC infection. By restraining and eradicating the hepatitis virus, DAAs played a key role in the rapid decrease of ALT and TBIL. Other comprehensive pharmacological treatment, including ursodeoxycholic acid at the previous dosage, glycyrrhizinate, and platelet and clotting factor transfusion, took subsidiary function in sustaining the liver cell membrane, promoting biliation and egestion, and preventing bleeding. It should also be noted that spontaneous viral resolution occurs in about 20% to 40% of infected patients. Currently, recommendations regarding when to start antiviral treatment in patients with AHC are conflicting. Some scholars recommend antiviral treatment if accompanied by elevated ALT, regardless of other clinical symptoms. Others suggest monitoring through HCV RNA quantification every 4 weeks, and, if patients display positive HCV RNA for 12 weeks, beginning antiviral therapy. In our patient, liver function, blood coagulation function, and platelet count declined significantly after AHC infection, and, thus, we chose antiviral therapy. When IFN was the main drug used in the treatment of HCV, there was no effective antiviral therapy for AHC patients with decompensated cirrhosis. The discovery and application of DAAs brought hope to the patients who need more choices for the treatment of their condition. Several trials had found that DAAs can effectively eradicate HCV in AHC patients coinfected with HIV. However, evidence remains limited. A potent nucleotide analogue, SOF, inhibits HCV NS5B polymerase with pan-genotypic activity. It was approved by the Food and Drug Administration and the European Medicines Agency in combination with RBV as the first IFN-free treatment option for patients with chronic HCV with and without contraindications to pegylated-IFN. The patient exhibited a rapid virological response in 4 weeks, with undetectable amounts of HCV RNA at 36 weeks after SOF and RBV treatment completion. Except autoimmune liver disease and psoriasis, this patient had a history of hypertension for 10 years. Over the course of therapy, the patient's blood pressure dropped from (140–150)/(80–90) to (100–105)/(55–60) mm Hg. Due to treatment with sustained-release nifedipine for hypertension, and furosemide and spironolactone for ascites, we cannot be clearly convinced that the blood pressure drop was related to SOF. No other side effects were noted during or after HCV treatment. Although several trials confirmed that SVR12 is an appropriate end point for assessing efficacy of therapy with SOF-containing regimens, some individuals experienced relapse between weeks 12 and 24. Monitoring liver function and HCV RNA quantification for 36 weeks, we found that the patient kept in good condition and did not relapse.
| 4.164063
| 0.936523
|
sec[2]/p[0]
|
en
| 0.999997
|
27930559
|
https://doi.org/10.1097/MD.0000000000005555
|
[
"liver",
"infection",
"that",
"patients",
"blood",
"function",
"antiviral",
"autoimmune",
"transmitted",
"transfusion"
] |
[
{
"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": "1H0Z",
"title": "Infection, unspecified"
},
{
"code": "1G40",
"title": "Sepsis without septic shock"
},
{
"code": "FA10.Z",
"title": "Direct infections of joint, unspecified"
},
{
"code": "1D9Z",
"title": "Unspecified viral infection of unspecified site"
},
{
"code": "1A40.Z",
"title": "Infectious gastroenteritis or colitis without specification of infectious agent"
}
] |
=== ICD-11 CODES FOUND ===
[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
[1H0Z] Infection, unspecified
Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS
[1G40] Sepsis without septic shock
Definition: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.
Also known as: Sepsis without septic shock | sepsis without septic shock with known organism | Sepsis-associated hypotension | Unspecified sepsis | general septic intoxication
Excludes: Septicaemia | Sepsis of fetus or newborn
[FA10.Z] Direct infections of joint, unspecified
Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection
[1D9Z] Unspecified viral infection of unspecified site
Also known as: Unspecified viral infection of unspecified site | viral infection NOS | viral disorder NOS | disease caused by virus | unspecified viremia
[1A40.Z] Infectious gastroenteritis or colitis without specification of infectious agent
Also known as: Infectious gastroenteritis or colitis without specification of infectious agent | Gastroenteritis or colitis without specification of infectious agent | diarrhoea and gastroenteritis of presumed infectious origin | diarrhoeal enteritis | GE - [gastroenteritis]
=== GRAPH WALKS ===
--- Walk 1 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--CHILD--> [DB92] Non-alcoholic fatty liver disease
Def: NAFLD is characterised by fatty liver related to insulin resistance in the absence of significant alcohol consumption. It embraces a pathological spectrum from simple steatosis to steatohepatitis. 10-...
--- Walk 2 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--RELATED_TO--> [?] Metabolic or transporter liver disease
--- Walk 3 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--CHILD--> [DB97.1] Hepatic berylliosis
--- Walk 4 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--EXCLUDES--> [?] Acute or subacute hepatic failure
Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....
--- Walk 5 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--EXCLUDES--> [?] Hepatic vein thrombosis
Def: Venous thrombosis within the hepatic vein....
--- Walk 6 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--RELATED_TO--> [?] Liver disorders in pregnancy, childbirth or the puerperium
Def: Any disorder affecting females, characterised by pathological changes to the liver that occur during pregnancy, childbirth, and the puerperium....
|
[
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB92] Non-alcoholic fatty liver disease\n Def: NAFLD is characterised by fatty liver related to insulin resistance in the absence of significant alcohol consumption. It embraces a pathological spectrum from simple steatosis to steatohepatitis. 10-...",
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Metabolic or transporter liver disease",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.1] Hepatic berylliosis",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....",
"[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--> [?] Hepatic vein thrombosis\n Def: Venous thrombosis within the hepatic vein....",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Liver disorders in pregnancy, childbirth or the puerperium\n Def: Any disorder affecting females, characterised by pathological changes to the liver that occur during pregnancy, childbirth, and the puerperium...."
] |
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
|
In January 2013, a 65-year-old male presented to Korea University Anam Hospital (Seoul, Republic of Korea), with an intra-abdominal mass that was localized to the right side. The mass had presented one month previously. In addition, the patient had experienced weight loss (5 kg) during the previous four months. The medical history was unremarkable, with the exception of pulmonary tuberculosis 30 years previously, from which the patient had recovered. On physical examination, a round mass was palpated and there was tenderness of the right upper quadrant area. Hematological examination revealed a marginal decrease of hematocrit (35.8%; normal range, 37–51%) and hemoglobin (11.8 g/dl; normal range, 12.6–17.4 g/dl). Liver function tests revealed elevated alkaline phosphatase (423 IU/l; normal range, 30–120 IU/l) and γ-glutamyl transferase (587 IU/l; normal range, 9–64 IU/l) levels. Aspartate aminotransferase, alanine aminotransferase and bilirubin levels were within the normal ranges of 3–45 IU/l, 3–45 IU/l and 0.0–0.4 mg/dl, respectively. An upper gastrointestinal endoscopy revealed a subepithelial mass with a fistulous hole on the second portion of the duodenum . A total colonoscopy revealed no abnormalities. A computed tomography (CT) scan, which was acquired from the referring local clinic (Choi Kang Sik Internal Medicine, Seoul, Republic of Korea), demonstrated a large, heterogeneously enhanced lobulated mass (11.5×9.3 cm; longest diameter × greatest perpendicular diameter) with internal necrosis at the pancreaticoduodenal groove . The internal cavity of the mass was connected to the second portion of the duodenum, which was consistent with the endoscopic findings. Furthermore, an ill-defined low-attenuation lesion was identified at segment eight of the liver, abutting the bile duct and hepatic artery . Significantly enlarged lymph nodes were not observed in the abdominal cavity. In addition, a fludeoxyglucose positron emission tomography (FDG-PET) scan also revealed hypermetabolic masses in the duodenal groove and in segment eight of the liver, which was consistent with the CT scan. Abdominal MRI (magnetic resonance imaging) was also conducted for further characterization of the duodenal and hepatic masses observed on the CT scan, which confirmed the same findings. An ultrasound-guided needle biopsy of the duodenal mass was performed and pathological examination identified whirling sheets of spindle-shaped cells . Immunohistochemical staining was positive for c-Kit, but negative for cluster of differentiation 34, S-100 and desmin . Mitotic features could not be evaluated, as a surgically excised sample was not obtained. The diagnosis of high-risk GIST with hepatic metastasis was determined and the patient was treated with 400 mg imatinib, daily. The treatment was tolerated well, and the abdominal mass and distension improved significantly. After seven weeks of treatment, the follow-up abdominal CT scan revealed that the duodenal mass had significantly reduced in size (7.9×6.5 cm; longest diameter × greatest perpendicular diameter) and exhibited an increased area of internal necrosis. However, the hepatic mass had increased from 1.7×1.5 cm to 3.9×3.2 cm in diameter (longest diameter × greatest perpendicular diameter) and the right hepatic duct was markedly dilated by the mass . Various enlarged lymph nodes were observed in the left gastric area, including the porta hepatis and portocaval space. The ultrasound-guided needle biopsy was repeated for the hepatic mass and histopathological examination of the biopsy specimen showed malignant cells with a glandular structure, which was consistent with adenocarcinoma. Immunohistochemical analysis exhibited c-Kit-negative and cytokeratin 19-positive staining . The final diagnosis was synchronous ICC and GIST. Two weeks after the ultrasound-guided liver biopsy, the patient developed jaundice and a fever, and the total level of bilirubin increased rapidly to 9.4 mg/dl (normal range, 0.0–0.4 mg/dl). Percutaneous transhepatic biliary drainage was conducted along with antibiotic treatment and administration of imatinib was withheld to allow the patient to recover from the condition. An abdominal CT scan following three weeks of conservative treatment revealed an increase in size of the liver mass (5.3×3.9 cm; longest diameter × greatest perpendicular diameter) with portal vein thrombosis, and the size of the duodenal mass had also increased to 9.5×8.7 cm (longest diameter × greatest perpendicular diameter). The treatment regimen became focused towards the ICC, which was associated with a poorer prognosis. Due to the well-known toxicity of combined chemotherapy, administration of imatinib was terminated and the patient was treated with intravenous gemcitabine (100 mg/m 2 for 30 min, days 1 and 8) and cisplatin (25 mg/m 2 for 1 h, days 1 and 8) ( 15 , 16 ) every three weeks for four cycles. During chemotherapy, the abdominal mass reappeared, as a follow-up CT scan, performed six weeks following treatment, revealed a prominent increase in the size of the duodenal mass (10.7×10 cm; longest diameter × greatest perpendicular diameter). However, the hepatic mass did not demonstrate a significant change in size during that interval. As the patient had tolerated the initial chemotherapy well, combined chemotherapy (consisting of imatinib, gemcitabine and cisplatin) was initiated for symptom control and treatment of the GIST. The addition of imatinib resulted in the duodenal mass decreasing significantly and the patient exhibited a good response to the treatment. However, certain toxicities are associated with combined chemotherapy, such as grade 1 bone marrow suppression, as observed in the present case. The follow-up CT scan revealed disease progression of the ICC, whereas the size of the GIST mass had decreased. The treatment modality was altered, due to refractory cholangiocarcinoma, from chemotherapy to radiation therapy (daily dose of 180 Gy), whilst maintaining the imatinib treatment. To date, the patient has been undergoing treatment for one year and is tolerating the treatment well.
| 4.109375
| 0.96582
|
sec[1]/p[0]
|
en
| 0.999998
|
25435952
|
https://doi.org/10.3892/ol.2014.2703
|
[
"diameter",
"scan",
"abdominal",
"which",
"hepatic",
"duodenal",
"longest",
"greatest",
"perpendicular",
"imatinib"
] |
[
{
"code": "LB70.0Y",
"title": "Other specified craniosynostosis"
},
{
"code": "9B75.1&XS5S",
"title": "Non-traumatic macular hole, stage 2, full thickness macular hole diameter"
},
{
"code": "9B75.1&XS00",
"title": "Non-traumatic macular hole, stage 3, full thickness macular hole >400 microns in maximum diameter"
},
{
"code": "9B75.1&XS6G",
"title": "Non-traumatic macular hole, stage 4, full thickness macular hole >400 microns in maximum diameter + complete vitreous detachment"
},
{
"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"
},
{
"code": "MD81.3",
"title": "Acute abdomen"
}
] |
=== ICD-11 CODES FOUND ===
[LB70.0Y] Other specified craniosynostosis
Also known as: Other specified craniosynostosis | Monosutural craniosynostosis | Scaphocephaly | Dolichocephaly | dolichocephalia
[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
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[LB70.0Y] Other specified craniosynostosis
--PARENT--> [LB70.0] Craniosynostosis
Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...
--CHILD--> [LB70.00] Plagiocephaly
Def: Isolated synostotic plagiocephaly is a form of nonsyndromic craniosynostosis characterised by premature fusion of one coronal or lambdoid suture leading to skull deformity and facial asymmetry....
--- Walk 2 ---
[LB70.0Y] Other specified craniosynostosis
--PARENT--> [LB70.0] Craniosynostosis
Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...
--CHILD--> [LB70.0Y] Other specified craniosynostosis
--- Walk 3 ---
[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system
--PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system
Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ...
--CHILD--> [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system
--- Walk 4 ---
[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system
--PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system
Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ...
--CHILD--> [MB71.Z] Clinical findings on diagnostic imaging of central nervous system, unspecified
|
[
"[LB70.0Y] Other specified craniosynostosis\n --PARENT--> [LB70.0] Craniosynostosis\n Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...\n --CHILD--> [LB70.00] Plagiocephaly\n Def: Isolated synostotic plagiocephaly is a form of nonsyndromic craniosynostosis characterised by premature fusion of one coronal or lambdoid suture leading to skull deformity and facial asymmetry....",
"[LB70.0Y] Other specified craniosynostosis\n --PARENT--> [LB70.0] Craniosynostosis\n Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...\n --CHILD--> [LB70.0Y] Other specified craniosynostosis",
"[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system\n --PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system\n Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ...\n --CHILD--> [MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system",
"[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system\n --PARENT--> [MB71] Clinical findings on diagnostic imaging of central nervous system\n Def: Clinical findings on diagnostic imaging of central nervous system is findings on diagnostic imaging of the brain or the spinal cord which don't appear in normal status of the body. Diagnostic imaging ...\n --CHILD--> [MB71.Z] Clinical findings on diagnostic imaging of central nervous system, unspecified"
] |
LB70.0Y
|
Other specified craniosynostosis
|
[
{
"from_icd11": "NE60",
"icd10_code": "T50A95A",
"icd10_title": "Adverse effect of other bacterial vaccines, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50Z15A",
"icd10_title": "Adverse effect of immunoglobulin, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50Z95A",
"icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50A95S",
"icd10_title": "Adverse effect of other bacterial vaccines, sequela"
},
{
"from_icd11": "NE60",
"icd10_code": "T50B95A",
"icd10_title": "Adverse effect of other viral vaccines, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50A25A",
"icd10_title": "Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50A91A",
"icd10_title": "Poisoning by other bacterial vaccines, accidental (unintentional), initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T498X5A",
"icd10_title": "Adverse effect of other topical agents, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T48905A",
"icd10_title": "Adverse effect of unspecified agents primarily acting on the respiratory system, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T48995A",
"icd10_title": "Adverse effect of other agents primarily acting on the respiratory system, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50A15A",
"icd10_title": "Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50B15A",
"icd10_title": "Adverse effect of smallpox vaccines, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T416X3A",
"icd10_title": ""
},
{
"from_icd11": "NE60",
"icd10_code": "T419X3A",
"icd10_title": ""
},
{
"from_icd11": "NE60",
"icd10_code": "T418X2A",
"icd10_title": ""
}
] |
T50A95A
|
Adverse effect of other bacterial vaccines, initial encounter
|
A 53-year-old woman visited a doctor and mainly complained of chest discomfort after meals. Esophagogastroduodenoscopy (EGD) showed multiple granular elevations in the gastric body. She was referred to our hospital for further examination. Her abdomen was flat and soft with no abnormal physical findings. Her medical history included angina and endometriosis, and she owned a pet cat, which is known to be a natural host for NHPH. Blood tests revealed no significant results. EGD showed closed-type atrophic changes in the background mucosa, with multiple granular elevations measuring 2–3 mm centered in the gastric body . A small depression was present at the tip of the elevations. Magnified narrow-band imaging showed dendritic dilated blood vessels on the surface layers of all elevations . In ultrasonic endoscopy, the lesions were extracted as hypoechoic masses in the shallow part of the second layer . Biopsies obtained from multiple elevations showed invasion of atypical cells and some scattered lymphoepithelial lesions and small-to-medium lymphocytes with mild nuclear constriction, even in the lamina propria . No lymphoma cell infiltration was observed in biopsy tissue from the background mucosa. Immunohistochemical analysis showed that the lesions were positive for CD20 , CD79a, and bcl-2 and negative for CD10 and cyclinD1. B-cell markers predominated the stain images, and the patient was diagnosed with MALT lymphoma. Fluorescence in situ hybridization (FISH) showed negative results for the API2-MALT1 gene , and IgH gene rearrangement detected a single peak in four out of five areas . The urea breath test did not show a high level (approximately 2.2‰) although serum H. pylori IgG antibodies were positive and H. pylori antigen was found in her stool. Because she lived with a cat and her endoscopic findings were atypical for gastric MALT lymphoma, we suspected NHPH infection. Polymerase chain reaction (PCR) was performed using biopsy specimens for H. pylori and five strains of NHPH ( H. suis, H. bizzozeroni, H. salmonis, H. felis, H. heilmannii ) that typically infect humans (Table 1 ) , and H. pylori and H. suis were detected . Gimenez staining of the biopsy tissue did show helical bacilli; however, differences from H. pylori were histologically indistinct, and it was difficult to make a definitive histopathological diagnosis of the NHPH . No lesions outside the stomach were found in colonoscopy, small bowel capsule endoscopy, and positron emission tomography–computed tomography. The patient was diagnosed with stage I lymphoma as per the international Lugano classification . Primary treatment involved 7-day bacterial eradication therapy using three oral agents: vonoprazan fumarate, amoxicillin hydrate, and clarithromycin. Subsequently, her stool tested negative for H. pylori antigen, and the bacterial eradication therapy was considered successful. Endoscopic images at 6 months after bacterial eradication showed that multiple granular elevations remained in the gastric body; however, the dilated blood vessels found in the surface layer had disappeared . Histopathologically, no lymphoma cells remained . PCR with gastric mucosal tissue after the bacterial eradication treatment confirmed that H. pylori and H. suis had been successfully eradicated . Follow-up observation with regular endoscopic examination was planned to check for the recurrence of gastric MALT lymphoma or any changes in the form of the granular elevations. Fig. 1 EGD at first visit (before bacterial eradication). a Inconspicuous granular elevations can be seen in the vestibular area, b , c with multiple granular elevations in the body. d Narrow-band-imaging shows dilated blood vessels at the surface layer of the elevations. e Spraying of indigo carmine shows no elevations in the vestibular area. f , g Highly distinct granular elevations can be seen in the body. h In endoscopic ultrasonography, the lesions are extracted as hypoechoic masses on the surface of the second layer. EGD esophagogastroduodenoscopy Fig. 2 Pathological findings and other results (before bacterial eradication). a There is atypical cell (mainly small-to-medium lymphocytes including mild nuclear constriction in the lamina propria) invasion (HE staining at × 100 magnification). b Some lymphoepithelial lesions can be seen (HE staining at 400 × magnification). c Immunohistochemical findings (before bacterial eradication). Tumor cells are positive for CD20. d Gimenez staining shows helical bacilli in the deep gastric glands. e FISH does not reveal the API2-MALT1 gene in the lesions. f IgH gene rearrangement detects a single peak in four out of five areas. Red, MALT1 signal; green, API2 signal g PCR assay (before bacterial eradication). H. pylori (217 bp) and H. suis (253 bp) are detected, with negativity for other NHPH. HE hematoxylin and eosin, FISH fluorescence in situ hybridization, PCR polymerase chain reaction, NHPH non- H. pylori helicobacters Table 1 Primers for detection of H. pylori and non- H. pylori Helicobacters NHPH Primer (F: forward, R: reverse) Size (bp) H. pylori F: AAAGAGCGTGGTTTTCATGGCG 217 R: GGGTTTTACCGCCACCGAATTTAA H. suis F: CACCACCCCGGGGAAGTGATCTTG 253 R: CTACATCAATCAAATGCACGGTTTTTTCTTCG H. bizzozeronii F:CGCTTTGAACCCGGTGAGAAAA 172 R:TATCGCAACCGCAATTCACAACA H. felis F:TCCCACTACCGGGGATCGTG 350 R:CAGCGGTTACAATCAAGCCCTCA H. salomonis F:CTTTGGGTCTGTGCCTGCCTG 219 R:CATCGCGGATAGTCTTACCGCCT H. heilmannii s.s F:CTTTCTCCTGGTGAAGTGATTCTC 368 R:CAGTTGATGGTGCCAAAG Fig. 3 EGD, pathological findings and PCR assay (after bacterial eradication). a , b EGD (after bacterial eradication) shows multiple granular elevations remaining in the gastric body. c Disappeared dilated blood vessels on the surface layer of the elevations. d , e Pathological analysis (after bacterial eradication) shows no remaining lymphoma cells ( d HE staining at × 100 magnification, e HE staining at × 400 magnification). f PCR assay (after bacterial eradication) shows negativity for H. pylori and H. suis . PC positive control, HE hematoxylin and eosin, EGD esophagogastroduodenoscopy, PCR polymerase chain reaction
| 4.246094
| 0.910645
|
sec[1]/p[0]
|
en
| 0.999996
|
33393060
|
https://doi.org/10.1007/s12328-020-01310-5
|
[
"elevations",
"pylori",
"bacterial",
"eradication",
"granular",
"gastric",
"nhph",
"lesions",
"lymphoma",
"multiple"
] |
[
{
"code": "MB24.8",
"title": "Elevated mood"
},
{
"code": "5C80.Z",
"title": "Hyperlipoproteinaemia, unspecified"
},
{
"code": "MA14.1B",
"title": "Prostate specific antigen positive"
},
{
"code": "MG26",
"title": "Fever of other or unknown origin"
},
{
"code": "LB00.Y",
"title": "Other specified structural developmental anomalies of diaphragm"
},
{
"code": "DA60.1",
"title": "Helicobacter pylori associated gastric ulcer"
},
{
"code": "DA62.1",
"title": "Helicobacter pylori associated anastomotic ulcer"
},
{
"code": "DA63.1",
"title": "Helicobacter-pylori associated duodenal ulcer"
},
{
"code": "MG50.40",
"title": "Clarithromycin resistant Helicobacter pylori"
},
{
"code": "MG50.4Z",
"title": "Antibiotic resistant Helicobacter pylori, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[MB24.8] Elevated mood
Definition: A positive mood state typically characterised by increased energy and self-esteem which may be out of proportion to the individual's life circumstances.
Also known as: Elevated mood
[5C80.Z] Hyperlipoproteinaemia, unspecified
Also known as: Hyperlipoproteinaemia, unspecified | Hyperlipoproteinaemia | Hyperlipidaemia | hyperlipemia | lipemia
[MA14.1B] Prostate specific antigen positive
Also known as: Prostate specific antigen positive | PSA - [prostate specific antigen] | elevated PSA | increased prostatic specific antigen | Abnormality of prostate-specific antigen [PSA]
[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
[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
[DA60.1] Helicobacter pylori associated gastric ulcer
Definition: Helicobacter pylori (H. pylori) is a gram-negative bacillus that is found in the mucous layer overlying gastric epithelium, within epithelial cells and attached to mucous cells, leading to inflammation. It accounts for the majority of gastric ulcer. H. pylori that involves the acid-producing mucosa of the stomach can lead to hypochlorhydria or achlorhydria, and subsequent gastric ulceration.
Also known as: Helicobacter pylori associated gastric ulcer
Excludes: Helicobacter pylori associated and drug-induced gastric ulcer
[DA62.1] Helicobacter pylori associated anastomotic ulcer
Definition: Helicobacter pylori associated anastomotic ulcer is an ulcer at the anastomosis that is associated with Helicobacter pylori infection. Helicobacter pylori infection is considered as one of the risk factors for anastomotic ulcer.
Also known as: Helicobacter pylori associated anastomotic ulcer
[DA63.1] Helicobacter-pylori associated duodenal ulcer
Definition: Helicobacter pylori (H. pylori) is a gram-negative bacillus that is found in the mucous layer overlying gastric epithelium, within epithelial cells and attached to mucous cells, leading to inflammation. In the case of duodenal ulcers, H. pylori is believed to infect the gastric antrum or ectopic gastric mucosa in the duodenum. This is associated with increased acid production and duodenal ulceration.
Also known as: Helicobacter-pylori associated duodenal ulcer
[MG50.40] Clarithromycin resistant Helicobacter pylori
Also known as: Clarithromycin resistant Helicobacter pylori
[MG50.4Z] Antibiotic resistant Helicobacter pylori, unspecified
Also known as: Antibiotic resistant Helicobacter pylori, unspecified | Antibiotic resistant Helicobacter pylori
=== GRAPH WALKS ===
--- Walk 1 ---
[MB24.8] Elevated mood
Def: A positive mood state typically characterised by increased energy and self-esteem which may be out of proportion to the individual's life circumstances....
--PARENT--> [MB24] Symptoms or signs involving mood or affect
Def: Symptoms and signs involving the regulation and expression of emotions or feeling states....
--CHILD--> [MB24.0] Ambivalence
Def: Conflicting ideas, wishes, or feelings toward a person, thing or situation that are distressing and may create difficulties in making decisions....
--- Walk 2 ---
[MB24.8] Elevated mood
Def: A positive mood state typically characterised by increased energy and self-esteem which may be out of proportion to the individual's life circumstances....
--PARENT--> [MB24] Symptoms or signs involving mood or affect
Def: Symptoms and signs involving the regulation and expression of emotions or feeling states....
--CHILD--> [MB24.1] Anger
Def: An emotional state related to one's psychological interpretation of having been threatened that may range in intensity from mild irritation to intense fury and rage....
--- Walk 3 ---
[5C80.Z] Hyperlipoproteinaemia, unspecified
--PARENT--> [5C80] Hyperlipoproteinaemia
Def: Disorders of lipoprotein metabolism that result in high levels of lipoproteins in the circulating blood...
--CHILD--> [5C80.2] Mixed hyperlipidaemia
Def: Elevated levels of both LDL cholesterol and triglycerides in the blood...
--- Walk 4 ---
[5C80.Z] Hyperlipoproteinaemia, unspecified
--PARENT--> [5C80] Hyperlipoproteinaemia
Def: Disorders of lipoprotein metabolism that result in high levels of lipoproteins in the circulating blood...
--PARENT--> [?] Disorders of lipoprotein metabolism or certain specified lipidaemias
Def: Elevated levels of lipoprotein(a), or Lp(a), in the blood. It is associated with an elevated risk of cardiovascular diseases....
--- Walk 5 ---
[MA14.1B] Prostate specific antigen positive
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.12] Anticitrullinated protein antibody positive
--- Walk 6 ---
[MA14.1B] Prostate specific antigen positive
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.10] Abnormal reaction to tuberculin test
|
[
"[MB24.8] Elevated mood\n Def: A positive mood state typically characterised by increased energy and self-esteem which may be out of proportion to the individual's life circumstances....\n --PARENT--> [MB24] Symptoms or signs involving mood or affect\n Def: Symptoms and signs involving the regulation and expression of emotions or feeling states....\n --CHILD--> [MB24.0] Ambivalence\n Def: Conflicting ideas, wishes, or feelings toward a person, thing or situation that are distressing and may create difficulties in making decisions....",
"[MB24.8] Elevated mood\n Def: A positive mood state typically characterised by increased energy and self-esteem which may be out of proportion to the individual's life circumstances....\n --PARENT--> [MB24] Symptoms or signs involving mood or affect\n Def: Symptoms and signs involving the regulation and expression of emotions or feeling states....\n --CHILD--> [MB24.1] Anger\n Def: An emotional state related to one's psychological interpretation of having been threatened that may range in intensity from mild irritation to intense fury and rage....",
"[5C80.Z] Hyperlipoproteinaemia, unspecified\n --PARENT--> [5C80] Hyperlipoproteinaemia\n Def: Disorders of lipoprotein metabolism that result in high levels of lipoproteins in the circulating blood...\n --CHILD--> [5C80.2] Mixed hyperlipidaemia\n Def: Elevated levels of both LDL cholesterol and triglycerides in the blood...",
"[5C80.Z] Hyperlipoproteinaemia, unspecified\n --PARENT--> [5C80] Hyperlipoproteinaemia\n Def: Disorders of lipoprotein metabolism that result in high levels of lipoproteins in the circulating blood...\n --PARENT--> [?] Disorders of lipoprotein metabolism or certain specified lipidaemias\n Def: Elevated levels of lipoprotein(a), or Lp(a), in the blood. It is associated with an elevated risk of cardiovascular diseases....",
"[MA14.1B] Prostate specific antigen positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.12] Anticitrullinated protein antibody positive",
"[MA14.1B] Prostate specific antigen positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.10] Abnormal reaction to tuberculin test"
] |
MB24.8
|
Elevated mood
|
[
{
"from_icd11": "5C80.Z",
"icd10_code": "E7849",
"icd10_title": "Other hyperlipidemia"
},
{
"from_icd11": "5C80.Z",
"icd10_code": "E7841",
"icd10_title": "Elevated Lipoprotein(a)"
},
{
"from_icd11": "5C80.Z",
"icd10_code": "E785",
"icd10_title": "Hyperlipidemia, unspecified"
},
{
"from_icd11": "5C80.Z",
"icd10_code": "E784",
"icd10_title": "Other hyperlipidemia"
},
{
"from_icd11": "MA14.1B",
"icd10_code": "R9720",
"icd10_title": "Elevated prostate specific antigen [PSA]"
},
{
"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"
}
] |
E7849
|
Other hyperlipidemia
|
A 73-year-old man was referred to our hospital because of elevated serum alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (γ-GTP) levels. He had a history of atrial fibrillation and cerebral infarction, but no family history, abdominal surgery, or allergies were noted. He had a history of smoking but no history of heavy alcohol consumption. The patient’s Performance Status was 1. Laboratory examination results showed elevated serum aspartate aminotransferase (137 U/L; reference: 13–30 U/L), alanine aminotransferase (139 U/L; reference: 17–23 U/L), ALP 526 U/L, γ-GTP 1071 U/L. Total bilirubin (T-Bil) was not elevated. The patient was negative for hepatitis virus and had elevated serum tumor markers (carcinoembryonic antigen [CEA] and carbohydrate antigen 19-9 [CA19-9]), and IgG4 levels were within the normal limits. Contrast-enhanced computed tomography (CT) showed wall thickening with thickened intrapancreatic bile ducts, upper common bile duct, and intrahepatic bile duct dilatation. The liver parenchyma showed speckled early staining, suggesting cholangitis-induced changes. Magnetic resonance imaging showed a signal defect in the bile duct, endoscopic retrograde cholangiopancreatography (ERCP) showed a 2 cm stenosis in the lower bile duct, and intraductal ultrasonography showed a circumferential wall thickening at the site of stenosis. Biliary cytology, brushing cytology, and biopsy were performed, but no malignant findings were proven in all specimens. Since distal cholangiocarcinoma was strongly suspected on endoscopic and radiographic findings, surgical treatment was embarked on with the patient’s full consent. A pylorus-preserving pancreaticoduodenectomy with regional lymph node dissection was performed. Intraoperatively, pancreatic duct cannulation was performed; reconstruction was carried out using the Child’s method. Pancreatic-jejunal anastomosis was completed using the Blumgart technique. 19Fr Blake drains (Ethicon, Somerville, New Jersey, USA) were placed in the foramen of Winslow and anterior to the pancreatic anastomosis, completing the procedure. Histopathological findings revealed proliferating tumor tissue in the distal bile duct showing a 55 × 25 mm foci-like structure. The tumor primarily manifested as a poorly differentiated ductal adenocarcinoma. Although the tumor invaded the peri-bile duct tissue into the sub-serosal tissue, there was no invasion into the pancreatic tissue. Extension into the duodenal papillary region was noted. Lymphatic and venous invasion was noted. However, no lymph node metastasis was observed. The pathological diagnosis, according to the TNM staging system of the Union for International Cancer Control 8th edition, was Stage IIA (T2 N0 M0) distal bile duct cancer. On postoperative day (POD) 2, vomiting and abdominal distention were observed, and white blood count , C-reactive protein (CRP; 44 mg/dL), serum pancreatic amylase , trypsin , lipase , and drain AMY were elevated. Nafamostat mesilate and ulinastatin were administered continuously up to POD 5. In addition, the antibiotic cefozopran hydrochloride (2 g/day) was used continuously from the day of surgery. On POD 3, the drain AMY content was greater than three times the serum AMY; a pancreatic fistula was diagnosed. On POD 9, contrast-enhanced CT showed increased peripancreatic fatty tissue density, fluid accumulation in the pancreatic resection surface to the superior mesenteric vein and around the portal vein, and a diagnosis of postoperative pancreatitis was made . On POD 9, the pancreatic drain in front of the anastomosis that had been placed intraoperatively was replaced with a 14Fr Nelaton catheter (Terumo Corporation, Tokyo, Japan). Continuous irrigation with normal saline was initiated through the catheter to prevent post-pancreatectomy hemorrhage (PPH) due to poor drainage. On POD 25, the 14Fr Nelaton catheter on the anterior surface of the pancreas was replaced with a 10Fr one; irrigation was continued. On POD 39, contrast-enhanced CT showed that the intra-abdominal cavity due to pancreatic juice disappeared, but there was an increase in fluid in the pancreatic body tail . On POD 43, an endoscopic ultrasonography (EUS) drainage procedure was performed for encapsulated pancreatic necrosis in the retroperitoneum . Endostomy was planned, but on POD 46, the patient developed fever after self-removal of the drainage tube. Enterobacter cloacae was identified using a culture obtained from the abscess drainage during this procedure. On POD 50, the patient underwent CT-guided drainage via the retroperitoneum for encapsulated pancreatic necrosis of the retroperitoneum. The same bacteria as those detected in EUS drainage were detected. Based on the detection of bacteria from the abscess drainage culture, persistent inflammatory responses with WBC and CRP (12.15 mg/dL), as well as the presence of fever, the patient underwent necrosectomy with guided retroperitoneal drainage on POD 69. A drain was placed in the abscess cavity located on the dorsal side of the stomach; continuous irrigation was performed. On POD 76, fecal discharge was observed from the drain, and drainage and enterography were performed to confirm a fistula with the colon, and an ileal bi-pore colostomy was performed on the same day. On POD 82, contrast-enhanced CT revealed a residual abscess posterior to the stomach , with persistently elevated inflammatory markers. Therefore, endoscopic necrosectomy via retroperitoneal incision was performed on PODs 83, 85, and 100 . The patient’s general condition improved, and the inflammatory response also improved . For postoperative nutritional management, peripheral parenteral nutrition (PPN) was administered intravenously from PODs 1 to 11, and total parenteral nutrition (TPN) was started and administered from POD 12. Enteral nutrition was administered via enterostomy starting from POD6. However, after 3 endoscopic necrosectomies, the inflammatory response decreased, and the fluid retention improved on the CT scan. The patient was transferred to the hospital for rehabilitation on POD 139 .
| 4.050781
| 0.975098
|
sec[2]/p[0]
|
en
| 0.999998
|
PMC11868872
|
https://doi.org/10.70352/scrj.cr.24-0002
|
[
"pancreatic",
"drainage",
"bile",
"duct",
"serum",
"endoscopic",
"tissue",
"drain",
"tumor",
"contrast"
] |
[
{
"code": "DC3Z",
"title": "Diseases of pancreas, unspecified"
},
{
"code": "DC3Y",
"title": "Other specified diseases of pancreas"
},
{
"code": "LB21.3",
"title": "Agenesis-aplasia of pancreas"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "DC35.0",
"title": "Atrophy of pancreas"
},
{
"code": "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"
}
] |
=== ICD-11 CODES FOUND ===
[DC3Z] Diseases of pancreas, unspecified
Also known as: Diseases of pancreas, unspecified
[DC3Y] Other specified diseases of pancreas
Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis
[LB21.3] Agenesis-aplasia of pancreas
Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.
Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[DC35.0] Atrophy of pancreas
Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[DC3Z] Diseases of pancreas, unspecified
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--CHILD--> [DC31] Acute pancreatitis
Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system...
--- Walk 2 ---
[DC3Z] Diseases of pancreas, unspecified
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--RELATED_TO--> [?] Structural developmental anomalies of pancreas
--- Walk 3 ---
[DC3Y] Other specified diseases of pancreas
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--CHILD--> [DC30] Cystic diseases of the pancreas
Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue, which may contain air, fluids, or semi-solid material, of the pancreas....
--- Walk 4 ---
[DC3Y] Other specified diseases of pancreas
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--PARENT--> [13] Diseases of the digestive system
--- Walk 5 ---
[LB21.3] Agenesis-aplasia of pancreas
Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....
--PARENT--> [LB21] Structural developmental anomalies of pancreas
--CHILD--> [LB21.2] Accessory pancreas
Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo...
--- Walk 6 ---
[LB21.3] Agenesis-aplasia of pancreas
Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....
--PARENT--> [LB21] Structural developmental anomalies of pancreas
--CHILD--> [LB21.2] Accessory pancreas
Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo...
|
[
"[DC3Z] Diseases of pancreas, unspecified\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC31] Acute pancreatitis\n Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system...",
"[DC3Z] Diseases of pancreas, unspecified\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --RELATED_TO--> [?] Structural developmental anomalies of pancreas",
"[DC3Y] Other specified diseases of pancreas\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC30] Cystic diseases of the pancreas\n Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue, which may contain air, fluids, or semi-solid material, of the pancreas....",
"[DC3Y] Other specified diseases of pancreas\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --PARENT--> [13] Diseases of the digestive system",
"[LB21.3] Agenesis-aplasia of pancreas\n Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....\n --PARENT--> [LB21] Structural developmental anomalies of pancreas\n --CHILD--> [LB21.2] Accessory pancreas\n Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo...",
"[LB21.3] Agenesis-aplasia of pancreas\n Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....\n --PARENT--> [LB21] Structural developmental anomalies of pancreas\n --CHILD--> [LB21.2] Accessory pancreas\n Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo..."
] |
DC3Z
|
Diseases of pancreas, unspecified
|
[
{
"from_icd11": "DC3Z",
"icd10_code": "K8681",
"icd10_title": "Exocrine pancreatic insufficiency"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K8689",
"icd10_title": "Other specified diseases of pancreas"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K869",
"icd10_title": "Disease of pancreas, unspecified"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K868",
"icd10_title": "Other specified diseases of pancreas"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K87",
"icd10_title": "Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K80-K87",
"icd10_title": ""
},
{
"from_icd11": "DC3Z",
"icd10_code": "K86",
"icd10_title": "Other diseases of pancreas"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K871",
"icd10_title": ""
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q450",
"icd10_title": "Agenesis, aplasia and hypoplasia of pancreas"
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q38-Q45",
"icd10_title": ""
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q45",
"icd10_title": "Other congenital malformations of digestive system"
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q452",
"icd10_title": "Congenital pancreatic cyst"
},
{
"from_icd11": "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"
}
] |
K8681
|
Exocrine pancreatic insufficiency
|
He denied any gastrointestinal symptoms, or any similar episodes in the past. He had no history of sick contact or tick bites while in Jordan. He received Pfizer- BioNTech COVID-19 booster dose vaccination three weeks before the onset of illness. On examination, he was febrile, tachypneic and hypotensive. Oral mucositis, bilateral non hemorrhagic conjunctivitis and generalized maculopapular rash were noted . Cardiac and respiratory system examination were unyielding. His laboratory parameters ( Table 1 ) were significant for mild anemia, thrombocytopenia, elevated inflammatory markers, liver enzymes, D Dimer, and Troponins. Chest x-ray was unremarkable. Echocardiography showed mild reduced left ventricular (LV) systolic function with an ejection fraction (EF) of 45 %, mild global hypokinesis of the LV. Initial CT brain was normal. Patient was admitted with a working diagnosis of meningitis and myocarditis. Initially his family didn’t consent for lumbar puncture, hence, he was empirically started on ceftriaxone and acyclovir. MRI Brain showed cytotoxic lesion of the corpus callosum (CLOCC) involving the splenium . The blood cultures and respiratory viral panel were negative including COVID-19 PCR. However, despite more than 48 hours on treatment, there was no clinical response regarding his neurological and cardiac status. At this point, Infectious Diseases team was consulted. Upon reviewing, patient fulfilled all the major, minor, and lab parameters of Brighton Collaboration Case Definition ( Table 2 ) of Multisystem Inflammatory Syndrome in Children and Adults (MIS-C/A), hence a diagnosis of possible MIS-C post COVID-19 vaccination was made. His clinical features more suggestive of MIS-C rather than Kawasaki disease considering his age, predominantly ventricular dysfunction rather than coronary artery dilatation along with thrombocytopenia, high ferritin, and D Dimer. Cerebrospinal fluid (CSF) study was done later after convincing his parents, which ruled out meningitis. He was begun on intravenous immunoglobulin (IVIG) at a dose of 1 mg/kg/day × 2 days, IV methyl prednisolone 40 mg, 12th hourly × 3 days then oralised on discharge to prednisolone 60 mg tapered over 4 weeks and aspirin 100 mg daily. Within one day, remarkable clinical improvement was noted. His neurological symptoms and his vital signs started to stabilize, and he was back to his baseline functional status in 2 days. Advanced COVID-19 serology results suggested a positive vaccine induced immune response rather than previous infection . He was discharged on oral tapering steroids for one month. He was followed up after 2 weeks as outpatient and was asymptomatic with normalization of inflammatory markers and platelets as shown in Table 1 . Fig. 1 (a) Bilateral non hemorrhagic conjunctivitis. (b) Generalized erythematous maculopapular rash. (c) Oral mucositis with cracked lips. Fig. 1 Table 1 Relevant laboratory findings during hospitalization and at follow up at 2 weeks. Table 1 Patient values on admission Patient values on discharge Patient values at 2 weeks follow-up Normal range WBC (× 103/ul) 5.5 13.5 12 4–10 Hb (gm/dL) 12.1 13.1 14.4 13–17 Platelets (× 10 3 /uL) 97 496 324 150–496 Absolute lymphocyte count (× 10 3 /uL) 0.8 1.7 3 1–3 D -Dimer (mg/L FEU) 2.13 0.89 < 0.19 0.00–0.46 Fibrinogen (gm/L) 7.48 – 2.14 1.7 – 4.2 Albumin (gm/L) 28 26 – 35–50 ALT/AST (U/L) 109/82 96/42 106 /30 0–40 LDH (U/L) – 338 160 135–225 Troponin T – HS (ng/L) 364 66 9 3–15 CRP (mg/L) 134 28.5 < 2.0 0–5 Procalcitonin (ng/mL) 0.51 – – Less than 0.5 Ferritin (ug/L) 1124 751 – 20–155 Coagulation profile – Normal, Thyroid function – normal, Interleukin-6 – normal, Brucella serology – normal, blood cultures– no growth. Nasopharyngeal swab for respiratory viral panel were all negative for: Influenza A, Parainfluenza Virus 1–4, Coronavirus (NL63,229E,OC43,HKU), hMPV, Human Bocavirus and Mycoplasma pneumoniae, Human Rhino/Enterovirus, RSV A and B, Bordetella, legionella, MERS and COVID-19. Serology: CMV IgG and IgM – negative, EBV capsid antigen IgG and IgM – negative, Herpes Typ1 IgG– positive, herpes IgM – negative, Parvo B19 – IgG and IgM – negative. HIV 4th generation test – negative, Hepatitis B surface Ag and Hepatitis C Ab – negative, Treponemal Antibody – negative. CSF WBC–20, lymphocyte predominant, normal protein and sugar, CSF viral panel and VDRL – negative, CSF culture – no growth, CSF TB PCR and cultures – negative. CSF viral panel PCR were negative for: HSV 1 and 2, Varicella Zoster virus, Parechovirus, and Enterovirus. CSF bacterial panel were negative for (H influenza, Listeria, Neisseria, Streptococcus pneumoniae and agalactiae – negative) and CSF Cryptococcus neoformans/gatti PCR – negative. Connective tissue and vasculitis screening – negative. Fig. 2 Oval shaped corpus callosum lesion with diffusion restriction, high T2 and FLAIR signal without enhancement or hemorrhagic component on SWI consistent with cytotoxic lesion of corpus callosum (Transient splenial lesion). Fig. 2 Table 2 Brighton collaboration case definition . Table 2 Age < 21 years (MIS-C) OR > 21 years (MIS-A) AND Fever > 3 consecutive days AND 2 or more of the following clinical features: • Mucocutaneous (rash, erythema, or cracking of the lips/mouth/pharynx, bilateral nonexudative conjunctivitis, erythema/edema of the hands and feet) • Gastrointestinal (abdominal pain, vomiting, diarrhea) • Shock/hypotension • Neurologic (altered mental status, headache, weakness, paresthesia’s, lethargy) AND Laboratory evidence of inflammation including any of the following: Elevated CRP, ESR, ferritin, or procalcitonin AND 2 or more measures of disease activity: • Elevated BNP or NT- proBNP or troponin • Neutrophilia, lymphopenia, or thrombocytopenia • Evidence of cardiac involvement by echocardiography or physical stigmata of heart failure • EKG changes consistent with myocarditis or myo-pericarditis AND Laboratory confirmed SARS-CoV-2 infection OR Personal history of confirmed COVID-19 within 12 weeks OR Close contact with known COVID-19 case within 12 weeks OR Following SAR-CoV-2 vaccination
| 3.830078
| 0.981445
|
sec[1]/p[1]
|
en
| 0.999997
|
35996419
|
https://doi.org/10.1016/j.idcr.2022.e01606
|
[
"covid",
"panel",
"laboratory",
"lesion",
"viral",
"vaccination",
"oral",
"hemorrhagic",
"conjunctivitis",
"rash"
] |
[
{
"code": "RA01.0",
"title": "COVID-19, virus identified"
},
{
"code": "RA02",
"title": "Post COVID-19 condition"
},
{
"code": "RA01",
"title": "COVID-19"
},
{
"code": "RA01.1",
"title": "COVID-19, virus not identified"
},
{
"code": "QA08.5",
"title": "Special screening examination for other viral diseases"
},
{
"code": "QA00.C",
"title": "Laboratory examination"
},
{
"code": "MG71.Z",
"title": "Abnormal laboratory results, not elsewhere classified, unspecified"
},
{
"code": "MG71.Y",
"title": "Other specified abnormal laboratory results, not elsewhere classified"
},
{
"code": "QA0B",
"title": "Preprocedural examination"
},
{
"code": "MA14.0",
"title": "Laboratory evidence of human immunodeficiency virus"
}
] |
=== ICD-11 CODES FOUND ===
[RA01.0] COVID-19, virus identified
Also known as: COVID-19, virus identified | 2019-new Coronavirus acute respiratory disease (deprecated) | 2019-nCoV acute respiratory disease [temporary name] (deprecated) | Coronavirus disease 2019 | SARS-CoV-2 disease
Includes: Coronavirus disease 2019 | COVID-19 NOS
Excludes: Coronavirus infection, unspecified site | Middle East respiratory syndrome | Severe acute respiratory syndrome
[RA02] Post COVID-19 condition
Definition: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others, and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist fr
Also known as: Post COVID-19 condition | postCOVID condition | post-COVID-19 condition | long COVID
[RA01] COVID-19
Definition: As definition may evolve, the URL for the Global surveillance document will be added as the short description
Also known as: COVID-19
[RA01.1] COVID-19, virus not identified
Also known as: COVID-19, virus not identified | clinically diagnosed COVID-19 | suspected COVID-19 | probable COVID-19 | clinical COVID-19
Excludes: COVID-19, virus identified | Coronavirus infection, unspecified site | Special screening examination for other viral diseases
[QA08.5] Special screening examination for other viral diseases
Also known as: Special screening examination for other viral diseases | Measles screening | Poliomyelitis screening | Rubella screening | Screening for Dengue fever
Includes: Screening for COVID-19
Excludes: Viral intestinal infections | Special screening examination for infections with a predominantly sexual mode of transmission | Special screening examination for human immunodeficiency virus
[QA00.C] Laboratory examination
Also known as: Laboratory examination | laboratory test
[MG71.Z] Abnormal laboratory results, not elsewhere classified, unspecified
Also known as: Abnormal laboratory results, not elsewhere classified, unspecified | Abnormal laboratory results, not elsewhere classified
[MG71.Y] Other specified abnormal laboratory results, not elsewhere classified
Also known as: Other specified abnormal laboratory results, not elsewhere classified
[QA0B] Preprocedural examination
Definition: Evaluation and testing for assessment and proactive management of risks of perioperative morbidity and mortality and implements measurements to minimize risks.
Also known as: Preprocedural examination | Encounter for preoperative examinations | Preprocedural general examination | Encounter for preprocedural examination NOS | preoperative assessment
[MA14.0] Laboratory evidence of human immunodeficiency virus
Also known as: Laboratory evidence of human immunodeficiency virus | human immunodeficiency virus test positive | positive test for HIV | laboratory evidence of HIV | Nonconclusive HIV-test finding in infants
Excludes: Human immunodeficiency disease complicating pregnancy, childbirth or the puerperium | Human immunodeficiency virus disease | Asymptomatic human immunodeficiency virus infection
=== GRAPH WALKS ===
--- Walk 1 ---
[RA01.0] COVID-19, virus identified
--EXCLUDES--> [?] Middle East respiratory syndrome
Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...
--PARENT--> [?] Certain zoonotic viral diseases
--- Walk 2 ---
[RA01.0] COVID-19, virus identified
--EXCLUDES--> [?] Middle East respiratory syndrome
Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...
--PARENT--> [?] Certain zoonotic viral diseases
--- Walk 3 ---
[RA02] Post COVID-19 condition
Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--CHILD--> [RA00] Conditions of uncertain aetiology and emergency use
--- Walk 4 ---
[RA02] Post COVID-19 condition
Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--CHILD--> [RA00] Conditions of uncertain aetiology and emergency use
--- Walk 5 ---
[RA01] COVID-19
Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--PARENT--> [25] Codes for special purposes
--- Walk 6 ---
[RA01] COVID-19
Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--CHILD--> [RA00] Conditions of uncertain aetiology and emergency use
|
[
"[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Middle East respiratory syndrome\n Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...\n --PARENT--> [?] Certain zoonotic viral diseases",
"[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Middle East respiratory syndrome\n Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...\n --PARENT--> [?] Certain zoonotic viral diseases",
"[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA00] Conditions of uncertain aetiology and emergency use",
"[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA00] Conditions of uncertain aetiology and emergency use",
"[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --PARENT--> [25] Codes for special purposes",
"[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA00] Conditions of uncertain aetiology and emergency use"
] |
RA01.0
|
COVID-19, virus identified
|
[
{
"from_icd11": "QA08.5",
"icd10_code": "Z1159",
"icd10_title": "Encounter for screening for other viral diseases"
},
{
"from_icd11": "QA08.5",
"icd10_code": "Z1151",
"icd10_title": "Encounter for screening for human papillomavirus (HPV)"
},
{
"from_icd11": "QA08.5",
"icd10_code": "Z115",
"icd10_title": "Encounter for screening for other viral diseases"
},
{
"from_icd11": "QA00.C",
"icd10_code": "Z017",
"icd10_title": ""
},
{
"from_icd11": "QA0B",
"icd10_code": "Z01818",
"icd10_title": "Encounter for other preprocedural examination"
},
{
"from_icd11": "QA0B",
"icd10_code": "Z01810",
"icd10_title": "Encounter for preprocedural cardiovascular examination"
},
{
"from_icd11": "QA0B",
"icd10_code": "Z01812",
"icd10_title": "Encounter for preprocedural laboratory examination"
},
{
"from_icd11": "MA14.0",
"icd10_code": "R75",
"icd10_title": "Inconclusive laboratory evidence of human immunodeficiency virus [HIV]"
}
] |
Z1159
|
Encounter for screening for other viral diseases
|
FH is an uncommon longitudinal deficit characterized by a shortening or lack of fibula. Fibula can range from a little deficit to non-existent. Fetus-Fibula-Ulna syndrome, congenital short tibia with missing or dysplastic fibula, congenital deficit of proximal femoral focal deficiency, and intercalary hemimelia of the fibula can also occur with FH. Due to a folate deficit, our case is unique in that it combines FH with spina bifida. Significant shortening of the femur, ossification, shortened or anteriorly bent tibia, malformed or missing fibula with normal mineralization, and foot abnormalities are the primary sonographic findings. 7 These findings are consistent with our case except for the femur finding, which is normal. About 60%-80% of instances are unilateral, and the right side is afflicted more frequently than the left. 8 At the end of the 8th or 10th week of pregnancy, the upper and lower limbs’ embryologic growth and recording by sonography occur, but because of negligence, our patient’s mother did not do any antenatal screening, including sonography. Limb development requires the interplay of several complex regulatory proteins, including hedgehog proteins, homeobox factors, fibroblast growth factor, and bone morphogenic proteins. 9 Although the exact cause is uncertain, it is hypothesized that disturbance of blood flow and muscle development leads to disruption of vascular development. 10 Following a diagnosis of congenital limb deficit, a comprehensive anatomical scan for further system defects should be performed on the foetus. Although longitudinal limb abnormalities can happen on their own, they can also be a symptom of another condition. To determine whether there is a family history of limb abnormalities, the parents should be questioned and checked for them. Our patient denies any history of limb abnormalities. Identification of etiologic variables may be aided by a comprehensive pregnancy history that includes drugs, medicines, trauma, diabetes mellitus, exposure to viruses, drug usage, and chorion villus samples in the early weeks of pregnancy. As we mentioned earlier, our patient mother took unsafe medications, which are metronidazole (category B) and glycerine suppository (category C). Foetal anatomic scanning can be done using 2D and 3D ultrasonography for the differential diagnosis of FH, 9 , 10 although our case did not do detailed ultrasonography or other antinatal screening, probably due to a history of infertility or negligence. All foetal long bones should be measured once long-bone shortening has been established. Our measurements showed that the right lower limb was shorter by 15 cm than the left lower limb, and both thighs were normal and equal in length without any bowing. To identify any co-existing disorders, assessments of the foetal facial profile, cardiovascular, neurological, genitourinary, and gastrointestinal systems must also be carried out, which was all normal in our case. Making a care plan after a presumptive diagnosis requires early examination using a multidisciplinary approach involving a paediatric orthopaedic surgery team and a geneticist. 11 When diagnosing and assessing the severity of an illness, imaging is crucial in guiding its care. A hypoplastic or aplastic fibula can be seen on radiographs of the knee and foot. Other features include a shallow trochlear groove, a hypoplastic lateral femoral condyle, and either an absence or a hypoplastic intercondylar notch. Usually convex, the proximal tibial epiphysis lacks or has hypoplastic tibial spines. Recognized characteristics also include genu valgum deformity and tibial bending. 12 In order to rule out proximal focal femoral deficits, a hip radiograph should also be obtained. 13 Our patient’s hip radiograph shows no proximal femoral deficit, and the femur was generally normal . For FH, a number of categorization schemes have been developed; these schemes can support judgements about surgical technique and parental counselling. In the postnatal phase, the Achtermann and Kalamchi categorization systems are more frequently employed. 7 , 9 However, there are 3 primary forms of fibula absence: type 1 (10% of cases) is marked by a moderate-to-non-existent bent tibia and whole or partial loss of the fibula. Characterized by unilateral fibula absence, anterior tibial bending, and severe limb shortening, type 2 accounts for 35% of all cases. Cases with same-leg and foot abnormalities and unilateral or bilateral fibula absences are included in type 3 (55% of all cases). 10 Our case was diagnosed as type 2 FH based on our radiograph findings, which included a bent tibia, valgus deformity, and lack of the right fibula. The degree of fibular insufficiency, related femoral abnormalities, and foot, ankle, or knee deformities all affect the prognosis of FH. 7 Our patient had a good prognosis, as she did not have any bad prognostic factors, as mentioned above. The degree of leg-length discrepancy and foot function are the determining factors in the treatment of FH. A limb lengthening procedure is advised for patients with mild-to-moderate foot deformities who also have stable hip, knee, and ankle. 14 Promising results have been seen with the implementation of Ilizarov’s limb-lengthening method, including substantial limb lengthening and foot preservation. 15 Amputation is the suggested course of treatment for severe foot malformations (Syme’s and Boyd’s), 14 but the family refuses to follow this recommendation. Changulani et al 15 state that the quantity of radiation in the foot can be used to guide therapy and determine the severity of the deformity. Conversely, children with fewer than 3 rays required Syme’s amputation. 15 Every case is treated differently and is completed at institutions that have access to a multidisciplinary team consisting of paediatricians, physical therapists, and orthopaedists, as well as a wealth of information. Children with FH who get any of the 2 treatment options have a lower quality of life, despite the fact that there is no connection between FH patients and mental disability. 11
| 4.304688
| 0.631836
|
sec[2]/p[0]
|
en
| 0.999996
|
PMC11879310
|
https://doi.org/10.1093/bjrcr/uaaf008
|
[
"fibula",
"limb",
"foot",
"that",
"deficit",
"abnormalities",
"femoral",
"shortening",
"tibia",
"which"
] |
[
{
"code": "LB9A.2",
"title": "Fibular hemimelia"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "ME85",
"title": "Stiffness of joint"
},
{
"code": "LB96.Y",
"title": "Other specified congenital bowing of long bones"
},
{
"code": "FB80.Y",
"title": "Other specified disorders of bone density or structure"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[LB9A.2] Fibular hemimelia
Definition: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone.
Also known as: Fibular hemimelia | Longitudinal reduction defect of fibula | agenesis of fibula | congenital absence of fibula | congenital absence of fibula with or without absence of some distal elements
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[ME85] Stiffness of joint
Definition: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes.
Also known as: Stiffness of joint | joint stiffness | stiff joint | stiffness in joint | Stiffness of joint, multiple sites
[LB96.Y] Other specified congenital bowing of long bones
Also known as: Other specified congenital bowing of long bones | Congenital bowing of fibula | Serpentine fibula | Congenital bowing of humerus | Congenital bowing of ulna
[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
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[LB9A.2] Fibular hemimelia
Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.0] Amelia of lower limb
--- Walk 2 ---
[LB9A.2] Fibular hemimelia
Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.0] Amelia of lower limb
--- Walk 3 ---
[FB86.11] Hypertrophy of bone
--PARENT--> [FB86.1] Bone hyperplasias
--CHILD--> [FB86.11] Hypertrophy of bone
--- Walk 4 ---
[FB86.11] Hypertrophy of bone
--PARENT--> [FB86.1] Bone hyperplasias
--CHILD--> [FB86.10] Hypertrophic osteoarthropathy
Def: Hypertrophic osteoarthropathy (HOA) is a syndrome of clubbing of the digits, subperiosteal new bone formation (periostitis) affecting the long bones, and arthritis. The primary hereditary form is asso...
--- Walk 5 ---
[ME85] Stiffness of joint
Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....
--PARENT--> [?] Symptoms or signs of the musculoskeletal system
--RELATED_TO--> [?] Abnormality of tonus or reflex
--- Walk 6 ---
[ME85] Stiffness of joint
Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....
--PARENT--> [?] Symptoms or signs of the musculoskeletal system
--CHILD--> [ME80] Clicking hip
|
[
"[LB9A.2] Fibular hemimelia\n Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.0] Amelia of lower limb",
"[LB9A.2] Fibular hemimelia\n Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.0] Amelia of lower limb",
"[FB86.11] Hypertrophy of bone\n --PARENT--> [FB86.1] Bone hyperplasias\n --CHILD--> [FB86.11] Hypertrophy of bone",
"[FB86.11] Hypertrophy of bone\n --PARENT--> [FB86.1] Bone hyperplasias\n --CHILD--> [FB86.10] Hypertrophic osteoarthropathy\n Def: Hypertrophic osteoarthropathy (HOA) is a syndrome of clubbing of the digits, subperiosteal new bone formation (periostitis) affecting the long bones, and arthritis. The primary hereditary form is asso...",
"[ME85] Stiffness of joint\n Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....\n --PARENT--> [?] Symptoms or signs of the musculoskeletal system\n --RELATED_TO--> [?] Abnormality of tonus or reflex",
"[ME85] Stiffness of joint\n Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....\n --PARENT--> [?] Symptoms or signs of the musculoskeletal system\n --CHILD--> [ME80] Clicking hip"
] |
LB9A.2
|
Fibular hemimelia
|
[
{
"from_icd11": "LB9A.2",
"icd10_code": "Q726",
"icd10_title": "Longitudinal reduction defect of fibula"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89351",
"icd10_title": "Hypertrophy of bone, right femur"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89361",
"icd10_title": "Hypertrophy of bone, right tibia"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M8938",
"icd10_title": "Hypertrophy of bone, other site"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89371",
"icd10_title": "Hypertrophy of bone, right ankle and foot"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89363",
"icd10_title": "Hypertrophy of bone, right fibula"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89333",
"icd10_title": "Hypertrophy of bone, right radius"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89362",
"icd10_title": "Hypertrophy of bone, left tibia"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M8930",
"icd10_title": "Hypertrophy of bone, unspecified site"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M893",
"icd10_title": "Hypertrophy of bone"
},
{
"from_icd11": "ME85",
"icd10_code": "M25661",
"icd10_title": "Stiffness of right knee, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M2560",
"icd10_title": "Stiffness of unspecified joint, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25662",
"icd10_title": "Stiffness of left knee, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25642",
"icd10_title": "Stiffness of left hand, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25621",
"icd10_title": "Stiffness of right elbow, not elsewhere classified"
}
] |
Q726
|
Longitudinal reduction defect of fibula
|
The pathogenic mechanisms leading to cerebral infarction following COVID-19 are not yet fully elucidated. Studies indicate that COVID-19 increases the risk of ischemic stroke ( 17 ). In this case, the infant developed cerebral infarction just three days after exhibiting fever from the infection, indicating rapid disease progression. Post-infection, COVID-19 may trigger cytokine cascade reactions and endothelial cell dysfunction ( 18 , 19 ), leading to an inflammatory response, thrombocytopenia, and coagulation dysfunction ( 20 ). Damage to endothelial cells and coagulation dysfunction may lead to the formation of microthrombi and the development of ischemic stroke ( 21 ). Moreover, it has been reported that cytokines and the body’s immune response are correlated with the severity or risk of COVID-19 ( 22 , 23 ). In severe COVID-19 cases, patients may face acute respiratory distress syndrome, multiple organ dysfunction syndrome, or even death due to a cytokine storm. This hyperinflammatory condition is characterized by the uncontrolled release of pro-inflammatory cytokines, leading to significant complications. High levels of numerous crucial pro-inflammatory cytokines, such as interleukin-1 (IL-1), IL-2, IL-6, tumor necrosis factor-α, interferon (IFN)-γ, IL-10 and so on, have been found in severe COVID-19 ( 24 , 25 ). Moreover, the hyperproduction of IL-10 and IL-6 have been linked to cytokine storm-induced mortality in fatal thrombocytopenia syndrome and severe and critically ill COVID-19 patients ( 26 ). In addition, elevated IL-6 levels in serum at the time of admission have been linked to predicting a more severe progression of COVID-19 ( 27 ). Furthermore, risk factors, such as male gender, age and pre-existing comorbidities could indicate the progression of COVID-19 into a severe and critical stage ( 23 ). Indeed, infants (six-month-old, male gender) with concurrent tuberculosis and COVID-19 may face a fatal outcome ( 8 , 9 ). Recently, Mierzewska-Schmidt et al. reported a case of acute hemorrhagic necrotizing encephalitis in a previously healthy, 2-month-old male infant with SARS-CoV-2 infection ( 10 ), suggested that even in the absence of underlying diseases, SARS-CoV-2 infection in younger male infants can potentially lead to a fatal outcome. We reported a case of a 7-month-old male infant presenting with thrombocytopenia, coagulation dysfunction, and elevated cytokines, such as IL-10, indicating that our case were a severe instance of pediatric COVID-19. Notably, in our case, only IL-10 level was elevated, while other cytokines, such as IL-6, remained within normal range. This unique cytokine profile indicates a distinct immune response, offering valuable insights into the complex role of cytokines in COVID-19 and its neurological effects. Furthermore, the proportions of immune cells in our patient also underwent changes. CD3 + , CD4 + , and CD8 + T lymphocytes was significantly increased while CD3 - CD16 + CD56 + natural killer cells was significantly decreased, these results may be related to the severity of the disease ( 28 ). Fortunately, our case involved no underlying diseases, including the absence of tuberculosis co-infection, and our patient was relatively older compared to the three infants previously reported to have succumbed to COVID-19 ( 8 – 10 ). The protective factors including relative older age and no underlying comorbidities could be a significant factor in the favorable outcome of our case. Other studies indicate that hypoxemia could be a key factor in the occurrence of cerebral infarctions associated with COVID-19. Hypoxemia results in reduced oxygen supply to tissues, causing ischemia and hypoxia, and leads to the accumulation of red blood cells, increasing blood viscosity. This heightened blood viscosity can exacerbate the reduction in tissue oxygenation and nutrition, thereby perpetuating a detrimental cycle ( 29 ). A significant correlation between elevated whole blood viscosity and increased mortality rates was determined in patients with COVID-19 ( 30 ).Alterations in blood viscosity can profoundly impact blood flow dynamics, potentially tripling the risk of thrombus formation in both arteries and veins ( 31 ). Although the infant in this case exhibited respiratory symptoms due to COVID-19, there was no involvement of the lungs or signs of hypoxemia. Therefore, there is currently no basis to attribute the occurrence of post-COVID-19 cerebral infarction to hypoxemia. Furthermore, COVID-19 itself exhibits neuro-invasive and neurotropic characteristics, implying that the virus can directly or indirectly invade the central nervous system ( 32 , 33 ). Several hypothesized pathways for the neuroinvasion of SARS-CoV-2 have been proposed, encompassing mechanisms like transsynaptic transfer through infected neurons, invasion through the olfactory nerves, infection of the vascular endothelium, and the migration of leukocytes across the blood-brain barrier (BBB) ( 34 ). The primary host cell receptor for the SARS-CoV-2 is the angiotensin-converting enzyme 2 (ACE2). ACE2 is expressed in both neurons and glial cells. The binding of SARS-CoV-2 to ACE2 can lead to vasoconstriction and cellular damage ( 35 , 36 ). The spike protein of SARS-CoV-2 can also cause dysfunction in cerebral vascular endothelium by activating Ras homolog family member A, a key molecule involved in regulating the dynamics of endothelial cell cytoskeleton and tight junction complexes ( 37 ). This activation can subsequently compromise the integrity of BBB ( 38 ) and the blood-cerebrospinal fluid barrier ( 39 ). This might also explain why the primary manifestation in this infant post-infection was ischemic stroke. The aforementioned pathophysiological mechanisms are consistent with the clinical presentation observed in this case post-infection: an inflammatory response, a decline in platelets, scattered pinpoint bleeding spots throughout the body, coagulation dysfunction, leading to a right-sided cerebral infarction, and consequently, limb weakness and neurological changes in the left side of the body.
| 4.390625
| 0.567871
|
sec[2]/p[2]
|
en
| 0.999997
|
38590518
|
https://doi.org/10.3389/fimmu.2024.1357307
|
[
"covid",
"this",
"infection",
"blood",
"dysfunction",
"cerebral",
"that",
"cytokines",
"sars",
"cells"
] |
[
{
"code": "RA01.0",
"title": "COVID-19, virus identified"
},
{
"code": "RA02",
"title": "Post COVID-19 condition"
},
{
"code": "RA01",
"title": "COVID-19"
},
{
"code": "RA01.1",
"title": "COVID-19, virus not identified"
},
{
"code": "QA08.5",
"title": "Special screening examination for other viral diseases"
},
{
"code": "4A01.03",
"title": "Transient hypogammaglobulinaemia of infancy"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[RA01.0] COVID-19, virus identified
Also known as: COVID-19, virus identified | 2019-new Coronavirus acute respiratory disease (deprecated) | 2019-nCoV acute respiratory disease [temporary name] (deprecated) | Coronavirus disease 2019 | SARS-CoV-2 disease
Includes: Coronavirus disease 2019 | COVID-19 NOS
Excludes: Coronavirus infection, unspecified site | Middle East respiratory syndrome | Severe acute respiratory syndrome
[RA02] Post COVID-19 condition
Definition: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others, and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist fr
Also known as: Post COVID-19 condition | postCOVID condition | post-COVID-19 condition | long COVID
[RA01] COVID-19
Definition: As definition may evolve, the URL for the Global surveillance document will be added as the short description
Also known as: COVID-19
[RA01.1] COVID-19, virus not identified
Also known as: COVID-19, virus not identified | clinically diagnosed COVID-19 | suspected COVID-19 | probable COVID-19 | clinical COVID-19
Excludes: COVID-19, virus identified | Coronavirus infection, unspecified site | Special screening examination for other viral diseases
[QA08.5] Special screening examination for other viral diseases
Also known as: Special screening examination for other viral diseases | Measles screening | Poliomyelitis screening | Rubella screening | Screening for Dengue fever
Includes: Screening for COVID-19
Excludes: Viral intestinal infections | Special screening examination for infections with a predominantly sexual mode of transmission | Special screening examination for human immunodeficiency virus
[4A01.03] Transient hypogammaglobulinaemia of infancy
Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy]
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[RA01.0] COVID-19, virus identified
--EXCLUDES--> [?] Middle East respiratory syndrome
Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...
--PARENT--> [?] Certain zoonotic viral diseases
--- Walk 2 ---
[RA01.0] COVID-19, virus identified
--EXCLUDES--> [?] Coronavirus infection, unspecified site
--EXCLUDES--> [?] COVID-19, virus identified
--- Walk 3 ---
[RA02] Post COVID-19 condition
Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--CHILD--> [RA00] Conditions of uncertain aetiology and emergency use
--- Walk 4 ---
[RA02] Post COVID-19 condition
Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--PARENT--> [25] Codes for special purposes
--- Walk 5 ---
[RA01] COVID-19
Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...
--CHILD--> [RA01.1] COVID-19, virus not identified
--EXCLUDES--> [?] Special screening examination for other viral diseases
--- Walk 6 ---
[RA01] COVID-19
Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...
--PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use
--CHILD--> [RA01] COVID-19
Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...
|
[
"[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Middle East respiratory syndrome\n Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...\n --PARENT--> [?] Certain zoonotic viral diseases",
"[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site\n --EXCLUDES--> [?] COVID-19, virus identified",
"[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA00] Conditions of uncertain aetiology and emergency use",
"[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --PARENT--> [25] Codes for special purposes",
"[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --CHILD--> [RA01.1] COVID-19, virus not identified\n --EXCLUDES--> [?] Special screening examination for other viral diseases",
"[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description..."
] |
RA01.0
|
COVID-19, virus identified
|
[
{
"from_icd11": "QA08.5",
"icd10_code": "Z1159",
"icd10_title": "Encounter for screening for other viral diseases"
},
{
"from_icd11": "QA08.5",
"icd10_code": "Z1151",
"icd10_title": "Encounter for screening for human papillomavirus (HPV)"
},
{
"from_icd11": "QA08.5",
"icd10_code": "Z115",
"icd10_title": "Encounter for screening for other viral diseases"
},
{
"from_icd11": "4A01.03",
"icd10_code": "D807",
"icd10_title": "Transient hypogammaglobulinemia of infancy"
},
{
"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"
}
] |
Z1159
|
Encounter for screening for other viral diseases
|
A 55-year-old woman with known medical history of arterial hypertension, hypercholesterolemia and aortic stenosis, presented with a subacute episode of visual loss started as an arcuate visual field defect in the left eye (LE) and evolved in the next days in a larger central defect. Visual symptoms were accompanied by the onset headache and diffuse muscular pain, in particular with proximal musculature involvement. Her younger brother was diagnosed a few years earlier with MELAS for relapsing episodes of intestinal pseudo-obstruction, followed by SLEs. In a short period of time he experienced a rapidly progressive cognitive decline, unfortunately leading to his death . He carried a high mutational load, estimated by Real-time PCR, with an amount of 52% in muscle tissue, 28% in urinary epithelial and 18% in peripheral blood. Instead, her sister here presented resulted to be a carrier of the m.3243A > G variant, with 12% of mutation load in urinary epithelial cells and no alteration detected in peripheral blood leukocytes. She did not undergo muscular biopsy. Two days after the onset of symptoms she underwent ophthalmologic examination that revealed optic disc swelling for which prednisone 50 mg/day was started, then reduced to 25 mg/day after twelve days of therapy. One week after symptoms onset she developed left ear tinnitus, orbital pain exacerbated by ocular movements and throbbing temporal pain extended to the auricular and masseteric region worsened by chewing. Diffuse muscular pain with asthenia were still reported as well. Two weeks after the onset of symptoms the case was referred to our hospital for evaluation. She was taking oral olmesartan 40 mg daily, hydrochlorothiazide 20 mg daily, prednisone 25 mg daily. She has not had any intercurrent infections or assumption of drugs with putative mitochondrial toxicity. Therapy with ubidecarenone and L-Arginine were immediately started at admission. L-Arginine was administered intravenously for the first five days at 0.5gr/kg daily. Ubidecarenone was started and continued with a posology of 300 mg/day subdivided in three administrations. Visual acuity was 20/20 in the right eye (RE) and 20/20 in the LE. Visual field exam confirmed a dense diffuse scotoma in the affected eye . Ophthalmologic evaluation confirmed left eye optic neuropathy consisting in unilateral swelling of the optic nerve head, with cotton wool spots, splinter haemorrhages and venous congestion. The right optic disc was normal and showed a physiological excavation. Mild pigmentary changes of the posterior pole, characteristic for MELAS, were detected bilaterally . Autofluorescence images confirmed this finding . Fluorescein angiography (FA) showed segmental perfusion delay in the optic disc, focal telangiectasia and papillary leakage, while indocyanine angiography ruled out delayed filling of the choroid. Late phase FA ruled out other signs of ocular inflammation such as vasculitis . OCT scans detected retinal nerve fiber layer (RNFL) thickening only in the LE and an initial thinning of macular ganglion cell layer (GCL) . Visual evoked potential showed a reduction in amplitude with prolonged P100 in the left eye. Brain MRI did not show optic nerve inflammation or any other pathological feature, while spectroscopy revealed abnormal lactate peak in the CSF. To rule out atypical presentation of multiple sclerosis (MS), neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD), spinal cord MRI was also performed nineteen days after the onset of symptoms and did not show demyelinating lesions at all. Short tau inversion recovery (STIR) and diffuse weighted imaging (DWI) sequences were performed too without any findings supporting inflammatory or SLE-related lesions. Serum myelin oligodendrocyte glyco (MOG) and aquaporin auto-antibodies were found to be negative. Erythrocyte Sedimentation Rate (ESR) and C Reactive Protein (CRP) were assessed for the first time after ten days of steroids therapy and were both negative. Fludeoxyglucose positron emission tomography (FDG-PET) and temporal artery biopsy were performed without any findings that might support large-vessel vasculitis of inflammatory processes. Other possible risk factors for non-arteritic anterior ischemic optic neuropathy (NAION) such as anaemia, diabetes, nocturnal dip, sleep apnoea were investigated and excluded. Serum lactate was 1.7 mmol/L. CSF analysis was unremarkable. CSF infection was excluded and oligoclonal bands were absent. mtDNA sequencing analysis was performed and ruled out the possible presence of mitochondrial mutations known to be associated with MELAS/LHON overlap syndrome. Mitochondrial sequencing analysis confirmed the m.3243A > G transition, and excluded the three most common LHON mutations, as well as the m.3376G > A, described in literature for being associated with LHON/MELAS overlap syndrome. Fig. 1 A Humphrey 30–2 visual field detected a normal visual field in the right eye (RE) and a dense diffuse scotoma in the left eye (LE). B Fundus colour picture: normal RE, LE optic disc swelling with cotton wool spots, splinter haemorrhages and venous congestion. C - D Autofluorescence images (FAF, Heidelberg Spectralis, 30 and 55 degrees lenses): bilateral mild pigmentary changes of the posterior pole, characteristic of MELAS. E Fluorescein angiography (FA, Heidelberg Spectralis, 30 degree lens) showed segmental perfusion delay in the optic disc, focal telangiectasia and papillary leakage, F Indocyanine angiography ( Heidelberg Spectralis, 55 degree lens) ruled out delayed filling of the choroid, while late phase FA ruled out other signs of ocular inflammation Fig. 2 A Optical coherence tomography (OCT) scans detected retinal nerve fiber layer (RNFL) thickening only in the LE and an initial thinning of macular ganglion cell layer (GCL). B At the follow-up visit after four months, visual field defects remained almost stable, while the swelling of the optic disc resolved leaving an atrophic optic nerve head. C Fundus colour picture and D OCT after four months since the onset of symptoms
| 4.109375
| 0.975098
|
sec[1]/p[0]
|
en
| 0.999997
|
37095452
|
https://doi.org/10.1186/s12883-023-03198-3
|
[
"optic",
"visual",
"onset",
"disc",
"field",
"melas",
"nerve",
"ruled",
"pain",
"swelling"
] |
[
{
"code": "9C40.BZ",
"title": "Optic atrophy, unspecified"
},
{
"code": "9C40.Z",
"title": "Disorder of the optic nerve, unspecified"
},
{
"code": "9C40.1Y",
"title": "Other specified optic neuritis"
},
{
"code": "9C40.B0",
"title": "Congenital optic atrophy"
},
{
"code": "9C40.Y",
"title": "Other specified disorder of the optic nerve"
},
{
"code": "9E1Z",
"title": "Diseases of the visual system, unspecified"
},
{
"code": "MC1Y",
"title": "Other specified symptoms or signs involving the visual system"
},
{
"code": "9D9Z",
"title": "Vision impairment, unspecified"
},
{
"code": "9D90.2",
"title": "Moderate vision impairment"
},
{
"code": "QA00.6Z",
"title": "Examination of eyes or vision, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[9C40.BZ] Optic atrophy, unspecified
Also known as: Optic atrophy, unspecified | Optic atrophy | optic nerve atrophy | Primary optic atrophy | OA - [optic atrophy]
[9C40.Z] Disorder of the optic nerve, unspecified
Also known as: Disorder of the optic nerve, unspecified | Disorder of the optic nerve | disease of optic cranial nerve | disease of optic nerve | disease of second cranial nerve
[9C40.1Y] Other specified optic neuritis
Also known as: Other specified optic neuritis | Idiopathic inflammatory optic neuropathy | Idiopathic demyelinating optic neuropathy | optic nerve inflammation | optic nerve neuropathy
[9C40.B0] Congenital optic atrophy
Also known as: Congenital optic atrophy
[9C40.Y] Other specified disorder of the optic nerve
Also known as: Other specified disorder of the optic nerve | Nutritional optic neuropathy | nutritional amblyopia | Toxic optic neuropathy | Haemorrhage in optic nerve sheath
[9E1Z] Diseases of the visual system, unspecified
Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder
[MC1Y] Other specified symptoms or signs involving the visual system
Also known as: Other specified symptoms or signs involving the visual system | Erythema of eyelid | Visual disturbances | disturbances of vision | difficulty seeing
[9D9Z] Vision impairment, unspecified
Also known as: Vision impairment, unspecified | sight impaired | blindness and low vision | impaired vision
[9D90.2] Moderate vision impairment
Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision]
Includes: visual impairment category 2, in both eyes
[QA00.6Z] Examination of eyes or vision, unspecified
Also known as: Examination of eyes or vision, unspecified | Examination of eyes or vision | general eye examination | routine eye examination | vision examination
=== GRAPH WALKS ===
--- Walk 1 ---
[9C40.BZ] Optic atrophy, unspecified
--PARENT--> [9C40.B] Optic atrophy
Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...
--RELATED_TO--> [?] Leber hereditary optic neuropathy
Def: Optic nerve disorders caused by mutations in mitochondrial DNA...
--- Walk 2 ---
[9C40.BZ] Optic atrophy, unspecified
--PARENT--> [9C40.B] Optic atrophy
Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...
--CHILD--> [9C40.B1] Acquired optic atrophy
--- Walk 3 ---
[9C40.Z] Disorder of the optic nerve, unspecified
--PARENT--> [9C40] Disorder of the optic nerve
--RELATED_TO--> [?] Congenital malformation of optic disc
--- Walk 4 ---
[9C40.Z] Disorder of the optic nerve, unspecified
--PARENT--> [9C40] Disorder of the optic nerve
--RELATED_TO--> [?] Malignant neoplasm of the optic nerve
--- Walk 5 ---
[9C40.1Y] Other specified optic neuritis
--PARENT--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--CHILD--> [9C40.1Y] Other specified optic neuritis
--- Walk 6 ---
[9C40.1Y] Other specified optic neuritis
--PARENT--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--RELATED_TO--> [?] Neuromyelitis optica
|
[
"[9C40.BZ] Optic atrophy, unspecified\n --PARENT--> [9C40.B] Optic atrophy\n Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...\n --RELATED_TO--> [?] Leber hereditary optic neuropathy\n Def: Optic nerve disorders caused by mutations in mitochondrial DNA...",
"[9C40.BZ] Optic atrophy, unspecified\n --PARENT--> [9C40.B] Optic atrophy\n Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...\n --CHILD--> [9C40.B1] Acquired optic atrophy",
"[9C40.Z] Disorder of the optic nerve, unspecified\n --PARENT--> [9C40] Disorder of the optic nerve\n --RELATED_TO--> [?] Congenital malformation of optic disc",
"[9C40.Z] Disorder of the optic nerve, unspecified\n --PARENT--> [9C40] Disorder of the optic nerve\n --RELATED_TO--> [?] Malignant neoplasm of the optic nerve",
"[9C40.1Y] Other specified optic neuritis\n --PARENT--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...\n --CHILD--> [9C40.1Y] Other specified optic neuritis",
"[9C40.1Y] Other specified optic neuritis\n --PARENT--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...\n --RELATED_TO--> [?] Neuromyelitis optica"
] |
9C40.BZ
|
Optic atrophy, unspecified
|
[
{
"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": "9C40.Z",
"icd10_code": "H47012",
"icd10_title": "Ischemic optic neuropathy, left eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47099",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47091",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, right eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47093",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, bilateral"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47019",
"icd10_title": "Ischemic optic neuropathy, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47013",
"icd10_title": "Ischemic optic neuropathy, bilateral"
}
] |
H47213
|
Primary optic atrophy, bilateral
|
The tumor from the youngest FGFR patient, F48, had FGFR2 alterations and a very aggressive course, resulting in rapid general status decline that precluded post-resection attempts to radio- and chemotherapy . F48 was admitted following seizure on the left side of her body with loss of consciousness at work. She also complained of tingling in her 3rd, 4th and 5th digits for 2–3 weeks prior admission, and of occasional headaches and vision blurring for years. Brain magnetic resonance imaging (MRI) showed a right temporal, 4 × 2 cm, rim-enhancing mass, hyperintense on T2-weighted (W) images and hypointense on T2W-FLAIR . T2W-FLAIR showed also peri-insular and posterosuperior temporoparietal white matter infiltration , and T1W post-contrast images showed contrast enhancement lining the Sylvian fissure, suggestive of LM infiltration . Gross total resection (Res 1 ) and histopathological examination of the rim-enhancing mass revealed a gelatinous neoplasm with embryonal/HG neuroendocrine morphology, abundant myxoid extracellular matrix (ECM), necrosis, microvascular proliferation and a very high mitotic index, with up to 33 mitotic figures per 1 high power field . GFAP was positive in a small subset of neoplastic cells, and IDH1-R132H and p53 were diffusely positive in neoplastic cells . MGMT gene promoter methylation was negative (Table 1 ). The diagnosis rendered was glioblastoma, IDH-mutant, WHO grade IV, roughly predicting a 2.5-year median survival. An MRI performed one month later was suspicious for meningitis or LM gliomatosis, for which the patient was placed on antibiotics without improvement. A second resection (Res 2 ) was performed consisting of re-resection of the initial mass, of a second lower temporal mass, and of multiple dura mater biopsies. Histopathological examination showed LM gliomatosis exhibiting rhabdoid tumor cell morphology, necrosis, and extensive loss of GFAP expression . Following the second surgery, F48 was placed in hospice, and expired 2 weeks later, with a post-surgery survival of 10 weeks. An autopsy was performed within 3 h postmortem. The recorded brain weight was 1215 g, slightly lower than the normal range for age and gender, most likely due to prior resections. The leptomeninges overlaying the base of the brain contained a thick, granular or frankly nodular infiltrate with focal areas of hyperemia, hemorrhage or necrosis, filling the interhemispheric space and encasing all the structures at the base . At sectioning, two masses were apparent in the right temporal lobe: a 6 × 4 cm hematoma containing white nodular infiltrate and corresponding to the previous resection sites, and an adjacent 3-cm-diameter necrotic mass in the Sylvian fissure, involving the anterior insula . Effacement of the grey-white matter junction and induration of the subjacent white matter extended posteriorly in the Heschl’s transverse and upper temporal gyri . Histopathological examination revealed massive infiltration of the leptomeninges by a HG mucinous neoplasm with extensive geographic necrosis and viable cells arranged around vessels . IHC showed diffuse positivity for p53, Olig2 and IDH1-R132H, but GFAP was retained only in a small perivascular subset, similarly to the Res 2 specimen. In contrast, the diffusely infiltrating (DI) astrocytic neoplasm corresponding to the indurated white-matter areas, displayed a low-grade (LG) appearance, with relatively sparse IDH1-R132H-positive and p53-positive neoplastic cells . The HG LM component was composed of small rhabdoid cells with round, mostly uniform nuclei containing salt-and-pepper granular chromatin and sometimes a cherry-red nucleolus . Ultrastructural examination confirmed the nuclear features, the numerous mitotic figures and the rhabdoid appearance imparted by perinuclear whorls of intermediate filaments . Since both GFAP and cytokeratin immunostains were negative, vimentin was tested, and its strong IHC positivity indicated the nature of the intermediate filaments composing the whorls. From the LM space, the rhabdoid neoplasm re-invaded the brain through Virchow–Robin perivascular spaces, with breach of the pia mater, and either radial diffusion into the parenchyma with single cell invasion on a short distance or “en bloc” penetration of the parenchyma . Many apparently uninvolved structures grossly were microscopically invaded by the LM neoplasm . Semiquantitative evaluation of the tumor burden showed extensive, and in most part, massive infiltration of the brain structures by the LM component . The LG DI component showed only a low tumor burden within the cerebral white matter and white matter tracts. Fig. 1 Three radiologically and histologically different neoplasms in F48 IDH-mutant glioblastoma with FGFR2 alterations. a Timeline of disease progression. b Initial axial MRI shows a rim-enhancing, T2W hyperintense and T2W-FLAIR hypointense mass (blue arrow), Sylvian fissure enhancement (red arrow), and extensive white matter infiltration (green arrow), each corresponding to a different tumor. c H&E and IHC with indicated antibodies of the resected rim-enhancing mass (Res 1 ). Note HG neuroendocrine/embryonal morphology with hyperchromatic nuclei and frequent mitoses (arrow). IHC with Cam5.2, TTF-1, HMB-45, p40, p63, CD45, estrogen receptor and mammaglobin to exclude a metastatic neoplasm showed negative results (not shown). d Autopsy showing the entire brain base covered in a thick, nodular, hyperemic or hemorrhagic LM infiltrate. e Gross and microscopic appearance of the HG LM infiltrate. Sections S3 and S4 show the resection site (blue arrows) and the Sylvian fissure LM neoplasm (red arrow). H&E and IHC with indicated antibodies of the Sylvian fissure LM tumor (LM S4 ). f H&E and IDH-R132H reactivity of the LG DI neoplasm from S6 white matter (DI S6 ). g Close-up H&E of the HG LM component showing rhabdoid cells embedded in myxoid ECM. h Ultrastructural evaluation showing true rhabdoid cells with perinuclear whorls of intermediate filaments, and numerous mitotic figures. IHC for vimentin shows strong positivity in the whorls
| 4.238281
| 0.92627
|
sec[2]/sec[0]/p[1]
|
en
| 0.999997
|
33853673
|
https://doi.org/10.1186/s40478-021-01170-1
|
[
"white",
"matter",
"neoplasm",
"cells",
"tumor",
"resection",
"brain",
"rhabdoid",
"infiltration",
"sylvian"
] |
[
{
"code": "EF5Y",
"title": "Other specified dermatoses attributable to hyperviscosity or microvascular occlusion"
},
{
"code": "JB41.1",
"title": "Deep phlebothrombosis in the puerperium"
},
{
"code": "EB60.Y",
"title": "Lichen sclerosus of other specified sites"
},
{
"code": "MC80.00",
"title": "White coat hypertension"
},
{
"code": "1F2D.2",
"title": "White piedra"
},
{
"code": "8A45.1",
"title": "White matter disorders due to toxicity"
},
{
"code": "8E7Y",
"title": "Other specified diseases of the nervous system"
},
{
"code": "EH93.2",
"title": "Foreign body reaction to organic matter in the skin"
},
{
"code": "8A45.0Z",
"title": "White matter disorders due to infections, unspecified"
},
{
"code": "8A45.3Z",
"title": "White matter disorders due to nutritional deficiency, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion
Also known as: Other specified dermatoses attributable to hyperviscosity or microvascular occlusion | Cutaneous microvascular occlusion by platelet plugs | Cutaneous microvascular disturbances due to myeloproliferative disorder-associated platelet plugs | Cutaneous microvascular disturbances due to paroxysmal nocturnal haemoglobinuria-associated platelet plugs | Cutaneous microvascular occlusion by emboli
[JB41.1] Deep phlebothrombosis in the puerperium
Also known as: Deep phlebothrombosis in the puerperium | postnatal deep vein thrombosis | postpartum deep phlebothrombosis | postpartum deep-vein thrombosis | DVT - [deep venous thrombosis] postnatal
[EB60.Y] Lichen sclerosus of other specified sites
Also known as: Lichen sclerosus of other specified sites | Extragenital lichen sclerosus | Guttate lichen sclerosus | White spot disease | Guttate scleroderma
[MC80.00] White coat hypertension
Definition: Persistently elevated office blood pressure readings with persistently normal out-of-the-office readings.
Also known as: White coat hypertension | white coat syndrome
[1F2D.2] White piedra
Definition: A disease of the hair shaft, caused by an infection with the fungi Trichosporon beigelii. This disease is characterised by irregular, soft, white, or light brown nodules which adhere to the hair follicle. Transmission is by direct contact with contaminated soil or water, or by airborne transmission. Confirmation is by identification of Trichosporon beigelii in a hair follicle sample.
Also known as: White piedra | Trichosporosis nodosa
Includes: Trichosporosis nodosa
[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
[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
[EH93.2] Foreign body reaction to organic matter in the skin
Also known as: Foreign body reaction to organic matter in the skin | Sea-urchin granuloma | Foreign body reaction to cactus spines
[8A45.0Z] White matter disorders due to infections, unspecified
Also known as: White matter disorders due to infections, unspecified | White matter disorders due to infections
[8A45.3Z] White matter disorders due to nutritional deficiency, unspecified
Also known as: White matter disorders due to nutritional deficiency, unspecified | White matter disorders due to nutritional deficiency
=== GRAPH WALKS ===
--- Walk 1 ---
[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion
--PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion
Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion....
--RELATED_TO--> [?] Disseminated intravascular coagulation
Def: A disorder that is characterised by the systemic intravascular activation of the coagulation system, simultaneously leading to intravascular thrombi, compromising an adequate blood supply to the organ...
--- Walk 2 ---
[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion
--PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion
Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion....
--RELATED_TO--> [?] Antiphospholipid syndrome
Def: Antiphospholipid syndrome, also known as Hughes syndrome, is a systemic autoimmune condition characterised by the presence of antiphospholipid antibodies (aPL) in the serum of patients with thrombotic...
--- Walk 3 ---
[JB41.1] Deep phlebothrombosis in the puerperium
--PARENT--> [JB41] Venous complications in the puerperium
--CHILD--> [JB41.2] Haemorrhoids in the puerperium
--- Walk 4 ---
[JB41.1] Deep phlebothrombosis in the puerperium
--PARENT--> [JB41] Venous complications in the puerperium
--CHILD--> [JB41.0] Superficial thrombophlebitis in the puerperium
--- Walk 5 ---
[EB60.Y] Lichen sclerosus of other specified sites
--PARENT--> [EB60] Lichen sclerosus
Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv...
--CHILD--> [EB60.Y] Lichen sclerosus of other specified sites
--- Walk 6 ---
[EB60.Y] Lichen sclerosus of other specified sites
--PARENT--> [EB60] Lichen sclerosus
Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv...
--CHILD--> [EB60.Y] Lichen sclerosus of other specified sites
|
[
"[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion\n --PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion\n Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion....\n --RELATED_TO--> [?] Disseminated intravascular coagulation\n Def: A disorder that is characterised by the systemic intravascular activation of the coagulation system, simultaneously leading to intravascular thrombi, compromising an adequate blood supply to the organ...",
"[EF5Y] Other specified dermatoses attributable to hyperviscosity or microvascular occlusion\n --PARENT--> [?] Dermatoses attributable to hyperviscosity or microvascular occlusion\n Def: A range of disorders characterised by vascular occlusion but attributable not to primary vascular inflammation but to intravascular occlusion....\n --RELATED_TO--> [?] Antiphospholipid syndrome\n Def: Antiphospholipid syndrome, also known as Hughes syndrome, is a systemic autoimmune condition characterised by the presence of antiphospholipid antibodies (aPL) in the serum of patients with thrombotic...",
"[JB41.1] Deep phlebothrombosis in the puerperium\n --PARENT--> [JB41] Venous complications in the puerperium\n --CHILD--> [JB41.2] Haemorrhoids in the puerperium",
"[JB41.1] Deep phlebothrombosis in the puerperium\n --PARENT--> [JB41] Venous complications in the puerperium\n --CHILD--> [JB41.0] Superficial thrombophlebitis in the puerperium",
"[EB60.Y] Lichen sclerosus of other specified sites\n --PARENT--> [EB60] Lichen sclerosus\n Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv...\n --CHILD--> [EB60.Y] Lichen sclerosus of other specified sites",
"[EB60.Y] Lichen sclerosus of other specified sites\n --PARENT--> [EB60] Lichen sclerosus\n Def: Lichen sclerosus is a chronic inflammatory dermatosis of unknown aetiology. It affects both women and men of all ages. It is characterised by the development of white, smooth, atrophic plaques on vulv...\n --CHILD--> [EB60.Y] Lichen sclerosus of other specified sites"
] |
EF5Y
|
Other specified dermatoses attributable to hyperviscosity or microvascular occlusion
|
[
{
"from_icd11": "JB41.1",
"icd10_code": "O871",
"icd10_title": "Deep phlebothrombosis in the puerperium"
},
{
"from_icd11": "1F2D.2",
"icd10_code": "B362",
"icd10_title": "White piedra"
},
{
"from_icd11": "EH93.2",
"icd10_code": "L923",
"icd10_title": "Foreign body granuloma of the skin and subcutaneous tissue"
}
] |
O871
|
Deep phlebothrombosis in the puerperium
|
As far as we know, this is the first described case in literature of a cervical schwannoma diagnosed and treated in pregnancy. Melanocytic schwannoma is a rare nerve sheath tumor that occurs in a wide variety of locations. Most commonly, it occurs in middle aged subjects, without a clear gender predilection . These tumors are usually detected as a solitary, painless, and slow-growing mass of variable size . They usually involve superficial soft tissues of the extremities, relatively most often in the head and neck region and the distal parts of the extremities. Uncommonly, large tumors are found in the posterior mediastinum or the retroperitoneum, as described in several reports [ 2 , 4 – 7 ]. When located in the pelvic cavity, schwannomas are usually misdiagnosed as gynecologic masses. Typical schwannomas can also primarily involve visceral sites such as the gastrointestinal tract, the kidneys, and the breasts; however, their diagnosis in the uterine cervix is extremely rare . They are usually asymptomatic until their massive growth compresses adjacent organs. Multiple similar lesions may be seen in association with von-Recklinghausen's neurofibromatosis. Schwannomas are mostly benign and less than 1% progresses towards malignancy transformation, known in these cases as malignant peripheral nerve sheath tumors (MPNSTs) . Primary malignant schwannomas are a type of neural sheath tumors, representing 10% of soft tissue sarcomas. They are remarkable for their aggressive growth. The median age of patients at onset is 36 years, with a typical high prevalence between the ages from 20 to 50 years (8). Among all schwannomas, the pelvic occurrence represents 1–3% of all cases . The melanin production by Schwann cells is explained by the common origin of melanocytes and Schwann cells from neural crest cells. The clinical behaviour of this neoplasm is variable. Conditions that should be considered in the differential diagnosis are neurofibromas, leiomyomas, angiomyofibroblastomas, and melanomas . The histological cell types of malignant schwannomas include glandular, melanocytic, malignant triton, and epithelioid types. The schwannoma is characterized by alternating areas of hyper- (Antoni A) and hypo- (Antoni B) cellularity. Clusters of parallel-arranged spindle cells are contained in Antoni A areas, forming palisades, commonly known as Verocay's bodies. Cells loosely arranged in a myxoid background are present in the Antoni B areas . The absence of staining for CD34 and neurofilament protein (NFP), together with the strong positivity for S100 protein, supports the diagnosis of schwannoma as opposed to neurofibroma. Moreover, the presence of thickened-wall hyalinized blood vessels favours the diagnosis of schwannoma. Positivity for the S100 protein and negativity for desmin and actin argue against leiomyoma and angiomyofibroblastoma. Finally, a negative pan-melanoma staining essentially excludes melanoma [ 9 – 13 ]. Preoperative neurologic findings, anatomic location, electron microscopy, and immunohistochemistry findings help to establish the diagnosis between this neoplasm and the more common malignant melanoma, with electron microscopy having a role in distinguishing between benign and malignant lesions. Literature review accounts for seventeen published cases of schwannomas of the cervix ( Table 1 ), ten of which were malignant. Malignancy in schwannomas or MPNST typically presents with abnormal vaginal bleeding . As far as it regards our reported case, the rationale behind the decision to perform a simple trachelectomy, rather than a radical procedure, was guided by several coexistent factors: first of all, the lack of any evidence of malignancy either preoperatively or from the pathological reviews of the first-line conservative excisions, and secondly, the ongoing pregnancy at the time of the patient's referral to our department played a significant role in our, together with the patient's willingness, decision-making process. Commonly, surgical excision is recommended in cases of benign schwannomas, which rarely recur if completely excised . The surgical approach to a mesenchymal neoplasm of the cervix, in fact, especially in young patients, actually requires a careful planning; conservative conization may be considered with the double meaning of a diagnostic procedure and the possible therapeutic role in cases of benign or noninvasive lesions. Hysterectomy, as described by Di Giovannantonio et al. , it may be considered in women in nonreproductive ages or in cases of infiltration of surgical resection margins in nonpregnant women. All reported cases of cervical malignant schwannoma have been treated with total abdominal hysterectomy. Our case is the first description of a low-malignant cervical schwannoma treated by local excision. Patients diagnosed with malignant schwannoma have a guarded prognosis. Metastatic disease is present in 16% of patients at the time of diagnosis, with the lungs being the most common site of metastasis. Malignant schwannoma has a high rate of local recurrence and a predilection to occur in sites of prior radiation. The 5-year survival rate has been reported as 47–65%, with an average survival of 24–48 months. Poor prognosis is associated with concomitant NF-1, tumor size greater than 5 cm, and younger age 5of patients at diagnosis. Better clinical prognosis is associated with surgical resectability, tumor size less than 5 cm at presentation, low histological grade, and patients' age higher than 30 years old at diagnosis . A preoperative diagnosis of this tumor may be challenging because of its rarity as well as the various differential diagnoses, which must be considered by both gynecologists and pathologists involved. Several studies have shown that FDG PET or PET/CT represents a sensitive technique in the detection of malignant schwannomas in patients with neurofibromatosis type 1. In addition, FDG PET can be used to guide biopsy, in order to plan the appropriate therapy, for the staging of the disease, restaging, and posttherapy follow-up of malignant schwannomas .
| 4.453125
| 0.804688
|
sec[2]/p[0]
|
en
| 0.999997
|
34925929
|
https://doi.org/10.1155/2021/6806960
|
[
"malignant",
"schwannomas",
"schwannoma",
"cases",
"patients",
"cells",
"this",
"tumor",
"tumors",
"usually"
] |
[
{
"code": "2D4Z",
"title": "Unspecified malignant neoplasms of unspecified sites"
},
{
"code": "2E2Z",
"title": "Malignant neoplasm metastasis, unspecified"
},
{
"code": "2B70.Z",
"title": "Malignant neoplasms of oesophagus, unspecified"
},
{
"code": "2B33.Y",
"title": "Other malignant haematopoietic neoplasms without further specification"
},
{
"code": "2B31.1",
"title": "Histiocytic sarcoma"
},
{
"code": "2F3Y",
"title": "Benign neoplasms except of mesenchymal origin, of other specified site"
},
{
"code": "2F24",
"title": "Benign cutaneous neoplasms of neural or nerve sheath origin"
},
{
"code": "2A02.3",
"title": "Benign neoplasm of cranial nerves"
},
{
"code": "2F30.Y",
"title": "Other specified benign neoplasm of breast"
},
{
"code": "LD2D.11",
"title": "Neurofibromatosis type 2"
}
] |
=== ICD-11 CODES FOUND ===
[2D4Z] Unspecified malignant neoplasms of unspecified sites
Also known as: Unspecified malignant neoplasms of unspecified sites | malignancy of unspecified site | malignancy unspecified primary site | malignant growth of unspecified site | malignant mass of unspecified site
[2E2Z] Malignant neoplasm metastasis, unspecified
Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases
[2B70.Z] Malignant neoplasms of oesophagus, unspecified
Also known as: Malignant neoplasms of oesophagus, unspecified | Malignant neoplasms of oesophagus | cancer of oesophagus | oesophageal malignancy | oesophageal cancer
[2B33.Y] Other malignant haematopoietic neoplasms without further specification
Also known as: Other malignant haematopoietic neoplasms without further specification | Malignant neoplasm blood other | Haematological malignancy NOS | Neoplasm blood benign or unspecified
[2B31.1] Histiocytic sarcoma
Also known as: Histiocytic sarcoma | Malignant Histiocytosis
Includes: Malignant Histiocytosis
[2F3Y] Benign neoplasms except of mesenchymal origin, of other specified site
Also known as: Benign neoplasms except of mesenchymal origin, of other specified site | Benign neoplasm of lymph vessels | Benign neoplasm of lymph nodes | Benign neoplasm of peripheral nerves or autonomic nervous system | benign neoplasm of the nerve NOS
[2F24] Benign cutaneous neoplasms of neural or nerve sheath origin
Also known as: Benign cutaneous neoplasms of neural or nerve sheath origin | Palisaded encapsulated neuroma | Cutaneous neurofibroma | Cutaneous schwannoma | Cutaneous neurolemmoma
[2A02.3] Benign neoplasm of cranial nerves
Definition: This is a tumour of cranial nerves having none of the characteristics of a malignant neoplasm.
Also known as: Benign neoplasm of cranial nerves | neurinoma of unspecified site | Vestibular schwannoma | acoustic schwannoma | Benign neoplasm of abducens nerve
Includes: Vestibular schwannoma
[2F30.Y] Other specified benign neoplasm of breast
Also known as: Other specified benign neoplasm of breast | Benign cystosarcoma phyllodes | Breast apocrine adenoma | Serocystic disease of Brodie | Pleomorphic adenoma of breast
[LD2D.11] Neurofibromatosis type 2
Definition: Neurofibromatosis type 2 (NF2) is a tumour-prone disorder characterised by the development of multiple schwannomas and meningiomas.
Also known as: Neurofibromatosis type 2 | Familial acoustic neuroma | Familial vestibular schwannoma | Neurofibromatosis, central type | Bilateral acoustic neurofibromatosis
=== GRAPH WALKS ===
--- Walk 1 ---
[2D4Z] Unspecified malignant neoplasms of unspecified sites
--PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites
--CHILD--> [2D40] Adenocarcinoma of unspecified site
Def: A common cancer characterised by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to ...
--- Walk 2 ---
[2D4Z] Unspecified malignant neoplasms of unspecified sites
--PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites
--PARENT--> [?] Malignant neoplasms, except primary neoplasms of lymphoid, haematopoietic, central nervous system or related tissues
--- Walk 3 ---
[2E2Z] Malignant neoplasm metastasis, unspecified
--PARENT--> [?] Malignant neoplasm metastases
Def: Spread of a malignant neoplasm into secondary sites....
--CHILD--> [2D52] Malignant neoplasm metastasis in spinal cord, cranial nerves or paraspinal nerves
--- Walk 4 ---
[2E2Z] Malignant neoplasm metastasis, unspecified
--PARENT--> [?] Malignant neoplasm metastases
Def: Spread of a malignant neoplasm into secondary sites....
--CHILD--> [2D50] Malignant neoplasm metastasis in brain
Def: A malignant neoplasm that has spread to the brain from another anatomic site or system. The majority are carcinomas (usually lung or breast carcinomas)....
--- Walk 5 ---
[2B70.Z] Malignant neoplasms of oesophagus, unspecified
--PARENT--> [2B70] Malignant neoplasms of oesophagus
Def: A primary malignant neoplasm involving the oesophagus...
--CHILD--> [2B70.1] Squamous cell carcinoma of oesophagus
Def: A squamous cell carcinoma arising from the esophagus. It can be associated with a long history of tobacco and alcohol abuse and is exceedingly rare before the age of 30. The median age is around 65 in...
--- Walk 6 ---
[2B70.Z] Malignant neoplasms of oesophagus, unspecified
--PARENT--> [2B70] Malignant neoplasms of oesophagus
Def: A primary malignant neoplasm involving the oesophagus...
--CHILD--> [2B70.1] Squamous cell carcinoma of oesophagus
Def: A squamous cell carcinoma arising from the esophagus. It can be associated with a long history of tobacco and alcohol abuse and is exceedingly rare before the age of 30. The median age is around 65 in...
|
[
"[2D4Z] Unspecified malignant neoplasms of unspecified sites\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --CHILD--> [2D40] Adenocarcinoma of unspecified site\n Def: A common cancer characterised by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to ...",
"[2D4Z] Unspecified malignant neoplasms of unspecified sites\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --PARENT--> [?] Malignant neoplasms, except primary neoplasms of lymphoid, haematopoietic, central nervous system or related tissues",
"[2E2Z] Malignant neoplasm metastasis, unspecified\n --PARENT--> [?] Malignant neoplasm metastases\n Def: Spread of a malignant neoplasm into secondary sites....\n --CHILD--> [2D52] Malignant neoplasm metastasis in spinal cord, cranial nerves or paraspinal nerves",
"[2E2Z] Malignant neoplasm metastasis, unspecified\n --PARENT--> [?] Malignant neoplasm metastases\n Def: Spread of a malignant neoplasm into secondary sites....\n --CHILD--> [2D50] Malignant neoplasm metastasis in brain\n Def: A malignant neoplasm that has spread to the brain from another anatomic site or system. The majority are carcinomas (usually lung or breast carcinomas)....",
"[2B70.Z] Malignant neoplasms of oesophagus, unspecified\n --PARENT--> [2B70] Malignant neoplasms of oesophagus\n Def: A primary malignant neoplasm involving the oesophagus...\n --CHILD--> [2B70.1] Squamous cell carcinoma of oesophagus\n Def: A squamous cell carcinoma arising from the esophagus. It can be associated with a long history of tobacco and alcohol abuse and is exceedingly rare before the age of 30. The median age is around 65 in...",
"[2B70.Z] Malignant neoplasms of oesophagus, unspecified\n --PARENT--> [2B70] Malignant neoplasms of oesophagus\n Def: A primary malignant neoplasm involving the oesophagus...\n --CHILD--> [2B70.1] Squamous cell carcinoma of oesophagus\n Def: A squamous cell carcinoma arising from the esophagus. It can be associated with a long history of tobacco and alcohol abuse and is exceedingly rare before the age of 30. The median age is around 65 in..."
] |
2D4Z
|
Unspecified malignant neoplasms of unspecified sites
|
[
{
"from_icd11": "2D4Z",
"icd10_code": "C802",
"icd10_title": "Malignant neoplasm associated with transplanted organ"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7650",
"icd10_title": "Malignant neoplasm of unspecified lower limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7642",
"icd10_title": "Malignant neoplasm of left upper limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7640",
"icd10_title": "Malignant neoplasm of unspecified upper limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7652",
"icd10_title": "Malignant neoplasm of left lower limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7651",
"icd10_title": "Malignant neoplasm of right lower limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7641",
"icd10_title": "Malignant neoplasm of right upper limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C801",
"icd10_title": "Malignant (primary) neoplasm, unspecified"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C768",
"icd10_title": "Malignant neoplasm of other specified ill-defined sites"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C761",
"icd10_title": "Malignant neoplasm of thorax"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C762",
"icd10_title": "Malignant neoplasm of abdomen"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C763",
"icd10_title": "Malignant neoplasm of pelvis"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C800",
"icd10_title": "Disseminated malignant neoplasm, unspecified"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C76-C80",
"icd10_title": ""
},
{
"from_icd11": "2D4Z",
"icd10_code": "C76",
"icd10_title": "Malignant neoplasm of other and ill-defined sites"
}
] |
C802
|
Malignant neoplasm associated with transplanted organ
|
A 70-year-old woman with no notable medical history was admitted to the ED with complaints of epigastric pain for 2 hours prior to admission and over 10 bouts of vomiting and diarrhea. The patient reported having a shared lunch with her family 3.5 hours prior to the onset of symptoms. The lunch comprised a blanched mountain herb assumed to be L. fischeri given to her by an acquaintance as collected from the mountain. Other family members (daughter and grand-daughter) who ate with the patient also experienced abdominal pain, vomiting, and diarrhea, all of which disappeared by the time they visited the ED with the patient. Upon ED admission, the patient's vital signs were as follows: blood pressure, 120/70 mm Hg; pulse rate, 48 beats/min; respiratory rate, 18 breaths/min; and body temperature, 35°C. The patient had clear consciousness, and physical examination revealed severe epigastric tenderness. Initial electrocardiography (ECG) upon admission showed sinus bradycardia with a heart rate of 45 beats/min , for which continuous ECG monitoring was performed. The plain chest radiograph was unremarkable. A complete blood count at ED admission showed the following: White blood cells 12,530/μL; hemoglobin 16.2 g/dL; hematocrit 49.6%; and platelets 219,000/μL, while the results of chemical batteries, electrolyte test, C- reactive protein, and cardiac enzyme test were all normal. Arterial blood gas analysis (ABGA) results were pH 7.31, paO 2 79 mm Hg, paCO 2 38 mm Hg, HCO 3 - 19.1 mEq/L, lactate 1.1 mg/L, and O 2 saturation 98% (Table 1 ). During continuous ECG monitoring, a change in heart rate from as low as 43 beats/min to 66 beats/min was observed, although the blood pressure after 30 minutes of ED admission was 71/53 mm Hg, the patient did not show symptoms of shock, such as dizziness, and complained only of epigastric pain. As hypotension was detected, the patient was rapidly administered physiological saline, while for epigastric pain, a proton-pump inhibitor was administered. Given that the other family members who consumed the plant with the patient also showed similar symptoms, the patient was diagnosed with plant poisoning, and 50 g of medicinal charcoal (Heuk powder) was orally administered. The patient was then administered up to 1 L of physiological saline, after which continuous intravenous (IV) infusion of physiological saline was rapidly administered to the patient; however, severe fluctuations in blood pressure from 69/46 mm Hg at minimum and 140/84 mm Hg at maximum and a heart rate change from 45 beats/min at minimum to 74 beats/min at maximum, were observed. Two hours after ED admission, blood pressure and pulse rate continued to show severe fluctuations, and hypotension and bradycardia persisted. Thus, peripheral IV infusion of dopamine (10 μg/kg/min) was administered to the patient. Administration of dopamine led to the disappearance of bradycardia , but hypotension persisted. The dopamine dose was then increased to 20 μg/kg/min following the insertion of the central venous catheter (central venous pressure 11 CmH 2 O); since hypotension persisted, an infusion of norepinephrine was started. Subsequently, since the patient continued to complain of severe epigastric pain, an emergency abdominal computed tomography (CT) scan was performed which detected luminal distention, edematous thickening of the entire stomach wall, and small and large intestinal wall edema, suggesting severe gastritis and enterocolitis . After 4 hours of ED admission, the ABGA showed pH 7.15, HCO 3 - 10.1 mEq/L, and lactate 3.0 mg/L (Table 1 ), indicating an increase in the severity of metabolic acidosis. Therefore, sodium bicarbonate administration was given to the patient. Six hours after ED admission, the patient developed drowsiness with persistent hypotension. Despite the infusion of the maximum dose of norepinephrine, the systolic blood pressure remained at below 50 mm Hg; thus, an infusion of epinephrine was started. Despite the infusion of epinephrine, the blood pressure remained persistently low, and the patient began to show stupor with abdominal distension. The follow-up chemical batteries showed normal liver enzymes and creatinine level, although albumin and total protein levels had decreased to 2.0 g/dL and 4.0 g/dL, respectively. The follow-up ABGA also indicated a further increase in metabolic acidosis (Table 1 ). The patient developed mental change, and as O 2 saturation steadily decreased despite external O 2 supply, intubation and artificial ventilation were performed. The follow-up monitoring of albumin level indicated a further decrease to 1.0 g/dL (Table 1 ), abdominal distension increased in severity; thus, chest and abdominal CT were performed again. Chest CT revealed a small amount of pleural effusion on the left side, and the abdominal CT indicated an increase in the severity of edematous wall thickening of the stomach, with ascites in the abdominal cavity . The patient was then administered an IV albumin to correct the reduced albumin level and abdominal ascites. As shock persisted despite conservative therapies with sodium bicarbonate and vasopressor injections, and as the level of lactic acid continued to increase on the follow-up ABGA with steadily increasing metabolic acidosis (Table 1 ), the patient was admitted to the intensive care unit after 10 hours of ED admission, and continuous renal replacement therapy (CRRT; CVVHDF mode) was performed. However, the chemical batteries after intensive care unit admission continued to show lower than normal levels of albumin at 2.8 g/dL and total protein at 3.6 g/dL, respectively. Despite CRRT, metabolic acidosis and hyperlactacidemia (lactate >15.0 g/dL) persisted (Table 1 ). The chemical batteries at hospital day 3 indicated an aspartate aminotransferase/alanine aminotransferase level of 3064/3314 IU/L and an increase in creatinine to 1.76 mg/dL, while the cardiac enzyme test showed CK-MB ≥300 ng/mL and an increase in troponin-T to 3.576 ng/mL, indicating a possibility of multiple organ failure. The patient died despite continued treatment.
| 3.96875
| 0.974121
|
sec[1]/p[0]
|
en
| 0.999997
|
34797336
|
https://doi.org/10.1097/MD.0000000000027891
|
[
"blood",
"abdominal",
"pressure",
"hours",
"beats",
"infusion",
"increase",
"despite",
"epigastric",
"pain"
] |
[
{
"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": "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 ===
[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
[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 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics
--- Walk 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--> [?] Anaemias or other erythrocyte disorders
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.41] Microscopic haematuria
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--PARENT--> [MF50] Abnormal micturition
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.2] Finding of hallucinogen in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Anaemias or other erythrocyte disorders",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --PARENT--> [MF50] Abnormal micturition",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
A 65-year-old female patient with no medical history had been observed for intraductal papillary mucinous neoplasia (IPMN) with main pancreatic duct dilation in the pancreatic body and tail at the local hospital for a few years. She was suspected with a malignant pancreatic tumor and visited our hospital. Laboratory data on hospital admission included white blood cell counts of 6500/μl, red blood cell count of 506 × 104/μl, hemoglobin of 13.7 g/dl, hematocrit of 42.1%, platelets of 25.4 × 104/μl, total protein of 7.4 g/dl, albumin of 4.4 g/dl; total bilirubin of 0.77 mg/dl, aspartate aminotransferase of 26 IU/l, alanine aminotransferase of 25 IU/l, alkaline phosphatase of 68 IU/l, γ-glutamyl transferase of 20 IU/l, amylase of 15 U/l, creatine kinase of 44 IU/l, lactate dehydrogenase of 278 IU/l, blood urea nitrogen of 14 mg/dl, creatinine of 0.65 mg/dl, Na of 140 mEq/dl, K of 4.3 mEq/dl, Cl of 103 mEq/dl, C-reactive protein of 0.25 mg/d, carcinoembryonic antigen of 1.7 ng/ml, CA19-9 of 109.1 U/ml, DUPAN-2 of 79 U/ml, and SPAN-1 of 17 U/ml. Computed tomography (CT) detected a mass of approximately 3 cm in the pancreatic body, dilation of the main pancreatic duct, and a cystic structure suspected of IPMN in the pancreatic tail. The tumor was in contact with the splenic artery (SpA) and left gastric vein (LGV) but was not in contact with the superior mesenteric artery (SMA) or celiac artery (CeA) . An evaluation of the arteries based on three-dimensional pictures revealed the RCHA originating from the SMA . Magnetic resonance imaging revealed a high-intensity signal in the mass of the pancreatic body with a diffusion-weighted image . Endoscopic ultrasound-guided fine needle aspiration detected adenocarcinoma. The patient was then diagnosed with intraductal papillary mucinous carcinoma cT2N0M0StageIB (UICC 8th) and planned to undergo surgery. Pancreaticoduodenectomy was not appropriate as a curative procedure because the tumor was located in the body of the pancreas and was also suspected to be invading the SpA. So, we decided to perform a distal pancreatectomy (DP) with the SpA dissection. In the surgical findings, the tumor was contact with the SpA and the LGV. Intraoperative ultrasound was used to confirm the extent of the tumor and right gastroepiploic vein (RGEV) was transected because it closed to the right edge of the tumor. DP was performed with resecting the pancreas at the left end of the gastroduodenal artery (GDA). The intraoperative frozen section diagnosis indicated residual cancer at the pancreatic stump of DP, and we decided to perform the subtotal stomach preserving TP (SSPTP) because additional pancreatic resection was deemed impossible. The right gastric vein (RGV) was determined to be very thin and ineffective as a drainage vein and therefore could not be preserved when performing SSPTP. In summary, SpA, LGV, left gastroepiploic artery, left gastroepiploic vein, short gastric artery, short gastric vein, and RGEV were transected during the DP, and RGV, right gastric artery and right gastroepiploic artery were transected during the change to SSPTP, so no gastric drainage veins could be preserved and only the left gastric artery (LGA) supplied blood flow to the stomach. Immediately after the specimen has been extracted, a GVC and massive bleeding from the nasogastric tube occurred. Strong pulsation in the LGA was observed, and we suspected increased blood flow in the LGA after the resection the SpA. Gastric vein reconstructions were technically impossible; thus, a partial gastrectomy was performed to remove the particularly congested pyloric region of the remnant stomach. However, the GVC and bleeding demonstrated no improvement. We determined the necessity of LGA dissection to control the bleeding with the severe GVC and performed total gastrectomy (TG) to avoid postoperative gastric necrosis. The patient was discharged from the hospital 19 days postoperatively without complications. Pathological diagnosis included pancreatic adenocarcinoma, wel > por > mod, Pb, TS2(25 mm), infiltrative type, sci, INFc, ly1, v1, ne3, mpd0, pCH0, pDU0, pS1, pRP1, pPV0, pA0, pPLX, pOO0, pBCM0, pDPM1, R1, pN1(3/27), M0, pT2N1M0StageIIB (UICC 8th) . Adjuvant chemotherapy was not administered due to her intension and physical condition. The patient had a local recurrence around the superior mesenteric vein and SMA 3 months postoperatively and started chemotherapy with gemcitabine plus nab-paclitaxel. Additionally, she changed the chemotherapy to FOLFIRINOX because of peritoneal dissemination 11 months postoperatively. She then currently continues her treatment 18 months postoperatively. She also received dietary therapy, insulin treatment, and lipase supplementation of the pancrelipase postoperatively, with serum albumin levels of 3.0 g/dl, 3.5 g/dl, and 3.0 g/dl, respectively, at 6, 12, and 18 months postoperatively. Fig. 1 Computed tomography (CT) and magnetic resonance imaging (MRI) of the case. a The enhanced CT detected the pancreatic body tumor and main pancreatic duct dilation in the pancreatic body and tail. The arrows indicated that the tumor was in contact with splenic artery (SpA). b The enhanced CT shows that the tumor was in contact with the left gastric vein (LGV). The arrows indicated the LGV. c Three-dimensional artery image from enhanced CT. Celiac artery (CeA), left gastric artery (LGA), SpA, superior mesenteric artery (SMA), replaced common hepatic artery (RCHA), left hepatic artery (LHA), right hepatic artery (RHA), gastroduodenal artery (GDA) and right gastric artery (RGA) were indicated. d MRI diffusion-weighted image revealed high intensity in the pancreatic body. The arrow indicated the tumor Fig. 2 The images of resection specimens of the case. a , b Distal pancreatectomy (DP) was performed and the tumor was detected in the pancreatic body. The intraoperative frozen section diagnosis revealed residual cancer at the pancreatic stump. The arrows indicated the tumor. c The subtotal stomach preserving TP (SSPTP) was performed (pancreaticoduodenectomy was performed adding to DP)
| 4.078125
| 0.96582
|
sec[1]/p[0]
|
en
| 0.999999
|
39112680
|
https://doi.org/10.1186/s40792-024-01983-x
|
[
"artery",
"pancreatic",
"tumor",
"gastric",
"vein",
"body",
"postoperatively",
"blood",
"contact",
"suspected"
] |
[
{
"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": "DC3Z",
"title": "Diseases of pancreas, unspecified"
},
{
"code": "DC3Y",
"title": "Other specified diseases of pancreas"
},
{
"code": "LB21.3",
"title": "Agenesis-aplasia of pancreas"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "DC35.0",
"title": "Atrophy of pancreas"
}
] |
=== ICD-11 CODES FOUND ===
[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
[DC3Z] Diseases of pancreas, unspecified
Also known as: Diseases of pancreas, unspecified
[DC3Y] Other specified diseases of pancreas
Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis
[LB21.3] Agenesis-aplasia of pancreas
Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.
Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[DC35.0] Atrophy of pancreas
Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy
=== GRAPH WALKS ===
--- Walk 1 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--EXCLUDES--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--- Walk 2 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--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--> [?] Acute arterial occlusion
--CHILD--> [?] Acute upper limb arterial occlusion
--- Walk 4 ---
[BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Acute arterial occlusion
--CHILD--> [?] Acute lower limb arterial occlusion
--- 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...
--CHILD--> [?] Injuries to the thorax
--- Walk 6 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--CHILD--> [?] Injuries to the head
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....",
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --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--> [?] Acute arterial occlusion\n --CHILD--> [?] Acute upper limb arterial occlusion",
"[BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Acute arterial occlusion\n --CHILD--> [?] Acute lower limb arterial occlusion",
"[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 --CHILD--> [?] Injuries to the thorax",
"[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 --CHILD--> [?] Injuries to the head"
] |
BD5Z
|
Diseases of arteries or arterioles, unspecified
|
[
{
"from_icd11": "BD5Z",
"icd10_code": "I7389",
"icd10_title": "Other specified peripheral vascular diseases"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7419",
"icd10_title": "Embolism and thrombosis of other parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7411",
"icd10_title": "Embolism and thrombosis of thoracic aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7410",
"icd10_title": "Embolism and thrombosis of unspecified parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7381",
"icd10_title": "Erythromelalgia"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I745",
"icd10_title": "Embolism and thrombosis of iliac artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I789",
"icd10_title": "Disease of capillaries, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I748",
"icd10_title": "Embolism and thrombosis of other arteries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I749",
"icd10_title": "Embolism and thrombosis of unspecified artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I781",
"icd10_title": "Nevus, non-neoplastic"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I788",
"icd10_title": "Other diseases of capillaries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I744",
"icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I70-I79",
"icd10_title": ""
},
{
"from_icd11": "BD5Z",
"icd10_code": "I74",
"icd10_title": "Arterial embolism and thrombosis"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I73",
"icd10_title": "Other peripheral vascular diseases"
}
] |
I7389
|
Other specified peripheral vascular diseases
|
Although there are previous case reports of patients with myocarditis and associated third-degree AVB , to our knowledge, this is the first report of a patient additionally developing myositis and thyroiditis during pembrolizumab therapy. However, hypothyroidism has also been described in lenvatinib monotherapy, but the incidence is markedly increased in combination with pembrolizumab . Importantly, the focus here will be on the events from a geriatric point of view, encompassing not only frail or severely impaired patients but also those starting treatment in a fit condition, as even these individuals may face unique challenges during ICI therapy. We applied the principle of keeping the hospital stay as long as necessary and as short as possible. The aim was an early discharge after completed diagnostics and first recognizable therapy successes, as well as further outpatient control of the patient. In our view, there are several reasons for this. First, it has been shown that a prolonged hospital stay leads to an increased risk of nosocomial infections, especially in geriatric patients . In addition, during hospitalization, patients engage in much less physical activity compared to their routine at home. This is particularly the case for elderly patients . Associated with such increased immobility is a marked decrease in lower extremity strength . A significant deterioration in sleep quality has been observed in geriatric patients, as well as an associated increase in blood pressure . Likewise, we try—for each of our geriatric patients—to keep diagnostics low and as non-invasive as possible. In a report, Schiopu et al. presented the case of a 75-year-old male patient who was treated with pembrolizumab for malignant mesothelioma and suffered from similar symptoms. In this case, the authors performed a cardiac catheter examination, which did not show any coronary abnormalities. We therefore decided against cardiac catheterization in regard of the risks, such as vascular injuries or infections , even if the probabilities were low. This is equally relevant for muscle or myocardial biopsies. In addition to blood tests, we used well-known geriatric assessments such as the Barthel motor index and the timed-up-and-go test to monitor the success of therapy. Geriatric assessments are valuable tools for evaluating therapeutic outcomes in elderly patients. While not consistently implemented in geriatric case reports , their application can provide a more nuanced understanding of patient progress and treatment impact. In comparison to other case reports , we decided to use an initial low dose of prednisolone—about 2 mg/kg of body weight—to minimize the side effects of glucocorticoid therapy such as infections , hypertension, or osteoporosis . To evaluate the success of the therapy, geriatric assessments were performed from the start of hospital admission. To adequately monitor patients at risk and select those who are likely to benefit from immune checkpoint inhibition (ICI) therapy, in a geriatric setting, it is necessary to assess the risks and efficiency. Therefore, we want to take a closer look at our patient’s risk profile. As described above, there are no other relevant pre-existing conditions and medications, so relevant factors are age and gender. With increasing age, the efficacy of immunotherapy decreases; accordingly, adverse events are less likely in older patients (>75 years) . However, age-related research on ICI efficiency is rather limited. Generally, responses to immunotherapy are heterogeneous. While differences have been observed in CTLA-4 inhibitors, such differences are not clearly evident in PD-1 inhibitors . Interestingly, very elderly patients (>85 years) do not appear to have a disadvantage compared to patients aged 80–85 years when treated with single-agent immune checkpoint inhibitors . Studies report varying results regarding the susceptibility to and severity of immune-related adverse events in relation to age. However, the data suggest that younger patients may have a higher risk of developing severe irAEs (median age 63.5 to 66.7 years) . Conversely, the risk of fatal adverse events appears to be higher in older patients (median age 70 years vs. 62 years) . In elderly patients, dermatologic and rheumatologic irAEs occur more frequently, while endocrine and gastrointestinal irAEs are commonly observed in younger patients . Of note, in a meta-analysis including 103 randomized studies conducted by Zhong et al. , males showed improved overall survival (OS) with ICI treatment over females, most pronounced in PD-1-targeting therapies. The authors suggest that heterogeneity in general immune response intensity and checkpoint molecule expression are key factors in those differences. Overall, the risks for irAEs do not differ significantly between men and women. However, they vary depending on the type of irAE and the specific immune checkpoint inhibitor used . To summarize, our patient had an increased risk of fatal side effects due to her gender and age and a lower chance to benefit from the therapy. It is therefore important to weigh the risk against the benefit before starting therapy and to ensure adequate monitoring of the side effects. Finally, we would like to focus on the course of the initial symptoms and the general monitoring of pembrolizumab therapy. In our case report, the initial hospitalization was only due to a new-onset ptosis of the left eye and the patient’s dysphagic complaints. She did not report cardiac symptoms at any time, such as dyspnea, fatigue, or syncope. If a routine ECG had not been performed on admission, the myocarditis would not have been prominent initially. This could have led to fatal consequences for the patient. Although the cardiac dangers of PD-1 inhibitor therapy have been reported in several case reports , an ECG was not performed on our patient before starting therapy or between pembrolizumab administrations. Therefore, as an inexpensive and noninvasive rapid method, regular ECG checks should be considered for future therapy monitoring.
| 4.171875
| 0.713379
|
sec[2]/p[0]
|
en
| 0.999997
|
39727819
|
https://doi.org/10.3390/geriatrics9060160
|
[
"patients",
"geriatric",
"risk",
"this",
"pembrolizumab",
"immune",
"however",
"events",
"cardiac",
"therefore"
] |
[
{
"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": "MG2A",
"title": "Ageing associated decline in intrinsic capacity"
},
{
"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"
}
] |
=== 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
[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
[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
=== 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
--EXCLUDES--> [?] Patient received diagnostic test or treatment intended for another patient
--- Walk 2 ---
[PL14.C] Patient received diagnostic test or treatment intended for another patient
--PARENT--> [PL14] Mode of injury or harm associated with other health care related causes
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure
--- Walk 3 ---
[QB14] Unavailability or inaccessibility of health care facilities
--EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere
--CHILD--> [?] Person awaiting admission to residential aged care service
--- Walk 4 ---
[QB14] Unavailability or inaccessibility of health care facilities
--EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere
--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
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure
--- 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--> [PL14.0] Non-administration of necessary drug
|
[
"[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 --EXCLUDES--> [?] Patient received diagnostic test or treatment intended for another patient",
"[PL14.C] Patient received diagnostic test or treatment intended for another patient\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure",
"[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --CHILD--> [?] Person awaiting admission to residential aged care service",
"[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --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 --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure",
"[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--> [PL14.0] Non-administration of necessary drug"
] |
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": "MG2A",
"icd10_code": "R54",
"icd10_title": "Age-related physical debility"
},
{
"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": ""
}
] |
Z753
|
Unavailability and inaccessibility of health-care facilities
|
A 55-year-old Caucasian woman was admitted for a right hip prosthesis reimplantation. The first arthroplasty was performed 3 years earlier due to hip osteoarthritis. However, after 2 years her prosthesis had been explanted and a spacer positioned due to infection. After 1 month the spacer had also been removed. No further data on microbiological results and medical treatment were available at the time of her admission at our hospital. On admission, she was complaining of pain and was not taking antibiotic therapy. Her erythrocyte sedimentation rate (ESR) was 35mm 1°hour, her white blood cell count and differential were normal, C-reactive protein (C-RP) was not available and a leukocyte scan resulted normal. She underwent hip reimplantation. At surgery, histopathological and microbiological investigations were not taken. After arthroplasty, she was discharged. Two weeks later she was seen as an out-patient complaining of hip pain, motion impairment and dehiscence of the wound. Enterobacter cloacae was grown from the wound exudate. The isolate was an extended spectrum β-lactamase producer, resistant to gentamicin, and susceptible to ciprofloxacin, imipenem, and colistin, according to Clinical and Laboratory Standards Institute (CLSI) breakpoints . She was started on a treatment with oral ciprofloxacin 500mg twice per day. Four days later, ultrasound evidenced periprosthesis fluid collection. Staphylococcus epidermidis and S. haemolyticus were cultured from the needle aspiration. Both coagulase-negative staphylococci (CoNS) isolates resulted oxacillin and ciprofloxacin resistant, teicoplanin susceptible . The same sample was also examined with the commercial real-time polymerase chain reaction-based system, SeptiFast (Roche Molecular Diagnostics, Mannheim, Germany) which detected E. cloacae/aerogenes and CoNS genomes. At this point, the patient was readmitted. Teicoplanin intravenous 400mg per day and meropenem intravenous 2g three times per day (patient’s weight was 68kg) were added to ciprofloxacin without clinical improvement. After 2 weeks, E. cloacae with the same susceptibility pattern of the previous isolate and Acinetobacter baumannii were grown from the aspirated synovial fluid of her hip. A. baumannii isolate resistant to aztreonam, cefepime, cefotaxime, ciprofloxacin, imipenem, fosfomycin, gentamicin, and trimethoprim/sulfamethoxazole, but susceptible to ceftazidime and colistin was obtained. Tigecycline minimal inhibitory concentration was 1.5mg/L, however, no breakpoints were available for this antimicrobial agent against A. baumannii , according to CLSI . At this point, a standard radiograph evidenced acetabular cup dislocation, therefore her prosthesis was removed. During surgery, extensive debridement was performed and a spacer with vancomycin and gentamicin was inserted. From the periprosthesis tissue samples, and her prosthesis, S. epidermidis and A. baumannii were identified while from the synovial fluid only S. epidermidis was isolated. Susceptibility patterns of A. baumannii isolates did not differ. The susceptibility pattern of the two latter S. epidermidis isolates was different from that of the previous one in respect to erythromycin, clindamycin, and trimethoprim/sulfamethoxazole. Ceftazidime was added to the pre-existing therapy. When in vitro antimicrobial susceptibility with synergism results were made available, therapy was modified as follows: daptomycin intravenous 500mg per day, ceftazidime intravenous 2g three times per day, colistin intravenous 3 million units three times per day, and rifampin 600mg daily administered orally. Four days later, rifampin was stopped due to a suspected liver toxicity. Overall, her condition improved despite recurrent episodes of wound dehiscence and purulence. After almost 12 weeks of antimicrobial treatment, she was accepted into a protected residence where she continued to undergo treatment of intravenous antimicrobial therapy with daptomycin 500mg per day, ceftazidime 2g three times per day, and colistin 3 million units three times per day. One month later, a computed tomography (CT) scan of her hip showed liquid around the spacer and femur inflammatory reaction . Two weeks later, another dehiscence of the wound manifested. She was readmitted for an ulterior debridement and this time the spacer was also removed. Prior to surgery antimicrobial therapy was not interrupted. Intraoperative microbiological investigations resulted negative including the molecular SeptiFast test. After surgery she returned to the protected residence and continued the same antimicrobial therapy. Three weeks later, colistin was reduced from 3 to 2 million units intravenous per day every 8 hours. After a total of 8 months, all antimicrobials were stopped. During the entire period antimicrobial therapy was administered, she was clinically monitored and, every 10 days, ESR, C-RP, blood count, creatine phosphokinase, liver and kidney function tests and electrolytes were obtained. No side effects were observed during treatment. When antimicrobials were discontinued, a further CT of her hip evidenced dislocation of her femur and inflammatory tissue surrounding her femur and the acetabular cavity. During the following 3-month period, she did not manifest clinical evidence of infection, and her ESR and C-RP were normal; then she was readmitted to another hospital to be reimplanted. A femoral transcondylar traction was first positioned for over 3 weeks in order to extend her muscles, thereafter a third prosthesis was implanted. At surgery, there was no evidence of purulence; however, there was necrotic tissue which underwent debridement. After several samples were collected for microbiologic investigations, she was administered daptomycin intravenous 500mg per day, ceftazidime intravenous 6g per day, and colistin intravenous 2 million units three times per day until microbiological results, including the SeptiFast test, were reported negative. For more than a year since her third prosthesis was reimplanted, she has been asymptomatic and has regained motility.
| 4.148438
| 0.963867
|
sec[1]/p[0]
|
en
| 0.999997
|
24923703
|
https://doi.org/10.1186/1752-1947-8-186
|
[
"intravenous",
"three",
"antimicrobial",
"prosthesis",
"colistin",
"times",
"spacer",
"ciprofloxacin",
"baumannii",
"ceftazidime"
] |
[
{
"code": "QE11.Z",
"title": "Hazardous drug use, unspecified"
},
{
"code": "PK91.16",
"title": "Cardiovascular devices associated with injury or harm: peripheral venous catheter"
},
{
"code": "QE11.3",
"title": "Hazardous use of cocaine"
},
{
"code": "JA61.5",
"title": "Cerebral venous thrombosis in pregnancy"
},
{
"code": "8B22.1",
"title": "Cerebral venous thrombosis"
},
{
"code": "1D45",
"title": "Sandfly fever"
},
{
"code": "PA09",
"title": "Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle"
},
{
"code": "LD50.Y",
"title": "Other specified number anomalies of chromosome X"
},
{
"code": "PA19",
"title": "Unintentional land transport nontraffic event injuring an occupant of a low powered passenger vehicle"
},
{
"code": "NA82.4",
"title": "Multiple fractures of ribs"
}
] |
=== 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
[PK91.16] Cardiovascular devices associated with injury or harm: peripheral venous catheter
Also known as: Cardiovascular devices associated with injury or harm: peripheral venous catheter | complication of intravenous line | IV - [intravenous] line complication
Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
[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
[JA61.5] Cerebral venous thrombosis in pregnancy
Also known as: Cerebral venous thrombosis in pregnancy | Cerebrovenous sinus thrombosis in pregnancy | cerebral venous thrombosis in pregnancy, unspecified trimester | intracranial venous sinus thrombosis of pregnancy
Includes: Cerebrovenous sinus thrombosis in pregnancy
[8B22.1] Cerebral venous thrombosis
Definition: Thrombosis (blood clot) of the cerebral venous sinuses, which drain blood from brain
Also known as: Cerebral venous thrombosis | nonpyogenic thrombosis of intracranial venous system | nonpyogenic thrombophlebitis of intracranial venous sinus | nonpyogenic thrombosis of intracranial venous sinus | Nonpyogenic thrombosis of cerebral vein
Excludes: Cerebral ischaemic stroke | Cerebral venous thrombosis in the puerperium
[1D45] Sandfly fever
Also known as: Sandfly fever | sandfly-borne phleboviral disease | pappataci fever | phlebotomus fever | three day fever
Includes: pappataci fever | phlebotomus fever
[PA09] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle
Also known as: Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle | Occupant of three-wheeled motor vehicle injured in transport accident | Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal | Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal : person injured while boarding or alighting | Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal : driver injured in traffic accident
[LD50.Y] Other specified number anomalies of chromosome X
Also known as: Other specified number anomalies of chromosome X | Female with more than three X chromosomes | abnormal female chromosomes, with more than three x chromosomes | Tetrasomy X | 48 xxxx syndrome
[PA19] Unintentional land transport nontraffic event injuring an occupant of a low powered passenger vehicle
Also known as: Unintentional land transport nontraffic event injuring an occupant of a low powered passenger vehicle | Occupant of three-wheeled motor vehicle injured in nontraffic accident NOS | Collision NOS involving three-wheeled motor vehicle, nontraffic | Accident NOS involving three-wheeled motor vehicle, nontraffic | Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal : driver injured in nontraffic accident
[NA82.4] Multiple fractures of ribs
Also known as: Multiple fractures of ribs | rib fractures | Multiple rib fractures, involving first rib | Multiple rib fractures, involving two ribs | Multiple rib fractures, involving three ribs
=== 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...
--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 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--> [QE11.2] 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...
--- Walk 3 ---
[PK91.16] Cardiovascular devices associated with injury or harm: peripheral venous catheter
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm
Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....
--- Walk 4 ---
[PK91.16] Cardiovascular devices associated with injury or harm: peripheral venous catheter
--PARENT--> [PK91.1] Cardiovascular devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices
--RELATED_TO--> [?] Extracorporeal life support procedure associated with injury or harm in therapeutic use
--- 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...
--EXCLUDES--> [?] Disorders due to use of cocaine
Def: Disorders due to use of cocaine are characterised by the pattern and consequences of cocaine use. Cocaine is a compound found in the leaves of the coca plant, Erythroxylum coca, which is indigenous to...
--EXCLUDES--> [?] Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone
Def: Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone are characterised by the pattern and consequences of use of these substances. There is a wide array of natur...
|
[
"[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 --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.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--> [QE11.2] 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...",
"[PK91.16] Cardiovascular devices associated with injury or harm: peripheral venous catheter\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm\n Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....",
"[PK91.16] Cardiovascular devices associated with injury or harm: peripheral venous catheter\n --PARENT--> [PK91.1] Cardiovascular devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices\n --RELATED_TO--> [?] Extracorporeal life support procedure associated with injury or harm in therapeutic use",
"[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 --EXCLUDES--> [?] Disorders due to use of cocaine\n Def: Disorders due to use of cocaine are characterised by the pattern and consequences of cocaine use. Cocaine is a compound found in the leaves of the coca plant, Erythroxylum coca, which is indigenous to...\n --EXCLUDES--> [?] Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone\n Def: Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone are characterised by the pattern and consequences of use of these substances. There is a wide array of natur..."
] |
QE11.Z
|
Hazardous drug use, unspecified
|
[
{
"from_icd11": "QE11.Z",
"icd10_code": "Z722",
"icd10_title": ""
},
{
"from_icd11": "PK91.16",
"icd10_code": "T8242XA",
"icd10_title": "Displacement of vascular dialysis catheter, initial encounter"
},
{
"from_icd11": "PK91.16",
"icd10_code": "T8249XD",
"icd10_title": "Other complication of vascular dialysis catheter, subsequent encounter"
},
{
"from_icd11": "PK91.16",
"icd10_code": "T8243XA",
"icd10_title": "Leakage of vascular dialysis catheter, initial encounter"
},
{
"from_icd11": "PK91.16",
"icd10_code": "T824",
"icd10_title": "Mechanical complication of vascular dialysis catheter"
},
{
"from_icd11": "JA61.5",
"icd10_code": "O2251",
"icd10_title": "Cerebral venous thrombosis in pregnancy, first trimester"
},
{
"from_icd11": "JA61.5",
"icd10_code": "O2252",
"icd10_title": "Cerebral venous thrombosis in pregnancy, second trimester"
},
{
"from_icd11": "JA61.5",
"icd10_code": "O2253",
"icd10_title": "Cerebral venous thrombosis in pregnancy, third trimester"
},
{
"from_icd11": "JA61.5",
"icd10_code": "O225",
"icd10_title": "Cerebral venous thrombosis in pregnancy"
},
{
"from_icd11": "8B22.1",
"icd10_code": "G08",
"icd10_title": "Intracranial and intraspinal phlebitis and thrombophlebitis"
},
{
"from_icd11": "8B22.1",
"icd10_code": "I676",
"icd10_title": "Nonpyogenic thrombosis of intracranial venous system"
},
{
"from_icd11": "8B22.1",
"icd10_code": "I636",
"icd10_title": "Cerebral infarction due to cerebral venous thrombosis, nonpyogenic"
},
{
"from_icd11": "1D45",
"icd10_code": "A931",
"icd10_title": "Sandfly fever"
},
{
"from_icd11": "PA09",
"icd10_code": "V30-V39",
"icd10_title": ""
},
{
"from_icd11": "PA09",
"icd10_code": "V32",
"icd10_title": "Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle"
}
] |
Z722
| |
A male preterm infant was born from healthy non-consanguineous parents at 32 + 6 weeks of gestation, via caesarean section delivery for foetal bradycardia and podalic presentation. The pregnancy was characterized by oligohydramnios and presence of voluminous cerebral cyst both detected at 28 + 2 weeks of gestation. Neonatal weight was 1230 g (<10th centile), length 40.0 cm (10th centile), occipital-frontal circumference 27.5 cm (<3th centile). Apgar score was 7/8 at 1 and 5 minutes, respectively. The patient was immediately transferred to the neonatal intensive care unit of our hospital because of moderate respiratory distress (FiO 2 > 0.3) requiring respiratory support by continuous positive airway pressure (CPAP) ventilation. Hemogasanalysis revealed a condition of metabolic acidosis (PH 7.11, PCO2 42 mmHg, PO2 60 mmHg, BE-16.2 mmol/L, HCO3- 13.3 mmHg, lactates 6,2 mmol/L). Laboratory investigations revealed hyperchloremia (> 110 mmol/L) and normal values of glycemia and ammoniemia. Clinical features were dominated by facial dysmorphisms (ogival palate, low-set ears), bilateral syndattilia of the 2th and 4th toes and empty scrotum. Minimal enteral feeding with formula and total parenteral nutrition were started. On day of life (DOL) 2 the persistence of hyperchloremic metabolic acidosis refractory to correction with bicarbonate was complicated by high values of liver transaminases, hyperglycemia (250 mg/dl) with glycosuria. Urine was negative for ketones. The infant underwent transfusion with packed red cells because of anaemia of the prematurity (hemoglobin 8,6 g/dl). B-mode abdominal ultrasound showed normal sized but echogenic kidneys with loss of cortico-medullary differentiation. On DOL 3, onset of leukopenia with neutropenia (< 0,5 × 10 9 /L), requiring infusion of granulocyte stimulating factor, was observed. The metabolic acidosis was unresponsive to sodium bicarbonate up to 5 mEq/kg every 6 hours. A “sweaty feet” smell of the urine was noted. Urine samples were collected to search for organic acids, and blood samples were used to perform the expanded newborn bloodspot screening and the determination of plasma acylcarnitine profiles to identify an eventual congenital metabolic disease. Peripheral blood samples from proband and parents were also collected for genetic testing. On DOL 4 the general conditions dramatically worsened, with severe respiratory failure and rapid deterioration of renal function, with contraction of the diuresis and increase of blood urea (171 mg /dl), serum creatinine (1.8 mg/dl) and ammonemia (225 mmol/L). Despite tracheal intubation, invasive mechanical ventilation and supportive care, the newborn died on DOL 5. Autopsy was not performed because of parents’ refusal. The results of NBS, along with plasma and urine exams, arrived on DOL 5. The results from the plasma acylglycines analysis were abnormal (Table 1 ), showing elevated concentrations of long and medium chain acylcarnitines species, including C4, C5, C5DC/C6OH, C6, C14, C14:2, C14OH, C16, C16:1, C161OH, C18, together with increased values of arginine, citrulline, glycine, methionine, proline, tyrosine (Table 2 ) supporting the diagnosis of GA II. Urine organic acids analysis revealed abnormal urinary excretion of lactic, glutaric, adipic, isovaleric and parahydroxyphenyllatic acids together with raised levels of isovalerylglycina. The results were strongly suggestive for the diagnosis of MADD and the results of NBS confirmed it. Genetic analysis carried out using next-generation sequencing revealed a homozygous mutation in the ETFDH gene of the infant (c606 + 1_606 + 2insT) in a canonical site of splicing. This previously unreported mutation was inherited from the parents, each of whom carried only one heterozygous variant. The same mutation was detected in mother’s sister. The diagnosis of autosomal recessive GA II was confirmed, and genetic counseling was therefore offered to parents to inform them about the percentage of risk to have an affected child in case of a new pregnancy. Table 1 Acylcarnitine profile of the patient. Numbers out of reference range are in bold Analyte Name Measured value Target value Reference range Units C0- Free carnitine 4.913 26.025 7.65-44.4 umol/L C2- Acetylcarnitine 3.729 26.64 8.81-44.47 umol/L C3-Propionylcarnitine 0.184 2.46 0-4.92 umol/L C3DC-Malonylcarnitine 0.081 0.185 0-0.37 umol/L C4-n-butyryl−/isobutyrylcarnitine 2.743 0.315 0-0.63 umol/L C5-Isovaleryl−/2-Methylbutyrylcarnitine 3.802 0.12 0-0.24 umol/L C5:1-Tiglylcarnitine 0.01 0.01 0–0.02 umol/L C5DC-Glutaryl/3-Hydroxydecanoylcarnitine 0.559 0.075 0-0.15 umol/L C6-Hexanoylcarnitine 0.124 0.05 0-0.1 umol/L C8-Octanoylcarnitine 0.091 0.065 0-0.13 umol/L C10-Decanoylcarnitine 0.14 0.1 0-0.2 umol/L C10:1-Decenoylcarnitine 0.045 0.035 0-0.07 umol/L C10:2-Decadienoylcarnitine 0.003 0.005 0-0.01 umol/L C12-Dodecanoylcarnitine 0.226 0.14 0-0.28 umol/L C12:1-Dodecenoylcarnitine 0.076 0.11 0-0.22 umol/L C14-Tetradecanoylcarnitine 1.011 0.215 0-0.43 umol/L C14:1-Tetradecenoylcarnitine 0.295 0.155 0-0.31 umol/L C14:2-Tetradecadienoylcarnitine 0.082 0.02 0-0.04 umol/L C16-Hexadecanoylcarnitine 9.634 4.41 1.59-7.23 umol/L C16:1-Hexadecenoylcarnitine 1.178 0.21 0-0.042 umol/L C18-Octadecanoylcarnitine 3.173 1.135 0.44-1.83 umol/L C18:1-Octadecenoylcarnitine 3.295 1.265 0-2.53 umol/L C18:2-Linoleylcarnitine 0.868 0.17 0-0.34 umol/L Table 2 Amino acids profile of the patient. Numbers out of reference range are in bold Analyte Name Measured value Target value Reference range Units Alanine 371.874 258.68 0-517.36 umol/L Arginine 59.701 14.595 2.03-27.16 umol/L Citrulline 43.409 15.085 6.36-23.81 umol/L Glutamine 712.633 554.695 0-1109.39 umol/L Glutamate 123.221 240.22 0-480.44 umol/L Glycine 400.043 94.81 0-786.9 umol/L Leucine/isoleucine/Proline 284.251 94.81 0-189.62 umol/L Methionine 36.801 15.38 6.46-24.3 umol/L Ornithine 297.692 101.73 0-203.46 umol/L Phenylalanine 55.204 37.3 0-74.6 umol/L Proline 904.92 138.295 68.16-208.43 umol/L Tyrosine 175.164 82.595 0-165.19 umol/L Valine 233.089 103.475 0-206.95 umol/L
| 4.148438
| 0.970215
|
sec[1]/p[0]
|
en
| 0.999999
|
PMC9446717
|
https://doi.org/10.1186/s13052-022-01356-w
|
[
"umol",
"parents",
"urine",
"metabolic",
"mmol",
"acids",
"reference",
"range",
"centile",
"because"
] |
[
{
"code": "QE50.4",
"title": "Relationship with parents, in-laws or other family members"
},
{
"code": "QE52.1",
"title": "Loss of love relationship in childhood"
},
{
"code": "QE9Y",
"title": "Other specified problems associated with upbringing"
},
{
"code": "QE52.0",
"title": "Caregiver-child relationship problem"
},
{
"code": "QE95",
"title": "Inappropriate parental pressure or other abnormal qualities of upbringing"
},
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "MF50.6Z",
"title": "Difficulties with micturition, unspecified"
},
{
"code": "MF50.0",
"title": "Frequent micturition"
},
{
"code": "MF50.3",
"title": "Retention of urine"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[QE50.4] Relationship with parents, in-laws or other family members
Also known as: Relationship with parents, in-laws or other family members | Problems in relationship with parents | problem with parent | Problem with aged parent | Problem with sibling
Excludes: Caregiver-child relationship problem | Problems associated with upbringing | Problem associated with interactions with spouse or partner
[QE52.1] Loss of love relationship in childhood
Definition: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection.
Also known as: Loss of love relationship in childhood | negative life event in childhood of loss of love relationship | life event in childhood of loss of love relationship | Loss of parent in childhood
[QE9Y] Other specified problems associated with upbringing
Also known as: Other specified problems associated with upbringing | Lack of learning or play experience | Problem with a parenting situation | problem with atypical parenting situation
[QE52.0] Caregiver-child relationship problem
Definition: Substantial and sustained dissatisfaction within a caregiver-child relationship, including a parental relationship, associated with significant disturbance in functioning.
Also known as: Caregiver-child relationship problem | parent-child relationship problem | Caregiver-child relationship problem with current caregiver | Caregiver-child relationship problem with former caregiver
[QE95] Inappropriate parental pressure or other abnormal qualities of upbringing
Definition: Parents forcing the child to be different from the local norm, either sex-inappropriate (e.g. dressing a boy in girl's clothes), age-inappropriate (e.g. forcing a child to take on responsibilities above her or his own age) or otherwise inappropriate (e.g. pressing the child to engage in unwanted or too difficult activities).
Also known as: Inappropriate parental pressure or other abnormal qualities of upbringing | problem of inappropriate parental pressure
[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
[MF50.6Z] Difficulties with micturition, unspecified
Also known as: Difficulties with micturition, unspecified | Other difficulties with micturition | difficulty passing urine NOS | difficulty urinating NOS | other difficulties with urination
[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
[MF50.3] Retention of urine
Definition: Incomplete emptying of the bladder
Also known as: Retention of urine | bladder retention of urine | not passing urine | unable to empty bladder | unable to pass urine
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[QE50.4] Relationship with parents, in-laws or other family members
--EXCLUDES--> [?] Problems associated with upbringing
--PARENT--> [?] Factors influencing health status
--- Walk 2 ---
[QE50.4] Relationship with parents, in-laws or other family members
--EXCLUDES--> [?] Caregiver-child relationship problem
Def: Substantial and sustained dissatisfaction within a caregiver-child relationship, including a parental relationship, associated with significant disturbance in functioning....
--CHILD--> [?] Caregiver-child relationship problem with current caregiver
Def: Substantial and sustained dissatisfaction within a relationship between a child and a current caregiver, including a parent, associated with significant disturbance in functioning....
--- Walk 3 ---
[QE52.1] Loss of love relationship in childhood
Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....
--PARENT--> [QE52] Problem associated with interpersonal interactions in childhood
--CHILD--> [QE52.1] Loss of love relationship in childhood
Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....
--- Walk 4 ---
[QE52.1] Loss of love relationship in childhood
Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....
--PARENT--> [QE52] Problem associated with interpersonal interactions in childhood
--CHILD--> [QE52.1] Loss of love relationship in childhood
Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....
--- Walk 5 ---
[QE9Y] Other specified problems associated with upbringing
--PARENT--> [?] Problems associated with upbringing
--CHILD--> [QE90] Inadequate parental supervision or control
Def: Lack of parental knowledge of what the child is doing or where the child is; poor control; lack of concern, understanding or comprehension or lack of attempted intervention when the child is in risky ...
--- Walk 6 ---
[QE9Y] Other specified problems associated with upbringing
--PARENT--> [?] Problems associated with upbringing
--PARENT--> [?] Factors influencing health status
|
[
"[QE50.4] Relationship with parents, in-laws or other family members\n --EXCLUDES--> [?] Problems associated with upbringing\n --PARENT--> [?] Factors influencing health status",
"[QE50.4] Relationship with parents, in-laws or other family members\n --EXCLUDES--> [?] Caregiver-child relationship problem\n Def: Substantial and sustained dissatisfaction within a caregiver-child relationship, including a parental relationship, associated with significant disturbance in functioning....\n --CHILD--> [?] Caregiver-child relationship problem with current caregiver\n Def: Substantial and sustained dissatisfaction within a relationship between a child and a current caregiver, including a parent, associated with significant disturbance in functioning....",
"[QE52.1] Loss of love relationship in childhood\n Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....\n --PARENT--> [QE52] Problem associated with interpersonal interactions in childhood\n --CHILD--> [QE52.1] Loss of love relationship in childhood\n Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....",
"[QE52.1] Loss of love relationship in childhood\n Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....\n --PARENT--> [QE52] Problem associated with interpersonal interactions in childhood\n --CHILD--> [QE52.1] Loss of love relationship in childhood\n Def: Loss of an emotionally close relationship, such as of a parent, a sibling, a very special friend or a loved pet, by death or permanent departure or rejection....",
"[QE9Y] Other specified problems associated with upbringing\n --PARENT--> [?] Problems associated with upbringing\n --CHILD--> [QE90] Inadequate parental supervision or control\n Def: Lack of parental knowledge of what the child is doing or where the child is; poor control; lack of concern, understanding or comprehension or lack of attempted intervention when the child is in risky ...",
"[QE9Y] Other specified problems associated with upbringing\n --PARENT--> [?] Problems associated with upbringing\n --PARENT--> [?] Factors influencing health status"
] |
QE50.4
|
Relationship with parents, in-laws or other family members
|
[
{
"from_icd11": "QE50.4",
"icd10_code": "Z601",
"icd10_title": ""
},
{
"from_icd11": "QE50.4",
"icd10_code": "Z631",
"icd10_title": "Problems in relationship with in-laws"
},
{
"from_icd11": "QE52.1",
"icd10_code": "Z610",
"icd10_title": ""
},
{
"from_icd11": "QE95",
"icd10_code": "Z626",
"icd10_title": "Inappropriate (excessive) parental pressure"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3915",
"icd10_title": "Urgency of urination"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3911",
"icd10_title": "Hesitancy of micturition"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3914",
"icd10_title": "Feeling of incomplete bladder emptying"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3912",
"icd10_title": "Poor urinary stream"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R39198",
"icd10_title": "Other difficulties with micturition"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3916",
"icd10_title": "Straining to void"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3919",
"icd10_title": "Other difficulties with micturition"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3913",
"icd10_title": "Splitting of urinary stream"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R391",
"icd10_title": "Other difficulties with micturition"
},
{
"from_icd11": "MF50.0",
"icd10_code": "R351",
"icd10_title": "Nocturia"
},
{
"from_icd11": "MF50.0",
"icd10_code": "R358",
"icd10_title": "Other polyuria"
}
] |
Z601
| |
A 68-year-old man with a history of hypertension, diabetes, and chronic kidney failure was undergoing treatment as an outpatient for angina pectoris and atrial fibrillation that was diagnosed 2 years prior to the carcinosarcoma. He reported a history of heavy smoking for approximately 40 years; moreover, his father had a history of lung cancer. The patient did not have any clinical symptoms of cancer, and no remarkable changes were noted on physical examination. However, a routine blood test done 3 months earlier indicated anemia (hemoglobin: 9.6 g/dL), and the patient’s stool sample tested positive for occult blood. We tested for tumor markers and found the squamous cell carcinoma (SCC) antigen was slightly elevated at 3.3 ng/mL, but the carcinoembryonic antigen (CEA) and CA 19–9 were within the reference range. An upper GI endoscopy showed a bleeding, irregular, protruding lesion located on the posterior wall of the lesser curvature within the body of the stomach ; the lesion was biopsied and identified as a poorly differentiated adenocarcinoma. Moreover, at the lower part of the esophagus, there was a slightly concave lesion that was entirely separate from the gastric tumor. Biopsy specimens from the esophageal lesion indicated SCC. The patient was scheduled for surgical tumor excision. First, en bloc resection via endoscopic submucosal dissection was performed for the esophageal cancer, and the pathological diagnosis was well-differentiated SCC with negative margins and slight infiltration of the mucosal lamina propria. At a later date, segmental gastrectomy was performed for the gastric tumor. The proximal gastric surgical margin was confirmed to be negative by rapid assessment. The resected gastric tumor was subjected to histopathological examination. Macroscopically, the gastrectomy specimen had a protruding lesion measuring 41 × 29 × 18 mm 3 . The cross-section showed a grayish-white tumor with growth mainly on the mucous membranous surface as well as areas with a cystic appearance and a translucent cartilage-like matrix in parts . Histologically, the tumor was a carcinosarcoma with mixed adenocarcinomatous and sarcomatous components . Tumor invasion was limited to the submucosa. The adenocarcinomatous component exhibited tubular, papillary, and, in some parts, solid growth patterns. The adenocarcinoma cells were acidophilic and cylindrical; however, some regions comprised adenocarcinoma cells with clear cytoplasm. The adenocarcinomatous component resulted in diffuse lymphatic and venous invasion. The sarcomatous portion showed proliferation of atypical spindle cells and atypical round cells with a high nucleus-to-cytoplasm (N/C) ratio . In the sarcomatous portion, some parts showed chondrogenesis, and dyskaryosis was observed in chondrocyte-like cells . Immunohistochemically, the adenocarcinomatous component with clear cytoplasm comprised areas with alpha-fetoprotein (AFP)- and Sal-like protein 4 (SALL4)-positive AFP-producing gastric carcinoma . Moreover, there were synaptophysin- and chromogranin A-positive adenocarcinomatous regions that showed neuroendocrine differentiation . The sarcomatous portion was predominantly composed of undifferentiated areas as indicated by unstained regions, but included smooth muscle actin-positive leiomyosarcomatous areas composed of spindle cells with acidophilic cytoplasm as well as areas of desmin- and MyoD1-positive atypical round cells with rhabdomyosarcomatous differentiation . Furthermore, a proliferative focus with atypical “bare nucleus” cells that was partly composed of SALL4-positive germ cell-like cells did not indicate any specific differentiation in immunostaining . Histopathological analysis of the background stomach revealed chronic gastritis with intestinal metaplasia and negativity for Helicobacter pylori . There was no dysplasia around the gastric tumor. Fig. 1 Endoscopic images showing the gastric mucosa at various levels of magnification. a Bleeding associated with an irregular, protruding lesion observed on the rear wall of the lesser curvature in the body of the stomach. b Segmental gastrectomy specimen. A 41 × 29 × 18 mm 3 protruding lesion is observed. c The cross-section shows a grayish-white tumor with growth mainly on the mucous membranous side, partly composed of cystoid portions and a translucent cartilage-like matrix (indicated by the red arrow). d Low magnification (× 0.4) imaging indicating carcinosarcoma invasion limited to the submucosa. Cartilaginous tissue is visible indicated by the red arrow. e Magnified imaging (× 20 magnification) indicating an adenocarcinomatous component with tubular and papillary growth mixed with a sarcomatous component (scale bar 200 μm). f Higher magnification (× 200) imaging, indicating an acidophilic and cylindrical adenocarcinomatous component as well as a sarcomatous component with atypical spindle cell and atypical round cell proliferation with a high N/C ratio (scale bar 50 μm). g Magnified imaging (× 100) of a region showing chondrogenesis. Dyskaryosis is visible in chondrocyte-like cells (scale bar 100 μm) Fig. 2 Immunohistochemistry (IHC) of the gastric carcinosarcoma showing H&E, AFP, and SALL4 immunostaining. a Tubular and solid growth patterns of adenocarcinoma with clear cytoplasm are visible; b The same area is positive for AFP by IHC; c Positivity for SALL4 staining is also shown; d indicates H&E staining showing a moderately differentiated adenocarcinomatous region with acidophilic cytoplasm; e this area indicates positivity of synaptophysin by IHC; f is also positive for chromogranin A; g is an H&E staining indicating proliferation of spindle cells with acidophilic cytoplasm; h this area is positive for SMA by IHC; i shows an H&E stained section indicating proliferation of atypical round cells; j: indicates positivity of desmin; and k MyoD1 by IHC; l: show a proliferative area of germ cell-like cells and proliferation of atypical “bare nuclei” cells is visible; m Immunohistochemically, the tumor is positive for SALL4. (scale bars in a–k : 50 μm and i, m: 20 μm)
| 4.175781
| 0.967773
|
sec[1]/p[0]
|
en
| 0.999997
|
32972454
|
https://doi.org/10.1186/s13000-020-01037-4
|
[
"cells",
"tumor",
"gastric",
"adenocarcinomatous",
"atypical",
"lesion",
"like",
"component",
"cytoplasm",
"sarcomatous"
] |
[
{
"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": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
}
] |
=== ICD-11 CODES FOUND ===
[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
[2F9Z] Neoplasms of unknown behaviour of unspecified site
Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature
Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules
Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung
Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site
[2F92] Neoplasms of unknown behaviour of skin
Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[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
--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 3 ---
[5C56.20] Mucolipidosis
--PARENT--> [5C56.2] Glycoproteinosis
Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....
--PARENT--> [5C56] Lysosomal diseases
--- Walk 4 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Wolman disease
Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...
--PARENT--> [?] Lysosomal acid lipase deficiency
Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.0] Sickle cell trait
Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --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 --PARENT--> [5C56.2] Glycoproteinosis\n Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....\n --PARENT--> [5C56] Lysosomal diseases",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Lysosomal acid lipase deficiency\n Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.0] Sickle cell trait\n Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ..."
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "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"
}
] |
D571
|
Sickle-cell disease without crisis
|
The patient was diagnosed with stage IVB ALK-positive advanced LSCC (cT2bN2M1c). Subsequently,the patient was prescribed crizotinib (250mg bid) in December 2019. A CT scan in March 2020 revealed a reduction in the size of the left mass (22x13mm), mediastinal and left hilar lymph nodes, and pleural tubercle. Concurrently, an MRI scan detected a hepatic S7 nodule, suspected to be a metastasis (11mm×10mm), as shown in Figure 3A . According to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, the condition was assessed as progressive disease (PD). He still had a PS of 1. In March 2020, the patient underwent radiofrequency and chemical ablation for the liver metastasis while continuing crizotinib. By July 2020, MRI scans demonstrated post-treatment alterations in the liver S7 metastasis, including coagulation and necrosis. However, a new T2W-FLAIR hypersignal focus, approximately 4.6mm in diameter, was identified in the left frontal lobe, suggesting potential brain metastasis. This again was evaluated as PD. The patient had a PS of 1 at the time. Consequently, the treatment regimen was switched to alectinib (600mg bid) in July 2020. Subsequent brain MRIs in August and October 2020 showed no evidence of brain metastasis. However, in January 2021, the patient experienced intermittent dizziness with PS 1, and an MRI revealed a nodule in the left frontal lobe with surrounding brain tissue edema, indicative of metastasis (9x9.5mm). Stereotactic radiosurgery (SRS) for the brain metastasis was performed from February 3 to February 7, 2021 (30Gy in 3Gy fractions), while maintaining the alectinib regimen. This treatment led to an improvement in the patient’s dizziness. A follow-up brain MRI in August 2021 showed changes in the left frontal mass consistent with post-radiotherapy effects for brain metastasis. Periodic subsequent evaluations have indicated no active tumor in the left frontal lobe lesion and no new brain metastases. June and October 2020 CT scans indicated a reduction in the size of the left lung mass. Subsequent regular CT scans from October 2020 to June 2021 suggested that the size of this mass remained largely unchanged. However, in April 2021, the patient noted a mass on the left side of his neck with PS 2, accompanied by symptoms, such as severe hoarseness and moderate dizziness. A CT scan at this time revealed no significant change in the left lung mass size, but there was an apparent fusion of lymph nodes in the left supraclavicular fossa into a larger mass measuring 32×47mm, as depicted in Figure 3B . This observation led to the suspicion of disease progression. A puncture biopsy of the left supraclavicular lymph node was conducted. Pathological examination identified the presence of metastatic poorly differentiated carcinoma, likely originating from the lung. Immunohistochemical analysis demonstrated that the tumor cells were positive for cytokeratin (CK), CK7, TTF-1, CK5/6, CD8 and Ki-67 (60%) , while negative for NapsinA, P40, P63, PAX-8, CD10, CgA, CD4, CD20, CD56, Hepatocyte, TG, and BEER. SCCA levels were within normal ranges. On May 1 and May 22, 2021, the patient received GP chemotherapy (gemcitabine 1.6g on days 1 and 8, and Nedaplatin 40mg on days 1-3) along with recombinant human endostatin (Endostar, 210mg). During the period of chemotherapy session, the patient showed second-degree vomiting and diarrhea, but no adverse hematological reactions were observed. A follow-up CT scan in June 2021 revealed an increase in the size of both the bilateral hilar and left supraclavicular fossa lymph nodes, measuring 52x69mm, indicating a progression of the metastatic disease. The disease was evaluated as PD; the patient had a PS score of 3, along with persistent hoarseness and dizziness. To further investigate, left cervical lymph node and peripheral blood samples underwent next-generation sequencing (NGS) of 550 tumor-related genes. Under the BioProject ID PRJNA1062325, the raw sequencing date have been submitted to the Sequence Read Archive (SRA). The NGS findings indicated a negative status for ALK fusion, while programmed death-ligand 1 (PD-L1) expression was significantly positive (90%) . Subsequently, the patient received treatment with nab-paclitaxel (400mg, day 1) and the PD-1 monoclonal antibody Pembrolizumab (200mg, day 1) on June 18 and July 9, 2021. An August 2021 CT scan revealed a notable reduction in the size of the pulmonary nodules, which had nearly disappeared, and a decrease in the size of the left supraclavicular fossa nodule to 19x20mm, as shown in Figure 1G . However, after using nab-paclitaxel, the patient developed neurotoxicity and numbness in his hands and feet and did not experience hematologic toxicity. The patient opted against further chemotherapy, continuing treatment with Pembrolizumab until July 2023. The patient’s neurotoxic symptoms disappeared about three months after the withdrawal of nab-paclitaxel. Regular follow-ups from August 2021 to March 2022 classified the patient’s condition as stable disease (SD). A CT scan in July 2022 found no pulmonary or supraclavicular nodules. Periodic assessments from July 2022 to November 2023 confirmed the maintenance of no pulmonary or supraclavicular nodules. The symptom of severe hoarseness lasted about one year and then gradually improved. In August 2023, the patient had a PS of 0 and elected to switch to sintilimab (PD-1 monoclonal antibody, 200 mg), citing economic reasons after two years of pembrolizumab treatment without medicinal donations. As of November 2023, chest CT scans showed no detectable lesions , and MRI scans revealed no active lesions in the spine, liver, and brain . With PS 0, the patient is satisfied with the therapeutic effect and the current quality of life. The timeline of the treatment process is depicted in Figure 3C . Figure 4 illustrates the dynamic changes in lesions located in the left lung, liver, brain, and left supraclavicular fossa throughout the course of treatment. Informed consent was obtained from the patient for the purpose of this case report.
| 3.927734
| 0.973633
|
sec[1]/p[1]
|
en
| 0.999999
|
38380327
|
https://doi.org/10.3389/fimmu.2024.1360671
|
[
"brain",
"metastasis",
"supraclavicular",
"scan",
"july",
"this",
"lymph",
"scans",
"august",
"liver"
] |
[
{
"code": "8E7Y",
"title": "Other specified diseases of the nervous system"
},
{
"code": "LA05.Z",
"title": "Cerebral structural developmental anomalies, unspecified"
},
{
"code": "1D00.Z",
"title": "Infectious encephalitis, unspecified"
},
{
"code": "LA00.0Z",
"title": "Anencephaly, unspecified"
},
{
"code": "NA07.3Y",
"title": "Other specified diffuse brain injury"
},
{
"code": "2E2Z",
"title": "Malignant neoplasm metastasis, unspecified"
},
{
"code": "2E03",
"title": "Malignant neoplasm metastasis in bone or bone marrow"
},
{
"code": "2E08",
"title": "Metastatic malignant neoplasm involving skin"
},
{
"code": "2E0Y&XA25Q2",
"title": "Malignant neoplasm metastasis in pelvic viscera"
},
{
"code": "2D8Y&XA1WN1",
"title": "Malignant neoplasm metastasis in oral cavity"
}
] |
=== ICD-11 CODES FOUND ===
[8E7Y] Other specified diseases of the nervous system
Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis
[LA05.Z] Cerebral structural developmental anomalies, unspecified
Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS
[1D00.Z] Infectious encephalitis, unspecified
Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation
[LA00.0Z] Anencephaly, unspecified
Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence
[NA07.3Y] Other specified diffuse brain injury
Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion
[2E2Z] Malignant neoplasm metastasis, unspecified
Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases
[2E03] Malignant neoplasm metastasis in bone or bone marrow
Definition: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas.
Also known as: Malignant neoplasm metastasis in bone or bone marrow | bone metastasis | bony metastasis | osseous metastasis | secondary cancer of bone
[2E08] Metastatic malignant neoplasm involving skin
Definition: Involvement of the skin by metastatic spread from a known or unknown primary malignant neoplasm. The secondary deposit may result from local migration of malignant cells, or from regional lymphatic or haematogenous spread from more distant sites.
Also known as: Metastatic malignant neoplasm involving skin | cutaneous metastasis | metastasis to skin, any site | skin metastasis | skin secondaries
=== GRAPH WALKS ===
--- Walk 1 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--CHILD--> [?] Disorders with neurocognitive impairment as a major feature
--- Walk 2 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--RELATED_TO--> [?] Non-viral and unspecified infections of the central nervous system
Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source....
--- Walk 3 ---
[LA05.Z] Cerebral structural developmental anomalies, unspecified
--PARENT--> [LA05] Cerebral structural developmental anomalies
Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....
--CHILD--> [LA05.1] Megalencephaly
Def: A condition caused by failure of the brain to correctly develop during the antenatal period. This condition is characterised by increased size or weight of an otherwise correctly formed brain. This co...
--- Walk 4 ---
[LA05.Z] Cerebral structural developmental anomalies, unspecified
--PARENT--> [LA05] Cerebral structural developmental anomalies
Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies of the nervous system
Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....
--- Walk 5 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.0] Bacterial encephalitis
--- Walk 6 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.2] Parasitic or protozoal encephalitis
Def: A disease of the brain, caused by an infection with a parasitic or protozoal source....
|
[
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Disorders with neurocognitive impairment as a major feature",
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --RELATED_TO--> [?] Non-viral and unspecified infections of the central nervous system\n Def: Any condition of the nervous system, caused by an infection with a bacterial, fungal, parasitic or unspecified source....",
"[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.1] Megalencephaly\n Def: A condition caused by failure of the brain to correctly develop during the antenatal period. This condition is characterised by increased size or weight of an otherwise correctly formed brain. This co...",
"[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the nervous system\n Def: Any condition caused by failure of the nervous system to correctly develop during the antenatal period....",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.0] Bacterial encephalitis",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.2] Parasitic or protozoal encephalitis\n Def: A disease of the brain, caused by an infection with a parasitic or protozoal source...."
] |
8E7Y
|
Other specified diseases of the nervous system
|
[
{
"from_icd11": "LA05.Z",
"icd10_code": "Q048",
"icd10_title": "Other specified congenital malformations of brain"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q043",
"icd10_title": "Other reduction deformities of brain"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q049",
"icd10_title": "Congenital malformation of brain, unspecified"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q04",
"icd10_title": "Other congenital malformations of brain"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0490",
"icd10_title": "Encephalitis and encephalomyelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0491",
"icd10_title": "Myelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0430",
"icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0431",
"icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0439",
"icd10_title": "Other acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0481",
"icd10_title": "Other encephalitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0489",
"icd10_title": "Other myelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G04",
"icd10_title": "Encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G048",
"icd10_title": "Other encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "LA00.0Z",
"icd10_code": "Q000",
"icd10_title": "Anencephaly"
},
{
"from_icd11": "2E2Z",
"icd10_code": "C7949",
"icd10_title": "Secondary malignant neoplasm of other parts of nervous system"
}
] |
Q048
|
Other specified congenital malformations of brain
|
A 44-year-old woman presented to our hospital with a 1-month history of appetite loss. A barium study and endoscopic examination revealed type 0–IIa + IIc gastric cancer with a pathologic diagnosis of moderately differentiated adenocarcinoma in the lesser curvature of the gastric angle. Contrast-enhanced computed tomography (CT) showed no lymph node swelling or distant metastasis. The serum carcinoembryonic antigen (CEA) level was 0.6 ng/mL, and the carbohydrate antigen 19-9 (CA19-9) level was 9.6 ng/mL. The preoperative diagnosis was cT1(M)cN0cM0cStageIA (Japanese Classification of Gastric Carcinoma [The 13th Edition]). She underwent laparoscopic distal gastrectomy (D1 +) + Roux-en-Y reconstruction. Histopathologic examination of the surgical specimen revealed a superficial extension of moderately to poorly differentiated adenocarcinoma and partial invasion of the serous membrane (T2:SS). Severe lymphatic invasion (ly3), moderate venous invasion (v2), and lymph node metastases in No. 1, 3, 7, and 9 lymph node stations (N2) were observed. The postoperative diagnosis was pT2(SS)pN2cM0pStageIIIA (Japanese Classification of Gastric Carcinoma [The 13th Edition]) . The patient received adjuvant chemotherapy with tegafur-uracil (400 mg/day) for 2 years. Blood tests, including tumor marker tests and a whole-body CT, were performed every 3 months and 6 months, respectively. Endoscopic examination was conducted at least annually. At postoperative year (POY) 5, a 19 × 12-mm lymph node was detected in the No. 16b1lat lymph node station (Japanese Classification of Gastric Carcinoma [The 13th Edition]) . However, positron emission tomography (PET) revealed no abnormal uptake, and the levels of tumor markers were within normal limits (CEA, 1.3 ng/mL; CA19-9, 20.3 U/mL) ; hence, the possibility of metastasis was considered to be low, and the patient was placed under observation. At POY 6, PET revealed no abnormal uptake. Annual whole-body CT showed no increase in tumor size, and the tumor marker expression levels remained within normal limits. At POY 10, a blood examination revealed that the CA19-9 level was elevated to 39.2 U/mL, although no increase in size was noted. At POY 12, the No. 16b1lat lymph node station was enlarged at 30 × 15 mm, the PET revealed abnormal uptake in the same lesion, and the CA19-9 level was further elevated to 72.6 U/mL . No other tumor was noted during esophagogastroduodenoscopy and colonoscopy. Endoscopic ultrasound-guided fine-needle aspiration revealed a moderately differentiated adenocarcinoma, similar to the previous surgery specimen’s histology. The immunohistochemistry (IHC) analysis showed that the HER2 score was negative; hence, a diagnosis of recurrence of gastric cancer was made. After two cycles of chemotherapy with tegafur–gimeracil–oteracil (120 mg/day) + oxaliplatin (100 mg/m 2 ), the recurrent lesion decreased in size to 18 × 9 mm (RECIST: PR; partial response), and tumor marker levels also decreased (CEA: 1.1 ng/mL, CA19-9: 20.3 U/mL). Para-aortic nodal dissection (PAND) of No. 16b1lat and int stations was performed. In the dissected lymph nodes, proliferating adenocarcinoma cells demonstrating conjoined tubular structures were observed, a finding consistent with that of gastric cancer metastasis . Scar-like fibrosis and aggregation of foamy histiocytes were observed around the adenocarcinoma cells, indicating that a part of the tumor had undergone necrosis following chemotherapy. The immunohistochemical staining showed that CK7 was expressed in primary and recurrent specimens . Immunohistochemical staining for CK20 expression was negative in primary and recurrent specimens . The degree of staining for CD44 variant 9 (CD44v9) was attenuated in recurrent specimens compared with primary specimens . Based on these immunohistochemical findings and the exclusion of other malignancies on preoperative examination, gastric cancer recurrence was diagnosed. IHC test showed a HER2 score was negative in recurrent specimens. Postoperatively, the patient received chemotherapy with tegafur–gimeracil–oteracil (80 mg/day) for 1 year. At POY4, after PAND bone metastasis was confirmed in a needle biopsy specimen of bone metastasis, the pathological finding showed adenocarcinoma, and the IHC analysis showed a HER2 score of 3 + . The expression of CD44v9 was slightly positive. The patient is being treated with chemotherapy with FOLFOX + rastuzumab. Fig. 1 a The tumor presented in the lesser curvature of the gastric angle. b Histopathologic examination of the surgical specimen revealed the superficial extension of intermediate to poorly differentiated adenocarcinoma and partial invasion of the serous membrane. On immunohistochemical analysis, the tumor cells were noted to be positive for CK7 ( c ) and negative for CK20 ( d ) and showed a Ki-67 labeling index of < 3% ( e ) Fig. 2 At postoperative year 5, computed tomography ( a ) /positron emission tomography ( b ) showed a 19 × 12 mm lymph node with no abnormal uptake in the No. 16b1lat lymph node station Fig. 3 At postoperative year 12, computed tomography ( a ) / positron emission tomography ( b ) detected a 30 × 14 mm lymph node with abnormal uptake in the No. 16b1lat lymph node station Fig. 4 a Histopathologically, proliferating adenocarcinoma cells demonstrated conjoined tubular structures. On immunohistochemical analysis, the tumor cells were positive for CK7 ( b ) and negative for CK20 ( c ) and showed a Ki-67 labeling index of less than 3% ( d ) Fig. 5 Case 1 (the present case): gastric cancer that recurred in para-aortic lymph nodes 12 years postoperatively. The expression of CD44 variant 9 (CD44v9) as primary ( a )/recurrence ( b ): positive/slightly positive. Case 2: gastric carcinoma with para-aortic lymph node recurrence 5 years postoperatively. The expression of CD44v9 as primary ( c )/recurrence ( d ): positive/negative or unclear. Case 3: esophagogastric junction carcinoma with skin metastasis 8 months postoperatively. The expression of CD44v9 as primary ( e )/recurrence ( f ): positive/positive
| 4.03125
| 0.974121
|
sec[1]/p[0]
|
en
| 0.999996
|
37212902
|
https://doi.org/10.1186/s40792-023-01660-5
|
[
"lymph",
"gastric",
"node",
"tumor",
"adenocarcinoma",
"tomography",
"metastasis",
"expression",
"that",
"recurrence"
] |
[
{
"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": "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 ===
[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
[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 ---
[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....
--RELATED_TO--> [?] Lymphatic malformations
Def: Lymphatic malformations (LM), formerly referred to by the term lymphangioma, are malformations of the lymphatic system which result in obstructed lymphatic drainage. There are two types of LM: macrocy...
--- 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....
--RELATED_TO--> [?] Lymphatic malformations
Def: Lymphatic malformations (LM), formerly referred to by the term lymphangioma, are malformations of the lymphatic system which result in obstructed lymphatic drainage. There are two types of LM: macrocy...
--- 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--> [BD90.0] Acute lymphadenitis
--- Walk 5 ---
[BD90.Y] Other specified lymphadenitis
--PARENT--> [BD90] Lymphadenitis
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--- Walk 6 ---
[BD90.Y] Other specified lymphadenitis
--PARENT--> [BD90] Lymphadenitis
--CHILD--> [BD90.0] Acute lymphadenitis
|
[
"[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --RELATED_TO--> [?] Lymphatic malformations\n Def: Lymphatic malformations (LM), formerly referred to by the term lymphangioma, are malformations of the lymphatic system which result in obstructed lymphatic drainage. There are two types of LM: macrocy...",
"[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 --RELATED_TO--> [?] Lymphatic malformations\n Def: Lymphatic malformations (LM), formerly referred to by the term lymphangioma, are malformations of the lymphatic system which result in obstructed lymphatic drainage. There are two types of LM: macrocy...",
"[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--> [BD90.0] Acute 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....",
"[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.0] Acute lymphadenitis"
] |
BD9Z
|
Disorders of lymphatic vessels or lymph nodes, unspecified
|
[
{
"from_icd11": "BD9Z",
"icd10_code": "I898",
"icd10_title": "Other specified noninfective disorders of lymphatic vessels and lymph nodes"
},
{
"from_icd11": "BD9Z",
"icd10_code": "I899",
"icd10_title": "Noninfective disorder of lymphatic vessels and lymph nodes, unspecified"
},
{
"from_icd11": "BD9Z",
"icd10_code": "I89",
"icd10_title": "Other noninfective disorders of lymphatic vessels and lymph nodes"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I889",
"icd10_title": "Nonspecific lymphadenitis, unspecified"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I88",
"icd10_title": "Nonspecific lymphadenitis"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I888",
"icd10_title": "Other nonspecific lymphadenitis"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "L00-L08",
"icd10_title": ""
},
{
"from_icd11": "MA01.Z",
"icd10_code": "R599",
"icd10_title": "Enlarged lymph nodes, unspecified"
},
{
"from_icd11": "MA01.Z",
"icd10_code": "R59",
"icd10_title": "Enlarged lymph nodes"
},
{
"from_icd11": "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"
}
] |
I898
|
Other specified noninfective disorders of lymphatic vessels and lymph nodes
|
Despite the significant incidence of cerebral toxoplasmosis, only five paradoxical CNS-IRIS cases associated to T. gondii have been previously described (Table 1 ) [ 15 – 18 ]. Similarly to other IRIS conditions, there is no consensual treatment for toxoplasmosis-associated IRIS and prognosis is poor . For these reasons, a better understanding of the immunopathology is needed to find biomarkers for early detection and to help developing targeted therapies leading to a consequent prognosis improvement. We report here the sixth case of paradoxical toxoplasmosis-associated CNS-IRIS and describe for the first time the evolution of different T cell subsets in the peripheral blood of the patient. Table 1 Review of the reported clinical cases of paradoxical CNS-IRIS associated to toxoplasmosis a Toxoplasmosis CNS-IRIS Ref. Case 1 Female, 30 yo At diagnosis: HIV infection for 6 months, not on HAART. Manifestations: Fever, left hemiparesis with the Babinski sign. Brain MRI: Ring-enhancing mass in the right basal nuclei. Treatment: ATT with trimethoprim–sulfamethoxazole, corticosteroids, HAART. Response to treatment: Clinical and radiographic improvement. Presentation: Approximately 6 weeks after toxoplasmosis diagnosis, patient was readmitted with headaches (for 2 weeks), imbalance, and left hemiparesis (for 48 h). Brain MRI: Mass persistence, more vasogenic edema and new, bilateral but smaller contrast enhancing lesions. Brain biopsy: Abundant tachyzoites. Treatment: Reduction of the corticosteroids tapering rate. Outcome: Clinical improvement without complete resolution (2 months after IRIS diagnosis). Case 2 Female, 26 yo At diagnosis: HIV infection for 8 years, not on HAART. History of cerebral toxoplasmosis 4 years before. Manifestations: Ataxia, left-sided weakness and hyperreflexia for 1 month. Brain CT scan: Scattered calcified lesions with no perilesional edema or contrast enhancement. CSF analysis: Negative PCR for T. gondii . Brain MRI: Multiple areas of high signal intensity on fluid-attenuated inversion recovery (FLAIR) images, some presenting nodular or ring enhancement. Treatment: ATT and HAART. Presentation: After a steady clinical period of 1 month, progression of symptoms. Brain MRI: Enlargement of most of the lesions, mainly with perilesional high signal intensity on FLAIR images, as well as stronger contrast enhancement. Brain biopsy: Collections of histiocytic giant multinucleated cells. Marked perivascular lymphocytic infiltrates with a predominance of CD8 + T cells. Reactive gliosis. No T.gondii cysts or tachyzoites. Treatment: Maintenance of therapeutic measures. No corticotherapy. Outcome: Clinical improvement. Case 3 Male, 34 yo At diagnosis: HIV infection, non-compliant with HAART. Manifestations: Lower extremities weakness for 6 months, sensory level at L4 and constipation. Toxoplasma serum IgG level: Increased. CSF studies: Negative. b Brain and spine MRI: No contrast-enhanced brain lesions. Expansive intramedullary enhancing lesion in spine, at T11 through T12. Treatment: Laminectomy and surgical spinal cord decompression, corticosteroids, ATT, HAART. Pathology of the excised spinal lesion: T. gondii cysts. Response to treatment: Clinical improvement. Presentation: Worsening of weakness 3 weeks after treatment initiation. Cachexy, dysarthria, hypotension and areflexia in upper and lower extremities after one month approximately. Brain and spine MRI: Two new enhancing lesions in brain. No new lesions in spine. CSF studies: All within normal. Electromyogram/nerve conduction study: Results consistent with a sensorimotor neuropathy superimposed on a predominantly proximal myopathic process. Muscle biopsy: Necrosis, lymphocytic and plasma cell infiltrates with abundant T. gondii cysts. c Outcome: Multiorgan dysfunction and death 2 weeks after the diagnosis of toxoplasmosis myositis. Case 4 Male, 35 yo At diagnosis: AIDS previously diagnosed, not on HAART or prophylaxis. Manifestations: Left upper extremity weakness for 3 weeks, associated to fever and respiratory symptoms for 1 week (concomitant respiratory infection). Brain MRI: Two ring-enhancing lesions in the right precentral and occipital temporal areas. Treatment: Ceftriaxone and azithromycin, ATT, HAART. Presentation: Progression of upper extremity weakness during the first 2 weeks on HAART. CSF studies: 6 WBC/mm 3 (96% lymphocytes; 4% monocytes); positive EBV PCR. Brain MRI: Enlargement of the two prior lesions and development of a third lesion. Brain biopsy: Rare T. gondii tachyzoites and numerous bradyzoites. CD8 + predominant lymphocytic infiltrates. Treatment: Corticosteroids. Outcome: Clinical improvement without complete resolution. Case 5 Male, 51 yo At diagnosis: AIDS previously diagnosed, not on HAART or prophylaxis. Manifestations: Unsteady gait, left upper extremity weakness, headaches, weight loss and fever for 2 weeks. Brain MRI: Multiple ring-enhancing lesions in his fronto parietal region. Treatment: ATT, HAART. Presentation: After an initial improvement, there was progression of neurological symptoms around 2 weeks after treatment initiation. CSF studies: 6 WBC/mm 3 (100% lymphocytes); no malignant cells. Brain MRI: No significant change. Brain biopsy: Presence of T. gondii. CD8 + predominant lymphocytic infiltrates. Treatment: Corticosteroids. Outcome: Clinical improvement. Cases are ordered by year of publication. a All case descriptions reported infection by Toxoplasma gondii , except for case 2 (no species was specified). b No specification for T. gondii. c IRIS treatment not available AIDS acquired immunodeficiency syndrome, ATT anti-toxoplasma therapy (unless otherwise stated, with sulfadiazine, pyrimethamine and folic acid), CNS-IRIS central nervous system immune reconstitution inflammatory syndrome, CSF cerebrospinal fluid, CT computed tomography, EBV Epstein-Barr virus, HAART highly active antiretroviral therapy, HIV human immunodeficiency virus, MRI magnetic resonance imaging, PCR polymerase chain reaction, T. gondii Toxoplasma gondii , WBC white blood cells, yo year-old
| 4.289063
| 0.569824
|
sec[0]/p[3]
|
en
| 0.999998
|
28086758
|
https://doi.org/10.1186/s12879-016-2159-x
|
[
"brain",
"haart",
"gondii",
"iris",
"lesions",
"toxoplasmosis",
"improvement",
"enhancing",
"weakness",
"associated"
] |
[
{
"code": "8E7Y",
"title": "Other specified diseases of the nervous system"
},
{
"code": "LA05.Z",
"title": "Cerebral structural developmental anomalies, unspecified"
},
{
"code": "1D00.Z",
"title": "Infectious encephalitis, unspecified"
},
{
"code": "LA00.0Z",
"title": "Anencephaly, unspecified"
},
{
"code": "NA07.3Y",
"title": "Other specified diffuse brain injury"
},
{
"code": "1F57.Y/GB5Z",
"title": "Renal tubulo-interstitial disorders due to toxoplasmoa gondii"
},
{
"code": "1F57.2",
"title": "Pulmonary toxoplasmosis due to Toxoplasma gondii"
},
{
"code": "1F57.3",
"title": "Eye disease due to Toxoplasma gondii"
},
{
"code": "1F57.Z",
"title": "Toxoplasmosis, unspecified"
},
{
"code": "1F57.1",
"title": "Meningoencephalitis due to Toxoplasma gondii"
}
] |
=== ICD-11 CODES FOUND ===
[8E7Y] Other specified diseases of the nervous system
Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis
[LA05.Z] Cerebral structural developmental anomalies, unspecified
Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS
[1D00.Z] Infectious encephalitis, unspecified
Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation
[LA00.0Z] Anencephaly, unspecified
Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence
[NA07.3Y] Other specified diffuse brain injury
Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion
[1F57.2] Pulmonary toxoplasmosis due to Toxoplasma gondii
Definition: 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, or cytotoxic drugs and those with hematologic malignancies, organ transplants, or acquired immunodeficiency syndrome (AIDS).
Pulmonary toxoplasmosis in the immunodeficient patient may appear in the form of interstitial pneumonitis, necrotizing pneumonitis, consolidation, pleural effusion, or empyema
Also known as: Pulmonary toxoplasmosis due to Toxoplasma gondii | pneumonia with toxoplasmosis | pneumonitis due to acquired toxoplasmosis | pneumonitis due to toxoplasmosis | toxoplasma pneumonia
Includes: Pulmonary toxoplasmosis
[1F57.3] Eye disease due to Toxoplasma gondii
Definition: Chorioretinitis or ocular toxoplasmosis is a relatively common manifestation of T. gondii infection. Ocular toxoplasmosis occurs when cysts deposited in or near the retina become active, producing tachyzoites. Focal necrotizing retinitis is the characteristic lesion, but retinal scars from prior reactivation are typically present.
Also known as: Eye disease due to Toxoplasma gondii | Toxoplasma oculopathy | Toxoplasma posterior uveitis | Toxoplasma chorioretinitis | chorioretinitis due to toxoplasmosis
Includes: Toxoplasma oculopathy
[1F57.Z] Toxoplasmosis, unspecified
Also known as: Toxoplasmosis, unspecified | Toxoplasmosis | acquired toxoplasmosis | toxoplasmosis disease or disorder | infection by toxoplasma gondii
[1F57.1] Meningoencephalitis due to Toxoplasma gondii
Definition: A disease of the meninges and brain, caused by an infection with the protozoan parasite Toxoplasma gondii. This disease is characterised by seizures, neck pain, neurological deficits, or alterations in behaviour, cognition, or consciousness. Transmission is by haematogenous spread to the meninges and brain after direct ingestion of contaminated food, or indirect transmission by consumption of food or water contaminated with infected cat faeces. Confirmation is by detection of antibodies against
Also known as: Meningoencephalitis due to Toxoplasma gondii | acquired toxoplasmal meningoencephalitis | meningoencephalitis due to acquired toxoplasmosis | meningoencephalitis due to toxoplasmosis | Toxoplasma meningoencephalitis
Includes: Toxoplasma meningoencephalitis
=== GRAPH WALKS ===
--- Walk 1 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--CHILD--> [?] Movement disorders
Def: This is a group of involuntary movement disorders....
--- Walk 2 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--RELATED_TO--> [?] Syndromes with central nervous system anomalies as a major feature
--- Walk 3 ---
[LA05.Z] Cerebral structural developmental anomalies, unspecified
--PARENT--> [LA05] Cerebral structural developmental anomalies
Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....
--CHILD--> [LA05.1] Megalencephaly
Def: A condition caused by failure of the brain to correctly develop during the antenatal period. This condition is characterised by increased size or weight of an otherwise correctly formed brain. This co...
--- Walk 4 ---
[LA05.Z] Cerebral structural developmental anomalies, unspecified
--PARENT--> [LA05] Cerebral structural developmental anomalies
Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....
--CHILD--> [LA05.2] Holoprosencephaly
Def: Holoprosencephaly is a brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the fa...
--- Walk 5 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.1] Fungal encephalitis
--- Walk 6 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.0] Bacterial encephalitis
|
[
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --CHILD--> [?] Movement disorders\n Def: This is a group of involuntary movement disorders....",
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --RELATED_TO--> [?] Syndromes with central nervous system anomalies as a major feature",
"[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.1] Megalencephaly\n Def: A condition caused by failure of the brain to correctly develop during the antenatal period. This condition is characterised by increased size or weight of an otherwise correctly formed brain. This co...",
"[LA05.Z] Cerebral structural developmental anomalies, unspecified\n --PARENT--> [LA05] Cerebral structural developmental anomalies\n Def: Any condition caused by failure of the brain to correctly develop during the antenatal period....\n --CHILD--> [LA05.2] Holoprosencephaly\n Def: Holoprosencephaly is a brain malformation resulting from incomplete cleavage of the prosencephalon, occurring between the 18th and the 28th day of gestation and affecting both the forebrain and the fa...",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.0] Bacterial encephalitis"
] |
8E7Y
|
Other specified diseases of the nervous system
|
[
{
"from_icd11": "LA05.Z",
"icd10_code": "Q048",
"icd10_title": "Other specified congenital malformations of brain"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q043",
"icd10_title": "Other reduction deformities of brain"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q049",
"icd10_title": "Congenital malformation of brain, unspecified"
},
{
"from_icd11": "LA05.Z",
"icd10_code": "Q04",
"icd10_title": "Other congenital malformations of brain"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0490",
"icd10_title": "Encephalitis and encephalomyelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0491",
"icd10_title": "Myelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0430",
"icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0431",
"icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0439",
"icd10_title": "Other acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0481",
"icd10_title": "Other encephalitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0489",
"icd10_title": "Other myelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G04",
"icd10_title": "Encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G048",
"icd10_title": "Other encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "LA00.0Z",
"icd10_code": "Q000",
"icd10_title": "Anencephaly"
},
{
"from_icd11": "1F57.2",
"icd10_code": "B583",
"icd10_title": "Pulmonary toxoplasmosis"
}
] |
Q048
|
Other specified congenital malformations of brain
|
On January 28, 2020, a 49-year-old female patient was transferred to our hospital for further treatment after being diagnosed with COVID-19. At admission, She presented with fever, cough, sputum, and mild dyspnea. Her body temperature was 38 °C, blood oxygen saturation (SPO2) was 93% under ambient air, oxygen inhalation was immediately given by nasal catheter. After admission, levofloxacin and human immunoglobulin were injected into the veins, recombinant with human interferon a2b atomized inhalation. On the 5th day of admission, the disease deteriorated and her mental state was poor, body temperature was 38.8 °C, blood gas analysis: PO2 49 mmHg, PCO2 38 mmHg. She suffered from type I respiratory failure, which conformed to the diagnostic criteria of severe COVID-19 according to the COVID-19 health guidelines of China national health commission. On the 8th day, oxygen inhalation was given by oxygen storage mask (8 L/min), SPO2 was 93%, blood gas analysis: PO2 49 mmHg, PCO2 38 mmHg, Chest CT indicated multifocal ground glass opacities in both lungs with consolidation in partial lungs, which involving more than 75% of the lungs . On the 12th day of admission, the patient was anxious, agitated, Alprazolam was administered for sedation. Under high-flow oxygen inhalation (FiO 2 90%, 50 L/min), SPO2 was 83 to 90%, blood gas analysis: PO2 55 mmHg, PCO2 44 mmHg, the oxygenation index<70 mmHg, which indicating poor oxygenation status, and non-invasive positive airway pressure ventilation was immediately performed. On the 14th day of admission, SPO2 was 90%, blood gas analysis: PO2 48 mmHg, pCO2 37 mmHg, under the condition of non-invasive positive airway pressure ventilation, FiO 2 70%, which revealed poor and difficult to ameliorate hypoxemia, mechanical ventilation became imperative. The patient progressed to critical cases and was transferred to intensive care unit (ICU), mechanical ventilation was performed by orotracheal intubation, ventilator conditions: Volume Control ventilation, VT 240 ml, VF 15 times/min, FiO2 100%, PEEP 10 cm H2O, prone position ventilation was performed at the same time. After intubation, maintaining the use of propofol and midazolam for sedation, SPO2 rose to 95% and hypoxemia improved. On the 16th day of admission, the patient’s SPO2 was difficult to maintain with poor oxygenation index and high airway platform pressure, salvage VV-ECMO therapy was performed. Under the guidance of B-ultrasound, the right femoral vein was inserted into the inflow cannula, the right jugular vein was inserted into the outflow cannula, the venous cannula was 20F, the arterial cannula was 17F, the depth of venous cannula was 43 cm, and the depth of arterial cannula was 14 cm. Initial ECMO parameters: speed 3200 rpm, flow 5 L/min, Sweep gas 3 L/min, FiO 2 70%. Coordinated ventilator parameters: Assist-Control ventilation, VT 210 ml, VF 18 times/min, FiO 2 40%, PEEP 12 cm H2O. Reviewed blood gas analysis: PO2 84 mmHg, PCO2 46 mmHg, oxygenation index improved significantly after ECMO. During the treatment of ECMO, deep sedation was performed and heparin was continuously pumped to maintain activated partial thromboplastin time (APTT) being 40–60s. On the 19th day of admission, support condition of ECMO for the patient was still high, ECMO could not be removed in a short time, and the lung compliance was poor. Chest radiograph showed increased multiple patchy density shadows in both lungs . We decided to coordinating prone position ventilation to improve pulmonary ventilation-to-perfusion ratio. On the 22th day of admission, bronchoscopy showed: a little white sputum could be seen in the main bronchus, and slightly swelling, hyperemia could be seen in the grade 1–4 bronchial mucosa of both lungs. On the 27th day of admission, the patient was tested negative for SARS-CoV-2 nucleic acid by the fluorescence quantitative RT-PCR for two consecutive times. After the withdrawal of sedative drugs, the patient was conscious, had a firm handshake, we stopped the ventilator, ECMO parameters was adjusted: speed 3600 rpm, flow 4 L/min, Sweep gas 3 L/min, FiO 2 70%, oxygen was inhaled through the endotracheal tube whit high-flow oxygen therapy (FiO 2 45%, 40 L/min). After observated for 30 min, blood gas analysis: PO2 71 mmHg, pCO2 45 mmHg, heart rate was 83 beats per minute, breathing rate was 25 times per minute, and blood pressure was 136/63 mmHg, the endotracheal tube was removed, awake ECMO was performed. Treatment strategies during awake ECMO stage: 1. Strengthen the monitoring and management of bleeding and thrombosis, monitoring the levels of hemoglobin, platelets, APTT and fibrinogen, and set the corresponding target values to be 90 g/L, 100*10^9/L, 40S, 2.0 g/L respectively, supplement the substrate by transfuse some components of blood if failed to meet target values. 2. Pulmonary rehabilitation: prone position or high lateral lying position was adopted for drainage to promote lung recruitment, and a large dose of ambroxol and acetylcysteine were used to dispersing phlegm. 3. During the awake ECMO period, patients had intermittent anxiety and delirium, enhanced psychological counseling, quetiapine and haloperidol were given to fight anxiety and delirium. 4. Combined Piperacillin tazobactam, Datomycin and Voriconazole to fight infection. 5. Strengthen liquid management and nutritional support therapy. On the 35th day of admission, the patient’s oxygen saturation could be maintained at 98%. After re-examination of chest radiograph , the patient was evacuated from ECMO. Reexamination chest CT on March 6, 2020 indicated the ground glass opacities absorbed, and leave some fibrotic stripes . After further treatments of anti-infection, pulmonary rehabilitation, nutritional support, psychological counseling and physical rehabilitation, the patient recovered and was discharged on March 15, 2020. Fig. 1 a Chest CT on the 8th day of admission. b Chest CT on the 39th day of admission Fig. 2 a Chest radiograph on the 19th day of admission. b Chest radiograph on the 35th day of admission
| 3.8125
| 0.979004
|
sec[1]/p[0]
|
en
| 0.999995
|
33334350
|
https://doi.org/10.1186/s13019-020-01376-9
|
[
"mmhg",
"ecmo",
"blood",
"ventilation",
"oxygen",
"chest",
"cannula",
"poor",
"lungs",
"inhalation"
] |
[
{
"code": "PK81.1",
"title": "Extracorporeal life support procedure associated with injury or harm in therapeutic use"
},
{
"code": "QC48.Y",
"title": "Other specified personal history of medical treatment"
},
{
"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": "MD11.Y",
"title": "Other specified abnormalities of breathing"
},
{
"code": "MD11.7",
"title": "Hyperventilation"
},
{
"code": "PK81.0",
"title": "Ventilation associated with injury or harm in therapeutic use"
}
] |
=== ICD-11 CODES FOUND ===
[PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use
Also known as: Extracorporeal life support procedure associated with injury or harm in therapeutic use | ECMO - [extracorporeal membrane oxygenation] | complication during or following extracorporeal life support procedure
Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm
[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
[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
[MD11.Y] Other specified abnormalities of breathing
Also known as: Other specified abnormalities of breathing | Bradypnoea | Choking sensation | Hypoventilation | hypoventilation syndrome NOS
[MD11.7] Hyperventilation
Definition: Hyperventilation refers to an increase in the rate of alveolar ventilation that is excessive for the rate of metabolic carbon dioxide production, resulting in a decrease in arterial PCO2 to below the normal range of 37 to 43 mm Hg. Hyperventilation should be distinguished from tachypnoea, an increase in respiratory frequency, and from hyperpnea, an increase in minute volume of ventilation.
Also known as: Hyperventilation | hyperventilating | overbreathing | HV - [hyperventilation] | increased respiratory rate
[PK81.0] Ventilation associated with injury or harm in therapeutic use
Also known as: Ventilation associated with injury or harm in therapeutic use | complication during or following ventilation | Ventilator associated pneumonia | VAP - [ventilator associated pneumonia] | respirator associated pneumonia
Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm
=== GRAPH WALKS ===
--- Walk 1 ---
[PK81.1] Extracorporeal life support procedure 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
--PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm
--- Walk 2 ---
[PK81.1] Extracorporeal life support procedure 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
--CHILD--> [?] Embolisation without injury or harm
Def: An embolisation without documented injury or harm occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there....
--- Walk 3 ---
[QC48.Y] Other specified personal history of medical treatment
--PARENT--> [QC48] Personal history of medical treatment
--CHILD--> [QC48.0] Personal history of long-term use of anticoagulants
--- Walk 4 ---
[QC48.Y] Other specified personal history of medical treatment
--PARENT--> [QC48] Personal history of medical treatment
--PARENT--> [?] Personal history of health problems
--- 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....
--PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics
--- 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....
--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...
|
[
"[PK81.1] Extracorporeal life support procedure 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 --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm",
"[PK81.1] Extracorporeal life support procedure 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 --CHILD--> [?] Embolisation without injury or harm\n Def: An embolisation without documented injury or harm occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there....",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.0] Personal history of long-term use of anticoagulants",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --PARENT--> [?] Personal history of health problems",
"[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",
"[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..."
] |
PK81.1
|
Extracorporeal life support procedure associated with injury or harm in therapeutic use
|
[
{
"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": "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"
}
] |
Z794
|
Long term (current) use of insulin
|
Although massive hepatosplenomegaly progressively worsened and renal and intestinal blood flow decreased, these findings were mitigated after the initiation of therapy. Despite intensive care and administration of rasburicase, the patient developed tumor lysis syndrome. Renal function was maintained without renal replacement therapy, but he developed severe acute encephalopathy and late seizures that required phenobarbital (PB) and levetiracetam. Despite blast cells infiltrating the cerebrospinal fluid (CSF), bacteria and fungi were not detected in the CSF. The blast cells responded well to treatment and became undetectable in the peripheral blood on day 14. The fever decreased in accordance with the blast reduction; however, the fever again increased on day 11. With the administration of meropenem, vancomycin, and micafungin [MCFG; 6 mg/kg intravenously (IV) every 24 h], the fever gradually decreased. On day 14, CRP and beta-D-glucan levels increased up to 23.65 mg/dL and 105.6 pg/mL, respectively, and the fever again increased on day 18. As yeast was detected in the blood culture on day 25, MCFG was switched to liposomal amphotericin B (L-AMB; 5 mg/kg IV, every 24 h) on day 27. Based on the echocardiographic findings, endocarditis was ruled out. Skin redness was observed in the left lower quadrant (LLQ) of the abdomen and left wrist, where the arterial line had previously been placed. The wrist lesion was covered with crust . The cultured blood specimen showed smooth and waxy yeast-like colonies appearing on potato dextrose agar and turned black on day 32 , suggesting the presence of Exophiala species. Sequence analysis of the internal transcribed spacer region confirmed E. dermatitidis and the fungus was also detected in the skin of the left wrist, stool, and endotracheal aspirate. However, E. dermatitidis was not detected from the skin culture from the abdominal lesion. The patient was diagnosed with fungemia and skin infection due to E. dermatitidis, and voriconazole (VRCZ) was added at a dose of 9 mg/kg IV and administered every 12 h; the dosage was further adjusted based on the results of therapeutic drug monitoring. Despite L-AMB and VRCZ administration and recovery of normal hematopoiesis, E. dermatitidis was repeatedly detected in the blood cultures. However, we were hesitant to remove the tunneled central venous catheter (CVC) due to multiple drug administrations for systemic management and difficulty in gaining vascular access. After approval by the Institutional Ethics Board, we initiated ethanol lock therapy (ELT) as a catheter salvage strategy on day 43. Both lumens of the tunneled catheter were instilled with a dose of 1 mL of 25% ethanol for 1–2 h every day . Blood culture became negative 4 days after the commencement of ELT. Although the skin lesion on the left wrist improved without debridement, the abdominal lesion gradually enlarged and became black, reaching a diameter of approximately 8 cm. The edge of the lesion turned yellow, and the center was necrotized, which was consistent with the findings of the EG . Contrast-enhanced thoraco-abdominal CT showed an extensive necrotic mass with gas in the left lower abdomen connected to the small intestine and subcutaneous tissue adjacent to the skin . Although consolidations and multiple nodules were also observed in both lungs , the respiratory condition was stable without the need for mechanical ventilation. The EG of the LLQ of the abdomen and adjacent necrotic intestine was resected en bloc , without complications, on day 52 . Intraoperatively, beneath the transmural necrosis of the abdominal wall, there were two perforations in the necrotic small intestine that required resection and oral jejunostomy/distal ileostomy. Because the adjacent sigmoid colon was also segmentally necrotized, the necrotic lesion was resected and end-to-end anastomosis was performed. Massive defects of the skin and abdominal wall were managed using negative-pressure wound therapy (Renasys-GO™, Smith & Nephew GmbH). Histological examination showed that the resected small intestine almost lacked a mucosal layer structure, and Grocott-methenamine-silver-staining-positive fungi were found . Subcutaneous adipose tissue showed fat necrosis, and numerous fungi were also observed in the skin lesions. . On day 53, caspofungin (CPFG; 50 mg/m 2 IV, every 24 h) was added because the isolated strain showed susceptibility to CPFG (the minimum inhibitory concentration being 0.25 μg/mL), and the trough level of VRCZ remained undetectable despite increasing the administration dose even after discontinuation of PB on day 61. The patient became afebrile on day 61 and his general condition improved. The highest value of beta-D-glucan (17,980 pg/mL) was seen on day 63, and the levels decreased thereafter. On day 66, the stomata and muscle layers were closed without complications. Subsequently, the skin defect was closed on day 107. ELT was continued until the removal of the CVC on day 72, without recurrence of fungemia. No fungi were detected at the tip of the CVC. The CRP level became normal just before removing the CVC, following which the administration of VRCZ, L-AMB, and CPFG was continued. Fig. 1 A Ecthyma gangrenosum on the left wrist, where the atrial line was inserted. B The edges of the ecthyma gangrenosum of the left lower quadrant of the abdomen that turned yellow after recovery of neutrophil counts Fig. 2 Colony of Exophiala dermatitidis on blood agar A and potato dextrose agar ( B ) Fig. 3 A Contrast-enhanced abdominal computed tomography showing extensive irregular necrotic mass (arrowheads) with gas (arrows), connecting with the small intestine and subcutaneous tissue. B Chest CT showing consolidations and multiple nodules in both lungs Fig. 4 A Intraoperative findings showing fusion of the skin and intestinal tract, and part of the small bowel being necrotic. B Photomicrograph depicting granulomas around the necrotic perforation in the ileum mucosa. C Photomicrograph showing tissue necrosis in all layers of the abdominal wall
| 4.074219
| 0.966797
|
sec[1]/p[1]
|
en
| 0.999998
|
PMC9590134
|
https://doi.org/10.1186/s12879-022-07773-w
|
[
"skin",
"blood",
"abdominal",
"necrotic",
"without",
"lesion",
"administration",
"became",
"every",
"wrist"
] |
[
{
"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": "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 ===
[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
[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 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [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 2 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--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 3 ---
[ME66.Y] Other specified skin changes
--PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs
Def: Other specified skin changes which cannot be more precisely defined....
--CHILD--> [ME66.0] Abnormal sensitivity to light or UV radiation of uncertain or unspecified nature
--- Walk 4 ---
[ME66.Y] Other specified skin changes
--PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs
Def: Other specified skin changes which cannot be more precisely defined....
--RELATED_TO--> [?] Abnormal skin pigmentation
Def: Abnormal skin pigmentation without specification of type or cause....
--- Walk 5 ---
[EM0Y] Other specified diseases of the skin
--PARENT--> [14] Diseases of the skin
Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
--RELATED_TO--> [?] Superficial incisional site infection
Def: A surgical site infection involving only skin and subcutaneous tissue of the incision....
--- Walk 6 ---
[EM0Y] Other specified diseases of the skin
--PARENT--> [14] Diseases of the skin
Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
--RELATED_TO--> [?] Haematoma of surgical wound of skin
Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...
|
[
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [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...",
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [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...",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --CHILD--> [ME66.0] Abnormal sensitivity to light or UV radiation of uncertain or unspecified nature",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --RELATED_TO--> [?] Abnormal skin pigmentation\n Def: Abnormal skin pigmentation without specification of type or cause....",
"[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Superficial incisional site infection\n Def: A surgical site infection involving only skin and subcutaneous tissue of the incision....",
"[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis..."
] |
ME67
|
Skin disorder of uncertain or unspecified nature
|
[
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "ME66.Y",
"icd10_code": "L578",
"icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L918",
"icd10_title": "Other hypertrophic disorders of the skin"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L988",
"icd10_title": "Other specified disorders of the skin and subcutaneous tissue"
},
{
"from_icd11": "ME66.1",
"icd10_code": "R234",
"icd10_title": "Changes in skin texture"
},
{
"from_icd11": "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"
}
] |
L989
|
Disorder of the skin and subcutaneous tissue, unspecified
|
A 62-year-old man with persistent symptomatic AF refractory to medical therapy was referred to Chukyo Hospital for catheter ablation of AF. The AF was estimated to last for approximately 1 year. Written informed consent was obtained from the patient before the procedure. The ablation procedure was performed under general anesthesia with ventilator management. First, a wide antral circumferential PVI was completed using a TactiFlex ablation catheter (Abbott) with the assistance of an EnSite X 3-dimensional mapping system (Abbott). For PVI, the RF application settings were power of 50 W, contact force of 10 to 20 g, and duration of 15 to 20 seconds. Because AF persisted after PVI was completed, electrical cardioversion was employed to convert AF to sinus rhythm. After recovery to sinus rhythm, several ectopic atrial beats with different activation patterns were observed, some of which were presumed to be originating from the LAPW. Therefore, using point-by-point applications, we added linear ablations to the LA roof and floor for the LAPW isolation. The target settings for linear ablations were power of 50 W, contact force of 10 to 20 g, duration of 20 seconds for the roof and 15 seconds for the floor, and interlesion distance of 4 mm. Because atrial electrograms remained in the LAPW after linear ablations, high-density mappings were created using the Advisor HD Grid mapping catheter (Abbott) during distal pacing of coronary sinus (CS) electrode . The activation mapping in the LAPW indicated a centrifugal pattern with the earliest activation site below the roofline. This suggests that epicardial propagation via an epicardial bundle crossed the roofline into the LAPW endocardium ( Supplemental Video 1 ). RF applications to the earliest activation site could eliminate a high and sharp component of electrograms in the LAPW but not exterminate a small and dull component, indicating the selective endocardial LAPW isolation . High-output pacing of 20 V at 2.0 ms from the ablation catheter on the LAPW could capture residual epicardial electrograms, demonstrating retrograde wavefront propagation beyond the roofline . Although additional RF applications with a 40 W power and 60-second duration were added to the roofline, they failed to eliminate residual epicardial electrograms in the LAPW. Therefore, CBA using a 28-mm cryoballoon (Arctic Front Advance Pro; Medtronic) was attempted on the LA roof under distal CS pacing while placing the grid catheter on the LAPW. CBA to the LA roof was performed by inserting a circular mapping catheter (Achieve Advance; Medtronic) deep into the right superior pulmonary vein to anchor the cryoballoon. 7 The cryoballoon was shifted and positioned below the target site on the LA roof by adjusting the orientation of the steerable sheath. 7 A raise-up technique was employed to facilitate the formation of larger lesions. 9 After 60 seconds to 130 seconds of freezing, the electrical interval from the pacing to epicardial electrograms on the grid catheter was gradually prolonged. Thereafter, epicardial electrograms were eliminated, indicating successful transmural roofline block and LAPW isolation . The minimum temperature of the cryoballoon was –50 °C during freezing. After 180 seconds of single-shot freezing, no reconnection of the LA roof was observed; however, additional freezings were applied along with the roofline to ensure the durability of roofline lesions. After successful transmural LAPW isolation, the ectopic beat originating from the epicardial LAPW with an exit block to the LA was observed . The procedure was completed without any complications. The patient had no atrial arrhythmia recurrences during the follow-up of 6 months. Figure 1 Voltage and activation maps after pulmonary vein isolation and linear ablations. (A) Voltage map during distal coronary sinus (CS) pacing. The purple and gray colors represent voltage amplitudes of >0.5 mV and <0.05 mV, respectively. (B) Atrial electrograms recorded by the grid catheter on the left atrial posterior wall (LAPW). (C) Activation map during distal CS pacing. A centrifugal pattern was observed in the LAPW with the earliest activation site (yellow arrows) below the roofline. This suggests that epicardial propagation via an epicardial bundle crossed the roofline into the LAPW endocardium. Note that the activation propagation did not cross the floorline into the LAPW, indicating that the floorline block was completed. ABL = ablation catheter; RA = right atrium. Figure 2 Voltage and activation maps after selective endocardial left atrial posterior wall (LAPW) isolation. (A) Voltage map during distal coronary sinus (CS) pacing. The purple and gray colors represent voltage amplitudes of >0.5 mV and <0.05 mV, respectively. The green tag indicates the ablated site at the earliest activation site. (B) Residual epicardial atrial electrograms (red arrowheads) recorded by the grid catheter on the LAPW. (C) Activation map during ablation catheter (ABL) pacing from the LAPW. The epicardial electrograms in the LAPW could be captured at a pacing output of 20 V at 2.0 ms. Note that the activation propagated across the roofline and broke out above the roofline but not above the floor line. RA = right atrium. Figure 3 Catheter position and epicardial electrograms on the left atrial posterior wall (LAPW) during cryoballoon ablation. (A) Relationship between the cryoballoon and grid catheter in the left anterior oblique (top) and right anterior oblique (bottom) fluoroscopic views. A1 and D1 indicate the positions of the corresponding electrodes of the grid catheter. (B) Epicardial electrograms (red arrowheads) recorded by the grid catheter on the LAPW during distal coronary sinus (CS) pacing. Before freezing, the interval from pacing to epicardial electrograms on the LAPW was 130 ms. After 60 seconds of freezing, the interval was gradually prolonged. After 130 seconds of freezing, epicardial electrograms were eliminated, indicating successful transmural roofline block and LAPW isolation. HRA = high right atrium.
| 4.21875
| 0.897949
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC12047457
|
https://doi.org/10.1016/j.hroo.2025.01.010
|
[
"lapw",
"catheter",
"epicardial",
"electrograms",
"activation",
"roofline",
"pacing",
"seconds",
"atrial",
"grid"
] |
[
{
"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"
},
{
"code": "BB2Y",
"title": "Other specified pericarditis"
},
{
"code": "2D7Y&XA6H07",
"title": "Malignant neoplasm metastasis in epicardium"
},
{
"code": "2C28.Z",
"title": "Malignant neoplasms of heart or mediastinum, unspecified"
},
{
"code": "2F01",
"title": "Benign neoplasm of other intrathoracic organs"
},
{
"code": "QF2Z",
"title": "Difficulty or need for assistance with unspecified activity"
}
] |
=== ICD-11 CODES FOUND ===
[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
[BB2Y] Other specified pericarditis
Also known as: Other specified pericarditis | Certain diseases of pericardium | Chronic adhesive pericarditis | adherent pericarditis | adherent pericardium
[2C28.Z] Malignant neoplasms of heart or mediastinum, unspecified
Also known as: Malignant neoplasms of heart or mediastinum, unspecified | Malignant neoplasms of heart or mediastinum | endocardial cancer | epicardial cancer | heart cancer
[2F01] Benign neoplasm of other intrathoracic organs
Also known as: Benign neoplasm of other intrathoracic organs | Benign neoplasm of heart | benign cardiac neoplasm | Adult heart tumour | Familial atrial myxoma
Excludes: Benign neoplasm of lung | Benign neoplasm of bronchus or lung | Benign neoplasm of bronchus
[QF2Z] Difficulty or need for assistance with unspecified activity
Also known as: Difficulty or need for assistance with unspecified activity | need for assistance with activities | dependence on care provider | difficulty with activities
=== GRAPH WALKS ===
--- Walk 1 ---
[QB62.Z] Attention to artificial openings, unspecified
--PARENT--> [QB62] Attention to artificial openings
--CHILD--> [QB62.1] Attention to gastrostomy
--- Walk 2 ---
[QB62.Z] Attention to artificial openings, unspecified
--PARENT--> [QB62] Attention to artificial openings
--EXCLUDES--> [?] Fitting, adjustment or management of devices
--- Walk 3 ---
[QB30.5] Fitting or adjustment of urinary device
--PARENT--> [QB30] Adjustment or management of implanted devices
--PARENT--> [?] Fitting, adjustment or management of devices
--- Walk 4 ---
[QB30.5] Fitting or adjustment of urinary device
--PARENT--> [QB30] Adjustment or management of implanted devices
--CHILD--> [QB30.1] Adjustment or management of infusion pump
--- Walk 5 ---
[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm
--- Walk 6 ---
[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm
Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....
|
[
"[QB62.Z] Attention to artificial openings, unspecified\n --PARENT--> [QB62] Attention to artificial openings\n --CHILD--> [QB62.1] Attention to gastrostomy",
"[QB62.Z] Attention to artificial openings, unspecified\n --PARENT--> [QB62] Attention to artificial openings\n --EXCLUDES--> [?] Fitting, adjustment or management of devices",
"[QB30.5] Fitting or adjustment of urinary device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --PARENT--> [?] Fitting, adjustment or management of devices",
"[QB30.5] Fitting or adjustment of urinary device\n --PARENT--> [QB30] Adjustment or management of implanted devices\n --CHILD--> [QB30.1] Adjustment or management of infusion pump",
"[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm",
"[PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm\n Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm...."
] |
QB62.Z
|
Attention to artificial openings, unspecified
|
[
{
"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"
},
{
"from_icd11": "PK93.10",
"icd10_code": "T83012A",
"icd10_title": "Breakdown (mechanical) of nephrostomy catheter, initial encounter"
},
{
"from_icd11": "PK93.10",
"icd10_code": "T83030A",
"icd10_title": "Leakage of cystostomy catheter, initial encounter"
}
] |
Z436
|
Encounter for attention to other artificial openings of urinary tract
|
A 47-year-old man with a history of chronic kidney disease since 1986, probably due to glomerulonephritis (kidney biopsy was not performed), was admitted to the Neurology Department in February 2014, 12 years after a second kidney transplantation from a deceased donor, because of paresthesia, numbness and symmetric progressive weakness of the lower limbs lasting for 3 weeks. First, kidney transplantation was performed in 1987 and was complicated with urinary fistula. The patient did not receive induction immunosuppression and received prednisone with azathioprine for maintenance treatment. Renal transplant was lost in the mechanism of antibody-mediated rejection, and graftectomy was performed in 1992. The right native kidney was removed in 1995 because of hydronephrosis. After the second kidney transplantation , graft function was stable (serum creatinine 1.1 mg/dl, estimated glomerular filtration rate [eGFR] 74.3 ml/min/1.73 m 2 ), and the haemoglobin concentration was within the normal range (17.1 g/dl – 17.4 g/dl; laboratory limit 18.0 g/dl). For immunosuppression after the second transplantation, the patient received mycophenolate mofetil with cyclosporine and prednisone, and no antibody induction was used. A year before neurological symptoms started to occur, abdominal ultrasound revealed a single cortical cyst 9 mm in diameter in the graft, whereas the left native kidney was not visualized. During hospitalization in the Neurology Department, symmetric paralysis of the lower limbs and areflexia were confirmed together with distal paralysis of the upper limbs. Abnormalities in superficial and deep sensation as well as pyramidal signs were not observed. The nerve conduction study revealed peripheral nerve damage, with local motor conduction blockade, slower nerve conduction in the popliteal area to 20–16.6 m/s and prolonged latency to 250% of the normal value. Lumbar puncture was performed, and in the cerebrospinal fluid, protein-cytological dissociation was confirmed (protein concentration 127 mg/dl, cytosis 3 cells/μl). During the observation period, the patient’s body temperature was normal, and gastrointestinal, urinary and respiratory symptoms were not observed. In the laboratory tests, the white blood cell (WBC) count was 9.41 × 10 3 /μl with 83.0% neutrophils and 11.1% lymphocytes, the haemoglobin level was 17.3 g/dl, C-reactive protein (CRP) was 0.737 mg/l, erythrocyte sedimentation rate (ESR) was 4 mm/h, procalcitonin (PCT) was 0.04 ng/ml, serum urea was 49.3 mg/dl, and serum creatinine was 1.1 mg/dl (eGFR 75.0 ml/min/1.73 m 2 ). Cyclosporine levels were in the range of 107–125 ng/ml. The patient was EBV IgG (immunoglobulin G)-positive and EBV IgM (immunoglobulin M)-negative. Similarly, CMV IgG was present, whereas CMV IgM was not found in the patient’s serum. CMV, EBV, Borrelia burgdorferi , hepatitis B virus (HBV) and hepatitis C virus (HCV) active infections were excluded by polymerase chain reaction (PCR) tests. Urine analysis revealed no abnormalities. In the ultrasound of the abdomen, a round-shaped normoechogenic mass 34x34x28 mm in size in the cortex of transplanted kidney was found. Doppler ultrasound of the transplanted kidney revealed a lack of signal in this area, which led to a suspicion of malignancy. In abdominal magnetic resonance imaging (MRI), except for two cortical cysts (10 mm and 3 mm in diameter), a well-organized tissue area in the transplanted kidney cortex was shown, providing more evidence of a neoplastic process . Due to severe neurological symptoms, the patient presented three procedures of therapeutic plasma exchange (TPE). The patient’s neurological condition after TPEs slightly improved. However, due to transplanted kidney malignancy suspicion, partial graftectomy was planned. Unfortunately, during surgery, a kidney tumour with multifocal infiltration of the renal medulla was found, so a decision was made to perform total graftectomy. Histopathological examination of the kidney revealed an encapsulated, solid tumour measuring 3 cm in diameter, located within the upper pole of the kidney, infiltrating the renal capsule and medulla. Microscopic examination showed papillary renal cell carcinoma (type 2) with papillary folds covered with eosinophilic mildly pleomorphic cells . Nucleoli were visible . Immunohistochemistry showed tumour cells positive for cluster of differentiation 10 (CD 10) and α-methylacyl CoA racemase (AMACR) and only focally positive for cytokeratin 7 (CK7) , which excluded clear cell papillary renal cell carcinoma in the differential diagnosis. After graftectomy, no tumour reoccurrence or metastases were observed, and the patient’s neurological symptoms resolved. Intermittent haemodialysis was started. Six years later, the patient’s neurological status was normal. Since no abnormalities in laboratory or radiological tests were observed and the oncological grace period expired, the patient qualified for third kidney transplantation. Fig. 1 a . Magnetic resonance imaging of the abdomen: tumour in the cortex of the transplanted kidney. Turbo spin echo (TSE), fat suppression sequence, transverse plane. b . Magnetic resonance imaging of the abdomen: tumour in the cortex of transplanted kidney. Cortical cyst in the upper pole of the transplanted kidney. Turbo spin echo (TSE), fat suppression sequence, frontal plane Fig. 2 Papillary renal cell carcinoma (type 2). Fibrovascular cores covered by pseudostratified eosinophilic neoplastic epithelium. Haematoxylin and eosin staining Fig. 3 Papillary renal cell carcinoma (type 2). Papillary structures covered by eosinophilic neoplastic cells with mild nuclear pleomorphism and visible nucleoli (International Society of Urologic Pathologists/World Health Organization grading system Grade 3). Haematoxylin and eosin staining Fig. 4 Papillary renal cell carcinoma (type 2). Strongly positive immunohistochemical staining for α-methylacyl CoA racemase (AMACR) Fig. 5 Papillary renal cell carcinoma (type 2). Focal positive immunohistochemical staining for cytokeratin 7 (CK 7)
| 4.09375
| 0.976074
|
sec[1]/p[0]
|
en
| 0.999995
|
33054714
|
https://doi.org/10.1186/s12882-020-02095-y
|
[
"kidney",
"renal",
"cell",
"papillary",
"transplanted",
"tumour",
"carcinoma",
"transplantation",
"neurological",
"type"
] |
[
{
"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": "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 ===
[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
[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 ---
[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 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....
--EXCLUDES--> [?] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2
Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene)....
--- Walk 4 ---
[LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or both kidneys....
--EXCLUDES--> [?] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--CHILD--> [?] Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis
Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin1 gene on chromosome 16 (PKD1 gene)...
--- Walk 5 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.00] Contusion 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 --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...",
"[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 --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene)....",
"[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin1 gene on chromosome 16 (PKD1 gene)...",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.00] Contusion 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": "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]"
}
] |
N19
|
Unspecified kidney failure
|
A 5-year-old boy who underwent KT experienced AKI after Deflux ® injection treatment for VUR following transplantation. An emergency ureteral stent was placed because ureteral obstruction occurred. The patient had been on peritoneal dialysis since the age of 4 months because of end-stage kidney disease associated with posterior urethral valves (PUVs). At age 3 months, he had undergone an endoscopic transurethral incision for PUVs at the referring hospital and had spontaneous voiding with oxybutynin hydrochloride (0.13 mg/kg). The patient presented to our hospital for KT. Preoperative voiding cystourethrography showed severe bladder trabeculation and grade V right VUR . The patient was able to store up to 150 mL of urine, had no urethral stricture, and was able to void without residual urine. A video urodynamic study showed low bladder compliance (10 mL/cmH 2 O), and no evidence of high pressure in the detrusor during voiding was observed. Preoperative management of bladder dysfunction involved oxybutynin hydrochloride and timed voiding. The patient underwent ABO-incompatible KT (blood type of A to O) at age 4 years with his father as the donor. Surgery was performed using the right retroperitoneal cavity as the graft bed. KT was performed after prior removal of the right kidney with high-grade VUR ureteral implantation performed using the extravesical approach and the Lich-Gregoir method. A 5-Fr ureteral stent was inserted and then removed on postoperative day 5. Subsequently, mild hydronephrosis (Society of Fetal Urology grade 1) and an increased creatinine level (from 0.5 mg/dL to 0.9 mg/dL) were observed. On postoperative day 7, we attempted cystoscopy and retrograde pyelography under general anesthesia but were unable to insert a guidewire and ureteral catheter into the ureteral opening of the transplanted kidney. Therefore, we performed an anterograde pyelogram after puncture of the dilated renal pelvis of the transplanted kidney.Antegrade pyelography showed that the contrast flow from the renal pelvis to the bladder was good and that the creatinine level decreased. Sulfamethoxazole/trimethoprim prophylaxis (1.2 g/day) was initiated postoperatively, and the patient was discharged without oxybutynin hydrochloride. At 4 months after KT, VUR after transplantation (grade IV) and VUR in the residual ureter of the right native kidney were detected by voiding cystourethrography . VUR to the transplanted kidney early during the filling phase, bladder wall irregularity, and severe bladder trabeculation were observed. VUR in the residual ureter of the right native kidney was observed during the voiding phase. Ultrasonography showed mild hydronephrosis (Society of Fetal Urology grade 1) of the transplanted kidney . The patient experienced daytime urinary incontinence and nocturia. Based on the voiding cystourethrography results, the bladder function was considered worse postoperatively; therefore, oxybutynin hydrochloride (0.3 mg/kg) was initiated and sulfamethoxazole/trimethoprim prophylaxis was continued. A febrile UTI with bacteremia caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae developed. Subsequently, a second febrile UTI developed. Therefore, after 2 weeks of antimicrobial therapy, the patient was promptly administered endoscopic Deflux ® injection treatment for VUR after KT. The bladder was observed using a rigid 30° cystoscope. The neo-orifice of the transplanted kidney was identified at the bladder sidewall, on the outer side of the right ureteral orifice. However, Deflux ® injection proved challenging. Therefore, a 0.035-inch-diameter hybrid guidewire (Sensor™ Straight Tip; Boston Scientific) was inserted in the neo-orifice of the transplanted kidney, lifted, and manipulated to achieve visibility of the ureteral opening. A total of 1.7 mL of Deflux ® was injected using the hydrodistension implantation technique (1.0-mL injection) and subureteral transurethral injection procedure (0.7-mL injection) with a guidewire inserted in the neo-orifice of the transplanted kidney . The VUR of the left native kidney had not been previously delineated, although preoperative ultrasound showed ureteral dilatation. In addition, cystoscopy prior to Deflux ® injection showed that the ureteral orifice of the left native kidney was type H1 (dynamic hydrostatic dilation classification system). Therefore, 1.3 mL of Deflux ® was injected into the left ureteral orifice using the hydrodistension implantation technique to prevent urinary tract infection. Postoperatively, the patient experienced a temporary decrease in urine output, painful urination and hematuria, and an increased creatinine level (from 0.69 mg/dL to 1.62 mg/dL) on postoperative day 1. The renal pelvis was more dilated than it was preoperatively, and ureteral dilatation was observed . A bulge associated with Deflux ® in the bladder consistent with the injection site was observed . Additionally, the creatinine level increased to 3.11 mg/dL and the graft function continued to decline. The patient’s bladder dysfunction might have caused a rapid foreign body reaction to the Deflux ® injection immediately after treatment for UTI. Furthermore, the injection for Deflux ® treatment was performed outside the anatomical target — at the neo-apical orifice of the transplanted kidney — making it difficult to inject the drug into the appropriate site. Therefore, AKI associated with ureteral obstruction after Deflux ® injection treatment was diagnosed, and a 4.8-Fr ureteral stent with a length of 14 cm (Tria™; Boston Scientific, Marlborough, MA, USA) was placed on postoperative day 4 . Increased urinary outflow occurred after ureteral stent placement, the creatinine level decreased to 1.04 mg/dL, and the graft function gradually recovered. Four months later, the ureteral stent was removed. Exacerbation of hydronephrosis of the transplanted kidney was not observed and the graft function was stable. Although the patient experienced residual VUR after KT, excretion control was continued and UTI did not recur.
| 4.019531
| 0.973633
|
sec[1]/p[0]
|
en
| 0.999998
|
40087625
|
https://doi.org/10.1186/s12894-025-01733-7
|
[
"ureteral",
"kidney",
"injection",
"bladder",
"deflux",
"transplanted",
"voiding",
"orifice",
"therefore",
"stent"
] |
[
{
"code": "GB90.Y",
"title": "Other specified disorders of kidney or ureter"
},
{
"code": "GC2Z&XA7156",
"title": "Disorder of ureter, not elsewhere classified"
},
{
"code": "LB31.9",
"title": "Agenesis of ureter"
},
{
"code": "NB92.1Y",
"title": "Other specified injury of ureter"
},
{
"code": "GB90.2",
"title": "Ureteral kinking or deviation without obstruction"
},
{
"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 ===
[GB90.Y] Other specified disorders of kidney or ureter
Also known as: Other specified disorders of kidney or ureter | Other secondary disorders of kidney or ureter | Other disorders of kidney and ureter NEC | Inflammatory diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis | Infectious diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis
[LB31.9] Agenesis of ureter
Definition: A condition caused by failure of the ureter to develop during the antenatal period. Confirmation verification that one or more ureters are missing by imaging.
Also known as: Agenesis of ureter | Absent ureter | congenital absence of ureter | ureteric agenesis | absence of ureter
Includes: Absent ureter
[NB92.1Y] Other specified injury of ureter
Also known as: Other specified injury of ureter | Injury of ureter without open wound into cavity | Injury of ureter with open wound into cavity | Traumatic rupture of ureter | rupture of ureter
[GB90.2] Ureteral kinking or deviation without obstruction
Definition: A condition characterised by a sharp twist, curve, or other deviation in the length of the ureter, but without an obstructed flow of urine.
Also known as: Ureteral kinking or deviation without obstruction | kinking and stricture of ureter without hydronephrosis | Kinking of the ureter without hydronephrosis | ureteral kink | Ureteral stenosis
Includes: Kinking of the ureter without hydronephrosis
Excludes: with infection | congenital ureteric stenosis
[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 ---
[GB90.Y] Other specified disorders of kidney or ureter
--PARENT--> [GB90] Certain specified disorders of kidney or ureter
Def: Any disorder characterised by pathological changes to the kidney or ureter....
--CHILD--> [GB90.2] Ureteral kinking or deviation without obstruction
Def: A condition characterised by a sharp twist, curve, or other deviation in the length of the ureter, but without an obstructed flow of urine....
--- Walk 2 ---
[GB90.Y] Other specified disorders of kidney or ureter
--PARENT--> [GB90] Certain specified disorders of kidney or ureter
Def: Any disorder characterised by pathological changes to the kidney or ureter....
--CHILD--> [GB90.2] Ureteral kinking or deviation without obstruction
Def: A condition characterised by a sharp twist, curve, or other deviation in the length of the ureter, but without an obstructed flow of urine....
--- Walk 3 ---
[LB31.9] Agenesis of ureter
Def: A condition caused by failure of the ureter to develop during the antenatal period. Confirmation verification that one or more ureters are missing by imaging....
--PARENT--> [LB31] Structural developmental anomalies of urinary tract
Def: Any condition caused by failure of the urinary tract to correctly develop during the antenatal period....
--RELATED_TO--> [?] Persistent urogenital sinus
Def: A urogenital sinus anomaly is a rare birth defect in women where the urethra and vagina both open into a common channel. The urogenital sinus is a part of the human body only present in the developmen...
--- Walk 4 ---
[LB31.9] Agenesis of ureter
Def: A condition caused by failure of the ureter to develop during the antenatal period. Confirmation verification that one or more ureters are missing by imaging....
--PARENT--> [LB31] Structural developmental anomalies of urinary tract
Def: Any condition caused by failure of the urinary tract to correctly develop during the antenatal period....
--CHILD--> [LB31.1] Congenital primary megaureter
Def: Congenital primary megaureter is an idiopathic condition in which the bladder and bladder outlet are normal but the ureter is dilated to some extent. It may be obstructed, refluxing or unobstructed an...
--- Walk 5 ---
[NB92.1Y] Other specified injury of ureter
--PARENT--> [NB92.1] Injury of ureter
--CHILD--> [NB92.11] Laceration of ureter
--- Walk 6 ---
[NB92.1Y] Other specified injury of ureter
--PARENT--> [NB92.1] Injury of ureter
--CHILD--> [NB92.1Y] Other specified injury of ureter
|
[
"[GB90.Y] Other specified disorders of kidney or ureter\n --PARENT--> [GB90] Certain specified disorders of kidney or ureter\n Def: Any disorder characterised by pathological changes to the kidney or ureter....\n --CHILD--> [GB90.2] Ureteral kinking or deviation without obstruction\n Def: A condition characterised by a sharp twist, curve, or other deviation in the length of the ureter, but without an obstructed flow of urine....",
"[GB90.Y] Other specified disorders of kidney or ureter\n --PARENT--> [GB90] Certain specified disorders of kidney or ureter\n Def: Any disorder characterised by pathological changes to the kidney or ureter....\n --CHILD--> [GB90.2] Ureteral kinking or deviation without obstruction\n Def: A condition characterised by a sharp twist, curve, or other deviation in the length of the ureter, but without an obstructed flow of urine....",
"[LB31.9] Agenesis of ureter\n Def: A condition caused by failure of the ureter to develop during the antenatal period. Confirmation verification that one or more ureters are missing by imaging....\n --PARENT--> [LB31] Structural developmental anomalies of urinary tract\n Def: Any condition caused by failure of the urinary tract to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Persistent urogenital sinus\n Def: A urogenital sinus anomaly is a rare birth defect in women where the urethra and vagina both open into a common channel. The urogenital sinus is a part of the human body only present in the developmen...",
"[LB31.9] Agenesis of ureter\n Def: A condition caused by failure of the ureter to develop during the antenatal period. Confirmation verification that one or more ureters are missing by imaging....\n --PARENT--> [LB31] Structural developmental anomalies of urinary tract\n Def: Any condition caused by failure of the urinary tract to correctly develop during the antenatal period....\n --CHILD--> [LB31.1] Congenital primary megaureter\n Def: Congenital primary megaureter is an idiopathic condition in which the bladder and bladder outlet are normal but the ureter is dilated to some extent. It may be obstructed, refluxing or unobstructed an...",
"[NB92.1Y] Other specified injury of ureter\n --PARENT--> [NB92.1] Injury of ureter\n --CHILD--> [NB92.11] Laceration of ureter",
"[NB92.1Y] Other specified injury of ureter\n --PARENT--> [NB92.1] Injury of ureter\n --CHILD--> [NB92.1Y] Other specified injury of ureter"
] |
GB90.Y
|
Other specified disorders of kidney or ureter
|
[
{
"from_icd11": "LB31.9",
"icd10_code": "Q624",
"icd10_title": "Agenesis of ureter"
},
{
"from_icd11": "GB90.2",
"icd10_code": "N135",
"icd10_title": "Crossing vessel and stricture of ureter without hydronephrosis"
},
{
"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"
}
] |
Q624
|
Agenesis of ureter
|
In December 2019, a 27-years-old Caucasian male was admitted to the Emergency Department of the University Hospital of Pisa for polyuria and polydipsia in the past 4-6 weeks, associated with fever and vomiting in the last 5 days. Upon admission, lab tests documented severe hyperglycemia (fasting plasma glucose 22.5 mmol/L) with no evidence of acidosis (blood gas analysis: pH of 7.42, pO 2 59 mmHg, pCO 2 of 37 mmHg, HCO3- of 24 mmol/L). Serum C-reactive protein level was 9.91 mg/dl (normal value <0.5 mg/dl) and procalcitonin level 11.14 ng/mL (normal value <0.05 ng/mL). Chest X-rays revealed reticular and micronodular interstitial involvement with pleural effusion at the bases, suggestive of pneumonia. The patient was transferred to our Section of Diabetes and Metabolic Diseases with a diagnosis of severe hyperglycemia in new-onset diabetes mellitus and sepsis . On admission to the ward, the patient was conscious. The clinical picture was characterized by dysmorphic facies with narrow minimal frontal diameter, almond-shaped eyes and thin upper lip, small hands and feet, scoliosis, gynecomastia, testicular hypoplasia, and bilateral lower limb swelling. His BW was 66 kg, and height was 148 cm, with a body mass index (BMI) of 30.1 kg/m 2 . Systolic blood pressure was 125 mmHg, diastolic blood pressure 80 mmHg, pulse rate 90 beats per minute, body temperature 38,5°C. The rest of the physical examination was unremarkable. Fasting plasma glucose (FPG) was 23.3 mmol/L and HbA1c 116 mmol/mol. The search of islet autoantibodies (i.e., glutamic acid decarboxylase autoantibodies, anti-GAD and islet tyrosine phosphatase autoantibodies, anti-IA2) was negative. Urine albumin to creatinine ratio (ACR) in a spot urine sample was 104.5 mg/g (normal value < 30 mg/g). Liver and renal function tests were within the normal range. Insulin-like Growth Factor 1 (IGF-1) values were within the lower limits of the reference range for age (96.6 µg/L). Gonadotropin and testosterone levels were consistent with mixed hypogonadism (FSH 22.6 UI/L; LH 7.1 UI/L; testosterone 1.69 μg/L; sex hormone binding globulin, SHBG, 42 nmoL/L), while thyroid and adrenal function was normal (data not shown). Blood cultures were positive for Candida glabrata . Microscopic urinalysis excluded urinary tract infections. Screening for retinopathy, hypertension and cardiovascular disease was uneventful. No foot problems were observed. Abdominal ultrasound was normal, while testicular ultrasound described small testes with hypoechoic echotexture and breast ultrasound confirmed the presence of true gynecomastia. Bone mineral density (BMD), measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine, femoral neck and total hip, was consistent with osteopenia (lumbar Z-score -2.3, femoral neck Z-score -2.3, total hip Z-score -2.2). Familial history was negative for neurodevelopmental delay, genetic syndromes, and diabetes mellitus. Consanguinity was not present in the family. The patient was treated with i.v. fluid and insulin infusion, and caspofungin was started to target C. glabrata . Upon hyperglycemia and sepsis resolution, a basal-bolus insulin therapy was initiated (total daily insulin requirement 0.4 unit per kg of BW, approximately 26 U/day) yielding a progressive improvement of daily glucose profiles. Insulin was subsequently managed by the parents because the patient was not self-sufficient. At discharge, the patient was equipped with the FreeStyle Libre Flash Glucose Monitoring System (Abbot Diabetes Care, Alameda, California, USA). In the meantime, a PWS was suspected and, after obtaining written informed consent from both parents, the genetic test was performed. The methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) identified 2 copies of chromosome 15q11, and an abnormal DNA methylation with 2 methylated copies. Short tandem repeat (STR) linkage analysis excluded uniparental disomy and suggested the imprinting defect by epimutation. At discharge the patient was prescribed testosterone but no GH replacement therapy, in accordance with the Endocrinology consultant. Because of the COVID-19 pandemic, the patient was only seen in the outpatient clinic in March 2022 when glycemic control was at target (FPG 4.89 mmol/L; HbA1c 41 mmol/mol) despite discontinuation of the Flash Glucose Monitoring. Several non-severe hypoglycemic events were reported. A 13 kg body weight gain (from 66 to 79 kg with a BMI of 36 kg/m 2 ) was observed. Given the poor adherence to diet and family burden in the management of insulin treatment and in the light of negative antibodies, insulin therapy was discontinued, and once-weekly semaglutide started at the initial dose of 0.25 mg per week, gradually increased to 0.5 mg per week. No metformin was given due to the swallowing difficulties of the patient. Twelve months after starting semaglutide, BW dropped from 79 to 73 kg , with a final BMI of 33.3 kg/m 2 , and glycemic control remained at target . Neither hypoglycemia nor side effects were reported. At 18-month follow-up, a slight weight gain was observed without deterioration in glycemic control . Semaglutide was continued at 0.5 mg once weekly, with a personalized physical activity program and nutritional intervention. To support family members in diabetes management, FreeStyle Libre 2 sensor was also prescribed. The 14 days ambulatory glucose profile (AGP) before the 18-month visit showed a time in range (TIR) of 94%, a time below range (TBR) of 3%, and a time above range (TAR) of 3%, time with active data 71%, glucose management indicator (GMI) 41 mmol/mol and coefficient of variation (CV) 23.5%. After 24 months semaglutide treatment, BW was 71 kg with persistent optimal glycemic control (FPG 5.4 mmol/L; HbA1c 38 mmol/mol) . No foot, micro- and macrovascular complications were observed. Urine ACR was within the normal range (11.4 mg/g). No hypoglycemia nor gastro-intestinal or psychiatric adverse events were reported; adherence to semaglutide was optimal and caregivers’ satisfaction high.
| 4.078125
| 0.974121
|
sec[1]/p[0]
|
en
| 0.999997
|
39996062
|
https://doi.org/10.3389/fendo.2025.1533209
|
[
"mmol",
"glucose",
"insulin",
"range",
"diabetes",
"semaglutide",
"blood",
"mmhg",
"glycemic",
"control"
] |
[
{
"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": "5A40.Z",
"title": "Intermediate hyperglycaemia, unspecified"
},
{
"code": "5C61.Y",
"title": "Other specified disorders of carbohydrate absorption or transport"
},
{
"code": "5A40.1",
"title": "Impaired glucose tolerance"
},
{
"code": "5A40.0",
"title": "Impaired fasting glucose"
},
{
"code": "5C61.5",
"title": "Disorders of facilitated glucose transport"
},
{
"code": "5A44",
"title": "Insulin-resistance syndromes"
},
{
"code": "5A4Y",
"title": "Other specified disorders of glucose regulation or pancreatic internal secretion"
}
] |
=== ICD-11 CODES FOUND ===
[GB42.1] Albuminuria, Grade A3
Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid.
Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy
[GB42.0] Albuminuria, Grade A2
Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid.
Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine
[MA18.0Y] Other specified elevated blood glucose level
Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified
[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
[5A40.1] Impaired glucose tolerance
Definition: Impaired glucose tolerance (IGT) is a metabolic disorder, which is characterised by 2-h postload glucose 140–199 mg/dl (7.8–11.1 mmol/l).
Also known as: Impaired glucose tolerance | IGT - [impaired glucose tolerance] | Impaired glucose tolerance with unspecified complication | Impaired glucose tolerance without complication | abnormal glucose tolerance
[5A40.0] Impaired fasting glucose
Definition: Impaired fasting tolerance is a metabolic disorder with Fasting Plasma Glucose (FPG) 110–125 mg/dl (6.1–6.9 mmol/l).
Also known as: Impaired fasting glucose | IFG - [impaired fasting glucose] | impaired fasting glycaemia | elevated fasting glucose | high fasting blood sugar
[5C61.5] Disorders of facilitated glucose transport
Also known as: Disorders of facilitated glucose transport | Encephalopathy due to GLUT1 deficiency | Glucose transporter defect, blood-brain barrier | Facilitated glucose transporter protein type 1 deficiency | Familial renal glucosuria
[5A44] Insulin-resistance syndromes
Also known as: Insulin-resistance syndromes | Insulin-resistance syndrome type A | Insulin-resistance syndrome type B | Rabson-Mendenhall syndrome | Laminopathy type Decaudain-Vigouroux
[5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion
Also known as: Other specified disorders of glucose regulation or pancreatic internal secretion | Other hypoglycaemia | Hyperinsulinaemia | hyperinsulinism | functional hyperinsulinaemia
=== GRAPH WALKS ===
--- Walk 1 ---
[GB42.1] Albuminuria, Grade A3
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--PARENT--> [?] Glomerular diseases
Def: Any disease characterised by pathological changes to the glomerulus....
--- Walk 2 ---
[GB42.1] Albuminuria, Grade A3
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Proteinuria
Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...
--- Walk 3 ---
[GB42.0] Albuminuria, Grade A2
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--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...
--EXCLUDES--> [?] Gestational proteinuria without hypertension
--- Walk 5 ---
[MA18.0Y] Other specified elevated blood glucose level
--PARENT--> [MA18.0] Elevated blood glucose level
--CHILD--> [MA18.00] Abnormal glucose tolerance test
Def: Greater than normal levels of glucose found in laboratory examination of the blood to check how the body breaks down (metabolizes) blood sugar. Positive findings may indicate diabetes or Cushing disea...
--- Walk 6 ---
[MA18.0Y] Other specified elevated blood glucose level
--PARENT--> [MA18.0] Elevated blood glucose level
--CHILD--> [MA18.00] Abnormal glucose tolerance test
Def: Greater than normal levels of glucose found in laboratory examination of the blood to check how the body breaks down (metabolizes) blood sugar. Positive findings may indicate diabetes or Cushing disea...
|
[
"[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --PARENT--> [?] Glomerular diseases\n Def: Any disease characterised by pathological changes to the glomerulus....",
"[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...",
"[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --CHILD--> [GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...",
"[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension",
"[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.00] Abnormal glucose tolerance test\n Def: Greater than normal levels of glucose found in laboratory examination of the blood to check how the body breaks down (metabolizes) blood sugar. Positive findings may indicate diabetes or Cushing disea...",
"[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.00] Abnormal glucose tolerance test\n Def: Greater than normal levels of glucose found in laboratory examination of the blood to check how the body breaks down (metabolizes) blood sugar. Positive findings may indicate diabetes or Cushing disea..."
] |
GB42.1
|
Albuminuria, Grade A3
|
[
{
"from_icd11": "5A40.Z",
"icd10_code": "R7309",
"icd10_title": "Other abnormal glucose"
},
{
"from_icd11": "5A40.0",
"icd10_code": "R7301",
"icd10_title": "Impaired fasting glucose"
},
{
"from_icd11": "5C61.5",
"icd10_code": "E748",
"icd10_title": "Other specified disorders of carbohydrate metabolism"
},
{
"from_icd11": "5A44",
"icd10_code": "E10-E14",
"icd10_title": ""
}
] |
R7309
|
Other abnormal glucose
|
A 57-year-old Chinese male with a past medical history significant for hypertension, hyperlipidemia, and moderate mitral regurgitation secondary to mitral valve prolapse presented with a 3-week history of progressive hemoptysis and worsening dyspnea. The symptoms started insidiously and progressed to a point where his exercise tolerance was reduced to a few steps. He was a plumber by profession and a lifetime nonsmoker. He denied wheezing, fever, night sweats, chest pain, and weight loss. He had no history of hemoptysis or bleeding from any other body sites. He did not use any medications and denied recent travel or sick contacts. On physical examination, he appeared to be in moderate respiratory distress, tachycardia, and tachypnea. His vital signs were blood pressure of 146/80 mmHg, heart rate of 116/min, respiratory rate of 34/min, temperature of 99.1 F, and saturating at 96% on 3 liters of oxygen by nasal cannula. He was oriented to time place and person and was found to be using his accessory muscles of respiration. His chest examination was notable for coarse crackles on the right side without any wheezing. His cardiac examination revealed tachycardia with a 3/6 pansystolic murmur best heard over the mitral area. The rest of his physical examination was unremarkable. His extremities were perfusing well and no peripheral edema was noted. His labs were notable for leukocytosis with neutrophilia (WBC: 12.7 k/mm 3 ; neutrophils: 84%; eosinophils < 1%), his electrolytes were within normal range, and renal function was deranged with elevated blood urea nitrogen (BUN) and creatinine (Na: 143 mEq/L; K: 4.6 mEq/L; Cl: 107 mEq/L; HCO 3 : 23 mEq/L; BUN: 40 mg/dL; creatinine: 1.5 mg/dL). His liver function tests (LFTs) were notable for elevated liver enzymes (AST: 48 U/L; ALT: 127 U/L). His arterial blood gas (ABG) was notable for a pH of 7.44, pCO 2 of 31 mmHg, and a pO 2 of 84 mmHg. His chest X-ray (CXR) showed right sided fluffy infiltrates ( Figure 1(a) ). He was admitted to the medical floor and started on ceftriaxone and azithromycin for presumed community acquired pneumonia. However, his respiratory status deteriorated and he was transferred to the Cardiac Intensive Care Unit where he was started on noninvasive mechanical ventilation (inspiratory pressure of 15 mmHg, expiratory pressure of 8 mmHg at 100% oxygen supplementation). An ABG showed a pH of 7.13, pCO 2 of 64 mmHg, and a pO 2 of 68 mmHg indicative of acute respiratory acidosis. His respiratory condition continued to deteriorate and he was intubated and mechanically ventilated with a positive end expiratory pressure (PEEP) of 5 mmHg and 50% oxygen supplementation. The patient's CXR revealed infiltrates which were more dense and confluent ( Figure 1(b) ). His labs were significant for up-trending leukocytosis (15 k/mm 3 ). The patient's blood and urine cultures were negative. Tests for legionella, mycoplasma, HIV, and influenza were also negative. Autoimmune and vasculitis panels [antinuclear antibody (ANA), antineutrophil cytoplasmic antibodies (ANCA), and antiglomerular basement membrane antibody (GBM)] tests were negative. An ABG after commencing mechanical ventilation showed a pH of 7.44, pCO 2 of 31 mmHg, and a pO 2 of 81 mmHg. Computed tomography (CT) of his chest confirmed the presence of dense infiltrates predominantly located in the right upper and middle lobes (Figures 1(c) and 1(d) ). Transthoracic echocardiogram showed an ejection fraction (EF) of 70%, mildly dilated left atrium, significant prolapse of the posterior mitral leaflet, and moderate tricuspid regurgitation. Right heart catheterization showed a pulmonary artery pressure of 56/23/35 mmHg (systolic/diastolic/mean); pulmonary capillary wedge pressure (PCWP) of 22 mmHg, right atrial pressure of 4 mmHg, RV: 53/6 mmHg (systolic/diastolic); cardiac Index (by thermo dilution) of 2.1 liters/min/m 2 , and a pulmonary artery resistance of 9 wood units. Bronchoscopy revealed fresh blood in all the lobes with no obvious source and no endobronchial lesions. Sequential lavage from the right middle lobe was not progressively bloodier and hence less consistent with diffuse alveolar hemorrhage. Bronchoalveolar lavage was negative for cytology, acid fast bacillus (AFB), fungal stain, and pneumocystis carinii pneumonia (PCP). Thoracentesis yielded 150 cc of serous fluid with a pH of 7.6, LDH of 80 U/L, protein of 0.9 g/dL, glucose of 120 mg/dL, cell count with a differential of 55% of neutrophils, lymphocytes of 25%, and mesothelial cells of 10%. This was consistent with a transudative pleural effusion. The cytology and culture results of the fluid from thoracentesis were also negative. A transesophageal echocardiogram (TEE) showed thickening and elongation of the anterior leaflet of the mitral valve consistent with myxomatous degeneration, up to 1 cm in thickness at the margin of the anterior leaflet, prolapse of posterior leaflet into left atrium, aneurysm measuring 1 × 1.6 cm 2 and perforation into left atrium and severe mitral regurgitation but no vegetations. The patient continued to have increased oxygen requirements and persistent hemoptysis and eventually underwent an emergent mitral valve repair. Perioperative TEE revealed hypertrophied right and left ventricles, normal right and left ventricular function with EF of 55%, mild anteroseptal wall hypokinesis, prolapse of the posterior mitral leaflet with a flail P3 segment, and severe mitral regurgitation with systolic flow reversal in right upper pulmonary vein (Figures 2(a) and 2(b) ). A final diagnosis of alveolar hemorrhage secondary to severe acute mitral regurgitation from myxomatous degeneration of mitral valve was made. Notably, his hemoglobin had decreased from 14.5 gm/dL to 11.7 gm/dL. Postoperative TEE did not show any evidence of mitral valve regurgitation ( Figure 2(c) ). A repeat bronchoscopy 3 days after the mitral valve repair showed clearing of the alveolar hemorrhage (Figures 3(a) , 3(b) , and 3(c) ). The patient rapidly recovered thereafter as was reflected in his CXR .
| 3.90625
| 0.979004
|
sec[1]/p[0]
|
en
| 0.999997
|
24383034
|
https://doi.org/10.1155/2013/179587
|
[
"mmhg",
"mitral",
"pressure",
"regurgitation",
"valve",
"respiratory",
"blood",
"leaflet",
"prolapse",
"chest"
] |
[
{
"code": "BB60.Z",
"title": "Mitral valve stenosis, unspecified"
},
{
"code": "LA89.2",
"title": "Mitral atresia"
},
{
"code": "BB6Z",
"title": "Mitral valve disease, unspecified"
},
{
"code": "LA87.11",
"title": "Congenital mitral valvar stenosis"
},
{
"code": "LA87.10",
"title": "Congenital mitral regurgitation"
},
{
"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 ===
[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
[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
[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
[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 ---
[BB60.Z] Mitral valve stenosis, unspecified
--PARENT--> [BB60] Mitral valve stenosis
--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 2 ---
[BB60.Z] Mitral valve stenosis, unspecified
--PARENT--> [BB60] Mitral valve stenosis
--EXCLUDES--> [?] Mitral valve stenosis with insufficiency
Def: This is a valvular heart disease characterised by the narrowing of the orifice of the mitral valve of the heart, with regurgitation....
--- Walk 3 ---
[LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--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 4 ---
[LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--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--> [LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--- Walk 5 ---
[BB6Z] Mitral valve disease, unspecified
--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...
--CHILD--> [BB61] Mitral valve insufficiency
Def: Mitral insufficiency is a clinical condition which mitral valve can't close properly. It is the antidromic leaking of blood from the left ventricle through the mitral valve, and into the left atrium....
--- Walk 6 ---
[BB6Z] Mitral valve disease, unspecified
--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...
--CHILD--> [BB62] Mitral valve prolapse
|
[
"[BB60.Z] Mitral valve stenosis, unspecified\n --PARENT--> [BB60] Mitral valve stenosis\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...",
"[BB60.Z] Mitral valve stenosis, unspecified\n --PARENT--> [BB60] Mitral valve stenosis\n --EXCLUDES--> [?] Mitral valve stenosis with insufficiency\n Def: This is a valvular heart disease characterised by the narrowing of the orifice of the mitral valve of the heart, with regurgitation....",
"[LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....\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....",
"[LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....\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--> [LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....",
"[BB6Z] Mitral valve disease, unspecified\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...\n --CHILD--> [BB61] Mitral valve insufficiency\n Def: Mitral insufficiency is a clinical condition which mitral valve can't close properly. It is the antidromic leaking of blood from the left ventricle through the mitral valve, and into the left atrium....",
"[BB6Z] Mitral valve disease, unspecified\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...\n --CHILD--> [BB62] Mitral valve prolapse"
] |
BB60.Z
|
Mitral valve stenosis, unspecified
|
[
{
"from_icd11": "BB60.Z",
"icd10_code": "I050",
"icd10_title": "Rheumatic mitral stenosis"
},
{
"from_icd11": "BB60.Z",
"icd10_code": "I342",
"icd10_title": "Nonrheumatic mitral (valve) stenosis"
},
{
"from_icd11": "LA89.2",
"icd10_code": "Q232",
"icd10_title": "Congenital mitral stenosis"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I059",
"icd10_title": "Rheumatic mitral valve disease, unspecified"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I058",
"icd10_title": "Other rheumatic mitral valve diseases"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I348",
"icd10_title": "Other nonrheumatic mitral valve disorders"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I349",
"icd10_title": "Nonrheumatic mitral valve disorder, unspecified"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I05-I09",
"icd10_title": ""
},
{
"from_icd11": "BB6Z",
"icd10_code": "I05",
"icd10_title": "Rheumatic mitral valve diseases"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I390",
"icd10_title": ""
},
{
"from_icd11": "BB6Z",
"icd10_code": "I34",
"icd10_title": "Nonrheumatic mitral valve disorders"
},
{
"from_icd11": "LA87.10",
"icd10_code": "Q233",
"icd10_title": "Congenital mitral insufficiency"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89623",
"icd10_title": "Pressure ulcer of left heel, stage 3"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89621",
"icd10_title": "Pressure ulcer of left heel, stage 1"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89899",
"icd10_title": "Pressure ulcer of other site, unspecified stage"
}
] |
I050
|
Rheumatic mitral stenosis
|
Hemodynamic monitoring was initiated on Day 6 due to persistent need of vasopressor support and worsening of gas exchange. It was performed using a single-use, monoplane TEE miniaturized probe (diameter 5.5 mm) connected to a dedicated echographic system which allows two-dimensional imaging and color Doppler mapping, but has no spectral Doppler capability (Imacor®, New-York, NY, USA). This device is approved by the Food and Drug Administration and has a European Community mark for 72 h of continuous use . The patient was hemodynamically assessed every 6 to 8 h and whenever a clinically relevant event occurred. The transverse view of great vessels, long axis view and transgastric short-axis view of the heart were analyzed to determine the main mechanism that caused circulatory failure . The first hemodynamic evaluations ruled out a preload-dependence, a relevant ventricular dysfunction and valvulopathy, and a pericardial effusion (Table 1 ). Specifically, there was no evidence for an early surgery-related complication such as mediastinal hematoma. Accordingly, the vasopressor support was maintained since patient’s hemodynamic status was stabilized with steady infusion rates. Despite a protective ventilation and a PEEP trial (FiO 2 : 1; respiratory rate: 22/min; tidal volume: 6 ml/kg ideal body weight; PEEP: 14 cmH 2 O), the PaO 2 /FiO 2 ratio remained as low as 63. Accordingly, a contrast study was performed at H37 to screen for a potential patent foramen ovale (PFO). A PFO shunting was depicted with an atrial septum aneurysm . PEEP was decreased to 8 cm H 2 O and inhaled nitric oxide was administered while the patient remained hemodynamically stable under vasopressor support (Table 1 ). This resulted in an increase of the PaO 2 /FiO 2 ratio up to 130. At H46, the clinical course was complicated by an abrupt hemodynamic deterioration with hypotension, skin mottling and oliguria associated with a rapid supraventricular tachycardia (170 bpm), which was efficiently treated by anti-arrhythmic drugs. A new hemodynamic assessment using the miniaturized TEE probe disclosed a large mediastinal hematoma compressing the entire left atrium (LA) and a moderate, non compressive pericardial effusion. To ascertain the diagnosis of localized tamponade prior to surgical decompression, a regular multiplane TEE study was immediately performed and was confirmatory . Fig. 1 Single-use miniaturized transesophageal echocardiographic probe. The single-use indwelling monoplane transesophageal echocardiography probe can be left in place for up to 72 h and is easily connected to a dedicated system for serial hemodynamic assessments ( left panel ). Its small size compared to regular multiplane transesophageal echocardiographic probes facilitates hemodynamic monitoring ( right panel ) Table 1 Hemodynamic monitoring using the single-use 72-h indwelling transesophageal echocardiography probe a H0 H5 H14 H22 H28 H37 H46 H50 Variations of SVC size Moderate Moderate Moderate None None None None None LV fractional area change Normal Normal Normal Normal Normal Normal Decreased Normal RV dilatation Absence Absence Absence Absence Absence Absence Absence Absence Paradoxical septal motion Absence Absence Absence Absence Absence Absence Absence Absence Severe left-sided valvular regurgitation Absence Absence Absence Absence Absence Absence Absence Absence Other relevant abnormality No No No No No PFO shunting Posterior mediastinal hematoma compressing the left atrium No Therapeutic impact Vaso-pressor Vaso-pressor Vaso-pressor Vaso-pressor Vaso-pressor Reduce PEEP Nitric oxide Emergency surgical evacuation of left atrial hematoma Vaso-pressor SVC superior vena cava, LV left ventricle, RV right ventricle, PEEP positive end-expiratory pressure a In the presence of a circulatory failure, the following therapeutic algorithm based on the analysis of three transverse views (great vessels, transesophageal long-axis four-chamber view of the heart, transgastric short-axis view of the heart) was used: large respiratory variations of superior vena cava size (inspiratory collapse) in the transverse view of the great vessel were indicative of preload-dependence (fluid loading); a right ventricular end-diastolic area exceeding the left ventricular end-diastolic area in the transesophageal long-axis four-chamber view of the heart was indicative of a marked dilatation of a failing right ventricle, potentially associated with an acute cor pulmonale; left ventricular fractional area change < 45 % in the transgastric short-axis view of the heart was indicative of systolic dysfunction in the absence of preload-dependence (administration of inotropes), while a paradoxical septal motion with a restrained left ventricle in this view was indicative of acute cor pulmonale (protective ventilation, reduced PEEP level, prone ventilation, nitric oxide administration, vasopressor support) Fig. 2 Patent foramen ovale revealed by a contrast study. The injection of agitated saline fully opacified the moderately dilated right atrium and underlined a septal aneurysm bulking towards the left atrium at end-expiration ( thick arrow ). A large shunting through a patent foramen ovale with full opacification of the left atrium was evidenced in this patient with severe acute respiratory distress syndrome ( thin arrows ). Abbreviations: LA, left atrium; RA, right atrium; RV, right ventricle Fig. 3 Extrapericardial tamponade. The miniaturized transesophageal echocardiographic probe disclosed a large mediastinal hematoma compressing the left atrium in this patient with severe shock ( left panel, asterisks ). The presence of a localized tamponade was confirmed during conventional transesophageal echocardiography which depicted a rounded heterogeneous mass consistent with a recent hematoma which compressed the left atrium and impaired atrial filling ( mid panel, asterisks ), as reflected by a narrow and turbulent inflow on color Doppler mapping ( right panel, arrow ). Abbreviations: LA, left atrium; RA, right atrium; RV, right ventricle
| 4.09375
| 0.908203
|
sec[1]/p[1]
|
en
| 0.999997
|
26271929
|
https://doi.org/10.1186/s12880-015-0070-3
|
[
"absence",
"atrium",
"view",
"hemodynamic",
"transesophageal",
"probe",
"axis",
"hematoma",
"peep",
"vaso"
] |
[
{
"code": "8A68.Y",
"title": "Other specified type of seizure"
},
{
"code": "LA75.1",
"title": "Agenesis of lung"
},
{
"code": "8A66.1Z",
"title": "Non-convulsive status epilepticus, unspecified"
},
{
"code": "LB20.0Y",
"title": "Other specified structural developmental anomalies of liver"
},
{
"code": "QF01.Y",
"title": "Other specified acquired absence of organs"
},
{
"code": "LA8E.Y",
"title": "Other specified congenital anomaly of atrial septum"
},
{
"code": "LA8G.0",
"title": "Divided left atrium"
},
{
"code": "LA8F",
"title": "Congenital anomaly of right atrium"
},
{
"code": "LA8G.Z",
"title": "Congenital anomaly of left atrium, unspecified"
},
{
"code": "LA8G.Y",
"title": "Other specified congenital anomaly of left atrium"
}
] |
=== ICD-11 CODES FOUND ===
[8A68.Y] Other specified type of seizure
Also known as: Other specified type of seizure | Absence episode | Absence seizure episode | Pseudotetanus | Clonic seizure disorder
[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
[8A66.1Z] Non-convulsive status epilepticus, unspecified
Also known as: Non-convulsive status epilepticus, unspecified | Non-convulsive status epilepticus | Epileptic absence status | Petit mal status epilepticus | Petit-mal status
[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
[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
[LA8E.Y] Other specified congenital anomaly of atrial septum
Also known as: Other specified congenital anomaly of atrial septum | Aneurysm of the atrial septum | atrial septal aneurysm | Interatrial communication | Atrial septal defect
[LA8G.0] Divided left atrium
Definition: A congenital cardiac malformation in which there is a partition that divides the left atrium into a posterosuperior chamber that receives some or all of the pulmonary veins and an antero-inferior chamber that communicates with the left atrial appendage and atrioventricular junction (usually the mitral valve).
Additional information: in differentiating 'Divided left atrium' from 'Congenital supravalvar or intravalvar mitral ring', in the latter, the antero-inferior compartment contains only the
Also known as: Divided left atrium | Cor triatriatum sinistrum | Left cor triatriatum | Cor triatriatum sinister | left triatrial heart
[LA8F] Congenital anomaly of right atrium
Definition: A congenital cardiovascular malformation in which there is an abnormality of the right atrium.
Also known as: Congenital anomaly of right atrium | Divided right atrium | Cor triatriatum dextrum | Right cor triatriatum | Cor triatriatum dexter
[LA8G.Z] Congenital anomaly of left atrium, unspecified
Also known as: Congenital anomaly of left atrium, unspecified | Congenital anomaly of left atrium
[LA8G.Y] Other specified congenital anomaly of left atrium
Also known as: Other specified congenital anomaly of left atrium | Right-sided juxtaposition of the atrial appendages
=== GRAPH WALKS ===
--- Walk 1 ---
[8A68.Y] Other specified type of seizure
--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.Y] Other specified type of seizure
--PARENT--> [8A68] Types of seizures
--CHILD--> [8A68.1] Absence seizures, atypical
Def: Absence seizures with changes in tone more pronounced than in typical absences or with non-abrupt onset and/or cessation, often associated with slow, irregular, generalised spike-wave activity....
--- Walk 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--> [LA75.2] Congenital hypoplasia of lung
--- Walk 5 ---
[8A66.1Z] Non-convulsive status epilepticus, unspecified
--PARENT--> [8A66.1] Non-convulsive status epilepticus
Def: Non-convulsive status epilepticus is defined as 5 min or more of (i) continuous clinical and/or electrographic seizure activity or (ii) recurrent seizure activity without recovery (returning to baseli...
--CHILD--> [8A66.10] Absence status epilepticus
Def: An absence seizure (see absence seizures, typical and atypical) lasting >10 min (on average 10-15 min)....
--- Walk 6 ---
[8A66.1Z] Non-convulsive status epilepticus, unspecified
--PARENT--> [8A66.1] Non-convulsive status epilepticus
Def: Non-convulsive status epilepticus is defined as 5 min or more of (i) continuous clinical and/or electrographic seizure activity or (ii) recurrent seizure activity without recovery (returning to baseli...
--CHILD--> [8A66.1Y] Other specified non-convulsive status epilepticus
|
[
"[8A68.Y] Other specified type of seizure\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.Y] Other specified type of seizure\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.1] Absence seizures, atypical\n Def: Absence seizures with changes in tone more pronounced than in typical absences or with non-abrupt onset and/or cessation, often associated with slow, irregular, generalised spike-wave activity....",
"[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--> [LA75.2] Congenital hypoplasia of lung",
"[8A66.1Z] Non-convulsive status epilepticus, unspecified\n --PARENT--> [8A66.1] Non-convulsive status epilepticus\n Def: Non-convulsive status epilepticus is defined as 5 min or more of (i) continuous clinical and/or electrographic seizure activity or (ii) recurrent seizure activity without recovery (returning to baseli...\n --CHILD--> [8A66.10] Absence status epilepticus\n Def: An absence seizure (see absence seizures, typical and atypical) lasting >10 min (on average 10-15 min)....",
"[8A66.1Z] Non-convulsive status epilepticus, unspecified\n --PARENT--> [8A66.1] Non-convulsive status epilepticus\n Def: Non-convulsive status epilepticus is defined as 5 min or more of (i) continuous clinical and/or electrographic seizure activity or (ii) recurrent seizure activity without recovery (returning to baseli...\n --CHILD--> [8A66.1Y] Other specified non-convulsive status epilepticus"
] |
8A68.Y
|
Other specified type of seizure
|
[
{
"from_icd11": "LA75.1",
"icd10_code": "Q333",
"icd10_title": "Agenesis of lung"
},
{
"from_icd11": "8A66.1Z",
"icd10_code": "G407",
"icd10_title": ""
},
{
"from_icd11": "8A66.1Z",
"icd10_code": "G411",
"icd10_title": ""
},
{
"from_icd11": "QF01.Y",
"icd10_code": "Z9049",
"icd10_title": "Acquired absence of other specified parts of digestive tract"
},
{
"from_icd11": "LA8E.Y",
"icd10_code": "Q211",
"icd10_title": "Atrial septal defect"
},
{
"from_icd11": "LA8G.0",
"icd10_code": "Q242",
"icd10_title": "Cor triatriatum"
},
{
"from_icd11": "LA8F",
"icd10_code": "Q208",
"icd10_title": "Other congenital malformations of cardiac chambers and connections"
}
] |
Q333
|
Agenesis of lung
|
The patient's medical history began with a sudden onset of chest pain radiating to the back. He presented to his outpatient clinic and was referred for a thoracic spine computed tomography (CT). Accumulation of fluid in the left pleural cavity was identified. The patient was referred to the pulmonary ward, already presenting with cough, moderate dyspnea, and a tightness on the left side of the chest. CT scan of the thorax and abdomen was performed which revealed fluid in the left pleural cavity, left lung atelectasis, and asymmetric thickening of the lower esophagus up to 26 mm, mainly on the left side. A note was also made of a 10 mm hypodense lesion in the pancreas tail. Using endoscopic ultrasound (EUS), the esophageal lesion was suspected to represent a Gastrointestinal Stromal Tumor (GIST), and material for cytological testing was collected through an EUS biopsy. A left thoracentesis was performed, and 1600 ml of bloody fluid was evacuated and sent for further cytological and microbiological tests. Only methicillin-susceptible S. epidermidis grew in the pleural sample: the patient was discharged home in good condition. After a week, he was readmitted because of increasing dyspnea. Due to the significant amount of reaccumulated fluid in the left pleura, a Robinson drain was placed in the left thoracic space. The patient was also referred to a gastroenterological outpatient clinic to follow up on the suspected esophageal GIST. During another scheduled hospitalization, videoscopic decortication of the left lung was performed. Lung expansion was achieved, but repeat CT scan showed an increase in the hypodense lesion in the pancreas tail. Histopathological examination of the pleura did not reveal any atypical cells. The patient was discharged home. After a month, he presented to the emergency department because of abdominal pain. Acute pancreatitis was diagnosed, and the patient was admitted to the general surgery department. The patient's general condition and laboratory test results improved after the conservative treatment; therefore, the patient was discharged home with a pancreatic diet recommendation. In the outpatient clinic, an abdominal magnetic resonance imaging (MRI) was performed. It demonstrated edema of the esophagus and pancreatic tail as well as several small fluid collections in the retroperitoneal space extending from the distal, swollen part of the esophagus to the pancreatic tail. There were also free fluid collections in the right pleural cavity and around the left lung. Shortly after this examination, the patient was again admitted to the pulmonology ward with acute shortness of breath and pain on the right side of the chest. Due to the large amount of fluid in the right pleural cavity, thoracentesis was performed, and the pleural fluid was tested for amylase. This laboratory test was performed for the first time. The level of the amylase was very high . Serum and urine amylase results were also significantly increased. The patient was discharged home with a recommendation for further urgent gastroenterological diagnostics, although this ended up being delayed. After another few weeks, due to the shortness of breath, he presented to the emergency ward, and another right thoracentesis was performed. The date of planned right-sided pleurodesis was set during the thoracic surgery consultation. In the next few days, the patient presented to the gastroenterological outpatient clinic. The chest X-ray, serum and urine amylase, C-reactive protein (CRP), and magnetic resonance cholangiopancreatography (MRCP) were performed. Due to high levels of amylase, a right hydrothorax, shortness of breath, and poor general condition, the patient was admitted to the Gastroenterological Department. MRCP showed normal diameters of the bile duct and pancreatic duct. There were no enlarged lymph nodes or retroperitoneal fluid. Chest CT was performed, and a large amount of fluid in the right pleural cavity was seen once again. It was causing atelectasis of the right lung and 60 mm displacement of the mediastinal structures to the left, as well as compression of the left lung. Drainage of the right pleural cavity was performed. Lab tests showed high levels of amylase in the right pleural fluid. CT of the abdomen was performed which demonstrated an 18 mm fluid collection next to the pancreas tail with an associated inflammatory infiltration of the retroperitoneal space, extending towards the aortic hiatus of the diaphragm and right pleural cavity. The patient was transferred to the Department of General, Endocrinological, and Gastroenterological Surgery for surgical intervention. At laparotomy, a peripancreatic tail collection as well as inflammatory infiltration of the retroperitoneal space connecting to the posterior wall of the gastric fundus and left adrenal gland was found. When the pancreatic collection was opened, the fistula channel was visible, running in the retroperitoneal space to the right pleura. Fistula dissection and distal pancreatic resection were performed. The pancreatic-side opening (originally connected to the Wirsung duct) of the fistula was oversewn. A splenectomy also was performed due to thrombosis of the splenic vein noted on the most recent CT scan. A drain was placed near the closed fistula. In the postoperative days, the patient's general condition improved, with reduction of the right pleural exudation and partial expansion of the right lung. Histopathology showed chronic inflammatory lesions of the pancreatic tail and the canal with fibrinous and purulent masses. The edema of the esophagus was the inflammatory reaction to the pancreaticopleural fistula (not GIST, as was initially suspected based on the CT scan). Due to incomplete expansion of the right lung and persistent exudate in the right pleura, the patient was transferred to the pulmonary and rehabilitation department. Finally, after successful rehabilitation, the patient was discharged home, remaining under observation for over a year, without any recurrent symptoms.
| 3.880859
| 0.981934
|
sec[1]/p[1]
|
en
| 0.999996
|
33763281
|
https://doi.org/10.1155/2021/6615612
|
[
"fluid",
"pleural",
"lung",
"pancreatic",
"cavity",
"tail",
"amylase",
"chest",
"discharged",
"home"
] |
[
{
"code": "FA36.Z",
"title": "Effusion of joint, unspecified"
},
{
"code": "5C70.0",
"title": "Dehydration"
},
{
"code": "5C78",
"title": "Fluid overload"
},
{
"code": "MG29.Z",
"title": "Oedema, unspecified"
},
{
"code": "ME04.Z",
"title": "Ascites, unspecified"
},
{
"code": "CB2Z",
"title": "Pleural, diaphragm or mediastinal disorders, unspecified"
},
{
"code": "LA76",
"title": "Structural developmental anomalies of pleura"
},
{
"code": "MD31",
"title": "Pleurisy"
},
{
"code": "NB32.60",
"title": "Laceration of pleura"
},
{
"code": "2F91.Y&XA5TT2",
"title": "Neoplasms of unknown behaviour of pleura"
}
] |
=== ICD-11 CODES FOUND ===
[FA36.Z] Effusion of joint, unspecified
Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis
[5C70.0] Dehydration
Definition: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water intake.
Also known as: Dehydration | fluid depletion | anhydration | anhydremia | fluid volume deficit
[5C78] Fluid overload
Definition: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compartment occurs due to an increase in total body sodium content and a consequent increase in extracellular body water. The mechanism usually stems from compromised regulatory mechanisms for sodium handling as seen in congestive heart failure (CHF), kidney failure, and liver failure. It may also be cause
Also known as: Fluid overload | fluid excess | fluid volume excess | hypervolemia | volume excess
[MG29.Z] Oedema, unspecified
Also known as: Oedema, unspecified | Oedema | dropsy | hydrops | Fluid retention NOS
[ME04.Z] Ascites, unspecified
Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS
[CB2Z] Pleural, diaphragm or mediastinal disorders, unspecified
Also known as: Pleural, diaphragm or mediastinal disorders, unspecified
[LA76] Structural developmental anomalies of pleura
Definition: Anomalies of the lining of the lung (visceral pleura) and thoracic cavity (parietal pleura)
Also known as: Structural developmental anomalies of pleura | Malformations of pleura | anomaly of pleura | abnormal pleura | pleural anomaly
[MD31] Pleurisy
Definition: Pleurisy or Pleuritis is the medical term for inflammation of the pleura. The most common cause of pleuritis is infection, but it can also be caused by lupus, rheumatoid arthritis, and certain medicines. Pleurisy or pleuritis usually accumulates exudative pleural effusions.
Also known as: Pleurisy | pleuritis | pleurisy NOS | double pleurisy | pleurisy without effusion
Excludes: pleurisy with effusion
[NB32.60] Laceration of pleura
Also known as: Laceration of pleura
=== GRAPH WALKS ===
--- Walk 1 ---
[FA36.Z] Effusion of joint, unspecified
--PARENT--> [FA36] Effusion of joint
Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....
--PARENT--> [?] Certain specified joint disorders or deformities of limbs
--- Walk 2 ---
[FA36.Z] Effusion of joint, unspecified
--PARENT--> [FA36] Effusion of joint
Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....
--CHILD--> [FA36.Z] Effusion of joint, unspecified
--- Walk 3 ---
[5C70.0] Dehydration
Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...
--RELATED_TO--> [?] Dehydration of newborn
Def: A paediatric condition characterised by excessive loss of body water in a newborn....
--PARENT--> [?] Certain specified transitory neonatal electrolyte or metabolic disturbances
Def: A group of paediatric conditions in which there is a temporary abnormality in the normal processes of enzyme catalyzed reactions within tissue cells (metabolism) or with the levels of minerals in the ...
--- Walk 4 ---
[5C70.0] Dehydration
Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...
--RELATED_TO--> [?] Dehydration of newborn
Def: A paediatric condition characterised by excessive loss of body water in a newborn....
--PARENT--> [?] Dehydration
Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...
--- Walk 5 ---
[5C78] Fluid overload
Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...
--PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance
--CHILD--> [5C71] Hyperosmolality or hypernatraemia
Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles...
--- Walk 6 ---
[5C78] Fluid overload
Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...
--PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance
--CHILD--> [5C71] Hyperosmolality or hypernatraemia
Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles...
|
[
"[FA36.Z] Effusion of joint, unspecified\n --PARENT--> [FA36] Effusion of joint\n Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....\n --PARENT--> [?] Certain specified joint disorders or deformities of limbs",
"[FA36.Z] Effusion of joint, unspecified\n --PARENT--> [FA36] Effusion of joint\n Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes....\n --CHILD--> [FA36.Z] Effusion of joint, unspecified",
"[5C70.0] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...\n --RELATED_TO--> [?] Dehydration of newborn\n Def: A paediatric condition characterised by excessive loss of body water in a newborn....\n --PARENT--> [?] Certain specified transitory neonatal electrolyte or metabolic disturbances\n Def: A group of paediatric conditions in which there is a temporary abnormality in the normal processes of enzyme catalyzed reactions within tissue cells (metabolism) or with the levels of minerals in the ...",
"[5C70.0] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...\n --RELATED_TO--> [?] Dehydration of newborn\n Def: A paediatric condition characterised by excessive loss of body water in a newborn....\n --PARENT--> [?] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...",
"[5C78] Fluid overload\n Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C71] Hyperosmolality or hypernatraemia\n Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles...",
"[5C78] Fluid overload\n Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C71] Hyperosmolality or hypernatraemia\n Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles..."
] |
FA36.Z
|
Effusion of joint, unspecified
|
[
{
"from_icd11": "FA36.Z",
"icd10_code": "M25471",
"icd10_title": "Effusion, right ankle"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25461",
"icd10_title": "Effusion, right knee"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25462",
"icd10_title": "Effusion, left knee"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25431",
"icd10_title": "Effusion, right wrist"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25472",
"icd10_title": "Effusion, left ankle"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25451",
"icd10_title": "Effusion, right hip"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M2548",
"icd10_title": "Effusion, other site"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25411",
"icd10_title": "Effusion, right shoulder"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25441",
"icd10_title": "Effusion, right hand"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25452",
"icd10_title": "Effusion, left hip"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25421",
"icd10_title": "Effusion, right elbow"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25432",
"icd10_title": "Effusion, left wrist"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25473",
"icd10_title": "Effusion, unspecified ankle"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25412",
"icd10_title": "Effusion, left shoulder"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25422",
"icd10_title": "Effusion, left elbow"
}
] |
M25471
|
Effusion, right ankle
|
This case report concerns a 12-year-old male admitted to the Department of Pediatric Cardiology and Rheumatology from the District Hospital due to suspected MIS-C associated with SARS-CoV-2 infection. According to his medical history, the boy presented with fever for 3 days, experienced emesis and sore throat, and reported headache and vertigo. Despite the incorporation of intravenous antibiotic therapy, his clinical condition did not improve; increasing markers of inflammation (high C-reactive protein (CRP), coagulopathy, thrombocytopenia, and escalating markers of heart failure (N-terminal prohormone of brain natriuretic peptide–NT-proBNP)) were observed. Five weeks prior to the onset of symptoms, the male had contact with a person who was infected with the SARS-CoV-2 virus. The result of a PCR test detecting ongoing COVID-19 infection was negative. After admission, his condition rapidly deteriorated, progressive cardiopulmonary failure occurred within hours, and he required a transfer to the pediatric intensive care unit (PICU). In the PICU, the patient’s condition was assessed as extremely severe, with visible respiratory effort, significant hypotension (NIBP 70/40 mmHg), and tachycardia. The boy was intubated and required high-flow oxygen therapy. Antimicrobial therapy was modified, and parenteral nutrition and intensive fluid therapy were incorporated. In regard to circulatory failure, norepinephrine infusion was included. The intravenous infusion of human immunoglobulins (IVIG) (a total dose of 100 g) and systemic steroid therapy were also implemented, as well as acetylsalicylic acid in accordance with MIS-C treatment guidelines. Chest X-ray revealed massive atelectatic and interstitial edematous changes, along with a left pneumothorax and features of mediastinal emphysema . Further deterioration of the patient’s condition was observed in consecutive days with critical arterial blood gas exchange parameters, increasing tachycardia, and oliguria. Follow-up laboratory tests revealed decreasing markers of inflammation; however, markers of myocardial damage had increasing tendencies with NT-proBNP levels of 33,812 pg/mL ( Table 2 ). Ventilatory parameters were modified to extremely high, catecholamine infusions were adjusted as levosimendan, and magnesium sulfate infusions were additionally included alongside norepinephrine and dobutamine infusions. From the 12th day of hospitalization, repeated deterioration was observed, cardiac enzymes increased significantly, and electrocardiographic changes in the form of widened QRS complexes, single premature ventricular and supraventricular beats, complex cardiac arrhythmias in the form of ventricular salvos with a frequency of 110/min, as well as repolarization abnormalities (negative T-wave in V4–V6 leads) appeared in the 12-lead resting ECG as well as in 24 h Holter ECG recordings . Echocardiography revealed progressive deterioration with significant myocardial hypokinesis (ejection fraction—EF of 34%) , significant atrioventricular valve regurgitations, and features of elevated pulmonary pressure (right ventricular systolic pressure—RSVP 45 mmHg); therefore, the patient was consulted with a cardiac surgeon; however, he was disqualified from receiving ECMO therapy. From the 14th day of hospitalization, the onset of anisocoria, a decrease in muscle strength was also observed—electroencephalographic examination showed no seizure activity and brain magnetic resonance imaging (MRI) revealed a subarachnoid cyst (irrelevant finding). An additional intravenous infusion of human immunoglobulins was administered. On the 16th day of treatment, the suspicion of post-inflammatory cardiomyopathy was raised and a beta-blocker, as well as cardioprotective treatment in the form of angiotensin-converting enzyme inhibitor, were included in the therapy. Due to the deteriorating condition of the patient, features of multiple organ failure, as well as persistence of fever, it was decided to incorporate a biologic drug—interleukin-1 inhibitor (anakinra). After the implementation of biological treatment, a gradual improvement in myocardial contractility was observed on echocardiography, and catecholamines were discontinued on day 19. Due to features of hepatic cell damage in laboratory tests, hepatoprotective treatment was started. The patient also required intensive rehabilitation as muscle atrophy and decreased muscle tone were detected in the physical examination. Echocardiographic examination on the day of the patient’s discharge showed preserved global systolic function with EF = 60%, with better contractility of the basal region of the heart in relation to the apical region. Due to the inability to accurately assess the coronary arteries in echocardiography, a coronary angio-CT study was performed, which revealed no abnormalities. Six months after discharge, he also underwent cardiac MRI, which showed no features of myocardial fibrosis and confirmed good myocardial contractility and correct dimensions of the heart cavities. During the two-year follow-up period, the patient has only reported decreased exercise tolerance, with no other cardiovascular symptoms. Resting ECG recordings showed a borderline QTc interval (0.44 s) and prolonged QTc interval to a maximum of 0.475 s in 24 h ECG recording. An exercise test demonstrated good exercise capacity; exercise did not generate arrhythmias or repolarization disorders. The patient remains under further cardiac care. Currently, there is no evidence of impairment in the neurological examination. The uniqueness of the presented case is that the patient developed several serious complications over a short period of time, including persistent and severe myocarditis unresponsive to standard treatment for MIS-C, as well as rare neurological complications. These changes improved spectacularly after treatment with an interleukin-1 inhibitor, highlighting the role of biologic therapy in severe cases of MIS-C. The timeline of the patient’s hospitalization is presented in Figure 4 .
| 4.046875
| 0.974609
|
sec[2]/p[0]
|
en
| 0.999995
|
PMC11278001
|
https://doi.org/10.3390/jcm13144146
|
[
"well",
"features",
"myocardial",
"cardiac",
"markers",
"failure",
"exercise",
"intravenous",
"increasing",
"heart"
] |
[
{
"code": "EB30",
"title": "Eosinophilic cellulitis"
},
{
"code": "QC2Y",
"title": "Other specified contact with health services associated with the health of others"
},
{
"code": "4A60.1",
"title": "Cryopyrin-associated periodic syndromes"
},
{
"code": "2D10.0",
"title": "Follicular carcinoma of thyroid gland"
},
{
"code": "2B5H",
"title": "Well differentiated lipomatous tumour, primary site"
},
{
"code": "MB28.Z",
"title": "Symptoms and signs related to personality features, unspecified"
},
{
"code": "LD20.1",
"title": "Syndromes with lissencephaly as a major feature"
},
{
"code": "EB90.1Y",
"title": "Other specified forms of cutaneous mucinosis"
},
{
"code": "MB28.Y",
"title": "Other specified symptoms and signs related to personality features"
},
{
"code": "LD23",
"title": "Syndromes with vascular anomalies as a major feature"
}
] |
=== ICD-11 CODES FOUND ===
[EB30] Eosinophilic cellulitis
Definition: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (clusters of eosinophils and histiocytes around a core of collagen and eosinophilic debris). It can affect either sex, usually in adult life. Any site may be involved, with single or multiple lesions, and recurrences are common. Initially, the lesions are itchy erythematous plaques with features resembling
Also known as: Eosinophilic cellulitis | Wells' syndrome
[QC2Y] Other specified contact with health services associated with the health of others
Also known as: Other specified contact with health services associated with the health of others | Boarder in health-care facility other than healthy person accompanying sick person | Health supervision or care of other healthy infant or child | child in care | healthy infant receiving care
[4A60.1] Cryopyrin-associated periodic syndromes
Definition: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical signs and symptoms of inflammation in the form of rash, fever, joint and eye symptoms with increased acute phase reactants.
Also known as: Cryopyrin-associated periodic syndromes | CAPS - [Cryopyrin-associated periodic syndromes] | Cryopyrinopathies | Chronic infantile neurological, cutaneous and articular syndrome | Infantile-onset multisystem inflammatory disease
Includes: Cryopyrinopathies
[2D10.0] Follicular carcinoma of thyroid gland
Definition: A differentiated adenocarcinoma arising from the follicular cells of the thyroid gland. The nuclear features which characterise the thyroid gland papillary carcinoma are absent. Radiation exposure is a risk factor and it comprises approximately 10% to 15% of thyroid cancers. Clinically, it usually presents as a solitary mass in the thyroid gland. It is generally unifocal and thickly encapsulated and shows invasion of the capsule or the vessels. Diagnostic procedures include: thyroid ultrasound a
Also known as: Follicular carcinoma of thyroid gland | follicular carcinoma of unspecified site | follicular thyroid carcinoma | moderately differentiated follicular carcinoma of thyroid gland | pure follicle carcinoma of thyroid gland
[2B5H] Well differentiated lipomatous tumour, primary site
Also known as: Well differentiated lipomatous tumour, primary site | Atypical liposarcoma
[MB28.Z] Symptoms and signs related to personality features, unspecified
Also known as: Symptoms and signs related to personality features, unspecified | Symptoms or signs related to personality features
[LD20.1] Syndromes with lissencephaly as a major feature
Definition: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) associated with abnormal organisation of the cortical layers as a result of neuronal migration defects during embryogenesis. Children with lissencephaly have feeding and swallowing problems, muscle tone anomalies (early hypotonia and subsequently limb hypertonia), seizures (in particular, infantile spas
Also known as: Syndromes with lissencephaly as a major feature | Pachygyria | Agyria | Classic lissencephaly | Lissencephaly type 1
Includes: Agyria | Pachygyria
[EB90.1Y] Other specified forms of cutaneous mucinosis
Also known as: Other specified forms of cutaneous mucinosis | Focal primary cutaneous mucinosis | Idiopathic follicular mucinosis | Alopecia mucinosa | Focal cutaneous mucinosis
Includes: Idiopathic follicular mucinosis
[MB28.Y] Other specified symptoms and signs related to personality features
Also known as: Other specified symptoms and signs related to personality features
[LD23] Syndromes with vascular anomalies as a major feature
Also known as: Syndromes with vascular anomalies as a major feature | Primary intraosseous vascular malformation | Retinal cavernous haemangioma | Sturge-Weber syndrome | encephalotrigeminal angiomatosis
=== GRAPH WALKS ===
--- Walk 1 ---
[EB30] Eosinophilic cellulitis
Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster...
--PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses
Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers...
--RELATED_TO--> [?] Inflammatory dermatoses of the newborn
Def: A range of inflammatory skin disorders presenting in the neonatal period....
--- Walk 2 ---
[EB30] Eosinophilic cellulitis
Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster...
--PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses
Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers...
--CHILD--> [EB12] Erythema multiforme
Def: Erythema multiforme is a self‐limiting reactive inflammatory dermatosis triggered by cell‐mediated hypersensitivity, most commonly to drugs or infection, particularly Herpes simplex. It is characteris...
--- Walk 3 ---
[QC2Y] Other specified contact with health services associated with the health of others
--PARENT--> [?] Contact with health services associated with the health of others
--CHILD--> [QC22] Health supervision or care of abandoned infant
--- Walk 4 ---
[QC2Y] Other specified contact with health services associated with the health of others
--PARENT--> [?] Contact with health services associated with the health of others
--CHILD--> [QC20] Person consulting on behalf of another person
--- Walk 5 ---
[4A60.1] Cryopyrin-associated periodic syndromes
Def: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical s...
--PARENT--> [4A60] Monogenic autoinflammatory syndromes
Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....
--CHILD--> [4A60.2] Tumour necrosis factor receptor 1 associated periodic syndrome
Def: TRAPS is an autoinflammatory disease associated with heterozygous mutations in the gene coding for tumour necrosis factor (TNF) receptor 1 (TNFR1). This results in clinical attacks of inflammation in ...
--- Walk 6 ---
[4A60.1] Cryopyrin-associated periodic syndromes
Def: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical s...
--PARENT--> [4A60] Monogenic autoinflammatory syndromes
Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....
--CHILD--> [4A60.1] Cryopyrin-associated periodic syndromes
Def: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical s...
|
[
"[EB30] Eosinophilic cellulitis\n Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster...\n --PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses\n Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers...\n --RELATED_TO--> [?] Inflammatory dermatoses of the newborn\n Def: A range of inflammatory skin disorders presenting in the neonatal period....",
"[EB30] Eosinophilic cellulitis\n Def: Eosinophilic cellulitis (Wells syndrome) is characterised by a distinctive clinical picture resembling cellulitis, and a typical histology with tissue eosinophilia, oedema and ‘flame’ figures (cluster...\n --PARENT--> [?] Inflammatory erythemas and other reactive inflammatory dermatoses\n Def: A heterogeneous group of disorders characterised by skin inflammation in response to known (usually infections or drugs) or unknown triggers...\n --CHILD--> [EB12] Erythema multiforme\n Def: Erythema multiforme is a self‐limiting reactive inflammatory dermatosis triggered by cell‐mediated hypersensitivity, most commonly to drugs or infection, particularly Herpes simplex. It is characteris...",
"[QC2Y] Other specified contact with health services associated with the health of others\n --PARENT--> [?] Contact with health services associated with the health of others\n --CHILD--> [QC22] Health supervision or care of abandoned infant",
"[QC2Y] Other specified contact with health services associated with the health of others\n --PARENT--> [?] Contact with health services associated with the health of others\n --CHILD--> [QC20] Person consulting on behalf of another person",
"[4A60.1] Cryopyrin-associated periodic syndromes\n Def: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical s...\n --PARENT--> [4A60] Monogenic autoinflammatory syndromes\n Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....\n --CHILD--> [4A60.2] Tumour necrosis factor receptor 1 associated periodic syndrome\n Def: TRAPS is an autoinflammatory disease associated with heterozygous mutations in the gene coding for tumour necrosis factor (TNF) receptor 1 (TNFR1). This results in clinical attacks of inflammation in ...",
"[4A60.1] Cryopyrin-associated periodic syndromes\n Def: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical s...\n --PARENT--> [4A60] Monogenic autoinflammatory syndromes\n Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....\n --CHILD--> [4A60.1] Cryopyrin-associated periodic syndromes\n Def: CAPS is an autoinflammatory disease associated with gain of function changes in the cryopyrin protein, resulting in inflammasome activation and enhanced IL1 beta production. This results in clinical s..."
] |
EB30
|
Eosinophilic cellulitis
|
[
{
"from_icd11": "EB30",
"icd10_code": "L983",
"icd10_title": "Eosinophilic cellulitis [Wells]"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D8982",
"icd10_title": "Autoimmune lymphoproliferative syndrome [ALPS]"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D89813",
"icd10_title": "Graft-versus-host disease, unspecified"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D89810",
"icd10_title": "Acute graft-versus-host disease"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D89811",
"icd10_title": "Chronic graft-versus-host disease"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D8989",
"icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D89812",
"icd10_title": "Acute on chronic graft-versus-host disease"
},
{
"from_icd11": "4A60.1",
"icd10_code": "D898",
"icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified"
},
{
"from_icd11": "MB28.Z",
"icd10_code": "R4689",
"icd10_title": "Other symptoms and signs involving appearance and behavior"
},
{
"from_icd11": "MB28.Z",
"icd10_code": "R4681",
"icd10_title": "Obsessive-compulsive behavior"
},
{
"from_icd11": "MB28.Z",
"icd10_code": "R468",
"icd10_title": "Other symptoms and signs involving appearance and behavior"
},
{
"from_icd11": "LD20.1",
"icd10_code": "Q043",
"icd10_title": "Other reduction deformities of brain"
},
{
"from_icd11": "LD23",
"icd10_code": "Q289",
"icd10_title": "Congenital malformation of circulatory system, unspecified"
}
] |
L983
|
Eosinophilic cellulitis [Wells]
|
A 68-year-old Caucasian woman presented with a six-month history of right knee pain, swelling, and reduced range of motion. The pain was described as insidious in onset, progressively worsening, characterized as a persistent, deep, dull ache, rated 6/10 in severity. It was exacerbated by weight-bearing activities like walking and climbing stairs and was partially relieved by rest and over-the-counter analgesics. Nocturnal pain was also present. Her medical history included surgically treated uterine leiomyoma (two years prior) and papillary thyroid carcinoma (diagnosed six years prior, treated with total thyroidectomy and iodine-131 ablation, considered in remission). Review of archived thyroid cancer slides confirmed papillary thyroid carcinoma, with typical nuclear features and architecture; no evidence of lymphoma or lymphoid infiltration was identified ruling out associated lymphoid malignancy . Physical examination revealed moderate effusion of the right knee, tenderness over the patella, and restricted range of motion (0-90 degrees flexion). There was no palpable lymphadenopathy or organomegaly. The patient reported no constitutional symptoms such as fever, night sweats, or recent unintentional weight loss at initial presentation. Laboratory findings, including lactate dehydrogenase (LDH, 180 U/L; normal range < 250 U/L), complete blood count (Hemoglobin 13.1 g/dL, WBC 7.5 × 10 9 /L, Platelets 280 × 10 9 /L), calcium (9.8 mg/dL), and alkaline phosphatase (ALP, 75 U/L; normal range 40-129 U/L ) were within normal limits. Radiographs of the right knee demonstrated a large, ill-defined lytic lesion involving almost the entire patella, with cortical thinning and suspected breach . Computed tomography (CT) confirmed a permeative, destructive lytic lesion with ill-defined margins occupying nearly the entire patella, associated with cortical disruption anteriorly and posteriorly, and subtle soft tissue extension. Magnetic resonance imaging (MRI) showed extensive marrow replacement appearing hypointense on T1-weighted images and hyperintense on STIR sequences, with avid, heterogeneous contrast enhancement. Cortical disruption was clearly visualized along with significant surrounding soft tissue edema and enhancement, extending into the prepatellar bursa and infra-patellar fat pad . Given the patient's history of thyroid cancer, metastatic disease was initially suspected. A CT-guided core biopsy of the patellar lesion was performed. Histopathology revealed diffuse infiltration by large, atypical lymphoid cells with irregular nuclear contours, vesicular chromatin, prominent nucleoli, and scant cytoplasm, admixed with frequent mitotic figures, set within a fibrous stroma . Immunohistochemistry was positive for CD45 (confirming hematopoietic origin), CD20, PAX5 (confirming B-cell lineage), MUM1, and BCL2. The tumor cells were negative for CD138 (ruling out myeloma), CD10, BCL6, C-MYC and pan-cytokeratin (ruling out carcinoma) . The Ki-67 proliferation index was high at approximately 70 %. These findings were consistent with a DLBCL, non-GCB subtype based on the Hans algorithm (CD10-, BCL6-, MUM1+). Systemic staging included a bone marrow biopsy, which showed no evidence of lymphoma involvement. A whole-body Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) scan demonstrated intense, focal hypermetabolic activity confined solely to the right patella (SUVmax 15.2), with no other abnormal FDG uptake in lymph nodes or organs. Based on these findings, the diagnosis was established as primary patellar DLBCL, non-GCB subtype, Ann Arbor stage IE. The patient was treated with the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). The patient completed 6 cycles of R-CHOP chemotherapy. A follow-up PET/CT scan was performed at 6 months and revealed unexpected widespread disease progression with multiple new hypermetabolic lesions involving diffuse lymph nodes (cervical, axillary, mediastinal, abdominal, pelvic), the right adrenal gland, multiple bones (vertebrae, ribs, pelvis), both breasts, and numerous subcutaneous tissues . A biopsy of one of the hypermetabolic lesions in the left breast was performed and confirmed infiltration by DLBCL with an identical immunohistochemical profile to the original patellar lesion (CD45+, CD20+, PAX5+, MUM1+, BCL2+, CD10-, BCL6-, CK-), confirming systemic progression/relapse of the non-GCB DLBCL. Fig. 1 Pathological features of the thyroid cancer (A): Hematoxylin & Eosin, X 4 magnification showing carcinomatous proliferation organized intro papillary and follicular structures set in a fibrous stroma (B) Hematoxylin & Eosin x 200: Papillary structures aligned with atypical cells (C) Hematoxylin & Eosin x 400:The tumor cells shows typical papillary nuclear atypia with clarification, irregular nuclei and grooves. Fig. 1 Fig. 2 Conventional radiography: Anteroposterior radiograph of the right knee showing a large, poorly defined lytic lesion involving the majority of the patella with cortical thinning. Fig. 2 Fig. 3 MRI findings: Marrow replacement with low T1 signal intensity, high STIR signal, marked contrast enhancement, cortical disruption, and adjacent soft tissue oedema. Fig. 3 Fig. 4 Pathological Findings (a-e): Diffuse tumor proliferation of discohesive tumor cells with scanty cytoplasm and atypical nuclei (f): The cells showed strong and diffuse staining for CD20 marker (g): The cells showed strong and diffuse staining for CD79 marker (h): The cells showed strong and diffuse staining for CD45 marker (i): High Ki67 proliferation rate (j): The cells showed negative staining for CK. Fig. 4 Fig. 5 Follow-up PET/CT demonstrating systemic progression at 6 months: Fused FDG PET/CT images showing multiple new sites of intense hypermetabolism including widespread lymphadenopathy bilateral adrenal glands, multiple osseous lesions with persistent marked fixation in the right patella, mammary, and subcutaneous involvement, indicating extensive disease progression. Fig. 5
| 4.089844
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999996
|
40279991
|
https://doi.org/10.1016/j.ijscr.2025.111344
|
[
"cells",
"patella",
"papillary",
"thyroid",
"lesion",
"cortical",
"knee",
"range",
"patellar",
"tumor"
] |
[
{
"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": "FA32.Z",
"title": "Disorders of patella, unspecified"
},
{
"code": "LB9Z",
"title": "Structural developmental anomalies of the skeleton, unspecified"
},
{
"code": "FA32.Y",
"title": "Other specified disorders of patella"
},
{
"code": "NC93.7",
"title": "Strain or sprain of other or unspecified parts of knee"
},
{
"code": "LB9Y",
"title": "Other specified structural developmental anomalies of the skeleton"
}
] |
=== 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
[FA32.Z] Disorders of patella, unspecified
Also known as: Disorders of patella, unspecified | Disorders of patella | disorder of patella | disease of patella | deformity of patella
[LB9Z] Structural developmental anomalies of the skeleton, unspecified
Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS
[FA32.Y] Other specified disorders of patella
Also known as: Other specified disorders of patella | Plica syndrome | Slipped patella
[NC93.7] Strain or sprain of other or unspecified parts of knee
Definition: A collective term for muscle and ligament injuries of other and unspecified tissues associated with the knee without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature.
Also known as: Strain or sprain of other or unspecified parts of knee | Sprain of meniscus of knee | Sprained patella | Strained patella | Sprain of semilunar cartilage of knee
Excludes: sprain of patellar ligament
[LB9Y] Other specified structural developmental anomalies of the skeleton
Also known as: Other specified structural developmental anomalies of the skeleton | Limb hypoplasia or limb reduction defects | hypoplastic extremities | Congenital joint dislocations | Congenital anomalies of patella
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--CHILD--> [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 2 ---
[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 3 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Wolman disease
Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...
--PARENT--> [?] Liver disease due to disorders of lysosomal storage
Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function....
--- Walk 4 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Wolman disease
Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...
--PARENT--> [?] Lysosomal acid lipase deficiency
Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--RELATED_TO--> [?] 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...
--- 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 --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....",
"[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 --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Lysosomal acid lipase deficiency\n Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] 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...",
"[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": "FA32.Z",
"icd10_code": "M228X2",
"icd10_title": "Other disorders of patella, left knee"
},
{
"from_icd11": "FA32.Z",
"icd10_code": "M228X1",
"icd10_title": "Other disorders of patella, right knee"
},
{
"from_icd11": "FA32.Z",
"icd10_code": "M22",
"icd10_title": "Disorder of patella"
},
{
"from_icd11": "FA32.Z",
"icd10_code": "M223",
"icd10_title": "Other derangements of patella"
},
{
"from_icd11": "FA32.Z",
"icd10_code": "M228",
"icd10_title": "Other disorders of patella"
},
{
"from_icd11": "FA32.Z",
"icd10_code": "M229",
"icd10_title": "Unspecified disorder of patella"
},
{
"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"
}
] |
D571
|
Sickle-cell disease without crisis
|
A 60-year-old man was diagnosed with esophageal cancer found incidentally on upper gastrointestinal endoscopy during a health examination. A superficial irregular ulcerative area was observed in the middle to lower third of the thoracic esophagus , with an elevated lesion covered by normal epithelium found caudal to the main lesion . A biopsy specimen of the latter obtained during the health examination was histologically shown to be a squamous cell carcinoma. Iodine staining showed that the lesion was about 6.0 cm in diameter and occupied two thirds of the esophageal lumen . Narrow-band imaging showed highly destroyed intrapapillary capillary loops in the ulcerative area, indicating tumor invasion of the submucosal layer . Endoscopic ultrasonography with a 20-MHz transducer estimated the depth of tumor invasion as cT1b (SM1). Histological examination of the biopsy specimen collected from the ulcerative lesion showed squamous cell carcinoma. Computed tomography scan could not detect the primary tumor in the esophagus, but detected an enhanced swollen lymph node, 0.8 cm in diameter, in the dorsal area of the thoracic aorta , as well as a swollen lymph node along the left gastric artery . F-deoxyglucose (FDG) positron emission tomography showed high FDG uptake by the esophageal tumor, as well as by the retroaortic and perigastric lymph nodes. These lymph nodes were suspected of being metastases of esophageal cancer. The patient was diagnosed with a superficial, esophageal squamous cell carcinoma in the middle and lower thoracic esophagus with intramural metastasis and perigastric and distant lymph node metastases, and was classified as having cT1bN4M0IM1 stage IVa according to the Japanese classification of esophageal cancer . Although the recommended therapeutic strategy for stage IV disease is not surgery, we tried to resect all metastatic lymph nodes to confirm the cancer spread by histopathologic examination. The patient underwent video-assisted thoracoscopic esophagectomy in the left lateral position with three-field lymph node dissection. HALS was used for all abdominal procedures. The retroaortic lymph node could not be identified by a thoracoscope inserted into the right thoracic cavity. The metastatic lymph node in the dorsal area of thoracic aorta was identified by mediastinal scope inserted from abdominal port and dissected by HALS using a transhiatal approach and a pneumomediastinum method . Following thoracoscopic surgery for mediastinal lymph node dissection and esophageal transection in the upper mediastinum, the patient was placed in the supine position and underwent the HALS procedure. A 7-cm upper-abdominal median incision was created for insertion of the operator’s left hand. Four ports were inserted as shown in Figure 3 . Carbon dioxide was introduced into the intra-abdominal space, and pressure in the pneumoperitoneum was controlled at 10 mmHg. After usual gastric mobilization and abdominal lymph node dissection, the esophagus was pulled down to the abdominal cavity from the esophageal hiatus. After enlargement of the esophageal hiatus, the adventitia of the thoracic aorta were exposed near the crura of the diaphragm, from the anterior to the left side and then to the dorsal side, in that order. Using pneumomediastinum and anterior retraction of thoracic aorta enabled visualization of the anatomy around the dorsal area of the thoracic aorta. A swollen lymph node between the dorsal side of the aorta and the hemiazygos vein was dissected, along with surrounding fatty tissue, using an EnSeal device (Ethicon, Cincinnati, OH, USA) without injuring the hemiazygos vein and intercostal arteries . A gastric conduit was created and raised through the posterior mediastinal route. The operation was completed by cervical esophagogastrostomy with circular stapling. The patient’s postoperative clinical course was uneventful, without postoperative bleeding, chylothorax, or anastomotic leakage. However, he experienced delayed, left recurrent laryngeal nerve palsy, which became apparent 1 week after surgery but disappeared 3 months later. The patient underwent two courses of adjuvant chemotherapy, consisting of CDDP and 5-fluorouracil. At present, 1 year and 8 months after surgery, the patient remains alive without tumor recurrence. Figure 1 The endoscopic findings. Endoscopic findings of the primary esophageal tumor under white light (a, b) , iodine staining (c) , and narrow-band imaging (d) . (a) An irregular ulcerative tumor in the middle to lower thoracic esophagus. (b) An elevated lesion covered with normal epithelium on the anal side of the main tumor. Biopsy scar was present on the elevated lesion. (c) Iodine staining showing surface extension of the tumor. (d) Destroyed intrapapillary capillary loops under magnified narrow-band imaging. Figure 2 The computed tomography findings. Findings of the metastatic mediastinal (a, c) and abdominal (b, d) lymph nodes. Computed tomography (CT) showing a swollen lymph node, 0.8 cm in size, in the retroaortic area and accumulation of F-deoxyglucose (FDG) in FDG positron emission tomography (FDG-PET) (black arrow). CT scan and FDG-PET imaging also showed a swollen lymph node with FDG accumulation in the perigastric node along the left gastric artery (white arrow). Figure 3 Schematic illustration of the mini-laparotomyand the port sites in the hand-assisted laparoscopic surgery. Small and large dots indicate the 5 mm and 12 mm ports, respectively. Dot line indicates the mini-laparotomy. Figure 4 Operative findings and schematic illustration of transhiatal dissection of the retroaortic lymph node. The retroaortic space was visualized by anterior rotation of the thoracic aorta by hand-assisted laparoscopic surgery. (a, b) Dissection of the metastatic lymph node by EnSeal device. (c) Schematic illustration of Figure 4b. The area spaced by dotted line in Figure 4c corresponds to Figure 4b. A, aorta; F, finger of the operator; H, hemi-azygos vein; L, metastatic lymph node; P, parietal pleura; V, vertebra.
| 4.078125
| 0.969238
|
sec[1]/p[0]
|
en
| 0.999997
|
26943393
|
https://doi.org/10.1186/s40792-015-0030-8
|
[
"lymph",
"node",
"esophageal",
"thoracic",
"tumor",
"aorta",
"area",
"abdominal",
"lesion",
"esophagus"
] |
[
{
"code": "BD9Z",
"title": "Disorders of lymphatic vessels or lymph nodes, unspecified"
},
{
"code": "BD90.Z",
"title": "Lymphadenitis, unspecified"
},
{
"code": "BD90.Y",
"title": "Other specified lymphadenitis"
},
{
"code": "BD9Y",
"title": "Other specified disorders of lymphatic vessels or lymph nodes"
},
{
"code": "MA01.Z",
"title": "Enlarged lymph nodes, unspecified"
},
{
"code": "FA20.0",
"title": "Seropositive rheumatoid arthritis"
},
{
"code": "MF30",
"title": "Breast lump or mass female"
},
{
"code": "BB40",
"title": "Acute or subacute infectious endocarditis"
},
{
"code": "FA0Z",
"title": "Osteoarthritis, unspecified"
},
{
"code": "FA85.10",
"title": "Localised central endplate defect"
}
] |
=== ICD-11 CODES FOUND ===
[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified
Also known as: Disorders of lymphatic vessels or lymph nodes, unspecified | Lymphatic system disorders | lymph disease NOS | lymph gland disease | Lymphatic system disease NOS
[BD90.Z] Lymphadenitis, unspecified
Also known as: Lymphadenitis, unspecified | Lymphadenitis | adenitis NOS | inflammation of gland | lymphatic gland inflammation
[BD90.Y] Other specified lymphadenitis
Also known as: Other specified lymphadenitis | Dermatopathic lymphadenopathy | lipomelanotic reticulosis | Infective inguinal bubo | bubo
[BD9Y] Other specified disorders of lymphatic vessels or lymph nodes
Also known as: Other specified disorders of lymphatic vessels or lymph nodes | Chylous cyst | Mesentery chylous cyst | Peritoneum chylous cyst | Lymphocele
[MA01.Z] Enlarged lymph nodes, unspecified
Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy
[FA20.0] Seropositive rheumatoid arthritis
Also known as: Seropositive rheumatoid arthritis | high positive rheumatoid factor | low positive rheumatoid factor | high positive anticitrullinated protein antibody | low positive anticitrullinated protein antibody
[MF30] Breast lump or mass female
Also known as: Breast lump or mass female | breast irregular nodularity | breast node | lump in breast | lump or mass in breast NOS
[BB40] Acute or subacute infectious endocarditis
Also known as: Acute or subacute infectious endocarditis | subacute infective endocarditis NOS | infective endocarditis NOS | acute infective endocarditis NOS | infectious endocarditis
Excludes: Infectious myocarditis
[FA0Z] Osteoarthritis, unspecified
Also known as: Osteoarthritis, unspecified | osteoarthritis NOS | arthrosis NOS | OA - [osteoarthritis] | Osteoarthritis with determinants
[FA85.10] Localised central endplate defect
Also known as: Localised central endplate defect | Schmorl nodes | schmorl's nodes | schmorl's nodules
=== GRAPH WALKS ===
--- Walk 1 ---
[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified
--PARENT--> [?] Disorders of lymphatic vessels or lymph nodes
Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....
--CHILD--> [BD92] Lymphangiectasia
--- Walk 2 ---
[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified
--PARENT--> [?] Disorders of lymphatic vessels or lymph nodes
Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--- Walk 3 ---
[BD90.Z] Lymphadenitis, unspecified
--PARENT--> [BD90] Lymphadenitis
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--- Walk 4 ---
[BD90.Z] Lymphadenitis, unspecified
--PARENT--> [BD90] Lymphadenitis
--EXCLUDES--> [?] Human immunodeficiency virus disease
Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...
--- Walk 5 ---
[BD90.Y] Other specified lymphadenitis
--PARENT--> [BD90] Lymphadenitis
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--- Walk 6 ---
[BD90.Y] Other specified lymphadenitis
--PARENT--> [BD90] Lymphadenitis
--CHILD--> [BD90.2] Chronic 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--> [BD92] Lymphangiectasia",
"[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...",
"[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....",
"[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Human immunodeficiency virus disease\n Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...",
"[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....",
"[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.2] Chronic lymphadenitis"
] |
BD9Z
|
Disorders of lymphatic vessels or lymph nodes, unspecified
|
[
{
"from_icd11": "BD9Z",
"icd10_code": "I898",
"icd10_title": "Other specified noninfective disorders of lymphatic vessels and lymph nodes"
},
{
"from_icd11": "BD9Z",
"icd10_code": "I899",
"icd10_title": "Noninfective disorder of lymphatic vessels and lymph nodes, unspecified"
},
{
"from_icd11": "BD9Z",
"icd10_code": "I89",
"icd10_title": "Other noninfective disorders of lymphatic vessels and lymph nodes"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I889",
"icd10_title": "Nonspecific lymphadenitis, unspecified"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I88",
"icd10_title": "Nonspecific lymphadenitis"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I888",
"icd10_title": "Other nonspecific lymphadenitis"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "L00-L08",
"icd10_title": ""
},
{
"from_icd11": "MA01.Z",
"icd10_code": "R599",
"icd10_title": "Enlarged lymph nodes, unspecified"
},
{
"from_icd11": "MA01.Z",
"icd10_code": "R59",
"icd10_title": "Enlarged lymph nodes"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0569",
"icd10_title": "Rheumatoid arthritis of multiple sites with involvement of other organs and systems"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0579",
"icd10_title": "Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M05612",
"icd10_title": "Rheumatoid arthritis of left shoulder with involvement of other organs and systems"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0570",
"icd10_title": "Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0560",
"icd10_title": "Rheumatoid arthritis of unspecified site with involvement of other organs and systems"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0500",
"icd10_title": "Felty's syndrome, unspecified site"
}
] |
I898
|
Other specified noninfective disorders of lymphatic vessels and lymph nodes
|
Three SPs (2 males - 23 and 45 years old, and a 37-year-old female) presented the three vignettes outlined in Table 1 at the community pharmacies. The older male and the female SPs were graduates of Theatre Arts and the younger male SP was an undergraduate final year pharmacy student. Briefly, in vignette 1, a young male supposedly diagnosed with anaemia, pleurisy, duodenal ulcer, and Tinea pedis presented a prescription to the pharmacist and would like to know if any of the drugs could cause him any harm as he does not like taking drugs. In vignette 2, a 45-year-old known type 2 diabetes mellitus and hypertensive patient took his medications pack to the pharmacist to help identify if his medications or his diseases were responsible for his weakness. Vignette 3 described a female hypertensive and peptic ulcer patient who had uncontrolled blood pressure due to non-adherence to her hypertensive medications. She took her current prescription to the community pharmacist and sought counsel. The vignettes described in Table 1 were designed by one of the authors, SJS, based on experiences garnered from precepting students on community pharmacy postings. With the assistance of a general practice physician in a private hospital, the pseudo-prescriptions, used for the presentation of vignettes 1 and 3 by the SPs were written solely for the study. Table 1 Description of vignettes re-enacted at the pharmacies by the simulated patients Vignette 1 Background Prescription/Medications Medical and medication history The patient experienced stomach pain at night for over 2 weeks and had a fungal infection in between the toes. He claimed to have a low blood level and pain on the right side of his chest when he inhales. He had been coughing for a week. His physician diagnosed anaemia, pleurisy, duodenal ulcer, and Tinea pedis . He presented the following prescription to the pharmacist. Prescription presented to the pharmacist at each pharmacy. Name: TJB Gender: Male Age: 23 yrs Rx Tab. Fluconazole 150 mg q12hr × 2/52 Tab. Ciprofloxacin 500 mg q12hr × 3/52 Tab. Omeprazole 20 mg nocte × 2/52 Tab. Ferrous gluconate 300 mg q8hr × 2/52 The simulated patient presented the prescription to the pharmacist and identified that he is the owner. He informed the pharmacists of the physician diagnoses but would like to know if any of the drugs would cause him any harm as he does not like taking medications. If the pharmacist expresses concern about the prescription and would like to speak with his physician, the simulated patient was to provide the contact number of SJS who would clarify the concern of the pharmacist. If the pharmacists refused to dispense the medications, the simulated patient must ask why? but if the pharmacist chose to dispense them the simulated patient must buy the medications. If asked of any known allergy, the SP would answer that he has no allergy. Vignette 2 Background Prescription/Medications Medical and medication history A 45-year-old semiliterate young male took his medications to the pharmacist to help identify if his medications or his diseases were responsible for his weakness. He has type 2 diabetes and hypertension. He was feeling weak and dizzy for the last 3 days and sometimes felt like fainting. His fasting blood glucose level and blood pressure were 60 mg/dL and 126/79 mmHg, respectively that morning before coming to see the pharmacist. The following medications were what he brought to show the pharmacist. Tab. Diamet® (Glibenclamide 5 mg) q24hr Tab. Lisinopril 10 mg q24hr Tab. Clamide® (Glibenclamide 5 mg) q24hr Syr. Coflin Linctus® 15 ml q6hr Tab. Metformin 1000 mg q12hr Tab. Diclofenac 100 mg q24hr He asked to speak with the pharmacist only and expressed his concern. He gave his medication pack to the pharmacist and informed him of his medical conditions. If the pharmacist asked why he was taking Diamet® and Clamide®, brands of glibenclamide, together, the SP claimed that his wife bought Clamide® for him with other drugs, but he had been using Diamet®. He did not know they were the same drug. If the pharmacist asked why he was using Coflin Linctus® and ibuprofen, he responded that he had a dry cough and his knees hurt. He bought the two drugs when his friend recommended them. Vignette 3 Background Prescription/Medications Medical and medication history A 37-year-old female took the prescription below to the pharmacy. She is a known hypertensive and gastric ulcer patient. Name: MN Gender: Female Age: 37 years Rx Tab. Hydrochlorothiazide 25 mg q12hr × 1/12 Tab. Amlodipine 10 mg daily × 1/12 Tab, Aspirin 75 mg daily × 1/12 Tab. Omeprazole 20 mg q12hr × 1/12 Tab. Furosemide 40 mg q24hr × 1/12 Tab. Clopidogrel 75 mg q24hr × 1/12 She wanted to buy the medications but asked to speak with the pharmacist first and she informed the pharmacist that she is hypertensive and has gastric ulcer. She claim that it was her second prescription for her condition. She was diagnosed a month ago and her blood pressure at the hospital this morning was 153/92 mmHg. She told the pharmacist that she has not been taking her medications as she should and that she is willing to cooperate now that her blood pressure is not well controlled. She provided the pharmacists with other relevant information when asked, such as her allergies and that she has no other known medical condition or oedema. She wants the pharmacist to counsel her. If the pharmacist is concerned about her medications and wanted to speak with her physician, she provided the contact number of the pseudo-physician who is one of the authors (SJS). SJS addressed the concern of the pharmacist such as the withdrawal of furosemide when the patient had no oedema and the removal of Aspirin and the modification of the frequency of use of Hydrochlorothiazide if any of the pharmacists suggested these. Calcimax® – contain Calcium carbonate, Magnesium hydroxide, Zinc sulphate and Vitamin D 3 ; Coflin Lintus® – contain Chlorpheniramine maleate, Ammonium Chloride, Sodium citrate, Menthol and Ephedrine hydrochloride.
| 3.835938
| 0.682129
|
sec[1]/sec[1]/p[0]
|
en
| 0.999996
|
PMC8848586
|
https://doi.org/10.1186/s12913-022-07535-z
|
[
"pharmacist",
"medications",
"prescription",
"that",
"vignette",
"like",
"blood",
"physician",
"asked",
"ulcer"
] |
[
{
"code": "QA1Y",
"title": "Contact with health services for other specified counselling"
},
{
"code": "QA00.0",
"title": "General adult medical examination"
},
{
"code": "QC48.Z",
"title": "Personal history of medical treatment, unspecified"
},
{
"code": "8A06.Y",
"title": "Other specified myoclonic disorders"
},
{
"code": "8D88.3",
"title": "Autonomic disorder due to toxins"
},
{
"code": "QE11.Z",
"title": "Hazardous drug use, unspecified"
},
{
"code": "QA79",
"title": "Drug or substance interactions without injury or harm"
},
{
"code": "QB92",
"title": "Contact with health services for issue of repeat prescription"
},
{
"code": "QA21.1",
"title": "Contact with health services for general counselling or advice on contraception"
},
{
"code": "PL13.0",
"title": "Overdose of substance, as mode of injury or harm"
}
] |
=== ICD-11 CODES FOUND ===
[QA1Y] Contact with health services for other specified counselling
Also known as: Contact with health services for other specified counselling | Consanguinity counselling | Medical counselling | medical advice NOS | Health advice
[QA00.0] General adult medical examination
Definition: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult.
Also known as: General adult medical examination | adult health checkup | check-up adult | general adult health examination | health check-up, adult NOS
Excludes: Routine child health examination | Routine general health check-up of defined subpopulation | Routine newborn health examination
[QC48.Z] Personal history of medical treatment, unspecified
Also known as: Personal history of medical treatment, unspecified | Personal history of medical treatment | history of medical treatment
[8A06.Y] Other specified myoclonic disorders
Also known as: Other specified myoclonic disorders | Secondary myoclonus | Myoclonus due to neurodegenerative or storage disorders | Myoclonus due to neuronal ceroid lipofuscinosis | Myoclonus due to Sialidosis
[8D88.3] Autonomic disorder due to toxins
Also known as: Autonomic disorder due to toxins | Autonomic dysfunction due to medications | Autonomic dysfunction due to heavy metal exposure | Autonomic dysfunction due to Vacor exposure | Autonomic dysfunction due to Acrylamide exposure
[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
[QA79] Drug or substance interactions without injury or harm
Definition: A drug interaction is a situation in which a substance affects the activity of another drug when both are administered together. Includes increased effectiveness, decreased effectiveness or a new effect that is not produced from either drug on its own. No injury or harm occurred as a result.
Also known as: Drug or substance interactions without injury or harm | drug-drug interaction | drug-food interaction | prescription and non-prescription interaction
Excludes: Drug or substance interactions, as mode of injury or harm
[QB92] Contact with health services for issue of repeat prescription
Also known as: Contact with health services for issue of repeat prescription | Issue of repeat prescription for appliance | Issue of repeat prescription for glasses | Issue of repeat prescription for medication
Excludes: Issue of medical certificate | repeat prescription for contraceptive
[QA21.1] Contact with health services for general counselling or advice on contraception
Also known as: Contact with health services for general counselling or advice on contraception | contraception counselling | advice on contraception | Contact with health services for contraception prescription | Contact with health services for family planning advice
[PL13.0] Overdose of substance, as mode of injury or harm
Definition: Incorrect dose - too high
Also known as: Overdose of substance, as mode of injury or harm | wrong dose of substance as mode of injury | wrong strength of substance as mode of injury | dose of substance administered or taken too early or too quickly as a mode of injury | extra dose of substance administered as mode of injury
Includes: overdose of prescribed drug | medication error leading to excess level or effect of prescribed drug
Excludes: Overdose of substance without injury or harm | Unintentional exposure to or harmful effects of drugs, medicaments or biological substances | Intentional self-harm by exposure to or harmful effects of drugs, medicaments or biological substances
=== GRAPH WALKS ===
--- Walk 1 ---
[QA1Y] Contact with health services for other specified counselling
--PARENT--> [?] Contact with health services for counselling
--RELATED_TO--> [?] Contact with health services for genetic counselling
--- Walk 2 ---
[QA1Y] Contact with health services for other specified counselling
--PARENT--> [?] Contact with health services for counselling
--EXCLUDES--> [?] Contact with health services for preconception counselling
Def: A reason for encounter to counsel an individual's queries or complaints regarding conception....
--- Walk 3 ---
[QA00.0] General adult medical examination
Def: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult....
--EXCLUDES--> [?] Routine general health check-up of defined subpopulation
--CHILD--> [?] Routine general health check-up of armed forces
--- Walk 4 ---
[QA00.0] General adult medical examination
Def: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult....
--EXCLUDES--> [?] Routine newborn health examination
Def: Health examination for infant under 29 days of age...
--EXCLUDES--> [?] Routine child health examination
Def: Routine health check for child over 28 days of age through 19 years of age....
--- Walk 5 ---
[QC48.Z] Personal history of medical treatment, unspecified
--PARENT--> [QC48] Personal history of medical treatment
--CHILD--> [QC48.Y] Other specified personal history of medical treatment
--- Walk 6 ---
[QC48.Z] Personal history of medical treatment, unspecified
--PARENT--> [QC48] Personal history of medical treatment
--CHILD--> [QC48.0] Personal history of long-term use of anticoagulants
|
[
"[QA1Y] Contact with health services for other specified counselling\n --PARENT--> [?] Contact with health services for counselling\n --RELATED_TO--> [?] Contact with health services for genetic counselling",
"[QA1Y] Contact with health services for other specified counselling\n --PARENT--> [?] Contact with health services for counselling\n --EXCLUDES--> [?] Contact with health services for preconception counselling\n Def: A reason for encounter to counsel an individual's queries or complaints regarding conception....",
"[QA00.0] General adult medical examination\n Def: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult....\n --EXCLUDES--> [?] Routine general health check-up of defined subpopulation\n --CHILD--> [?] Routine general health check-up of armed forces",
"[QA00.0] General adult medical examination\n Def: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult....\n --EXCLUDES--> [?] Routine newborn health examination\n Def: Health examination for infant under 29 days of age...\n --EXCLUDES--> [?] Routine child health examination\n Def: Routine health check for child over 28 days of age through 19 years of age....",
"[QC48.Z] Personal history of medical treatment, unspecified\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.Y] Other specified personal history of medical treatment",
"[QC48.Z] Personal history of medical treatment, unspecified\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.0] Personal history of long-term use of anticoagulants"
] |
QA1Y
|
Contact with health services for other specified counselling
|
[
{
"from_icd11": "QA00.0",
"icd10_code": "Z0001",
"icd10_title": "Encounter for general adult medical examination with abnormal findings"
},
{
"from_icd11": "QA00.0",
"icd10_code": "Z0000",
"icd10_title": "Encounter for general adult medical examination without abnormal findings"
},
{
"from_icd11": "QA00.0",
"icd10_code": "Z000",
"icd10_title": "Encounter for general adult medical examination"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9221",
"icd10_title": "Personal history of antineoplastic chemotherapy"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9282",
"icd10_title": "Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9225",
"icd10_title": "Personal history of immunosupression therapy"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9229",
"icd10_title": "Personal history of other drug therapy"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9289",
"icd10_title": "Personal history of other medical treatment"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9222",
"icd10_title": "Personal history of monoclonal drug therapy"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z92241",
"icd10_title": "Personal history of systemic steroid therapy"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9223",
"icd10_title": "Personal history of estrogen therapy"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9283",
"icd10_title": "Personal history of failed moderate sedation"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z9281",
"icd10_title": "Personal history of extracorporeal membrane oxygenation (ECMO)"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z923",
"icd10_title": "Personal history of irradiation"
},
{
"from_icd11": "QC48.Z",
"icd10_code": "Z920",
"icd10_title": "Personal history of contraception"
}
] |
Z0001
|
Encounter for general adult medical examination with abnormal findings
|
In-hospital complications were medical problems not present on admission, which increased length of stay by greater than 24 h. The following encounter demonstrates a case where medical complications contributed to hospital costs: A 69 year-old woman was admitted for induction chemotherapy for newly diagnosed acute myeloid leukemia. After about a week in hospital, she developed febrile neutropenia due to a central line infection. She was treated with broad-spectrum antibiotics, with empiric antifungal agents added later due to ongoing fevers. Two weeks into the admission, she developed acute kidney injury necessitating placement of a hemodialysis catheter. Following the line insertion the patient developed an unstable tachyarrhythmia resulting in hypotension and shock. She was transferred to ICU where she required vasopressors and intubation. She was electrically cardioverted with no improvement in blood pressure. Soon after admission to ICU, a family meeting was held and it was decided to change goals of care to focus on comfort measures. The patient died later that day after withdrawing life-sustaining therapies. Delays in patient disposition were identified when length of stay was prolonged by greater than 24 h due to a delay in finding an appropriate discharge location after acute medical issues had resolved. Anecdotally, most patients who required additional ongoing care on discharge from hospital (i.e. homecare, long-term care) had a delay in discharge due to issues with disposition. For example: An 86 year-old woman was transferred from a community hospital for fluid overload secondary to end stage renal disease. She was started on hemodialysis and her volume status improved in less than one week. The remainder of her one-month stay was spent waiting for transfer to a long-term care facility that could provide her with regular dialysis. Her application to long-term care had been started in the community hospital more than a month prior when it was first identified she would likely require more care. Service delays were defined as a delay in the provision of required hospital services by greater than 24 h, which likely contributed to an increase in overall cost. Anecdotally, the leading two causes of service delays were due to delays in transferring patients between various acuities of care (i.e. ICU to regular ward, regular ward to rehabilitation), and in delays due to waiting for allied health (i.e. physiotherapy, speech-language pathology). An example where service delays increased the cost of a hospitalization: A 77 year-old man was admitted for unilateral lower extremity weakness resulting in falls. Neuro-imaging with CT and MRI revealed a tumor in the left temporal lobe of the brain. The admitting team decided to obtain a biopsy, however there was a delay of four days before the patient was taken to the operating room for the biopsy. Following the biopsy, there was a delay of five days while waiting for biopsy results. Radiation oncology was subsequently consulted, and a decision was made to pursue treatment with palliative radiation therapy. The patient waited for one week before he was transferred to a different campus of the hospital for initiation of treatment. Inefficient clinical decision-making was when the length of stay was prolonged by greater than 24 h because of a missed diagnosis, sequential single systems approach, or narrow differential diagnosis considered by healthcare providers. An example of a case where inefficient decision-making led to increased cost: A 60 year-old man was transferred from a community hospital for resection of an oral cancer. He had been initially admitted to a community hospital for a hip fracture requiring surgery. There he had been treated with warfarin as prophylaxis for venous thromboembolic disease; heparins were not used due to a local reaction to injections. At our hospital, his surgery was delayed by one week because of excessively thinned blood (elevated international normalized ratio (INR)). The hematology inpatient service was consulted and recommended administering parenteral vitamin K to reverse his coagulopathy – which took several days. For illustrative purposes, we chose the above vignettes for each of our contributors to length of stay as they are clear examples of a single contributing factor. However, the majority of charts that we reviewed contained multiple contributors as exemplified by the following case: An 83 year-old woman was admitted for fatigue, peripheral edema, and declining function at her retirement home. Although one member of the attending service noted that the most likely cause of the edema was poor nutrition, the team undertook an extensive series of investigations for conditions with much lower clinical likelihood, beginning with an echocardiogram to investigate for heart failure. When the echocardiogram was reported as normal, urinary biochemistry studies to pursue unlikely diagnoses such as carcinoid tumour was undertaken. After one week of serial testing, the inpatient gastroenterology team was consulted for assistance [inefficient clinical decision-making]. The GI team elected to perform an esophago-gastro-duodenoscopy, which showed delayed gastric emptying; there was a one-week wait for this test due to a lack of urgent indication, with the endoscopy suite running at full capacity [service delay]. After being diagnosed with delayed gastric emptying and malnutrition, the patient was seen by the geriatric rehabilitation service who determined that she was not a suitable candidate. The decision was made to transfer her to long-term care, with a subsequent one-month wait in the acute care hospital [disposition delay]. Very few high-cost cases had none of the four contributors identified above. An example of such a case: A 66 year-old female was admitted for elective endovascular repair of an infra-renal abdominal aortic aneurism measuring 5.9 cm. The patient spent a few days in hospital for recovery, and was subsequently discharged with no complications.
| 3.974609
| 0.839844
|
sec[2]/sec[0]/p[1]
|
en
| 0.999997
|
29178870
|
https://doi.org/10.1186/s12913-017-2746-6
|
[
"delay",
"service",
"delays",
"stay",
"that",
"decision",
"which",
"length",
"greater",
"transferred"
] |
[
{
"code": "MG44.1Z",
"title": "Lack of expected normal physiological development, unspecified"
},
{
"code": "PL14.A",
"title": "Delayed diagnosis"
},
{
"code": "6A00.Z",
"title": "Disorders of intellectual development, unspecified"
},
{
"code": "PL14.B",
"title": "Delayed treatment"
},
{
"code": "GA20.00",
"title": "Primary amenorrhoea"
},
{
"code": "QC2Y",
"title": "Other specified contact with health services associated with the health of others"
},
{
"code": "QC2Z",
"title": "Contact with health services associated with the health of others, unspecified"
},
{
"code": "QB95.7",
"title": "Occupational therapy or vocational rehabilitation"
},
{
"code": "QA01.8",
"title": "Encounter for adoption services"
},
{
"code": "QA21.3",
"title": "Contact with health services for sterilisation"
}
] |
=== ICD-11 CODES FOUND ===
[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
[PL14.A] Delayed diagnosis
Also known as: Delayed diagnosis
[6A00.Z] Disorders of intellectual development, unspecified
Also known as: Disorders of intellectual development, unspecified | Disorders of intellectual development | Mental retardation | Intellectual developmental disorder | Intellectual disability
[PL14.B] Delayed treatment
Also known as: Delayed treatment | avoidable delay in treatment | Problem associated with delayed administration of a needed medication | Problem associated with delayed surgery
Excludes: Incorrect timing of drug or medicament, as mode of injury | Non provision of necessary procedure
[GA20.00] Primary amenorrhoea
Definition: No menses by age 14 in the absence of growth or development of secondary sexual characteristics; or no menses by age 16 regardless of the presence of normal growth and development of secondary sexual characteristics.
Also known as: Primary amenorrhoea | primary physiologic amenorrhoea | menstruation delay | failure of menstruation at puberty | delayed menses
[QC2Y] Other specified contact with health services associated with the health of others
Also known as: Other specified contact with health services associated with the health of others | Boarder in health-care facility other than healthy person accompanying sick person | Health supervision or care of other healthy infant or child | child in care | healthy infant receiving care
[QC2Z] Contact with health services associated with the health of others, unspecified
Also known as: Contact with health services associated with the health of others, unspecified
[QB95.7] Occupational therapy or vocational rehabilitation
Also known as: Occupational therapy or vocational rehabilitation | rehabilitation by occupational therapy | occupational therapist service | occupational therapy | therapy by occupational therapist
[QA01.8] Encounter for adoption services
Definition: Encounter to provide pre or post-adoption services to assist prospective adoptive parents in making an informed decision prior to adoption or to address the medical history and current health of the child and provide parental guidance
Also known as: Encounter for adoption services | adoption medical examination | general medical examination for adoption | pre adoption examination | examination for adoption
[QA21.3] Contact with health services for sterilisation
Also known as: Contact with health services for sterilisation | prophylactic sterilisation | Admission for interruption of fallopian tube | sterilisation female | Admission for interruption of vas deferens
=== GRAPH WALKS ===
--- Walk 1 ---
[MG44.1Z] Lack of expected normal physiological development, unspecified
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--PARENT--> [MG44] Symptoms peculiar to infancy
--- Walk 2 ---
[MG44.1Z] Lack of expected normal physiological development, unspecified
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--PARENT--> [MG44] Symptoms peculiar to infancy
--- Walk 3 ---
[PL14.A] Delayed diagnosis
--PARENT--> [PL14] Mode of injury or harm associated with other health care related causes
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft
--- Walk 4 ---
[PL14.A] Delayed diagnosis
--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 5 ---
[6A00.Z] Disorders of intellectual development, unspecified
--PARENT--> [6A00] Disorders of intellectual development
Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...
--CHILD--> [6A00.2] Disorder of intellectual development, severe
Def: A severe disorder of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour th...
--- Walk 6 ---
[6A00.Z] Disorders of intellectual development, unspecified
--PARENT--> [6A00] Disorders of intellectual development
Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...
--EXCLUDES--> [?] Dementia
Def: Dementia is characterized by the presence of marked impairment in two or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive functionin...
|
[
"[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --PARENT--> [MG44] Symptoms peculiar to infancy",
"[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --PARENT--> [MG44] Symptoms peculiar to infancy",
"[PL14.A] Delayed diagnosis\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft",
"[PL14.A] Delayed diagnosis\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",
"[6A00.Z] Disorders of intellectual development, unspecified\n --PARENT--> [6A00] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...\n --CHILD--> [6A00.2] Disorder of intellectual development, severe\n Def: A severe disorder of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour th...",
"[6A00.Z] Disorders of intellectual development, unspecified\n --PARENT--> [6A00] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...\n --EXCLUDES--> [?] Dementia\n Def: Dementia is characterized by the presence of marked impairment in two or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive functionin..."
] |
MG44.1Z
|
Lack of expected normal physiological development, unspecified
|
[
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6250",
"icd10_title": "Unspecified lack of expected normal physiological development in childhood"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6259",
"icd10_title": "Other lack of expected normal physiological development in childhood"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6251",
"icd10_title": "Failure to thrive (child)"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6252",
"icd10_title": "Short stature (child)"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R62",
"icd10_title": "Lack of expected normal physiological development in childhood and adults"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R628",
"icd10_title": ""
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R629",
"icd10_title": ""
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F79",
"icd10_title": "Unspecified intellectual disabilities"
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F78",
"icd10_title": "Other intellectual disabilities"
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F70-F79",
"icd10_title": ""
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F780",
"icd10_title": ""
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F781",
"icd10_title": ""
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F788",
"icd10_title": ""
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F789",
"icd10_title": ""
},
{
"from_icd11": "6A00.Z",
"icd10_code": "F790",
"icd10_title": ""
}
] |
R6250
|
Unspecified lack of expected normal physiological development in childhood
|
XY was treated for the onset of a PD with mild depressive symptoms at the age of 30. These symptoms determined XY's first contact with a psychiatrist who introduced the antidepressant Paroxetine, with full recovery within a few months and complete remission without any treatment for almost 10 years. During this time span, XY experienced at least two episodes of mood elevation of hypomanic intensity, characterized by increased energy level and working activities, and reduced need for sleep (about 4 hour at night) and more pressure in talking. These episodes showed duration of about 2 weeks and did not come to medical attention since the patient had no insight about their pathological nature, and adequate working and social functioning were conserved despite an increased irritability was noted by relatives and friends. Indeed, they were identified and reported only at a subsequent time, during anamnestic collection at the first hospital admission. In 2014, in relation to persistent familial and working stressors, XY experienced a progressive increase of anxiety associated to panic attacks, ruminative thinking about his problems, and low mood with irritability and insomnia. For this reason, he was prescribed the antidepressant Duloxetine, which did not produce any improvement and exacerbated anxiety, irritability, and internal tension. Duloxetine was thus discontinued, and XY switched to a combined therapy with mood stabilizer (Divalproex), antidepressant (Paroxetine), and benzodiazepines with a rapid clinical response and later reduction of the dosages up to a maintenance treatment. About two years later, XY was diagnosed with pT1bN0 G3 ER+/HER+ breast cancer: he underwent surgery and one and a half years adjuvant chemotherapic treatment. During this period, XY showed mild periodical exacerbations of depressive symptoms that remitted with minor changes to the ongoing therapy. Tamoxifen therapy was subsequently introduced (daily dose: 20 mg). After about 10 months from the introduction of Tamoxifen, XY showed a progressive psychopathological worsening with increasing anxiety, lower mood, and reduced energy, so that the psychiatrist tried different antidepressants trials (Escitalopram, Trimipramine, Fluoxetine) along with Divalproex, with a partial response. In January 2019, a further symptomatological exacerbation, with increased tension, low mood with lability, hopelessness, ruminative and obsessive thinking about physical, familiar, and working problems with concurrent worsening of suicidal ideation required the first admission to Psychiatric Clinic of University of Pisa. XY was clinically diagnosticated with BD-II comorbid with PD, and afterwards, he was discharged with Divalproex, Sertraline, and Olanzapine, showing partial clinical improvement; meanwhile, he continued undergoing a Tamoxifen therapy. In the following months, despite several treatment changes were undertaken, XY showed a gradual worsening of symptoms up to an aborted suicidal attempt by defenestration. The subsequent introduction of Lithium in addition to Divalproex, Citalopram, Quetiapine, and Delorazepam did not lead to any significant improvement, and suicidal ideation kept worsening. Therefore, approximately 5 months after the previous discharge, the patient needed hospital readmission. The ongoing therapy at the second admission was Divalproex 300 mg/day, Lithium Sulphate 41.5 mg/day, Citalopram 20 mg/day, and Quetiapine 75 mg/day. During the second hospitalization, he was assessed with the following instruments: the Structured Clinical Interview for DSM-5 Disorders (SCID-5) , a diagnostic instrument used by clinicians to make psychiatric diagnoses through a semistructured interviewing process, the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Depression Scale (HAM-D) , to evaluate depressive symptoms severity, the Columbia Suicide Severity Rating Scale (C-SSRS) , to assess suicidality, and the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) . The clinical diagnosis of BD-II, comorbid with PD, was confirmed by means of the SCID-5 due to the lifetime presence of at least one full-blown depressive episode and of at least a hypomanic episode, described by the patient although never clinically observed. At the hospitalization, the C-SSRS showed the presence of suicidal ideation (intensity of 14 points) with lifetime, yet not current, suicidal behavior. During this hospitalization, XY was treated with mood stabilizers (Divalproex 500 mg and Lithium Sulfate 83 mg), antidepressant (Citalopram 20 mg, then Sertraline 125 mg), and antipsychotics (Quetiapine 125 mg, then Olanzapine 10 mg) with only moderate improvement of the symptoms. We then contacted the oncologist in order to consider the possibility of discontinuation of treatment with Tamoxifen. The oncologist agreed on the interruption of Tamoxifen treatment, as about 18 months had been already occurred since its first assumption. After the discharge, we started a close follow-up aimed at observing XY's clinical evolution and at repeating the psychometric assessments, without making any further therapeutic changes. At the following evaluations until today, XY has shown a global clinical improvement, with progressive reduction of depressive and anxious symptoms, reduction of ruminative concern about familiar and working problems, increasing energy level, complete absence of delusional ideation, and fully recover of his work capacity. No suicidal thoughts or plan have emerged so far. The scores reported in the subsequent assessments confirmed the clinical improvement (see Table 1 ), showing a progressive reduction of depressive symptoms and a global improvement in quality of life, mainly after Tamoxifen's suspension. To date, after 20 months from Tamoxifen interruption, Olanzapine and Divalproex have been discontinued and XY is on a Lithium and Paroxetine maintenance therapy. At the same time, the patient had a good oncological follow-up despite Tamoxifen interruption.
| 4.0625
| 0.973145
|
sec[1]/sec[0]/p[1]
|
en
| 0.999998
|
33833890
|
https://doi.org/10.1155/2021/5547649
|
[
"about",
"tamoxifen",
"improvement",
"divalproex",
"depressive",
"mood",
"suicidal",
"working",
"antidepressant",
"this"
] |
[
{
"code": "QD3Z",
"title": "Concern about body appearance, unspecified"
},
{
"code": "QA1B",
"title": "Concern about or fear of medical treatment"
},
{
"code": "QD3Y",
"title": "Other specified concern about body appearance"
},
{
"code": "QD30",
"title": "Concern about breast appearance"
},
{
"code": "QA20",
"title": "Contact with health services for concerns about pregnancy"
},
{
"code": "PL00",
"title": "Drugs, medicaments or biological substances associated with injury or harm in therapeutic use"
},
{
"code": "6A7Z",
"title": "Depressive disorders, unspecified"
},
{
"code": "6A72",
"title": "Dysthymic disorder"
},
{
"code": "KD30.Z",
"title": "Birth depression, unspecified"
},
{
"code": "6A7Y",
"title": "Other specified depressive disorders"
}
] |
=== ICD-11 CODES FOUND ===
[QD3Z] Concern about body appearance, unspecified
Also known as: Concern about body appearance, unspecified
[QA1B] Concern about or fear of medical treatment
Also known as: Concern about or fear of medical treatment | fear of medical treatment | concern about medical treatment
[QD3Y] Other specified concern about body appearance
Also known as: Other specified concern about body appearance | Concern with appearance of ears
[QD30] Concern about breast appearance
Also known as: Concern about breast appearance
Excludes: Body dysmorphic disorder
[QA20] Contact with health services for concerns about pregnancy
Also known as: Contact with health services for concerns about pregnancy
[PL00] Drugs, medicaments or biological substances associated with injury or harm in therapeutic use
Also known as: Drugs, medicaments or biological substances associated with injury or harm in therapeutic use | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Penicillins | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Cephalosporins or other beta-lactam antibiotics | Drugs medicaments or biological substances associated with injury or harm in therapeutic use, Systemic antibiotics, Chloramphenicol group
Excludes: Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm
[6A7Z] Depressive disorders, unspecified
Also known as: Depressive disorders, unspecified | depression NOS | depressive disorder NOS | depressed NOS
[6A72] Dysthymic disorder
Definition: Dysthymic disorder is characterised by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifest as pervasive irritability. The depressed mood is accompanied by additional symptoms such as markedly diminished interest or pleasure in activities, reduced concentration and attention or indecisiveness, low self-worth or excessive or inappropriate guilt, hopelessness about the future, disturbed sl
Also known as: Dysthymic disorder | Dysthymia | chronic depressive disorder | chronic depression | depressive personality
Includes: Dysthymia
Excludes: anxiety depression (mild or not persistent)
[KD30.Z] Birth depression, unspecified
Also known as: Birth depression, unspecified | Birth depression
[6A7Y] Other specified depressive disorders
Also known as: Other specified depressive disorders
=== GRAPH WALKS ===
--- Walk 1 ---
[QD3Z] Concern about body appearance, unspecified
--PARENT--> [?] Concern about body appearance
--CHILD--> [QD31] Contact with health services for concerns about body image related to pregnancy
--- Walk 2 ---
[QD3Z] Concern about body appearance, unspecified
--PARENT--> [?] Concern about body appearance
--EXCLUDES--> [?] Body dysmorphic disorder
Def: Body Dysmorphic Disorder is characterised by persistent preoccupation with one or more perceived defects or flaws in appearance that are either unnoticeable or only slightly noticeable to others. Indi...
--- Walk 3 ---
[QA1B] Concern about or fear of medical treatment
--PARENT--> [?] Contact with health services for counselling
--EXCLUDES--> [?] Contact with health services for preconception counselling
Def: A reason for encounter to counsel an individual's queries or complaints regarding conception....
--- Walk 4 ---
[QA1B] Concern about or fear of medical treatment
--PARENT--> [?] Contact with health services for counselling
--CHILD--> [QA12] Contact with health services for drug use counselling or surveillance
--- Walk 5 ---
[QD3Y] Other specified concern about body appearance
--PARENT--> [?] Concern about body appearance
--CHILD--> [QD31] Contact with health services for concerns about body image related to pregnancy
--- Walk 6 ---
[QD3Y] Other specified concern about body appearance
--PARENT--> [?] Concern about body appearance
--CHILD--> [QD30] Concern about breast appearance
|
[
"[QD3Z] Concern about body appearance, unspecified\n --PARENT--> [?] Concern about body appearance\n --CHILD--> [QD31] Contact with health services for concerns about body image related to pregnancy",
"[QD3Z] Concern about body appearance, unspecified\n --PARENT--> [?] Concern about body appearance\n --EXCLUDES--> [?] Body dysmorphic disorder\n Def: Body Dysmorphic Disorder is characterised by persistent preoccupation with one or more perceived defects or flaws in appearance that are either unnoticeable or only slightly noticeable to others. Indi...",
"[QA1B] Concern about or fear of medical treatment\n --PARENT--> [?] Contact with health services for counselling\n --EXCLUDES--> [?] Contact with health services for preconception counselling\n Def: A reason for encounter to counsel an individual's queries or complaints regarding conception....",
"[QA1B] Concern about or fear of medical treatment\n --PARENT--> [?] Contact with health services for counselling\n --CHILD--> [QA12] Contact with health services for drug use counselling or surveillance",
"[QD3Y] Other specified concern about body appearance\n --PARENT--> [?] Concern about body appearance\n --CHILD--> [QD31] Contact with health services for concerns about body image related to pregnancy",
"[QD3Y] Other specified concern about body appearance\n --PARENT--> [?] Concern about body appearance\n --CHILD--> [QD30] Concern about breast appearance"
] |
QD3Z
|
Concern about body appearance, unspecified
|
[
{
"from_icd11": "QD3Z",
"icd10_code": "Z7682",
"icd10_title": "Awaiting organ transplant status"
},
{
"from_icd11": "QD3Z",
"icd10_code": "Z7689",
"icd10_title": "Persons encountering health services in other specified circumstances"
},
{
"from_icd11": "QD3Z",
"icd10_code": "Z76",
"icd10_title": "Persons encountering health services in other circumstances"
},
{
"from_icd11": "QD3Z",
"icd10_code": "Z768",
"icd10_title": "Persons encountering health services in other specified circumstances"
},
{
"from_icd11": "QA1B",
"icd10_code": "Z711",
"icd10_title": "Person with feared health complaint in whom no diagnosis is made"
},
{
"from_icd11": "QA1B",
"icd10_code": "Z71",
"icd10_title": "Persons encountering health services for other counseling and medical advice, not elsewhere classified"
},
{
"from_icd11": "PL00",
"icd10_code": "Y40",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y400",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y401",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y402",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y403",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y404",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y405",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y406",
"icd10_title": ""
},
{
"from_icd11": "PL00",
"icd10_code": "Y407",
"icd10_title": ""
}
] |
Z7682
|
Awaiting organ transplant status
|
An 82-year-old Caucasian man was admitted to a regional tertiary hospital for low mood and behavioral change for 2 weeks, as well as reduced appetite, malnutrition and weight loss. His past medical history was unremarkable other than chronic lower urinary tract symptoms, and he was not taking any regular medications. He is a retired engineer who is independent with his activities of daily living. He is also the main caregiver for his daughter who has been diagnosed with brain cancer. His wife passed away a year ago. He does not have significant alcohol use and does not use recreational drugs. He has a distant smoking history, last smoked 50 years ago. On admission his blood pressure was 108/70 mmHg. His heart rate was 70 beats per minute. His oxygen saturation was 98% on room air. His respiratory rate was 19 breaths per minute. He was afebrile at 36.3 °C. He was oriented to time and place, and performed serial sevens calculations without difficulty. Speech was slow and affect was flat. Cardiovascular examination was normal with dual heart sounds, no murmur and no clinical evidence of heart failure. Respiratory and abdominal examination was normal. Cranial nerve examination was unremarkable. Neurological examination of upper limbs and lowers limbs was unremarkable, with normal tone, power, coordination, sensation and reflexes. A dental examination was not performed. Blood tests showed a normal white cell count (WCC) 6.2 × 10 9 /L (reference range: 4–11 × 10 9 /L) and C-reactive protein (CRP) < 2.9 mg/L (< 2.9 mg/L). Figure 1 shows his electrocardiogram at admission. Importantly, there was no atrioventricular (AV) block. Magnetic resonance imaging of his brain showed small old lacunar infarct in left lentiform nucleus, which would not explain his presentation. He was reviewed by the psychiatry team, who diagnosed severe psychotic depression and commenced the patient on citalopram and risperidone. On day 9 of his hospital stay, he developed acute urinary retention, requiring indwelling urinary catheter placement. A renal tract ultrasound revealed moderate prostatomegaly. He remained in hospital for management of his severe malnutrition and monitoring for re-feeding syndrome. He had two episodes of presumed catheter associated urinary tract infection with growth of Enterococcus faecalis and Escherichia coli , and received courses of oral amoxicillin 500 mg TDS and oral trimethoprim 300 mg daily respectively. On day 34, a febrile episode prompted blood cultures. He had no localizing symptoms. On examination there were no heart murmurs, peripheral stigmata of infective endocarditis, or signs of heart failure. After 25 hours, both aerobic and anaerobic blood culture bottles flagged with gram-positive cocci in clusters resembling Staphylococci, which were eventually identified by mass spectrometry as Aerococcus urinae. Susceptibility testing was performed using Etest with breakpoints as described by Clinical and Laboratory Standards Institute (CLSI) criteria. The penicillin and ceftriaxone MICs were 0.064 µg/mL and 0.50 µg/mL respectively (both susceptible). Urine culture was sterile. A repeat WCC was 5.5 × 10 9 /L (4–11 × 10 9 /L) while CRP increased to 73 mg/L (< 2.9 mg/L). See Table 1 . Hepatitis B surface antigen,hepatitis C antibody, and Human Immunodeficiency Virus (HIV) antigen/antibody was not detected. Treponema pallidum Immunoglobulin G (Ig) was non-reactive. The patient was commenced on intravenous ceftriaxone 1 g twice a day. A summary of the antibiotics administered is shown in Fig. 2 . He remained bacteraemic after 6 days so a transthoracic echocardiogram was performed which showed a bicuspid aortic valve and mobile densities on both mitral and aortic valves as well as aorto-mitral curtain thickening. A transesophageal echocardiogram (TOE) subsequently showed a cavity (1.6 cm × 0.9 cm) at the aorto-mitral curtain, consistent with an abscess . The patient proceeded to have an aortic valve replacement and patch repair of the left coronary sinus, which had been destroyed by the abscess. Operative specimens were sterile however the operation had been delayed due to the patient’s initial reluctance to proceed with surgery and he had received antibiotics for over 2 weeks by the time surgery was performed. He received a total of 6 weeks of ceftriaxone, and was transferred to a subacute rehabilitation centre for re-conditioning. Fig. 1 Electrocardiogram at admission Table 1: Investigation results At admission Day 34 of hospital admission Normal range Haemoglobin (g/L) 157 128 130–180 White cell count (× 10 9 /L) 6.2 6.9 4–11 Neutrophils (× 10 9 /L) 4.2 5.2 2–8 Lymphocytes (× 10 9 /L) 1.4 1.1 14 Monocytes (× 10 9 /L) 0.5 0.4 < 1.1 Eosinophils (× 10 9 /L) < 0.1 < 0.1 < 0.6 Basophils (× 10 9 /L) < 0.1 < 0.1 < 0.3 Platelets (× 10 9 /L) 227 257 150–450 Sodium (mmol/L) 139 132 135–145 Potassium (mmol/L) 4.2 4.5 3.5–5.2 Chloride (mmol/L) 103 94 95–110 Bicarbonate (mmol/L) 29 29 22–32 Anion gap (mmol/L) 11 14 9–19 Urea (mmol/L) 7.7 6.8 3.5–11 Creatinine (µM/L) 95 80 60–110 eGFR (mL/min) 64 79 > 59 Adjusted calcium (mmol/L) 2.16 2.12 2.15–2.55 Magnesium (mmol/L) 0.86 0.76 0.7–1.1 Phosphate (mmol/L) 1.14 0.81 0.75–1.5 Total protein (g/L) 65 51 60–80 Albumin (g/L) 38 23 35–50 Globulin (g/L) 27 28 23–39 ALP (U/L) 42 60 40–140 Bilirubin (micromole/L) 17 6 < 25 GGT (U/L) 18 49 < 51 AST (U/L) 19 24 < 41 ALT (U/L) 21 35 < 51 CRP (mg/L) < 2.9 73.4 < 2.9 TSH (mIU/L) 1.98 0.50–5.00 Hb Haemoglobin, WCC White cell count, eGFR estimated glomerular filtration rate, ALP alkaline phosphatase, GGT gamma-glutamyl transferase, AST aspartate aminotransferase, ALT alanine transaminase, CRP C-Reactive protein, TSH Thyroid-stimulating hormone, mmol/L millimole per litre, micromol/L micromole per litre, g/L gram per litre, L Litre, mg/L milligram per litre, U/L Units per Litre, ml/min millilitre per minute, mIU/L milliunits per litre Fig. 2 Summary of antibiotics given during this hospital admission Fig. 3 Transesophageal echocardiogram demonstrating aortic root abscess
| 3.791016
| 0.981934
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC9670598
|
https://doi.org/10.1186/s13256-022-03564-8
|
[
"mmol",
"litre",
"heart",
"urinary",
"blood",
"which",
"aortic",
"unremarkable",
"tract",
"minute"
] |
[
{
"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": "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": "GB6Z",
"title": "Kidney failure, unspecified"
},
{
"code": "GC04.Z",
"title": "Fistula of the genitourinary tract, unspecified"
}
] |
=== 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
[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
[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
=== 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--> [GB42.1] 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 3 ---
[GB42.0] Albuminuria, Grade A2
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Proteinuria
Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...
--- Walk 4 ---
[GB42.0] Albuminuria, Grade A2
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Proteinuria
Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...
--- Walk 5 ---
[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....
--- Walk 6 ---
[MA18.0Y] Other specified elevated blood glucose level
--PARENT--> [MA18.0] Elevated blood glucose level
--EXCLUDES--> [?] Syndrome of infant of mother with gestational diabetes
Def: Describes the range of effects on the infant born to a woman with gestational diabetes (onset or first recognition of carbohydrate intolerance of variable severity in pregnancy). Common neonatal effec...
|
[
"[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--> [GB42.1] 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 --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...",
"[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Proteinuria\n Def: Excessive serum proteins in the urine, such as in renal disease when albumin is the main protein, but also may be due to other proteins such as immunoglobulin light chains in plasma cell dyscrasia suc...",
"[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....",
"[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Syndrome of infant of mother with gestational diabetes\n Def: Describes the range of effects on the infant born to a woman with gestational diabetes (onset or first recognition of carbohydrate intolerance of variable severity in pregnancy). Common neonatal effec..."
] |
GB42.1
|
Albuminuria, Grade A3
|
[
{
"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
|
The case is about a 39-year-old female, without any relevant medical background; which started 29 days prior to her admission, with insidious and progressive generalized myalgias and arthralgias; followed by non-productive, intermittent cough; to which dyspnea on small efforts was added, associated with intermittent febrile peaks. The diagnosis of COVID-19 pneumonia was confirmed, and for this reason, she was admitted to another hospital, 19 days prior to her admission to our hospital; where she presented a torpid evolution and a need for oxygen therapy with progressive requirements, starting invasive mechanical ventilation 6 days prior to our hospital admission. Also, computed tomography was realized, showing interstitial pneumonia with a ground glass pattern. However, during this hospitalization, she continued with hypoxemia refractory to changes in position and FiO 2 at 100%; because of this, she was referred to our hospital to start with ECMO therapy. Once the patient arrived at our hospital, it was determined that it met the criteria for ECMO support, which according to the ELSO criteria , was the presence of hypoxemic respiratory failure (with a PaO 2 /FiO 2 < 80 mmHg) after optimal medical management, including, in the absence of contraindications, a trial of prone positioning. At her arrival, some of the parametric measurements were a height of 1.87 m, a weight of 86 kg, body weight index of 24.6 kg/m 2 ; also, the vital signs were a heart rate of 67 bpm, respiratory rate of 34 rpm, arterial blood pressure of 113/78 mmHg and a temperature of 36 °C. Analgesia and sedation were optimized once the patient was established in the Intensive Care Unit (ICU) of our hospital. Also, protocol laboratories such as blood cultures were taken, initiating prophylactic antibiotic therapy with Meropenem 2 g every 8 h, linezolid 600 mg every 12 h and Voriconazole 300 mg every 12 h. Once admitted to the ICU, the ventilator was adjusted to the modality of Bilevel, with a respiratory rate of 14 rpm, PEEP high of 20 cmH 2 O, and PEEP low of 10 cmH 2 O. The initial venous gases with these ventilator parameters were a pH of 7.51, pCO 2 49, bicarbonate 39.1, Lactate 1.9, and oxygen saturation of 89%; and no arterial gases were taken. Hours after her arrival at the hospital, the patient was cannulated to ECMO, with a V-V ECMO type; and a cannulation strategy of one femoral cannula that led to the superior vena cava and one jugular cannula that led to the right atrium; because this strategy was used for oxygenation support (as no ventricular support was needed). Once the ECMO therapy started, 3 days later, elective extubation was realized and high flux cannulas were installed with a flux of 60 L/min and FiO 2 of 50%, with a peripheral oxygen saturation of 95%. Although, on the fifth day of hospitalization, the patient started with a sudden polyuria of 7 L in 24 h and serum sodium (Na) of 145 mmol/L (normal values of 135–145 mmol/L). Because of this, volume repositions of 50% of the milliliters lost in diuresis per hour was made with the Hartmann solution. As the amount of urinary volume continued to increase up to 17 L in 24 h, the levels of urinary osmolarity and sodium were measured, reporting an osmolarity of 215 mOsm/Kg and a urinary sodium of 111 mmol/L. Due to these results, treatment with intravenous vasopressin was initiated, with 30 IU every 24 h. Despite this, the patient persisted for 3 consecutive days with polyuria of 10 L per day; changing intravenous vasopressin to desmopressin. Later, a brain Computed Tomography (CT) was made, with no evidence of pituitary adenoma or vascular event, making the diagnosis of central diabetes insipidus (CDI). The patient received an intravenous dose of 20 mcg/day of desmopressin; but due to persistent polyuria of 12 L in 24 h, 25 mg of intravenous hydrochlorothiazide every 12 h was added, reducing the desmopressin dose to 8 mcg every 24 h. After 15 days of hospitalization, hydrochlorothiazide was discontinued. On her 18th day of hospitalization, polyuria recurred, showing serum Na of 145 mmol/L, urinary Na of 129 mmol/L, and urinary osmolarity of 340 mOsm/kg. Oral indomethacin was started at a dose of 75 mg/day, with a progressive increase in dosage up to 125 mg, continuing this dosage for 12 days in which urinary volumes decreased to 4.5 L/day and IV desmopressin dose to 3 mcg/day, which later was decided to switch to inhaled desmopressin. After this, diuresis improved to 2,800 mL/day, serum Na decreased to 141 mEq/L and urinary osmolarity increased to 519 mOsm/kg on the 37th day of hospitalization. Daily applications of inhaled desmopressin were decreased and on the 40th day, diuresis was less than 2.5 L/day, with urinary osmolarity of 516 mOsm/kg. Treatment was continued with ECMO, vasopressor support, and IMV during this time. While this therapeutical adjustment was made, the ECMO had several changes in the way it ran; as hypovolemia caused by polyuria, modified the extraction pressure, causing a flow decrease. Whenever there was significant hypovolemia, which translated into an increase in extraction, it led to the occurrence of chattering in the extraction line, as a collapsing right ventricle moved this line; also the ECMO marked the presence of obstruction (made by the phenomenon of the collapsing right ventricle, previously described). As soon as this was seen, the ECMO flow was decreased by about 50% and repositions of volume were made. Once the volume was replaced IV, the ECMO flow was again increased to previous levels. Later, as the pulmonary condition improved, ECMO was withdrawn after 55 days of extracorporeal support. Physical rehabilitation was continued, and the supplementary oxygen supply was progressively reduced. Finally, she was discharged on her 84th day of hospitalization, requiring supplementary oxygen through nasal prongs at 2 L per minute. For a summary of diuresis volume per day, urinary osmolarity per day, and desmopressin doses per day, please refer to Graphs 1–3 respectively .
| 3.945313
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999998
|
37682212
|
https://doi.org/10.1051/ject/2023021
|
[
"this",
"ecmo",
"urinary",
"desmopressin",
"which",
"hospitalization",
"every",
"osmolarity",
"oxygen",
"support"
] |
[
{
"code": "4A01.03",
"title": "Transient hypogammaglobulinaemia of infancy"
},
{
"code": "PK81.1",
"title": "Extracorporeal life support procedure associated with injury or harm in therapeutic use"
},
{
"code": "QC48.Y",
"title": "Other specified personal history of medical treatment"
},
{
"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": "BD50.41",
"title": "Abdominal aortic aneurysm with rupture"
},
{
"code": "EK91",
"title": "Dermatoses which may presage cutaneous lymphoma"
}
] |
=== 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]
[PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use
Also known as: Extracorporeal life support procedure associated with injury or harm in therapeutic use | ECMO - [extracorporeal membrane oxygenation] | complication during or following extracorporeal life support procedure
Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm
[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
[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
[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 ---
[4A01.03] Transient hypogammaglobulinaemia of infancy
--PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects
Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...
--PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity
--- Walk 2 ---
[4A01.03] Transient hypogammaglobulinaemia of infancy
--PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects
Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...
--CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells
--- Walk 3 ---
[PK81.1] Extracorporeal life support procedure 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 4 ---
[PK81.1] Extracorporeal life support procedure 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
--CHILD--> [?] 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....
--- Walk 5 ---
[QC48.Y] Other specified personal history of medical treatment
--PARENT--> [QC48] Personal history of medical treatment
--CHILD--> [QC48.Z] Personal history of medical treatment, unspecified
--- Walk 6 ---
[QC48.Y] Other specified personal history of medical treatment
--PARENT--> [QC48] Personal history of medical treatment
--CHILD--> [QC48.Y] Other specified personal history of medical treatment
|
[
"[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --PARENT--> [4A01] Primary immunodeficiencies due to disorders of adaptive immunity",
"[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells",
"[PK81.1] Extracorporeal life support procedure 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",
"[PK81.1] Extracorporeal life support procedure 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 --CHILD--> [?] 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....",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.Z] Personal history of medical treatment, unspecified",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.Y] Other specified personal history of medical treatment"
] |
4A01.03
|
Transient hypogammaglobulinaemia of infancy
|
[
{
"from_icd11": "4A01.03",
"icd10_code": "D807",
"icd10_title": "Transient hypogammaglobulinemia of infancy"
},
{
"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": "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": "BD50.41",
"icd10_code": "I713",
"icd10_title": "Abdominal aortic aneurysm, ruptured"
}
] |
D807
|
Transient hypogammaglobulinemia of infancy
|
A Korean male infant with a weight of 2980 g (91st percentile) was born to a 37-year-old woman (gravida 2 and para 2) at 34 + 5 weeks’ gestation via normal spontaneous vaginal delivery. Apgar scores were 8 and 9 at 1 and 5 min after birth, respectively. The mother and other family members had no known allergies and no other particular medical history including the maternal history of diabetes, hypertension, dyslipidemia, and neurologic disease, with the mother’s consumption of a small amount of cow’s milk only as food additives during pregnancy. The pregnancy was not complicated by any abnormalities encompassing maternal fever, gestational diabetes, preeclampsia, premature or prolonged rupture of membranes, and placental abruption. The placental examination was unremarkable. The infant’s general condition was good and oral intake commenced with a total of 60 ml of preterm formula milk. Four hours after initial feeding, three episodes of non-projectile, non-bilious emesis developed with approximately 5 ml milky vomitus on each occasion, followed by hematochezia 5 h later. Table 1 shows the flow of the infant’s laboratory and clinical data. Initial laboratory evaluation demonstrated a mild leukocytosis (white blood cells 11,400/μL) and eosinophilia , raised D-dimer 1718.3 vs. control < 500 ng/mL DDU, and mild conjugated hyperbilirubinemia (total bilirubin 1.5 mg/dL with the direct fraction 40%), with the other following data (hemoglobin 13.0 g/dL, hematocrit 37.7%, platelets 274,000/μL, C-reactive protein 0.04 mg/dL, prothrombin time 13.4 vs. 10.1–12.6 s with the international normalized ratio 1.19 vs. 0.93–1.13, partial thromboplastin time 42.8 vs. 23.6–31.1 s, antithrombin III 43%, and fibrinogen 256 vs. 180–350 mg/dL). Serum total immunoglobulin E (IgE) was 0.1 IU/ml (normal values < 5.0) and specific IgEs to cow’s milk proteins (CMPs) were negative. The Apt test for fresh blood in the stools did not change color and fecal occult blood was positive. A chest-abdomen plain radiograph showed a normal bowel gas pattern without other abnormalities. Oral feeds were discontinued from postnatal day 1. Total parenteral nutrition was instituted on day 2 and maintained until day 9. The stools mixed with macroscopic bleeding more than in the form of spots persisted during the first 3 days of life. From day 5, oral feedings were reintroduced with breast milk without maternal diet modification and/or casein hydrolyzed milk, which were tolerable without reactions including gastrointestinal symptoms and metabolic acidosis. On day 6, abdominal ultrasonography revealed a non-obstructive thrombus within the umbilico-portal confluence of the left portal vein as a hypoechoic tubular structure . On day 19, the peak eosinophil count of 3790/μL was observed with a low serum 25-hydroxyvitamin D 16.1 ng/mL (insufficiency < 30 and deficiency < 10). On day 75, the eosinophil count decreased to 590/μL and a supervised oral challenge to cow’s milk was performed. Feeding intolerance with vomiting and blood-tinged stools was noted and the feeding was changed back to the casein-hydrolyzed formula. At 6 months of age, oral re-challenge to regular cow’s milk feeding was attempted and no reaction was observed. The sonographic signal of the intraluminal thrombus gradually decreased in size and became heterogeneously hyperechoic over time . At 1 year of age of the last follow-up ultrasonography, the thrombus completely resolved. The infant showed good weight gain with well-tolerated formula feeds. Table 1 Laboratory and clinical data of the present case Serum parameters Day 1 Day 6 Day 13 Day 19 Day 33 Day 75 1 year Hemoglobin (g/dL) 13.0 12.5 10.9 11.0 9.5 9.4 12.3 Hematocrit (%) 37.7 35.1 30.6 29.8 26.0 27.5 35.4 White cell count (/μL) 11,400 11,570 13,700 15,800 10,300 7800 9540 Eosinophil fraction (%) 14 16 11 24 15 7 4 Eosinophils (/μL) 1530 1800 1560 3790 1630 590 380 Platelets (/μL) 274,000 292,000 470,000 574,000 485,000 390,000 309,000 C-reactive protein (mg/dL) 0.04 0.4 0.17 – – – – Total bilirubin (mg/dL) 1.5 9.3 4.4 3 1.5 – 0.2 Direct bilirubin (mg/dL) 0.6 1.7 1.6 1.5 0.8 – 0.1 Direct fraction (%) 40 18 36 50 53 – 50 AST (22–71 IU/L) 18 19 18 22 22 – 40 ALT (10–40 IU/L) 4 7 10 10 10 – 20 25(OH) VitD (ng/mL) – – – 16.1 – 20.9 26.4 Sonographic findings of the LPV thrombus – 1.10 × 0.60 cm-sized, hypoechoic 0.80 × 0.30 cm-sized, hypoechoic 0.65 × 0.20 cm-sized, hyperechoic – 0.36 × 0.13 cm-sized, hyperechoic Completely resolved Clinical notes Emesis (on day 1 only) and hematochezia (for 3 days) after MF, thereafter, NPO until day 4 No GI Sx (from day 4) TPN (from day 2 to day 9) BF (from day 5) No GI Sx BF + CHMF (from day 10) No GI Sx BF + CHMF No GI Sx BF + CHMF Emesis and hematochezia after supervised OCMC, thereafter, recommencing CHMF MF + CF since the successful OCMC at 6 months of age AST Aspartate transaminase, ALT Alanine transaminase, 25(OH) VitD 25-Hydroxyvitamin D, LPV Left portal vein, MF Cow’s milk-based formula feeding, NPO Nil per os, TPN Total parenteral nutrition, GI Sx Gastrointestinal symptoms, BF Breast feeding, CHMF Casein hydrolyzed milk feeding, OCMC Oral cow’s milk challenge, CF Complementary feeding Fig. 1 a Longitudinal gray scale sonogram of the left lobe of the liver on postnatal day 6 shows a thrombus (white arrow) within the umbilico-portal confluence of the left portal vein contiguous with the umbilical vein (open arrow) as a 1.10 × 0.60 cm-sized, hypoechoic tubular structure in two dimensions. b Corresponding color Doppler sonogram shows non-obstructive thrombosis (white arrow) with the presence of flow around the thrombus Fig. 2 Longitudinal gray scale sonogram of the left lobe of the liver at the age of 6 months depicts partial resolution of the thrombus (white arrow) within the left portal vein, as the sonographic signal of the intraluminal thrombus decreased in size and became hyperechoic over time, with the adjacent ligamentum teres (open arrow) as a result of the involution of the umbilical vein via fibrotic transformation
| 4.097656
| 0.976074
|
sec[1]/p[0]
|
en
| 0.999996
|
33485314
|
https://doi.org/10.1186/s12887-021-02510-9
|
[
"milk",
"feeding",
"thrombus",
"oral",
"total",
"portal",
"vein",
"white",
"sized",
"chmf"
] |
[
{
"code": "JB46.7",
"title": "Other or unspecified disorders of lactation"
},
{
"code": "5C61.6Z",
"title": "Lactose intolerance, unspecified"
},
{
"code": "KC40.1",
"title": "Neonatal milia"
},
{
"code": "JB41.1",
"title": "Deep phlebothrombosis in the puerperium"
},
{
"code": "JB46.6",
"title": "Galactorrhoea"
},
{
"code": "MG43.3Z",
"title": "Feeding difficulties, unspecified"
},
{
"code": "MG43.32",
"title": "Feeding problem of adult"
},
{
"code": "MG43.31",
"title": "Feeding problem of child"
},
{
"code": "6B8Z",
"title": "Feeding or eating disorders, unspecified"
},
{
"code": "MG43.30",
"title": "Feeding problem of infant"
}
] |
=== ICD-11 CODES FOUND ===
[JB46.7] Other or unspecified disorders of lactation
Also known as: Other or unspecified disorders of lactation | unspecified disorder of lactation, unspecified as to episode of care | puerperal lactation disorder | Other or unspecified disorders of lactation, without mention of attachment difficulty | Other or unspecified disorders of lactation, with mention of attachment difficulty
[5C61.6Z] Lactose intolerance, unspecified
Also known as: Lactose intolerance, unspecified | Lactose intolerance | Lactose malabsorption | Cow milk enteropathy | intolerance or malabsorption of lactose
[KC40.1] Neonatal milia
Also known as: Neonatal milia | Milk spots
[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
[JB46.6] Galactorrhoea
Definition: Excessive or inappropriate lactation in females or males, and not necessarily related to pregnancy. Galactorrhoea can occur either unilaterally or bilaterally, and be profuse or sparse. Its most common cause is hyperprolactinemia.
Also known as: Galactorrhoea | galactorrhoea associated with childbirth | galactorrhoea in pregnancy and the puerperium | increased postpartum lactation | persistent secretion of milk associated with childbirth
Includes: Oversupply of milk
Excludes: Galactorrhoea not associated with childbirth
[MG43.3Z] Feeding difficulties, unspecified
Also known as: Feeding difficulties, unspecified | Feeding difficulties | difficult feeding | faulty feeding | Feeding difficulties and mismanagement
[MG43.32] Feeding problem of adult
Also known as: Feeding problem of adult
Excludes: Anorexia Nervosa | Bulimia Nervosa | Binge eating disorder
[MG43.31] Feeding problem of child
Also known as: Feeding problem of child
Excludes: Feeding or eating disorders | Anorexia Nervosa | Avoidant-restrictive food intake disorder
[6B8Z] Feeding or eating disorders, unspecified
Also known as: Feeding or eating disorders, unspecified | Eating disorder, not elsewhere classified | eating disorder NOS
[MG43.30] Feeding problem of infant
Also known as: Feeding problem of infant
Excludes: Feeding problems of newborn | Avoidant-restrictive food intake disorder
=== GRAPH WALKS ===
--- Walk 1 ---
[JB46.7] Other or unspecified disorders of lactation
--PARENT--> [JB46] Certain specified disorders of breast or lactation associated with childbirth
--CHILD--> [JB46.1] Cracked nipple associated with childbirth
--- Walk 2 ---
[JB46.7] Other or unspecified disorders of lactation
--PARENT--> [JB46] Certain specified disorders of breast or lactation associated with childbirth
--CHILD--> [JB46.1] Cracked nipple associated with childbirth
--- Walk 3 ---
[5C61.6Z] Lactose intolerance, unspecified
--PARENT--> [5C61.6] Lactose intolerance
Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...
--PARENT--> [5C61] Disorders of carbohydrate absorption or transport
--- Walk 4 ---
[5C61.6Z] Lactose intolerance, unspecified
--PARENT--> [5C61.6] Lactose intolerance
Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...
--CHILD--> [5C61.61] Congenital lactase deficiency
Def: This is a congenital deficiency of lactase (EC 3.2.1.108), inherited as an autosomal recessive trait, presenting in infancy and manifested by profuse watery diarrhoea in response to dietary milk, due ...
--- Walk 5 ---
[KC40.1] Neonatal milia
--PARENT--> [KC40] Miscellaneous skin disorders in the neonate
--RELATED_TO--> [?] Neonatal miliaria
--- Walk 6 ---
[KC40.1] Neonatal milia
--PARENT--> [KC40] Miscellaneous skin disorders in the neonate
--CHILD--> [KC40.Y] Other specified skin disorders in the neonate
|
[
"[JB46.7] Other or unspecified disorders of lactation\n --PARENT--> [JB46] Certain specified disorders of breast or lactation associated with childbirth\n --CHILD--> [JB46.1] Cracked nipple associated with childbirth",
"[JB46.7] Other or unspecified disorders of lactation\n --PARENT--> [JB46] Certain specified disorders of breast or lactation associated with childbirth\n --CHILD--> [JB46.1] Cracked nipple associated with childbirth",
"[5C61.6Z] Lactose intolerance, unspecified\n --PARENT--> [5C61.6] Lactose intolerance\n Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...\n --PARENT--> [5C61] Disorders of carbohydrate absorption or transport",
"[5C61.6Z] Lactose intolerance, unspecified\n --PARENT--> [5C61.6] Lactose intolerance\n Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...\n --CHILD--> [5C61.61] Congenital lactase deficiency\n Def: This is a congenital deficiency of lactase (EC 3.2.1.108), inherited as an autosomal recessive trait, presenting in infancy and manifested by profuse watery diarrhoea in response to dietary milk, due ...",
"[KC40.1] Neonatal milia\n --PARENT--> [KC40] Miscellaneous skin disorders in the neonate\n --RELATED_TO--> [?] Neonatal miliaria",
"[KC40.1] Neonatal milia\n --PARENT--> [KC40] Miscellaneous skin disorders in the neonate\n --CHILD--> [KC40.Y] Other specified skin disorders in the neonate"
] |
JB46.7
|
Other or unspecified disorders of lactation
|
[
{
"from_icd11": "JB46.7",
"icd10_code": "O9279",
"icd10_title": "Other disorders of lactation"
},
{
"from_icd11": "JB46.7",
"icd10_code": "O927",
"icd10_title": "Other and unspecified disorders of lactation"
},
{
"from_icd11": "JB46.7",
"icd10_code": "O9270",
"icd10_title": "Unspecified disorders of lactation"
},
{
"from_icd11": "5C61.6Z",
"icd10_code": "E739",
"icd10_title": "Lactose intolerance, unspecified"
},
{
"from_icd11": "5C61.6Z",
"icd10_code": "E738",
"icd10_title": "Other lactose intolerance"
},
{
"from_icd11": "5C61.6Z",
"icd10_code": "E73",
"icd10_title": "Lactose intolerance"
},
{
"from_icd11": "JB41.1",
"icd10_code": "O871",
"icd10_title": "Deep phlebothrombosis in the puerperium"
},
{
"from_icd11": "JB46.6",
"icd10_code": "O926",
"icd10_title": "Galactorrhea"
},
{
"from_icd11": "MG43.3Z",
"icd10_code": "R633",
"icd10_title": "Feeding difficulties"
},
{
"from_icd11": "6B8Z",
"icd10_code": "F5082",
"icd10_title": "Avoidant/restrictive food intake disorder"
},
{
"from_icd11": "6B8Z",
"icd10_code": "F5089",
"icd10_title": "Other specified eating disorder"
},
{
"from_icd11": "6B8Z",
"icd10_code": "F5081",
"icd10_title": "Binge eating disorder"
},
{
"from_icd11": "6B8Z",
"icd10_code": "F9829",
"icd10_title": "Other feeding disorders of infancy and early childhood"
},
{
"from_icd11": "6B8Z",
"icd10_code": "F9821",
"icd10_title": "Rumination disorder of infancy"
},
{
"from_icd11": "6B8Z",
"icd10_code": "F508",
"icd10_title": "Other eating disorders"
}
] |
O9279
|
Other disorders of lactation
|
Our patient is an Italian female neonate, the first child of nonconsanguineous healthy parents, born at 35 weeks of gestation by elective cesarean section for preterm premature rupture of membranes and breech presentation. Except for an underweighting mother (BMI 16.5), the pregnancy was otherwise uneventful. The Apgar scores were 8 and 9 at 1 and 5 min, respectively. Her birth weight was 2755 g (89th centile), length 47 cm (84th centile) and occipitofrontal circumference (OFC) 33 cm (84th centile). She was transferred at 12 h of life for prematurity and persistent hypoglycemia not responsive to enteral feeding to our Neonatal Intensive Care Unit (UTIN). On physical examination, she showed mild dysmorphic facial features that became highly suggestive of a syndromic condition at around 15 days of life: long palpebral fissures, arched eyebrows with sparse outer lateral half, anteverted nares, short columella with depressed nasal tip, and thin vermillion of the upper lip. Other findings were high-arched palate, retrognathia, short neck, brachydactyly, joint hypermobility, right hand single palmar crease, and sacral dimple. At admission neurologic examination revealed generalized hypotonia of central origin, weak cry, reduced reactivity with impairment of sucking and swallowing. Thus, a nasogastric tube was inserted for feeding. Severe hypoglycemia was confirmed (29 mg/dL; equivalent to 1.6 mmol/L), and 200 mg/kg intravenous bolus of 10% dextrose, followed by continuous infusion (8 mg/kg/min) was given. Persistent hypoglycemia (< 40 mg/dL) was not responsive to intravenous 10% dextrose infusion up to 20 mg/kg/min and concomitant milk feeding, providing an adequate caloric intake. Plasmatic adrenocorticotropic hormone (ACTH), cortisol, basal insulin, C peptide, Growth hormone (GH) were normal, urine ketones were absent and free fatty acids were low. Thus, on day 15, a glucagon stimulation test was performed. After basal glycemia (32 mg/dL) was measured (T0), intramuscular Glucagon (0.5 mg IM) was administered causing an increase in glycemic values at T15 (75 mg/dL), and T30 (89 mg/dL), thus, confirming the clinical suspicion of hyperinsulinism. Then, treatment with oral diazoxide was started with 7 mg/kg divided in 3 daily doses, and on day 19, increased to 10 mg/kg/day. After 6 doses glycemic values over the suggested cut-off point (63 mg/dL), were finally achieved . Neonatal screening revealed a congenital hypothyroidism, confirmed on day 5 (TSH 28.7 mIU/L, fT4 0.86 ng/L, fT3 2.39 ng/L), treated with levothyroxine 10 μg/kg/day. Thyroid US was normal. Transitory hypocalcemia, with normal parathyroid hormone values (26.1 ng/L), was responsive to slow bolus infusion of 10% calcium gluconate and subsequent oral therapy lasting one week. Cardiac ultrasound assessment revealed an interventricular septum defect, restrictive during hospital stay, and accessory chordae tendineae without hemodynamic alterations (neither mitral regurgitation, nor left ventricle outflow obstruction). Ophthalmological examination and evoked otoacoustic emissions screening were normal. Brain ultrasonography (US) performed on day 15, showed hypoplasia of the cerebellar vermis with enlarged fourth ventricle and cisterna magna . Since facial dysmorphic features were highly suggestive of Kabuki syndrome, whole-exome sequence analysis was carried out in the proband and her parents. In the patient a novel heterozygous acceptor splicing-site mutation c.674-1G > A in KMT2D gene was identified. The pathogenetic variant of disease associated gene in the patient was confirmed by Sanger sequencing. The father was carrying a heterozygous mutation c.1441C > T (p.Arg481Ter) in pantothenate kinase 2 ( PANK2 ) (Hallervorden-Spatz syndrome), transmitted to the daughter. Sanger sequencing did not reveal alterations of PANK2 gene in the mother. Since the latter is a recessive disorder and not related to the clinical profile, no further genetic investigation was considered in the patient. On request of the mother, in relation to family logistical difficulties of managing the child at home due to lockdown restriction for COVID-19, they remained in our hospice until the child was 3 months CrA (1 months and 25 days CA). A brain MR at 1 months and 24 days CA confirmed the hypoplasia of cerebellar vermis . At the last follow up evaluation at 4.5 months CrA (3 months and 10 days CA) she was bottle fed with formula milk, and maintained adequate glycemic values with 8 mg/kg/day of diazoxide. Levothyroxine treatment has been effective to normalize plasmatic TSH and fT4 values. Nevertheless, she showed a postnatal growth failure involving weight 4270 g (− 2.78 SD), and OFC 37 cm (− 2.33 SD), with relative sparing of length equal to 60 cm (38th centile; − 0.3 SD). In front of a further reduction of length centile, IGF-1 and GH assessments have been scheduled. Her global development is slightly delayed, with persistent mild generalized hypotonia causing in prone position inability to extend in the thorax area, delayed achievement of social smile (3 months CA) and absence of reciprocal vocalization. A home monitoring program of glycemic values, diazoxide dosage and alimentary regimen has been started with her parents and the reference pediatrician, obtaining adequate glycemic control. She has been enrolled in a neurodevelopmental multidisciplinary follow-up program. Fig. 1 Brain ultrasound. a . Axial view through the mastoid fontanel: enlarged fourth ventricle (black arrow). b . Sagittal view through the anterior fontanel: cerebellar vermis hypoplasia with secondary enlarged of the fourth ventricle (black arrow) and enlarged cisterna magna (white arrow) Fig. 2 Dysmorphic facial features suggestive of Kabuki syndrome Fig. 3 T2 weighted FSE Brain Magnetic Resonance Imaging. a . Sagittal scan: enlarged fourth ventricle (black arrow), and cisterna magna with inferior vermian hypoplasia (white arrow). b . Coronal scan: Enlarged vallecula cerebelli and hypoplasia of the cerebellar hemispheres (black arrow)
| 4.085938
| 0.972168
|
sec[1]/p[1]
|
en
| 0.999997
|
32948218
|
https://doi.org/10.1186/s13052-020-00902-8
|
[
"enlarged",
"arrow",
"centile",
"glycemic",
"ventricle",
"hypoplasia",
"brain",
"cerebellar",
"fourth",
"black"
] |
[
{
"code": "ME10.00",
"title": "Hepatomegaly, not elsewhere classified"
},
{
"code": "GA16.Y",
"title": "Other specified acquired abnormalities of uterus, except cervix"
},
{
"code": "ME10.01",
"title": "Splenomegaly, not elsewhere classified"
},
{
"code": "DA03.Y",
"title": "Other specified diseases of tongue"
},
{
"code": "LA11.1",
"title": "Structural developmental anomalies of cornea"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[ME10.00] Hepatomegaly, not elsewhere classified
Also known as: Hepatomegaly, not elsewhere classified | enlarged liver | enlargement of liver | Hepatomegaly NOS | acute hepatomegaly
[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
[ME10.01] Splenomegaly, not elsewhere classified
Definition: This refers to swelling of the spleen beyond its normal size, not elsewhere described.
Also known as: Splenomegaly, not elsewhere classified | splenomegalia | Splenomegaly NOS | spleen palpable | enlarged spleen NOS
Excludes: Hypersplenism
[DA03.Y] Other specified diseases of tongue
Also known as: Other specified diseases of tongue | Crenated tongue | Glossoplegia | Hemiatrophy of tongue | Thickening of tongue
[LA11.1] Structural developmental anomalies of cornea
Definition: Any condition caused by failure of the cornea to correctly develop during the antenatal period.
Also known as: Structural developmental anomalies of cornea | Malformations of cornea | Cornea plana | Flat cornea | Cornea plana, unilateral
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[ME10.00] Hepatomegaly, not elsewhere classified
--PARENT--> [ME10.0] Hepatomegaly or splenomegaly
Def: Hepatomegaly is swelling of the liver beyond its normal size and splenomegaly is an enlargement of the spleen beyond its normal size....
--PARENT--> [ME10] Abnormalities related to hepatobiliary system
--- Walk 2 ---
[ME10.00] Hepatomegaly, not elsewhere classified
--PARENT--> [ME10.0] Hepatomegaly or splenomegaly
Def: Hepatomegaly is swelling of the liver beyond its normal size and splenomegaly is an enlargement of the spleen beyond its normal size....
--CHILD--> [ME10.01] Splenomegaly, not elsewhere classified
Def: This refers to swelling of the spleen beyond its normal size, not elsewhere described....
--- Walk 3 ---
[GA16.Y] Other specified acquired abnormalities of uterus, except cervix
--PARENT--> [GA16] Acquired abnormalities of uterus, except cervix
Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....
--RELATED_TO--> [?] Leiomyoma of uterus
Def: A well-circumscribed benign smooth muscle neoplasm of uterus characterised by the presence of spindle cells with cigar-shaped nuclei, interlacing fascicles, and a whorled pattern....
--- Walk 4 ---
[GA16.Y] Other specified acquired abnormalities of uterus, except cervix
--PARENT--> [GA16] Acquired abnormalities of uterus, except cervix
Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....
--RELATED_TO--> [?] Caesarean scar defect of uterus
Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar...
--- Walk 5 ---
[ME10.01] Splenomegaly, not elsewhere classified
Def: This refers to swelling of the spleen beyond its normal size, not elsewhere described....
--EXCLUDES--> [?] Hypersplenism
Def: A disease caused by determinants such as cirrhosis, malaria, tuberculosis or inflammatory disorders leading overactive spleen function. This disease is characterised by the presence of an enlarged spl...
--PARENT--> [?] Acquired disorders of spleen
Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....
--- Walk 6 ---
[ME10.01] Splenomegaly, not elsewhere classified
Def: This refers to swelling of the spleen beyond its normal size, not elsewhere described....
--EXCLUDES--> [?] Hypersplenism
Def: A disease caused by determinants such as cirrhosis, malaria, tuberculosis or inflammatory disorders leading overactive spleen function. This disease is characterised by the presence of an enlarged spl...
--CHILD--> [?] Splenic primary panhaematopenia
|
[
"[ME10.00] Hepatomegaly, not elsewhere classified\n --PARENT--> [ME10.0] Hepatomegaly or splenomegaly\n Def: Hepatomegaly is swelling of the liver beyond its normal size and splenomegaly is an enlargement of the spleen beyond its normal size....\n --PARENT--> [ME10] Abnormalities related to hepatobiliary system",
"[ME10.00] Hepatomegaly, not elsewhere classified\n --PARENT--> [ME10.0] Hepatomegaly or splenomegaly\n Def: Hepatomegaly is swelling of the liver beyond its normal size and splenomegaly is an enlargement of the spleen beyond its normal size....\n --CHILD--> [ME10.01] Splenomegaly, not elsewhere classified\n Def: This refers to swelling of the spleen beyond its normal size, not elsewhere described....",
"[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --RELATED_TO--> [?] Leiomyoma of uterus\n Def: A well-circumscribed benign smooth muscle neoplasm of uterus characterised by the presence of spindle cells with cigar-shaped nuclei, interlacing fascicles, and a whorled pattern....",
"[GA16.Y] Other specified acquired abnormalities of uterus, except cervix\n --PARENT--> [GA16] Acquired abnormalities of uterus, except cervix\n Def: Any condition of the uterus, caused by determinants arising after birth. These conditions are characterised by a malfunction, malformation, or another anomaly of the uterus (excluding the cervix)....\n --RELATED_TO--> [?] Caesarean scar defect of uterus\n Def: Caesarean scar defect of uterus is the formation of a pouch or indentation at the site of a previous caesarean incision with a depth of at least 2mm. When symptoms are associated with a Caesarean scar...",
"[ME10.01] Splenomegaly, not elsewhere classified\n Def: This refers to swelling of the spleen beyond its normal size, not elsewhere described....\n --EXCLUDES--> [?] Hypersplenism\n Def: A disease caused by determinants such as cirrhosis, malaria, tuberculosis or inflammatory disorders leading overactive spleen function. This disease is characterised by the presence of an enlarged spl...\n --PARENT--> [?] Acquired disorders of spleen\n Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....",
"[ME10.01] Splenomegaly, not elsewhere classified\n Def: This refers to swelling of the spleen beyond its normal size, not elsewhere described....\n --EXCLUDES--> [?] Hypersplenism\n Def: A disease caused by determinants such as cirrhosis, malaria, tuberculosis or inflammatory disorders leading overactive spleen function. This disease is characterised by the presence of an enlarged spl...\n --CHILD--> [?] Splenic primary panhaematopenia"
] |
ME10.00
|
Hepatomegaly, not elsewhere classified
|
[
{
"from_icd11": "ME10.00",
"icd10_code": "R160",
"icd10_title": "Hepatomegaly, not elsewhere classified"
},
{
"from_icd11": "ME10.01",
"icd10_code": "R161",
"icd10_title": "Splenomegaly, not elsewhere classified"
},
{
"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"
}
] |
R160
|
Hepatomegaly, not elsewhere classified
|
We have considered differences to include: 3.2.1 Fluctuating DMC . This is more significant for mental health ADM due to the cyclical nature of illness and concomitant capacity loss in conditions such as bipolar and psychosis. Repeated episodes of mental state change and treatment provide opportunities to learn what treatment may be wanted in future episodes. This learning may naturally lead to advance treatment and care requests. 3.2.2 Anticipating marked changes in expressed will and preferences about treatment and care . Again, this is more significant in mental health ADM than physical health ADM and is related to the phenomenon of loss of awareness of mental illness. Consider a person with bipolar who also has a cardiac problem. The person transitions into a manic episode. The loss of awareness is (typically) centred on being manic, rather than on having a cardiac problem. The effect is that the person, when well, has to anticipate themselves making more objection to mental health treatment than to physical health treatment during the period where DMC to decide treatment is lost. This means that the idea of “self-binding” over one's future objection is more relevant in mental health ADM than physical health ADM. 3.2.3 Life sustaining ADRT . It would be very difficult to get an ethical or policy consensus on enabling people to die of mental illness through advance decisions to refuse mental health treatment. The Wooltorton case is illustrative of this dilemma. Kerrie Wooltorton was a 26 year old woman known to mental health services with an emotionally unstable (or borderline) personality disorder and a history of self-harm with compulsory treatment under the MHA. She sought to take her life in 2007 by swallowing antifreeze, and although she had herself called an ambulance and had allowed herself to be taken to hospital, she refused the medical treatment which would have saved her life. Her written statement on arrival at hospital read: To whom this may concern, if I come into hospital regarding taking an overdose or any attempt on my life, I would like for NO lifesaving treatment to be given. I would appreciate if you could continue to give medicines to help relieve my discomfort, painkillers, oxygen, etc. I would hope these wishes will be carried out without loads of questioning. Please be assured that I am 100% aware of the consequences of this and the probable outcome of drinking anti-freeze, e.g. death in 95–99% of cases and if I survive then kidney failure, I understand and accept them and will take 100% responsibility for this decision. I am aware that you may think that because I call the ambulance I therefore want treatment. THIS IS NOT THE CASE! I do however want to be comfortable as nobody want to die alone and scared and without going into details there are loads of reasons I do not want to die at home which I will realise that you will not understand and I apologise for this. Please understand that I definitely don't want any form of ventilation, resuscitation or dialysis, these are my wishes, please respect and carry them out. She was considered to have capacity to refuse treatment under the MCA and died in hospital. The coroner made no criticisms of the actions of the medical staff and regarded them as consistent with the MCA although he did not consider the possibility that the medical treatment was for mental disorder and whether the MHA should have been used to treat without consent under S.63. Although on the facts this was not an ADRT case because she was assessed to have capacity to refuse on presentation, with small clinical and administrative variations, it could have been. The case generated intense debate and was raised as an early day motion in the UK House of Commons which criticised the Mental Capacity Act and called for amendments to prevent future cases . 3.2.4 Third party harm ADRT . Mental health ADRT resulting in third party harms is likely to raise different public interests than physical health ADRT because of the possibility of a direct relationship between mental illness and third-party harms. For example, if a person were to make ADRT for all antipsychotic treatment and then to become violent whilst psychotic this would raise distinctive public interests . The Starson v. Swayze, 1 S.C.R. 722 [Starson] case is illustrative of this dilemma. The case involved Scott Jeffery Starson a man with paranoid schizophrenia who by 2005 had been continuously detained in Ontario psychiatric hospitals for nearly seven years without treatment on the basis that his death threats to others made it impossible for him to be discharged but his capacity to refuse treatment made him untreatable. Starson's psychiatrists believed that he was not capable and wanted to treat him with the standard antipsychotic medications. Legal clarification of his capacity to refuse took 5 years and in 2003, a majority of the Supreme Court of Canada upheld Starson's position that he had been capable to refuse the proposed treatment in 1998 and to make an advance refusal of antipsychotic treatment. Starson's mental health deteriorated particularly after 2003 developing paranoid delusions that if he ate or drank too much his imaginary son would be tortured. Starson's weight fell to 118 pounds and he became dehydrated to the point that he was at imminent risk of kidney failure and death. He was eventually treated on the basis that his capacity was likely to have changed since the Supreme Court ruling and because his mother, who was considered his proxy, wished for it. This individual case shows: a) the unintended consequences of separating the criteria for admission (risk to others) from treatment (incapacity and best interests), b) the controversy of allowing a very mentally ill person to die because of their refusal of treatment for mental illness (see also 3.2.3 above) and c) the importance of consistent statutory positions about harm to others due to mental illness as a ground for compulsory mental health inpatient treatment
| 4.054688
| 0.404541
|
sec[2]/sec[1]/p[0]
|
en
| 0.999997
|
31122626
|
https://doi.org/10.1016/j.ijlp.2019.02.002
|
[
"mental",
"this",
"that",
"capacity",
"starson",
"illness",
"adrt",
"refuse",
"person",
"because"
] |
[
{
"code": "6E8Z",
"title": "Mental, behavioural or neurodevelopmental disorders, unspecified"
},
{
"code": "6A00.Z",
"title": "Disorders of intellectual development, unspecified"
},
{
"code": "6E6Z",
"title": "Secondary mental or behavioural syndrome, unspecified"
},
{
"code": "MB21.4",
"title": "Disorientation"
},
{
"code": "6A2Z",
"title": "Schizophrenia or other primary psychotic disorders, unspecified"
},
{
"code": "4A01.03",
"title": "Transient hypogammaglobulinaemia of infancy"
},
{
"code": "8A80.Z",
"title": "Migraine, unspecified"
},
{
"code": "QA76",
"title": "Medication or substance that is known to be an allergen without injury or harm"
},
{
"code": "PL13.6",
"title": "Medication or substance that is known to be an allergen, as mode of injury or harm"
},
{
"code": "9C40.A0",
"title": "Papilloedema"
}
] |
=== ICD-11 CODES FOUND ===
[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
[6A00.Z] Disorders of intellectual development, unspecified
Also known as: Disorders of intellectual development, unspecified | Disorders of intellectual development | Mental retardation | Intellectual developmental disorder | Intellectual disability
[6E6Z] Secondary mental or behavioural syndrome, unspecified
Also known as: Secondary mental or behavioural syndrome, unspecified | organic mental disorders | Secondary mental and behavioural disorders | Mental or behavioural syndromes due to health conditions not classified under mental or behavioural disorders
[MB21.4] Disorientation
Definition: Impairment in or loss of awareness of the position of the self in relation to place, time, situation, or other persons. In severe cases, the sense of personal identity may also be lost.
Also known as: Disorientation | mental confusion NOS
[6A2Z] Schizophrenia or other primary psychotic disorders, unspecified
Also known as: Schizophrenia or other primary psychotic disorders, unspecified | Unspecified nonorganic psychosis | nonorganic psychosis | confusional psychosis | atypical psychosis
[4A01.03] Transient hypogammaglobulinaemia of infancy
Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy]
[8A80.Z] Migraine, unspecified
Also known as: Migraine, unspecified | Migraine
[QA76] Medication or substance that is known to be an allergen without injury or harm
Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.
Also known as: Medication or substance that is known to be an allergen without injury or harm
Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance
[9C40.A0] Papilloedema
Definition: Optic disc swelling that results from increased intracranial pressure
Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure
Includes: Optic disc swelling that results from increased intracranial pressure
=== GRAPH WALKS ===
--- Walk 1 ---
[6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified
--PARENT--> [06] Mental, behavioural or neurodevelopmental disorders
Def: Mental, behavioural and neurodevelopmental disorders are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a ...
--EXCLUDES--> [?] Uncomplicated bereavement
--- Walk 2 ---
[6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified
--PARENT--> [06] Mental, behavioural or neurodevelopmental disorders
Def: Mental, behavioural and neurodevelopmental disorders are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a ...
--CHILD--> [?] Catatonia
Def: Catatonia is a syndrome of primarily psychomotor disturbances, characterized by the co-occurrence of several symptoms of decreased, increased, or abnormal psychomotor activity. The assessment of catat...
--- Walk 3 ---
[6A00.Z] Disorders of intellectual development, unspecified
--PARENT--> [6A00] Disorders of intellectual development
Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...
--CHILD--> [6A00.0] Disorder of intellectual development, mild
Def: A mild disorder of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that...
--- Walk 4 ---
[6A00.Z] Disorders of intellectual development, unspecified
--PARENT--> [6A00] Disorders of intellectual development
Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...
--PARENT--> [?] Neurodevelopmental disorders
Def: Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intel...
--- Walk 5 ---
[6E6Z] Secondary mental or behavioural syndrome, unspecified
--PARENT--> [?] Secondary mental or behavioural syndromes associated with disorders or diseases classified elsewhere
Def: This grouping includes syndromes characterised by the presence of prominent psychological or behavioural symptoms judged to be direct pathophysiological consequences of a medical condition not classif...
--EXCLUDES--> [?] 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 6 ---
[6E6Z] Secondary mental or behavioural syndrome, unspecified
--PARENT--> [?] Secondary mental or behavioural syndromes associated with disorders or diseases classified elsewhere
Def: This grouping includes syndromes characterised by the presence of prominent psychological or behavioural symptoms judged to be direct pathophysiological consequences of a medical condition not classif...
--EXCLUDES--> [?] 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....
|
[
"[6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified\n --PARENT--> [06] Mental, behavioural or neurodevelopmental disorders\n Def: Mental, behavioural and neurodevelopmental disorders are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a ...\n --EXCLUDES--> [?] Uncomplicated bereavement",
"[6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified\n --PARENT--> [06] Mental, behavioural or neurodevelopmental disorders\n Def: Mental, behavioural and neurodevelopmental disorders are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a ...\n --CHILD--> [?] Catatonia\n Def: Catatonia is a syndrome of primarily psychomotor disturbances, characterized by the co-occurrence of several symptoms of decreased, increased, or abnormal psychomotor activity. The assessment of catat...",
"[6A00.Z] Disorders of intellectual development, unspecified\n --PARENT--> [6A00] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...\n --CHILD--> [6A00.0] Disorder of intellectual development, mild\n Def: A mild disorder of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that...",
"[6A00.Z] Disorders of intellectual development, unspecified\n --PARENT--> [6A00] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...\n --PARENT--> [?] Neurodevelopmental disorders\n Def: Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intel...",
"[6E6Z] Secondary mental or behavioural syndrome, unspecified\n --PARENT--> [?] Secondary mental or behavioural syndromes associated with disorders or diseases classified elsewhere\n Def: This grouping includes syndromes characterised by the presence of prominent psychological or behavioural symptoms judged to be direct pathophysiological consequences of a medical condition not classif...\n --EXCLUDES--> [?] 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...",
"[6E6Z] Secondary mental or behavioural syndrome, unspecified\n --PARENT--> [?] Secondary mental or behavioural syndromes associated with disorders or diseases classified elsewhere\n Def: This grouping includes syndromes characterised by the presence of prominent psychological or behavioural symptoms judged to be direct pathophysiological consequences of a medical condition not classif...\n --EXCLUDES--> [?] 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...."
] |
6E8Z
|
Mental, behavioural or neurodevelopmental disorders, unspecified
|
[
{
"from_icd11": "6E8Z",
"icd10_code": "F99",
"icd10_title": "Mental disorder, not otherwise specified"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F488",
"icd10_title": "Other specified nonpsychotic mental disorders"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F988",
"icd10_title": "Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F530",
"icd10_title": "Postpartum depression"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F688",
"icd10_title": "Other specified disorders of adult personality and behavior"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F59",
"icd10_title": "Unspecified behavioral syndromes associated with physiological disturbances and physical factors"
},
{
"from_icd11": "6E8Z",
"icd10_code": "V",
"icd10_title": ""
},
{
"from_icd11": "6E8Z",
"icd10_code": "F531",
"icd10_title": "Puerperal psychosis"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F538",
"icd10_title": ""
},
{
"from_icd11": "6E8Z",
"icd10_code": "F539",
"icd10_title": ""
},
{
"from_icd11": "6E8Z",
"icd10_code": "F680",
"icd10_title": ""
},
{
"from_icd11": "6E8Z",
"icd10_code": "F989",
"icd10_title": "Unspecified behavioral and emotional disorders with onset usually occurring in childhood and adolescence"
},
{
"from_icd11": "6E8Z",
"icd10_code": "F99-F99",
"icd10_title": ""
},
{
"from_icd11": "6E8Z",
"icd10_code": "F00-F09",
"icd10_title": ""
},
{
"from_icd11": "6E8Z",
"icd10_code": "F40-F48",
"icd10_title": ""
}
] |
F99
|
Mental disorder, not otherwise specified
|
An 85-year-old woman, retired and living on her own, presented in our memory clinic complaining of a progressive loss of spatial and time orientation and memory probably for 6 month. Her son, who is also her guardian, also mentioned slight speech and language problems, noticing disrupted sentences in her spontaneous speech, and difficulty speaking caused by word-finding problems; she was also impaired in performing everyday tasks and showed signs of social squalidness. Our patient has two sons. She lived first with one of them in another city. However, as he had to look after for another needy member of his family, he had no time to take care of his mother. Her condition worsened slowly and finally she lived in squalid conditions, so that her other son (and actual guardian) took her to his home in another city where he looked after her. It was there that he noticed her worsening memory and language problems. Both sons have been reporting memory disturbances for about 6 months. However, when exactly her symptoms' first onset appeared is unknown, thus a slowly progressive and no abrupt decline is most probable. This patient had no prior mental health or neurological disorder. She had several comorbidities that were treated pharmacologically as indicated in the following in brackets: (1) diabetes mellitus type 2 , (2) arterial hypertension (olemsartan /amlodipine/ hydrochlorothiazide 40/ 5/ 12.5 mg/d, bisoprolol 10 mg /d), (3) dermatitis (methylprednisolone ointment two times daily), (4) paroxysmal atrial fibrillation (Apixaban 10 mg/d, digitoxin 0.07 mg/d, bisoprolol 10mg/d), (5) hypothyreosis (L-Thyroxin 50 μg/ d), (6) tinea pedis (ciclopirox crème), and a (7) presbyacusis. The patient underwent a comprehensive dementia assessment. Her psychopathological assessment confirmed deficits in orientation, concentration, and memory. Furthermore, she had a reduced awareness of her cognitive abilities. In her neurological examination, no neurological deficits were detected. Cognitive screening results were normal for the clock drawing test (CDT = 2), but cognitive impairment became already obvious in the Mini-Mental Status Test (MMST = 21). Neuropsychological assessment further revealed impairments in cognitive flexibility and severe deficits in verbal and visual memory, including immediate and delayed recall . Together with impaired activities of daily living, these findings were compatible with a diagnosis of mild dementia. MRI showed reduced parietal and cerebellar brain volume and microangiopathy, as well as a central necrosis in the corpora mammillaria. The unknown onset of symptoms with cognitive dysfunction accompanied by speech and language problems prompted us to perform an extensive differential diagnosis including a search for a wide spectrum of neural autoantibodies that could potentially be involved in the differential diagnosis of cognitive impairment such as neurochondrin autoantibodies. Neurochondrin autoantibodies have been reported to be associated with an encephalopathy and cognitive dysfunction ( 3 ). CSF analysis revealed neurochondrin autoantibodies in immunofluorescence testing (1:32). Furthermore, titin antibodies were detected in CSF via Euroline immunoblots. Both autoantibody types [neurochondrin (1:3,200) and titin] were also verified in blood samples. We found no specific intrathecal antibody synthesis of anti-neurochondrin antibodies in the central nervous system with an antibody specific index of 2.85 [cut off is higher than 4 for indirect immunohistochemistry due to non-linear quantification according to Reiber and Peter ( 4 ), Table 1 ]. Furthermore, we did not detect isolated oligoclonal bands in the CSF or an intrathecal IgG synthesis. However, a. Neurodegenerative markers were above normative levels in CSF (measured in the Neurochemistry Cerebrospinal Fluid Laboratory of the Neurology Department, University Medical Center Göttingen), i.e., tau protein and ptau 181 protein ( Table 1 ) were above normative levels, and the ratio Aß42/40 was below normative levels ( Table 1 ). Results of neurodegenerative CSF markers were confirmed by an external laboratory (Laboratory of Clinical Neurochemistry and Neurochemical Dementia Diagnostics, Department of Psychiatry and Psychotherapy, University Hospital Erlangen) ( Table 1 , second column). To assess brain damage, neurofilament phosphorylated heavy chain (pNfH) were determined in CSF at the Department of Neurology, University Hospital Ulm ( Table 1 ). However, laboratory reference values adapted from the work of Steinacker et al. ( 5 ) from a cohort with amyotrophic lateral sclerosis indicated no levels above normative levels ( Table 1 ). AD dementia is probable due to her typical hippocampal subtype of memory dysfunction together with biomarker-based AD (elevated ptau181, reduced Aß42/Aß40 ratio). Our patient ‘s normal Aß42 in the CSF fails to support the hypothesis of Alzheimer's disease. Nevertheless, the combination of a reduced Aß42/40 ratio and elevated ptau181 in the CSF argues for a biomarker-confirmed Alzheimer's disease concurring with the latest diagnostic criteria ( 6 ). However, as the coexistence of neurochondrin autoantibodies in her serum and CSF are relevant in our patient, we thus diagnosed an AD dementia associated with neurochondrin autoantibodies. A therapy with cholinesterase inhibitors rivastigmine at 4.6 mg per day has been started and is well tolerated so far. No adverse events were reported. 40 mg/d pipamperone was also applied to help her sleep. Immunotherapy with corticosteroids as an individual off label therapy was briefly discussed, but not considered as a therapeutic option, as AD is very likely caused by a biomarker profile and typical clinical syndrome entailing memory and orientation disturbances. The patient and her son accepted the diagnosis of AD with dignity. Potential neurochondrin autoimmunity was not mentioned as a separate diagnosis as it is not currently a diagnostic category for such a clinical presentation.
| 4.136719
| 0.973145
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC9243764
|
https://doi.org/10.3389/fneur.2022.879009
|
[
"memory",
"neurochondrin",
"cognitive",
"autoantibodies",
"however",
"dementia",
"problems",
"that",
"normative",
"laboratory"
] |
[
{
"code": "MB21.1Z",
"title": "Amnesia, unspecified"
},
{
"code": "MB21.0",
"title": "Age-associated cognitive decline"
},
{
"code": "6D71",
"title": "Mild neurocognitive disorder"
},
{
"code": "MB21.Z",
"title": "Symptoms, signs or clinical findings involving cognition, unspecified"
},
{
"code": "6D81",
"title": "Dementia due to cerebrovascular disease"
},
{
"code": "8D43.1",
"title": "Cognitive impairment due to toxicity"
},
{
"code": "6B60.9",
"title": "Dissociative neurological symptom disorder, with cognitive symptoms"
},
{
"code": "MA14.1A",
"title": "Neural autoantibody positive"
},
{
"code": "MA14.19",
"title": "Neural autoantibody negative"
},
{
"code": "8E4A.0",
"title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord"
}
] |
=== ICD-11 CODES FOUND ===
[MB21.1Z] Amnesia, unspecified
Also known as: Amnesia, unspecified | Amnesia | disturbance of memory | lack of memory | loss of memory
[MB21.0] Age-associated cognitive decline
Definition: A normative (non-pathological) deterioration of higher cortical functions such as thinking, reasoning, comprehension, calculation, learning, language, and judgment.
Also known as: Age-associated cognitive decline | Age-associated memory impairment | Age related cognitive decline | Ageing-related cognitive decline | Senile degeneration of brain, not elsewhere classified
[6D71] Mild neurocognitive disorder
Definition: Mild neurocognitive disorder is characterized by mild impairment in one or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive functioning, which represents a decline from the individual’s previous level of functioning. Diagnosis is based on report from the patient, informant, or clinical observation, and is accompanied by objective evidence of impairment by quantified clinical assessment or standardized cognitive testing. Cognitiv
Also known as: Mild neurocognitive disorder | minor neurocognitive disorder | Postconcussional syndrome | post-concussion syndrome | post-concussional syndrome
[MB21.Z] Symptoms, signs or clinical findings involving cognition, unspecified
Also known as: Symptoms, signs or clinical findings involving cognition, unspecified | Symptoms, signs or clinical findings involving cognition | cognitive impairment NOS
[6D81] Dementia due to cerebrovascular disease
Definition: Dementia due to brain parenchyma injury resulting from cerebrovascular disease (ischemic or haemorrhagic). The onset of the cognitive deficits is temporally related to one or more vascular events. Cognitive decline is typically most prominent in speed of information processing, complex attention, and frontal-executive functioning. There is evidence of the presence of cerebrovascular disease considered to be sufficient to account for the neurocognitive deficits from history, physical examination
Also known as: Dementia due to cerebrovascular disease | arteriosclerotic dementia | Strategic-infarct dementia | Post stroke dementia | vascular cognitive impairment
Excludes: Alzheimer disease dementia, mixed type, with cerebrovascular disease
[8D43.1] Cognitive impairment due to toxicity
Definition: These are conditions of impaired cognition due to the toxicity of substances.
Also known as: Cognitive impairment due to toxicity | Cognitive impairment due to lead toxicity
[6B60.9] Dissociative neurological symptom disorder, with cognitive symptoms
Definition: Dissociative neurological symptom disorder, with cognitive symptoms is characterised by impaired cognitive performance in memory, language or other cognitive domains that is internally inconsistent and not consistent with a recognised disease of the nervous system, a neurodevelopmental or neurocognitive disorder, other mental, behavioural or neurodevelopmental disorder, or another medical condition and does not occur exclusively during another dissociative disorder.
Also known as: Dissociative neurological symptom disorder, with cognitive symptoms | Functional neurological symptom disorder, with cognitive symptoms
Excludes: Dissociative amnesia
[MA14.1A] Neural autoantibody positive
Also known as: Neural autoantibody positive
[MA14.19] Neural autoantibody negative
Also known as: Neural autoantibody negative
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[MB21.1Z] Amnesia, unspecified
--PARENT--> [MB21.1] Amnesia
Def: An inability to recall past experiences, especially where recall is to be expected....
--CHILD--> [MB21.11] Retrograde amnesia
Def: An inability to recall past experiences, especially where recall is to be expected, preceding an event (psychological or physical) presumed to be responsible for the amnesia....
--- Walk 2 ---
[MB21.1Z] Amnesia, unspecified
--PARENT--> [MB21.1] Amnesia
Def: An inability to recall past experiences, especially where recall is to be expected....
--PARENT--> [MB21] Symptoms, signs or clinical findings involving cognition
Def: Symptoms, signs, and clinical findings indicative of a disturbance in mental abilities and processes related to attention, memory, judgment, reasoning, problem solving, decision making, or comprehensi...
--- Walk 3 ---
[MB21.0] Age-associated cognitive decline
Def: A normative (non-pathological) deterioration of higher cortical functions such as thinking, reasoning, comprehension, calculation, learning, language, and judgment....
--PARENT--> [MB21] Symptoms, signs or clinical findings involving cognition
Def: Symptoms, signs, and clinical findings indicative of a disturbance in mental abilities and processes related to attention, memory, judgment, reasoning, problem solving, decision making, or comprehensi...
--CHILD--> [MB21.2] Anosognosia
Def: A lack of awareness or failure to recognize one's own illness, symptoms, or functional deficits, considered to be an aspect of the illness....
--- Walk 4 ---
[MB21.0] Age-associated cognitive decline
Def: A normative (non-pathological) deterioration of higher cortical functions such as thinking, reasoning, comprehension, calculation, learning, language, and judgment....
--PARENT--> [MB21] Symptoms, signs or clinical findings involving cognition
Def: Symptoms, signs, and clinical findings indicative of a disturbance in mental abilities and processes related to attention, memory, judgment, reasoning, problem solving, decision making, or comprehensi...
--CHILD--> [MB21.1] Amnesia
Def: An inability to recall past experiences, especially where recall is to be expected....
--- Walk 5 ---
[6D71] Mild neurocognitive disorder
Def: Mild neurocognitive disorder is characterized by mild impairment in one or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive function...
--PARENT--> [?] Neurocognitive disorders
Def: Neurocognitive disorders are characterised by primary clinical deficits in cognitive functioning that are acquired rather than developmental. That is, neurocognitive disorders do not include disorders...
--EXCLUDES--> [?] Neurodevelopmental disorders
Def: Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intel...
--- Walk 6 ---
[6D71] Mild neurocognitive disorder
Def: Mild neurocognitive disorder is characterized by mild impairment in one or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive function...
--PARENT--> [?] Neurocognitive disorders
Def: Neurocognitive disorders are characterised by primary clinical deficits in cognitive functioning that are acquired rather than developmental. That is, neurocognitive disorders do not include disorders...
--CHILD--> [6D72] Amnestic disorder
Def: Amnestic disorder is characterised by prominent memory impairment relative to expectations for age and general premorbid level of cognitive functioning, which represents a decline from the individual’...
|
[
"[MB21.1Z] Amnesia, unspecified\n --PARENT--> [MB21.1] Amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected....\n --CHILD--> [MB21.11] Retrograde amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected, preceding an event (psychological or physical) presumed to be responsible for the amnesia....",
"[MB21.1Z] Amnesia, unspecified\n --PARENT--> [MB21.1] Amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected....\n --PARENT--> [MB21] Symptoms, signs or clinical findings involving cognition\n Def: Symptoms, signs, and clinical findings indicative of a disturbance in mental abilities and processes related to attention, memory, judgment, reasoning, problem solving, decision making, or comprehensi...",
"[MB21.0] Age-associated cognitive decline\n Def: A normative (non-pathological) deterioration of higher cortical functions such as thinking, reasoning, comprehension, calculation, learning, language, and judgment....\n --PARENT--> [MB21] Symptoms, signs or clinical findings involving cognition\n Def: Symptoms, signs, and clinical findings indicative of a disturbance in mental abilities and processes related to attention, memory, judgment, reasoning, problem solving, decision making, or comprehensi...\n --CHILD--> [MB21.2] Anosognosia\n Def: A lack of awareness or failure to recognize one's own illness, symptoms, or functional deficits, considered to be an aspect of the illness....",
"[MB21.0] Age-associated cognitive decline\n Def: A normative (non-pathological) deterioration of higher cortical functions such as thinking, reasoning, comprehension, calculation, learning, language, and judgment....\n --PARENT--> [MB21] Symptoms, signs or clinical findings involving cognition\n Def: Symptoms, signs, and clinical findings indicative of a disturbance in mental abilities and processes related to attention, memory, judgment, reasoning, problem solving, decision making, or comprehensi...\n --CHILD--> [MB21.1] Amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected....",
"[6D71] Mild neurocognitive disorder\n Def: Mild neurocognitive disorder is characterized by mild impairment in one or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive function...\n --PARENT--> [?] Neurocognitive disorders\n Def: Neurocognitive disorders are characterised by primary clinical deficits in cognitive functioning that are acquired rather than developmental. That is, neurocognitive disorders do not include disorders...\n --EXCLUDES--> [?] Neurodevelopmental disorders\n Def: Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intel...",
"[6D71] Mild neurocognitive disorder\n Def: Mild neurocognitive disorder is characterized by mild impairment in one or more cognitive domains relative to that expected given the individual’s age and general premorbid level of cognitive function...\n --PARENT--> [?] Neurocognitive disorders\n Def: Neurocognitive disorders are characterised by primary clinical deficits in cognitive functioning that are acquired rather than developmental. That is, neurocognitive disorders do not include disorders...\n --CHILD--> [6D72] Amnestic disorder\n Def: Amnestic disorder is characterised by prominent memory impairment relative to expectations for age and general premorbid level of cognitive functioning, which represents a decline from the individual’..."
] |
MB21.1Z
|
Amnesia, unspecified
|
[
{
"from_icd11": "MB21.1Z",
"icd10_code": "R413",
"icd10_title": "Other amnesia"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R4189",
"icd10_title": "Other symptoms and signs involving cognitive functions and awareness"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R4181",
"icd10_title": "Age-related cognitive decline"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R41840",
"icd10_title": "Attention and concentration deficit"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R4183",
"icd10_title": "Borderline intellectual functioning"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R41842",
"icd10_title": "Visuospatial deficit"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R41841",
"icd10_title": "Cognitive communication deficit"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R41844",
"icd10_title": "Frontal lobe and executive function deficit"
},
{
"from_icd11": "MB21.0",
"icd10_code": "G311",
"icd10_title": "Senile degeneration of brain, not elsewhere classified"
},
{
"from_icd11": "MB21.0",
"icd10_code": "R418",
"icd10_title": "Other symptoms and signs involving cognitive functions and awareness"
},
{
"from_icd11": "6D71",
"icd10_code": "F067",
"icd10_title": ""
},
{
"from_icd11": "6D71",
"icd10_code": "F072",
"icd10_title": ""
},
{
"from_icd11": "MB21.Z",
"icd10_code": "R419",
"icd10_title": "Unspecified symptoms and signs involving cognitive functions and awareness"
},
{
"from_icd11": "MB21.Z",
"icd10_code": "R414",
"icd10_title": "Neurologic neglect syndrome"
},
{
"from_icd11": "MB21.Z",
"icd10_code": "R41",
"icd10_title": "Other symptoms and signs involving cognitive functions and awareness"
}
] |
R413
|
Other amnesia
|
The patient was admitted to hospital at age 8 months and again at 9 months with the aim of carrying out surgery to manage HD. Preoperative blood tests showed that infection parameters (white blood cell count and serum C-reactive protein levels) were in the normal range. Preoperative preparation involved intravenous fluid replacement with fasting and colonic lavage. For the latter, a gastric tube was placed to inject a colon-cleansing agent and a transanal drain was placed to guide the stool. His body movements were restrained to prevent the various medical devices from being removed by himself. However, on the morning of the scheduled surgical procedure, he suddenly developed a body temperature of 38.2–40.0 °C, but physical examination and an absence of symptoms suggested an infectious disease was not present. The procedure was postponed and he was discharged from hospital without medication. His fever resolved immediately the same day . He was readmitted to hospital for surgery at 10 months of age with body weight of 6.9 kg (−2 standard deviations), height of 63 cm (−2 standard deviations), and Kaup index of 17.3. His development was equivalent to that of a child with DS. The patient was admitted to hospital 4 days before the surgical procedure to observe general status and adapt to the hospital environment. To reduce psychological stress, he was accompanied by his mother throughout the day. During colonic lavage on the day before the surgical procedure, a stool was excreted with a finger instead of transanal drainage. Blood tests on the day before the surgical procedure did not reveal inflammation or fever (Table 1 ). He underwent the Soave procedure as scheduled. During anesthesia, there was no muscle rigidity, hyperthermia, tachycardia, myoglobinuria, or respiratory/metabolic acidosis suggestive of malignant hyperthermia, and other intraoperative complications were absent. Eight hours after the surgical procedure, his body temperature increased to 40.2 °C and antipyretic medications were ineffective . He showed no signs of respiratory distress or peripheral circulatory failure, and blood tests did not reveal abnormalities. Fluid replacement was continued, meropenem (120 mg/kg/day)was initiated and the surgical wound dressing was changed. However, he developed status epilepticus on postoperative day (POD) 1, with respiratory failure and a body temperature of 42.0 °C. Mechanical ventilation was initiated. Computed tomography revealed bilateral ground-glass opacities in the lungs, with acute respiratory distress syndrome and localized cerebral edema with partial agenesis of the corpus callosum . Seizure clusters occurred on POD2 and he was administered midazolam (0.1 mg/kg, intravenous) twice with phenobarbital (20 mg/kg, intravenous) as an anticonvulsant. Despite administration of acetaminophen (15 mg/kg, intravenous), his high fever persisted, together with progressive hypoxemia and respiratory/metabolic acidosis, as well as concurrent increased serum levels of transaminases, reduced coagulation, and pancytopenia (Table 1 ). He was transferred to the intensive care unit and administered high-dose methylprednisolone (30 mg/kg/day) for suspected acute encephalopathy. His core body temperature was lowered to 36–37 °C by a whole-body cooling system, and hyperosmotic therapy was initiated to treat cerebral edema and catecholamines were given to support cardiac function. However, his condition deteriorated rapidly, with uncontrolled bradycardia and hypotension. Multiple organ dysfunction occurred and the patient died on POD2. Fig. 1 Changes in perioperative body temperature during hospitalization. Each segment on the X -axis represents a 24 hour period. The points on the graph represent the body temperature at around 6 am, 2 pm, and 8 pm Table 1 Blood and cerebrospinal fluid examination at the time of the third hospitalization Blood examination The day before surgery POD 0 POD 1 POD 2 Reference range WBC (/μL) 8700 10700 8400 5300 6000–17500 Hemoglobin (g/dL) 14.1 10.9 9.2 7.0 10.5–14.1 Platelet (10 3 /μL) 450 307 207 16 150–400 TP (g/dL) 3.6 5.9–7.5 Albumin (g/dL) 2.9 3.4–4.7 T-bil (mg/dL) 6.3 4.1 4.5 0.7 0.2–0.7 AST (U/L) 4.4 2.8 3.0 2730 23–51 ALT (U/L) 0.3 0.4 0.3 2206 5–25 LDH (U/L) 48 51 73 3523 202–437 CPK (U/L) 24 17 23 2959 54–389 BUN (mg/dL) 256 234 394 17.0 6–20 Creatinine (mg/dL) 143 676 1013 0.91 0.14–0.34 Na (mEq/L) 10.2 5.6 6.4 147 139–146 K (mEq/L) 0.33 0.49 0.47 3.9 4.1–5.3 Cl (mEq/L) 140 143 141 114 98–106 CRP (mg/dL) 4.8 3.6 3.3 2.49 < 0.14 Lactate (mg/dL) 105 109 109 62 3–17 TSH (μIU/mL) 0.02 0.42 6.75 1.25 0.42–4.3 Free triiodothyronine (ng/mL) 11 27 3.3 2.28–4.56 Free thyroxine (ng/mL) 1.9 0.99–1.91 Cortisol (μg/mL) 27 3–23 PT-INR 1.40 3.66 0.75–1.15 APTT (sec) 0.85 49 251 30–45 Fibrinogen (mg/dL) 34 308 105 200–400 D-dimer (μg/mL) 266 2.8 7.8 0.15–1.0 pH 7.311 7.454 7.225 7.35–7.45 pCO 2 (mmHg) 43.8 27.5 23.9 35–45 pO 2 (mmHg) 80.3 80–100 HCO 3 − (mmol/L) 21.4 19.0 9.5 22–26 BE (mmol/L) −4.1 −3.6 −16.6 0 ± 2 IL-6 (pg/mL) 1.2 44.8 < 4.0 IL-10 (pg/mL) < 2 1010 < 5.0 TNF-α (pg/mL) 0.7 0.6 < 1.66 Cerebrospinal fluid examination The day before surgery POD 0 POD 1 POD 2 Reference range WBC (/μL) (pg/mL) 1 0–6 IL-6 4.4 < 19.9 IL-10 (pg/mL) < 2 < 14.2 TNF-α (pg/mL) < 0.15 < 11.1 ALT alanine aminotransferase, APTT activated partial thromboplastin time, AST aspartate aminotransferase, BE base excess, BUN blood urea nitrogen, CPK creatine phosphokinase, CRP C-reactive protein, IL interleukin, LDH lactate dehydrogenase, POD postoperative day, PT-INR prothrombin time-international normalized ratio, T-bil total bilirubin, TNF tumor necrosis factor, TP total protein, TSH thyroid-stimulating hormone, WBC white blood cell Fig. 2 Computed tomography of the lung on postoperative day 1 showing bilateral ground-glass opacities (black arrow) Fig. 3 Computed tomography of the brain on postoperative day 1 showing localized cerebral edema with a narrowed sulcus in the right frontal and temporal lobes (white arrow head)
| 3.804688
| 0.980469
|
sec[1]/p[1]
|
en
| 0.999997
|
PMC8882270
|
https://doi.org/10.1186/s13256-022-03305-x
|
[
"body",
"blood",
"temperature",
"respiratory",
"intravenous",
"fluid",
"postoperative",
"white",
"protein",
"range"
] |
[
{
"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"
},
{
"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 ===
[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
[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 ---
[ND51.Y] Other specified injuries of spine or trunk, level unspecified
--PARENT--> [ND51] Other injuries of spine or trunk, level unspecified
--CHILD--> [ND51.1] Injury of unspecified nerve, spinal nerve root or plexus of trunk
--- Walk 2 ---
[ND51.Y] Other specified injuries of spine or trunk, level unspecified
--PARENT--> [ND51] Other injuries of spine or trunk, level unspecified
--EXCLUDES--> [?] Crushing injuries involving multiple body regions
--- Walk 3 ---
[MG20.Z] Cachexia, unspecified
--PARENT--> [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....
--PARENT--> [?] General symptoms
--- Walk 4 ---
[MG20.Z] Cachexia, unspecified
--PARENT--> [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....
--CHILD--> [MG20.Z] Cachexia, unspecified
--- Walk 5 ---
[ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region
--PARENT--> [ND56] Injury of unspecified body region
Def: Damage inflicted on the body in an unspecified area as the direct or indirect result of an external force, with or without disruption of structural continuity....
--PARENT--> [?] Injuries to unspecified part of trunk, limb or body region
--- Walk 6 ---
[ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region
--PARENT--> [ND56] Injury of unspecified body region
Def: Damage inflicted on the body in an unspecified area as the direct or indirect result of an external force, with or without disruption of structural continuity....
--EXCLUDES--> [?] Injuries involving multiple body regions
|
[
"[ND51.Y] Other specified injuries of spine or trunk, level unspecified\n --PARENT--> [ND51] Other injuries of spine or trunk, level unspecified\n --CHILD--> [ND51.1] Injury of unspecified nerve, spinal nerve root or plexus of trunk",
"[ND51.Y] Other specified injuries of spine or trunk, level unspecified\n --PARENT--> [ND51] Other injuries of spine or trunk, level unspecified\n --EXCLUDES--> [?] Crushing injuries involving multiple body regions",
"[MG20.Z] Cachexia, unspecified\n --PARENT--> [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....\n --PARENT--> [?] General symptoms",
"[MG20.Z] Cachexia, unspecified\n --PARENT--> [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....\n --CHILD--> [MG20.Z] Cachexia, unspecified",
"[ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region\n --PARENT--> [ND56] Injury of unspecified body region\n Def: Damage inflicted on the body in an unspecified area as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region",
"[ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region\n --PARENT--> [ND56] Injury of unspecified body region\n Def: Damage inflicted on the body in an unspecified area as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --EXCLUDES--> [?] Injuries involving multiple body regions"
] |
ND51.Y
|
Other specified injuries of spine or trunk, level unspecified
|
[
{
"from_icd11": "ND51.Y",
"icd10_code": "S30860A",
"icd10_title": "Insect bite (nonvenomous) of lower back and pelvis, initial encounter"
},
{
"from_icd11": "ND51.Y",
"icd10_code": "S30861A",
"icd10_title": "Insect bite (nonvenomous) of abdominal wall, initial encounter"
},
{
"from_icd11": "MG20.Z",
"icd10_code": "R627",
"icd10_title": "Adult failure to thrive"
},
{
"from_icd11": "MG20.Z",
"icd10_code": "R64",
"icd10_title": "Cachexia"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1491XA",
"icd10_title": "Suicide attempt, initial encounter"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1490XS",
"icd10_title": "Injury, unspecified, sequela"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1490",
"icd10_title": "Injury, unspecified"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1491",
"icd10_title": "Suicide attempt"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1490XA",
"icd10_title": "Injury, unspecified, initial encounter"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T148XXS",
"icd10_title": "Other injury of unspecified body region, sequela"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T148XXD",
"icd10_title": "Other injury of unspecified body region, subsequent encounter"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T148",
"icd10_title": "Other injury of unspecified body region"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T14",
"icd10_title": "Injury of unspecified body region"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T149",
"icd10_title": "Unspecified injury"
},
{
"from_icd11": "ME86.Z",
"icd10_code": "R6881",
"icd10_title": "Early satiety"
}
] |
S30860A
|
Insect bite (nonvenomous) of lower back and pelvis, initial encounter
|
A 33-year-old multipara was referred for persistent proteinuria, hematuria, and hypoalbuminemia two months postpartum. Her serum creatinine (sCr) level was 0.43 mg/dL, with no proteinuria and hematuria observed before pregnancy. She was diagnosed with proteinuria for the first time at 36 weeks of gestation. Her sCr levels were 0.45 mg/dL and 0.61 mg/dL at 37 and 38 weeks of gestation, respectively. There were no signs of infection immediately prior to the onset of proteinuria. She was normotensive with no symptoms such as swelling, headaches, upper abdominal pain, or shortness of breath before and after 36 weeks. Further, she showed no signs of cytomegalovirus or chlamydia infection during pregnancy. She had no significant medical history, allergies, or medications. There were no problems with her previous pregnancy. At 38 weeks, labor was induced, and she delivered a 3,290 g male infant. She presented with extensive peripheral edema on her first visit. She did not present with purpura, arthralgia, or abdominal pain. The laboratory findings on her first visit at two months postpartum are summarized in Table 1 . Urinalysis revealed proteinuria (7.39 g/gCr) and hematuria (sediment red blood cells > 100 per high-power field). Urinary excretion of beta2-microglobulin (MG) and N-acetyl-beta-D-glycosaminidase were markedly elevated . Her sCr level was normal (0.70 mg/dL). She had low serum total protein and albumin levels of 5.3 g/dL and 2.2 g/dL, respectively. Based on these results, the patient was diagnosed with nephrotic syndrome. The antinuclear antibody titer was 1:160. She also tested negative for anti-DNA, IgG anticardiolipin antibodies, myeloperoxidase anti-neutrophil cytoplasmic, proteinase 3 anti-neutrophil cytoplasmic antibodies (ANCA), anti-glomerular basement membrane (anti-GBM), and anti-Smith antibodies. Serum protein electrophoresis revealed no monoclonal spikes. Renal ultrasound showed that the kidneys were normal in size (right, 108 × 51 mm; left, 110 × 55 mm) without dilation of the urinary tract, renal pelvis, or calyces. The corticomedullary junction was obscured. The renal arterial resistive index was normal (right, 0.50; left, 0.51). A renal biopsy was performed because the urinary protein persisted until 4 months postpartum. There were 35 glomeruli with no global sclerotic glomeruli. Diffuse and moderate mesangial proliferation and crescent formation were also observed. Crescent formation (28 cellular and one fibro-cellular) was observed in 29 of 35 glomeruli . Endotheliosis was not observed in the glomeruli. No fibrinoid necrosis was observed in the glomeruli or arteries. IgA immunofluorescence staining showed a strong granular pattern for IgA associated with IgG, IgM, and C3 and fibrinogen levels in the mesangium. C1q and C4 levels were negative. Interstitial fibrosis and tubular atrophy were not observed. Electron microscopy showed electron-dense deposits, mainly in the mesangial area . Based on these findings, the patient was diagnosed with crescentic IgA nephropathy (M1E1S1T0C2 according to the Oxford Classification ). The clinical course of the patient is shown in Fig. 2 . She was treated with methylprednisolone (mPSL) pulse therapy, followed by conventional prednisolone therapy. A tonsillectomy was performed 10 months postpartum. Both proteinuria and serum albumin levels gradually improved (0.89 g and 4.1 mg/dL, respectively), as well as hematuria at 16 months postpartum. Table 1 Laboratory data Blood WBC 6900 /μL Triglyceride 200 mg/dL PT-INR 0.97 RBC 4.76 × 10 6 /μL LDL-cholesterol 321 mg/dL APTT 30.0 sec Hemoglobin 13.9 g/dL HDL-cholesterol 71 mg/dL aCL IgG 2 Hematocrit 41.9 % C-reactive protein 0.64 mg/dL HBs Ag − Platelet count 666 × 10 3 /μL ASO 27 IU/mL HCV Ab − Total protein 5.3 g/dL IgG 472 mg/dL T-SPOT − Albumin 2.2 g/dL IgA 371 mg/dL Total bilirubin 0.2 mg/dL IgM 88 mg/dL Urine BUN 12.2 mg/dL IgE 45 IU/mL Dipstick protein 3 + Creatinine 0.70 mg/dL C3 136 mg/dL Occult blood 3 + Uric acid 4.6 mg/dL C4 29.3 mg/dL RBC > 100 /HPF AST 27 mg/dL CH50 58 mg/dL Protein 7.39 g/gCr ALT 20 IU/L ANA 160 β 2 MG 1079 µg/mL LDH 260 IU/L Anti-DNA ab − NAG 90.1 IU/L ALP 77 IU/L RF 6 IU/mL γGTP 12 IU/L MPO-ANCA − CK 83 IU/L RP3-ANCA − Sodium 141 mEq/L Anti-GBM Ab − Potassium 3.7 mEq/L Anti-Sm Ab − Chloride 106 mEq/L TSH 1.02 µU/mL Calcium 8.3 mg/dL FT3 2.0 pg/mL Phosphorus 3.3 mg/dL FT4 0.98 ng/dL WBC White blood cell, RBC Red blood cell, BUN Blood urea nitrogen, AST Aspartate aminotransferase, ALT Alanine aminotransferase, LDH Lactate dehydrogenase, ALP Alkaline phosphatase, γGTP γ − glutamyl transpeptidase, HDL High density lipoprotein, LDL Low density lipoprotein, Ig Immunoglobulin, C3 Complement component 3, C4 Complement component 4, CH50 50% Hemolytic complement , ANA Antinuclear antibody, RF Rheumatoid factor, MPO-ANCA Myeloperoxidase anti-neutrophil cytoplasmic antibody, PR3-ANCA Proteinase-3 anti-neutrophil cytoplasmic antibody, GBM Glomerular basement membrane, Sm Smith, PT-INR prothrombin time-international normalized ratio, APTT Activated partial thromboplastin time, aCL Anticardiolipin antibodies, HBs Hepatitis B surface, HCV Hepatitis C virus, HPF High power field, β 2 MG Beta2-microglobulin, NAG N-acetyl-beta-D-glucosaminidase Fig. 1 Renal biopsy specimen by light microscopy. a Glomerulus with a cellular crescent. Representative Periodic acid-Schiff staining (400 × magnification), Scale bars is 50 µm; Immunofluorescence staining shows a granular pattern for ( b ) IgA and ( c ) C3 in the mesangium (400 × magnification), Scale bars is 50 µm, Images were acquired using BZ-X710 all-in-one fluorescence microscope with BZ-X Viewer program (Keyence, Osaka, Japan). No enhancement of the images was performed. The measured resolution was 4080 × 3060; d Electron microscopy shows electron-dense deposits mainly in mesangial area , Scale bars is 20 µm Fig. 2 Clinical course of the patient. UP, urine protein; sAlb, serum albumin; sCr, serum creatinine; PSL, prednisolone; mPSL, methylprednisolone
| 4.101563
| 0.974121
|
sec[1]/p[0]
|
en
| 0.999994
|
PMC10084611
|
https://doi.org/10.1186/s12882-023-03152-y
|
[
"anti",
"protein",
"proteinuria",
"serum",
"blood",
"postpartum",
"anca",
"renal",
"glomeruli",
"hematuria"
] |
[
{
"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": "5B71",
"title": "Protein deficiency"
},
{
"code": "5B7Z",
"title": "Unspecified undernutrition"
},
{
"code": "DA96.02",
"title": "Malabsorption or intolerance of specific nutrients"
},
{
"code": "MF96.Z",
"title": "Proteinuria, unspecified"
},
{
"code": "3B61.1",
"title": "Acquired thrombophilia"
}
] |
=== 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
[5B71] Protein deficiency
Also known as: Protein deficiency | protein deprivation
[5B7Z] Unspecified undernutrition
Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS
[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
[MF96.Z] Proteinuria, unspecified
Also known as: Proteinuria, unspecified | Proteinuria | Albuminuria NOS | Proteinuria NOS
[3B61.1] Acquired thrombophilia
Definition: A disease caused by determinants arising after birth. This disease is characterised by abnormality of blood coagulation that increases the risk of thrombosis, clots in blood vessels. This disease may present with deep vein thrombosis or pulmonary embolism. Confirmation is identification of abnormal blood coagulation in a blood sample.
Also known as: Acquired thrombophilia | Gaisbock syndrome | polycythaemia due to stress | stress erythrocytosis | stress polycythaemia
=== 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....
--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--> [MB23.0] Aggressive behaviour
Def: 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 app...
--- 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 --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 --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--> [MB23.0] Aggressive behaviour\n Def: 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 app...",
"[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": "5B71",
"icd10_code": "E46",
"icd10_title": "Unspecified protein-calorie malnutrition"
}
] |
O26841
| |
Ophthalmological and audiological exams as well as ECHO were normal at 5 and 12 years respectively. At 12 years, she showed moderate ID and attended mainstream school with an adapted program. She had normal muscle strength in her face and limbs with mild hypotonia and no bulbar symptoms. Her deep tendon reflexes were normal. Her seizures varied and were well controlled with clobazam, levetiracetam, lamotrigine and ethosuximide. Hence the modified Atkins diet was not attempted. Growth parameters were consistently normal with height and weight between the 90th–95th centile and her head circumference between 25th–50th centile. For a clinical summary of these two cases see patient numbers 4 and 5 of Table 1 . Table 1 Overview of the clinical data of patients with confirmed MTO1 deficiency. Table 1 Pat. No. M/F Ethnicity +/- Consang (C or NC) Age of Presentation (days/yrs) Presenting feature (s) Current age/age at publication (yrs) Clinical features Psychomotor delay CNS/muscular Cardiac disease Optic pathology FTT, feeding difficulties, others Brain MRI/MRS ID/GDD GMD FMD SD SZ Hypotonia/dystonia/ataxia Weakness CM Abnormal Rhythm MRI MRS 1 F Caucasian NC 2 yrs DD, seizures; visual deterioration; ptosis, ataxia, hypotonia, myopathy 16 Y Y N Y Y Hypotonia Y N N Visual deterioration FTT, FD Ab NR 2 F Caucasian NC 2 yrs DD, seizures, hypotonia, myopathy 12 Y Y N Y Y Hypotonia Ataxia Y N Y N FTT, FD NL NL 3 M Syrian C Day 1 LA, hypocalcaemia, resp. distress 4.41 Y Y Y Y N Hypotonia Ataxia Y HCM N N FTT, FD Ab Ab 4 M Caucasian NC Day 2 Lactic acidosis mild tubulopathy Resp. distress 1.08 Y Y Y N N Hypotonia Y N N ND FTT, FD, Tubulopathy Ab NR 5 F Caucasian NC Day 1 LA, SGA, dysmorphic features 8.9 Y Y Y Y Y Hypotonia Y HCM WPW Ophthalmopl-egia FTT, FD Terminal deletion chr 8 (P arm) Ab NR 6 F Turkish NC Day 2 Drowsiness, ataxia, fatigue, seizures, cardiac murmur, hepatomegaly 12.33 Y Y Y N Y Hypotonia Ataxia Y HCM Y N FTT, FD Autistic spectrum disorder Hepatomegaly Ab NR 7 F Pakistan C Day 2 HCM, LA Deceased at 0.66yr Y Y Y NA N Hypotonia Y HCM N Mottling of retinal pigment epithelium FD NL NL 8 M Caucasian NC 0.58 yrs HCM, LA, DD, Hypotonia, 5.83 yr Y Y Y Y N Hypotonia Ataxia N HCM N N FTT, FD Ab NR 9 F Caucasian NC 0.167 yrs HCM, LA, hypotonia Deceased at 0.66 yr Y Y Y NA NR Hypotonia NR HCM N NR FTT, FD Ab NR 10 F Croatian NC Day 1 HCM, muscle, CNS Deceased on day 2 NR NR NR NR N Hypotonia Y HCM N NR NR NR NR 11 M British -Pakistani C 0.08 yr HCM, muscle, CNS; LA deceased at 0.08 yr - - - - N Hypotonia N HCM N N N NR NR 12 M British-Pakistani C 1 yr DD, microcephaly, hepatosplenomegaly deceased at 2.75 yr Y Y Y Y N Hypotonia Y DCM NR NR Hepatic involvement NL NR 13 M British NC 0.5 yr Muscle, lactic acidosis 2 Y NR NR NR NR Hypotonia Y N NR NR NR NR NR 14 M European (Italy) NC Day 1 LA, HCM, hypoglycemia, hyperammonemia (mild) Deceased 0.052 yr NR NR NR NR NR NR NR HCM Y NR NR NR 15 F European (Italy) NC Day 1 LA, HCM, hypotonia Deceased at 0.110 years NR NR NR NR NR NR NR HCM Y NR NR 16 M European (Italy) NC 0.08 yr HCM; LA, FD, weakness, reduced ocular fixation 20 + yr N N Y N N N N HCM Y bilateral optic atrophy and increased P100 latency FD Hepatic involvement NL NR 17 F European (Italy) NC Day 2 LA; hypotonia, dystonia 14 yr Y Y NR Y Y Hypotonia/dystonia NR HCM N abnormalities of visual and brainstem evoked potentials and nerve conduction velocities. FTT, FD Ab NR 18 M Pakistan C Day 1 FTT, FD, hypotonia Deceased at 1 yr Y Y Y NR N Hypotonia NR HCM N NR FTT; FD Ab Ab 19 M Pakistan C Day 1 HCM, FTT, FD, hypotonia. Deceased at 0.25 yr NR NR NR NR N Hypotonia NR HCM NR NR FTT, FD NR NR 20 F Pakistan C 0.25 yr LA, HCM, encephalopathy, seizures; fatigue 19 yr Y Y NR Y Y NR NR HCM NR NR Encephalopathy Vitamin D deficiency NR NR 21 F Pakistan C 0.42 yr LA, HCM, WPW; DD 12 yr Y Y Y Y N NR Nr HCM WPW Pericardial effusion NR NR 22 M NR C NR HCM, DD, hypotonia, dysdiachokinesia, 15 yr NR NR NR NR NR NR NR HCM NR NR NR NR NR 23 F Caucasian NC 0.038 yr LA, tachypnoea deceased at 23 yr Y Y Y Y Y Hypotonia Y N N Optic atrophy FD Ab NR 24 F Caucasian NC Day 1 LA, hypoglycaemia (persistent) 22 yr Y Y Y Y N Hypotonia Y HCM N Optic atrophy FD Ab NR 25 M Turkish NC 0.42 yr LA (infection) 13.83 yr Y Y Y Y N Hypotonia/ataxia Y HCM N N FTT Ab Ab 26 M Turkish NC 0.08 yr LA (infection) deceased at 3.25 yr Y Y Y Y N Hypotonia/ataxia Y HCM N N FTT, FD NR NR 27 M Caucasian NC Day 1 HCM, tachypnea, multiorgan failure (cardiac, pulmonary, renal) deceased at 0.005 yr NA NA NA NA Y Hypotonia NR Unknown unknown NR Hyperpnea; pulmonary edema Renal failure NR NR 28 M Caucasian NC Day 1 Tachypnea, somnolence deceased at 0.043 yr NA NA NA NA N NR NR HCM NR NR Hyperpnea, FTT NR NR 29 M European (Spain) NC 0.5 yr FTT, DD, hypotonia, truncal ataxia 16 yr Y NR NR NR Y Ataxia Nr HCM NR Optic atrophy NL NR 30 F European NC 8 yr ID, clumsiness, fatigability 19 yr Y Y NR NR N N NR HCM tachycardia bilateral partial papillary atrophy Ab NR 31 F European (Germany) NC Day 1 LA NR Y Y NR Y Y NR NR HCM N Optic atrophy Ab NR 32 F NR C 0.5 yr FTT 30 yr Y NR NR NR Y NR NR HCM NR Optic atrophy, severe myopia FTT Dorsal kyphosis NR NR 33 M NR C 5 yr (but DD noted from young age) Fatigue, HCM 28 yr Y NR NR NR NR NR NR HCM NR Optic atrophy Dorsal kyphosis NR NR 34 F India C Day 1 LA, tachypnoea 0.42 yr Y Y Y NA N Hypotonia N HCM N N FD NL NL 35 F European (Germany) 6 yr Seizures 22 yr Y N N N Y N N N N Optic Atrophy, bilateral cataracts N Ab NL Detailed phenotype of 35 patients with MTO1 deficiency including, sex, ethnicity, age at presentation, presenting features and eventual clinical features including neurological, cardiac, ophthalmic pathology and Brain MRI/CT). Ab: Abnormal; C: Consanguineous; DD: developmental delay; FD: feeding difficulties; FTT: failure to thrive; HCM: hypertrophic cardiomyopathy; LA: lactic acidosis; N: no; NL: normal; NC: non-consanguineous; NR: not recorded; SGA: small for gestational age; SZ: seizures; WPW: Wolf Parkinson White; Y: yes.
| 4.179688
| 0.780273
|
sec[1]/sec[0]/p[5]
|
en
| 0.999996
|
29331171
|
https://doi.org/10.1016/j.ymgme.2017.11.003
|
[
"hypotonia",
"deceased",
"ataxia",
"caucasian",
"optic",
"atrophy",
"european",
"seizures",
"pakistan",
"muscle"
] |
[
{
"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"
},
{
"code": "5C54.2",
"title": "Disorders of multiple glycosylation or other pathways"
},
{
"code": "QB63.0",
"title": "Presence of transplanted kidney"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[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
[5C54.2] Disorders of multiple glycosylation or other pathways
Also known as: Disorders of multiple glycosylation or other pathways | Dolichol-phosphate-mannose synthase 1 deficiency | GDP-Man: Dol-P-mannosyltransferase deficiency | Carbohydrate deficient glycoprotein syndrome type 1E | Congenital disorder of glycosylation type 1E
[QB63.0] Presence of transplanted kidney
Also known as: Presence of transplanted kidney | kidney transplant status | Presence of transplanted kidney with failed graft | kidney transplant status with failed graft | kidney transplant status with failed graft from living or deceased donor
Includes: kidney transplant status
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[KB08.2] Congenital hypotonia
Def: A paediatric condition characterised by abnormally decreased muscle tone that is present at birth in a newborn....
--PARENT--> [KB08] Disorders of muscle tone of newborn
Def: A group of paediatric conditions characterised by abnormal muscle tone in a newborn....
--CHILD--> [KB08.1] Congenital hypertonia
Def: A paediatric condition characterised by abnormally increased muscle tone that is present at birth in a newborn....
--- Walk 2 ---
[KB08.2] Congenital hypotonia
Def: A paediatric condition characterised by abnormally decreased muscle tone that is present at birth in a newborn....
--PARENT--> [KB08] Disorders of muscle tone of newborn
Def: A group of paediatric conditions characterised by abnormal muscle tone in a newborn....
--CHILD--> [KB08.1] Congenital hypertonia
Def: A paediatric condition characterised by abnormally increased muscle tone that is present at birth in a newborn....
--- Walk 3 ---
[9A83] Flat anterior chamber hypotony of eye
--PARENT--> [?] Disorders of the anterior chamber
--RELATED_TO--> [?] Retained foreign body in anterior chamber of eye
--- Walk 4 ---
[9A83] Flat anterior chamber hypotony of eye
--PARENT--> [?] Disorders of the anterior chamber
--CHILD--> [9A80] Hyphaema
--- Walk 5 ---
[GC01.4] Neuromuscular dysfunction of bladder, not elsewhere classified
--EXCLUDES--> [?] Other injuries of spine or trunk, level unspecified
--PARENT--> [?] Injuries to unspecified part of trunk, limb or body region
--- Walk 6 ---
[GC01.4] Neuromuscular dysfunction of bladder, not elsewhere classified
--EXCLUDES--> [?] Cauda equina syndrome
--CHILD--> [?] Cauda equina syndrome due to spinal stenosis
|
[
"[KB08.2] Congenital hypotonia\n Def: A paediatric condition characterised by abnormally decreased muscle tone that is present at birth in a newborn....\n --PARENT--> [KB08] Disorders of muscle tone of newborn\n Def: A group of paediatric conditions characterised by abnormal muscle tone in a newborn....\n --CHILD--> [KB08.1] Congenital hypertonia\n Def: A paediatric condition characterised by abnormally increased muscle tone that is present at birth in a newborn....",
"[KB08.2] Congenital hypotonia\n Def: A paediatric condition characterised by abnormally decreased muscle tone that is present at birth in a newborn....\n --PARENT--> [KB08] Disorders of muscle tone of newborn\n Def: A group of paediatric conditions characterised by abnormal muscle tone in a newborn....\n --CHILD--> [KB08.1] Congenital hypertonia\n Def: A paediatric condition characterised by abnormally increased muscle tone that is present at birth in a newborn....",
"[9A83] Flat anterior chamber hypotony of eye\n --PARENT--> [?] Disorders of the anterior chamber\n --RELATED_TO--> [?] Retained foreign body in anterior chamber of eye",
"[9A83] Flat anterior chamber hypotony of eye\n --PARENT--> [?] Disorders of the anterior chamber\n --CHILD--> [9A80] Hyphaema",
"[GC01.4] Neuromuscular dysfunction of bladder, not elsewhere classified\n --EXCLUDES--> [?] Other injuries of spine or trunk, level unspecified\n --PARENT--> [?] Injuries to unspecified part of trunk, limb or body region",
"[GC01.4] Neuromuscular dysfunction of bladder, not elsewhere classified\n --EXCLUDES--> [?] Cauda equina syndrome\n --CHILD--> [?] Cauda equina syndrome due to spinal stenosis"
] |
KB08.2
|
Congenital hypotonia
|
[
{
"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"
},
{
"from_icd11": "GC01.4",
"icd10_code": "N311",
"icd10_title": "Reflex neuropathic bladder, not elsewhere classified"
},
{
"from_icd11": "GC01.4",
"icd10_code": "N31",
"icd10_title": "Neuromuscular dysfunction of bladder, not elsewhere classified"
},
{
"from_icd11": "5C54.2",
"icd10_code": "E778",
"icd10_title": "Other disorders of glycoprotein metabolism"
},
{
"from_icd11": "QB63.0",
"icd10_code": "Z940",
"icd10_title": "Kidney transplant status"
},
{
"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"
}
] |
P942
|
Congenital hypotonia
|
We described the case of a patient with a diagnosis of BD and FTD. Since the beginning of her psychopathological history, the patient reported significant subthreshold autistic traits, although apparently not affecting her global functioning. Despite the onset of the mood disorder in younger age, the patient maintained a good adjustment without pharmacological therapy for a long time, until the age of 60 years, when she experienced new episodes of the mood disorder with progressively increasing severity and associated with the onset of FTD, and, more recently, catatonic symptoms. According to the literature, subthreshold and full-threshold autistic features could be present in up to 50% of BD patients [ 7 , 30 – 33 ]. A previous study from our group reported that BD patients with subthreshold autistic traits may show an early onset of the BD, longer hospital stay, more severe depressive symptoms, alteration of rhythmicity and suicidality thoughts across lifetime . The above-described case may be in line with the literature that stressed a possible neurodevelopmental pathway underlying mood disorder: according to this hypothesis, autistic traits could be a vulnerability factor for the development of mood symptoms, especially after a history of stressful life events. The subthreshold autistic symptoms of the patient, despite their apparent non-clinical significance, might have been a ground of vulnerability for BD development, further stressing the need of early detection and prevention strategies targeting subjects with subthreshold autistic traits . The case of Mrs. X.Y. also adds further insights on the relationship between BD and FTD. BD is the psychiatric disorder most frequently associated with dementia, while, among other kinds of dementias, FTD is often preceded by mood symptoms . Previous reports highlighted that manic behaviors may be an early sign of FTD, while manic or hypomanic symptoms may actually show several overlaps with those of FTD [ 36 – 38 ]. In addition, late-onset BD may constitute a precursor of FTD or, conversely, may be associated with cognitive and behavioral alterations similar to those reported in FTD . This close association led an increasing number of authors to hypothesize the presence of shared vulnerability factors and neurobiological bases between FTD and BD, highlighting a continuum between psychiatric and neurological disorders . Despite that, research in this field is still scant . Our case further supports the presence of interlaced relationships between these two conditions. While the clinical history of Mrs. X.Y. featured an earlier onset of the BD, the disorder remained of milder intensity, without requiring pharmacological treatment for several years. The severity of the mood symptoms increased only later in life, and soon after she was diagnosed with FTD. On the basis of this data, the development of FTD might be considered as a neuro-degenerative outcome of the BD. On the other hand, it is also possible that the BD symptoms would have been instead a prodromal condition of an underlying FTD. From an integrative perspective, FTD and BD could be even conceptualized as deeply interlaced conditions, sharing similar pathogenetic underpinnings, while featuring different presentations and impact on global functioning depending on the severity of the neurobiological alteration . The hypothesis of a continuum between psychiatric and neurological conditions would be in line, and further expand, the increasing literature highlighting a possible neurodevelopmental approach to psychopathology. In particular, it was hypothesized that a neurodevelopmental alteration may be at the basis of different psychiatric disorders. The specific timing, severity, and location of the alteration, interacting with other biological as well as environmental factors, may lead to different psychopathological trajectories: from the more severe forms of ASD to the different forms of psychotic, mood and anxiety disorders [ 12 – 21 ]. In this framework, the presence of catatonic symptoms in the patient's clinical picture may be of particular interest. Catatonia is a life-threatening condition, which may be associated with different psychiatric disorders, including BD . In addition, several overlaps between catatonic and autism symptoms have been highlighted in the literature, while Autism Spectrum have been recently hypothesized to be a vulnerability factor towards the development of more severe outcomes, including catatonic states, in patients with other mental disorders . The clinical overlap between the two disorders has been highlighted by a recent systematic review that observed that 10.4% of individuals with ASD also have catatonia . Several explanations for this clinical overlap have been proposed, including a common alteration in the GABAergic system, in neuronal networks, or in the size of cerebellar structures, as well as a potential genetic connection resulting from susceptibility regions on chromosome 15. ASD and catatonia both share a wide range of clinical traits, including mutism, echolalia, stereotyped movements, repetitive behaviors, negativism, and arousal. The tendency to overestimate subthreshold catatonia and the failure to identify catatonic symptoms once they initially emerge in patients with ASD may both be caused by this clinical overlap . Subthreshold autism spectrum, which does not significantly impair daily functioning, was also hypothesized to increase the risk of catatonia if unrecognized, possibly in line with the illness trajectory of the case presented here. In this framework, it should be noted that, as autism spectrum, and particularly subthreshold autistic traits, seems to be continuously distributed from the clinical to the general population, catatonia may as well be related to the autism dimension even when subthreshold or not clinically evident, in the framework of an intertwined relationship between the two broader dimensions of autism and catatonia spectrums .
| 4.34375
| 0.863281
|
sec[2]/p[0]
|
en
| 0.999997
|
36997907
|
https://doi.org/10.1186/s12888-023-04709-9
|
[
"subthreshold",
"that",
"this",
"autistic",
"mood",
"catatonia",
"traits",
"disorders",
"autism",
"onset"
] |
[
{
"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": "4A01.03",
"title": "Transient hypogammaglobulinaemia of infancy"
},
{
"code": "6A02.Z",
"title": "Autism spectrum disorder, unspecified"
},
{
"code": "6A02.Y",
"title": "Other specified autism spectrum disorder"
},
{
"code": "6A02.5",
"title": "Autism spectrum disorder with disorder of intellectual development and with absence of functional language"
},
{
"code": "6A02.3",
"title": "Autism spectrum disorder with disorder of intellectual development and with impaired functional language"
}
] |
=== 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
[4A01.03] Transient hypogammaglobulinaemia of infancy
Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy]
[6A02.Z] Autism spectrum disorder, unspecified
Also known as: Autism spectrum disorder, unspecified | Autism spectrum disorder | Autistic disorder | autistic | autistic disorder of childhood onset
[6A02.Y] Other specified autism spectrum disorder
Also known as: Other specified autism spectrum disorder | Autism spectrum disorder without disorder of intellectual development and with absence of functional language | Autism spectrum disorder without disorder of intellectual development and with absence of functional language with loss of previously acquired skills | Autism spectrum disorder without disorder of intellectual development and with absence of functional language without loss of previously acquired skills | Atypical autism
[6A02.5] Autism spectrum disorder with disorder of intellectual development and with absence of functional language
Definition: All definitional requirements for both autism spectrum disorder and disorder of intellectual development are met and there is complete, or almost complete, absence of ability relative to the individual’s age to use functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires
Also known as: Autism spectrum disorder with disorder of intellectual development and with absence of functional language | Autism spectrum disorder with disorder of intellectual development and absence of functional language with loss of previously acquired skills | Autism spectrum disorder with disorder of intellectual development and absence of functional language without loss of previously acquired skills
[6A02.3] Autism spectrum disorder with disorder of intellectual development and with impaired functional language
Definition: All definitional requirements for both autism spectrum disorder and disorder of intellectual development are met and there is marked impairment in functional language (spoken or signed) relative to the individual’s age, with the individual not able to use more than single words or simple phrases for instrumental purposes, such as to express personal needs and desires.
Also known as: Autism spectrum disorder with disorder of intellectual development and with impaired functional language | Autism spectrum disorder with disorder of intellectual development and with impaired functional language with loss of previously acquired skills | Childhood disintegrative disorder | Heller syndrome | Disintegrative psychosis
=== 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--> [8A80.0] 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 3 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 4 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 5 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--- Walk 6 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.1] Underdosing, as mode of injury or harm
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] 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--> [8A80.0] 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...",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm"
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
A 59-year-old Korean female came in with a chief complaint of palpable mass present in shoulder and upper back regions . She had not previously received any diagnosis of disease except for psychiatric conditions. Height, weight, and BMI of the patient were 158 cm, 63 kg, and 25.2, respectively. Physical examination was done, and other than the presence of palpable protruding mass, no clinical signs or specific symptoms (e.g., pain or numbness) have been found. Ultrasonography was the first imaging study performed , which revealed characteristics of lipoma. Computed tomography (CT) images and magnetic resonance images (MRI) were obtained to evaluate the depth and distribution of mass. Diffuse non-encapsulated adipose tissues were found in subcutaneous layers of suboccipital and posterior neck. There was no mass surrounding the tracheal area . Partial excision of the mass was planned because the patient wanted it removed for cosmetic reasons and physical discomfort. There were no apparent brain lesions in MRI and no specific findings in neurologic examinations. The preoperative evaluation included plain radiography of the thorax, electrocardiography, and blood analyses. Our patient had impaired fasting glucose levels and elevated aspartate aminotransferase, alanine aminotransferase, and uric acid levels. The values for total cholesterol and rheumatic factor, anti-cyclic citrullinated peptides, and antinuclear antibody levels were within the reference ranges. The laboratory findings are presented in Table 1 . Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Homeostatic Model Assessment for beta-cell function (HOMA-B) scores were 2.6 and 68.7% respectively, which meant that the patient had early insulin resistance. Additional history taking revealed that she had a history of high alcohol consumption. The patient consumed 48.6 g of alcohol daily, which is a high risk for alcohol consumption according to WHO criteria .. Abdominal ultrasound and liver CT were performed in order to determine any existing hepatobiliary problems. Mild gallbladder edema was found in ultrasound. The CT scan found liver cirrhosis with mild splenomegaly. Consequently, the patient received a diagnosis of compensated alcoholic liver cirrhosis (Child-Turcotte-Pugh Classification B) due to heavy alcohol consumption. Under general anesthesia, excisional biopsies were performed via lipectomy at accumulated areas . The histological findings revealed large dystrophic adipocyte morphology. However, there were no findings of any sarcomatous changes . There were no problems with wound healing (e.g., infection, hematoma, or seroma formation) during the post-operative period. There was no recurrence or obvious enlargement of the remnant mass during the 3 years of follow-up observation. Fig. 1 Preoperative distribution of masses. There was symmetrical swelling caused by masses of adipose tissue in both shoulders, the back, and the posterior neck, but the anterior neck was relatively spared. Anterior view ( a ), posterior view ( b ), neck lateral view ( c ) Fig. 2 Ultrasonography findings. Ultrasonography indicated excessive adipose tissue (white lines) located in the subcutaneous layer of the shoulders ( a , 5.73 × 2.12 × 4.32 cm), posterior neck ( b , 4.7 × 7.7 × 2.0 cm), and back ( c , 8.2 × 8.6 × 2.2 cm). All masses were compressible and had minimal vascularity Fig. 3 Magnetic resonance images of the patient’s neck. Coronal and sagittal T1 weighted sequences from the neck MRI revealed subcutaneous adipose tissue in both the shoulders ( a ) and posterior neck ( b ). Axial T1 weighted sequence findings also revealed diffuse subcutaneous fatty infiltration in both shoulders, but there was no mediastinal lipomatosis ( c ). MRI: Magnetic resonance image Fig. 4 Computed tomography image of the patient’s neck. CT images were taken to evaluate the trachea and esophagus. There was no apparent airway or esophageal obstruction on the coronal view ( a ) or the axial view ( b ). CT: Computed tomography Table 1 Findings for hepato-renal function, lipid metabolism, and autoimmune disease parameters in a patient with multiple symmetric lipomatosis Parameter Case Normal range Min. Max. Unit Autoimmune disease ANA Negative Anti-CCP Negative RF 7.32 0 ESR 3 1 10 mm/h CRP 0.08 0 0.3 mg/dL Renal function BUN 15.5 8 23 mg/dL Creatinine 1.3 0.6 1.2 mg/dL Liver function Glucose 178 70 110 mg/dL T.PRO 5.1 5.8 8 g/dL Albumin 2.4 3.1 5.2 g/dL r-GTP 104 0 40 IU/L D.Bil 1.76 0 0.3 mg/dL T.Bil 2.54 0 1.2 mg/dL PT (INR) 1.46 0.89 1.09 aPTT 41 26 38 % Platelet count 78 k 150 k 380 k /μL AST (GOT) 85 10 40 IU/L ALT (GPT) 20 5 40 IU/L ALP 140 35 129 IU/L Lipid metabolism Total cholesterol 50 0 200 mg/dL HDL cholesterol 10.2 35 65 mg/dL LDL cholesterol 31 77 135 mg/dL Triglycerides 1029 50 200 mg/dL Others Calcium 8.5 8.5 10.5 mg/dL Phosphorus 1.6 2.5 5.5 mg/dL Uric acid 10 2.5 8.3 mg/dL ANA: Antinuclear antibody, Anti-CCP: Anti-citrullinated peptides, RF: Rheumatic factor, ESR: Erythrocyte sedimentation rate, CRP: C-reactive protein, BUN: Blood urea nitrogen, T.PRO: Total protein, r-GTP: R-glutamyl transpeptidase, D.Bil: Direct bilirubin, T.Bil: Total bilirubin, PT: Prothrombin time, aPTT: Activated partial thromboplastin time, AST: Aspartate aminotransferase, ALT: Alanine aminotransferase, ALP: Alkaline phosphatase Fig. 5 Gross photo and histologic finding of the excised mass. Specimens consisted of well-defined, pale yellow, fatty tissue. They had homogeneous, soft, solid, greasy cut surfaces without hemorrhage or necrosis. They were 8 × 4.5 × 2 cm (left), 8 × 4 × 2 cm (middle), and 6 × 4.5 × 1.5 cm (right) ( a ). Hematoxylin and eosin staining of the biopsy sample showed fatty tissue without any signs of malignant transformation. The adipocytes had significantly larger cross-sectional surface areas of the lipid vacuoles, compared with those from normal regions (40× ( b ), 200× ( c )). The estimated weights were 64.8 g (Left), 57.6 g (Middle), 40.5 g (Right)
| 4.035156
| 0.977539
|
sec[1]/p[0]
|
en
| 0.999996
|
32928192
|
https://doi.org/10.1186/s12905-020-01055-w
|
[
"neck",
"tissue",
"view",
"adipose",
"subcutaneous",
"aminotransferase",
"total",
"cholesterol",
"anti",
"function"
] |
[
{
"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"
},
{
"code": "FB6Z",
"title": "Soft tissue disorders, unspecified"
},
{
"code": "MC85",
"title": "Gangrene"
},
{
"code": "FB56.6",
"title": "Other specified soft tissue disorders"
},
{
"code": "GB61.Z",
"title": "Chronic kidney disease, stage unspecified"
},
{
"code": "4A43.3",
"title": "Mixed connective tissue disease"
}
] |
=== ICD-11 CODES FOUND ===
[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
[FB6Z] Soft tissue disorders, unspecified
Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS
[MC85] Gangrene
Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply.
Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene
Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis
[FB56.6] Other specified soft tissue disorders
Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia
[GB61.Z] Chronic kidney disease, stage unspecified
Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease
[4A43.3] Mixed connective tissue disease
Definition: Mixed connective tissue disease is an overlapping syndrome combining features of systemic lupus erythematosus, systemic sclerosis, and polymyositis with the presence of autoantibodies to U1-ribonucleoprotein. Raynaud’s phenomenon is seen in nearly all patients and pulmonary arterial hypertension is the most common cause of death in MCTD patients.
Also known as: Mixed connective tissue disease | Sharp syndrome | MCTD - [mixed connective tissue disease] | Paediatric-onset mixed connective tissue disease | Paediatric-onset Sharp syndrome
=== GRAPH WALKS ===
--- Walk 1 ---
[ME86.C] Symptom or complaint of the neck
--EXCLUDES--> [?] Chronic primary musculoskeletal pain
Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...
--CHILD--> [?] Chronic primary thoracic pain
Def: Chronic primary thoracic pain is chronic pain in the muscles, bones, joints or tendons of the thoracic region that is characterised by significant emotional distress (anxiety, anger/frustration or dep...
--- Walk 2 ---
[ME86.C] Symptom or complaint of the neck
--EXCLUDES--> [?] Chronic secondary musculoskeletal pain
Def: Chronic secondary musculoskeletal pain is chronic pain arising from bone(s), joint(s), muscle(s), vertebral column, tendon(s) or related soft tissue(s). It is a heterogeneous group of chronic pain con...
--EXCLUDES--> [?] 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 3 ---
[LA6Z] Structural developmental anomalies of the neck, unspecified
--PARENT--> [?] Structural developmental anomalies of the neck
Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....
--CHILD--> [LA61] Congenital sternomastoid tumour
--- Walk 4 ---
[LA6Z] Structural developmental anomalies of the neck, unspecified
--PARENT--> [?] Structural developmental anomalies of the neck
Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....
--CHILD--> [LA61] Congenital sternomastoid tumour
--- Walk 5 ---
[ME84.0] Cervical spine pain
Def: 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 t...
--EXCLUDES--> [?] Chronic primary cervical pain
Def: Chronic primary cervical pain is chronic pain in the muscles, bones, joints or tendons of the neck region that is characterised by significant emotional distress (anxiety, anger/frustration or depress...
--PARENT--> [?] Chronic primary musculoskeletal pain
Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...
--- Walk 6 ---
[ME84.0] Cervical spine pain
Def: 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 t...
--EXCLUDES--> [?] Chronic primary cervical pain
Def: Chronic primary cervical pain is chronic pain in the muscles, bones, joints or tendons of the neck region that is characterised by significant emotional distress (anxiety, anger/frustration or depress...
--PARENT--> [?] Chronic primary musculoskeletal pain
Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...
|
[
"[ME86.C] Symptom or complaint of the neck\n --EXCLUDES--> [?] Chronic primary musculoskeletal pain\n Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...\n --CHILD--> [?] Chronic primary thoracic pain\n Def: Chronic primary thoracic pain is chronic pain in the muscles, bones, joints or tendons of the thoracic region that is characterised by significant emotional distress (anxiety, anger/frustration or dep...",
"[ME86.C] Symptom or complaint of the neck\n --EXCLUDES--> [?] Chronic secondary musculoskeletal pain\n Def: Chronic secondary musculoskeletal pain is chronic pain arising from bone(s), joint(s), muscle(s), vertebral column, tendon(s) or related soft tissue(s). It is a heterogeneous group of chronic pain con...\n --EXCLUDES--> [?] 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....",
"[LA6Z] Structural developmental anomalies of the neck, unspecified\n --PARENT--> [?] Structural developmental anomalies of the neck\n Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....\n --CHILD--> [LA61] Congenital sternomastoid tumour",
"[LA6Z] Structural developmental anomalies of the neck, unspecified\n --PARENT--> [?] Structural developmental anomalies of the neck\n Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....\n --CHILD--> [LA61] Congenital sternomastoid tumour",
"[ME84.0] Cervical spine pain\n Def: 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 t...\n --EXCLUDES--> [?] Chronic primary cervical pain\n Def: Chronic primary cervical pain is chronic pain in the muscles, bones, joints or tendons of the neck region that is characterised by significant emotional distress (anxiety, anger/frustration or depress...\n --PARENT--> [?] Chronic primary musculoskeletal pain\n Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...",
"[ME84.0] Cervical spine pain\n Def: 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 t...\n --EXCLUDES--> [?] Chronic primary cervical pain\n Def: Chronic primary cervical pain is chronic pain in the muscles, bones, joints or tendons of the neck region that is characterised by significant emotional distress (anxiety, anger/frustration or depress...\n --PARENT--> [?] Chronic primary musculoskeletal pain\n Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ..."
] |
ME86.C
|
Symptom or complaint of the neck
|
[
{
"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"
},
{
"from_icd11": "FB6Z",
"icd10_code": "M60-M79",
"icd10_title": ""
},
{
"from_icd11": "MC85",
"icd10_code": "R02",
"icd10_title": ""
},
{
"from_icd11": "MC85",
"icd10_code": "I96",
"icd10_title": "Gangrene, not elsewhere classified"
},
{
"from_icd11": "FB56.6",
"icd10_code": "M7981",
"icd10_title": "Nontraumatic hematoma of soft tissue"
},
{
"from_icd11": "FB56.6",
"icd10_code": "M7989",
"icd10_title": "Other specified soft tissue disorders"
}
] |
Q680
|
Congenital deformity of sternocleidomastoid muscle
|
Patient 2-2 is a girl that was born as second child to consanguineous parents of Turkish origin at term after an uneventful pregnancy (birth weight 4290 g (+2.4 SD), length 54 cm (+1.1 SD), head circumference 36 cm (+1.7 SD)). From early on, she showed a slow development and was able to sit at age 16 months and walked independently 4 months later. She developed secondary microcephaly in the first years. Examination at the age of 8 years revealed generalized hypotonia, ataxia and dysmorphic features with wide nasal bridge, arched eyebrows, up slanting palpebral fissures, epiblepharon, and diastema of the upper incisors. She speaks ~20 words. Brain MRI showed pontocerebellar hypoplasia (see Table 1 ). The thalami were slightly small, though the basal ganglia were normal. Dilated frontal CSF spaces indicated possible hypoplasia of the frontal lobes . She developed bilateral cataracts in toddler age and artificial lenses were inserted at age 3 years. She suffered from refractory seizures since the age of 4 years. EEGs showed continuous generalized slow spike-waves in sleep. Table 1 Clinical findings of patients with MINPP1 variants. family 1 (Dusseldorf/Leipzig) family 2 (Munich) family 3 (Leiden) family 4 (London) Ucuncu et al. patient 1-1 patient 1-2 patient 2-1 patient 2-2 patient 3-1 patient 4-1 patient 4-2 patient 4-3 8 patients male male female female male male male male 5 female/ 3 male Variant Genomic Position (hg19) Chr10 g.87504979-87505009del g.87513139C>A g.87552224C>T g.87521094T>G 3 truncating / 4 missense variants HGVS cDNA c.75_94del c.851C>A c.1210C>T c.992T>G HGVS Protein p.(Leu27Argfs*39) p.(Ala284Asp) p.(Arg404*) p.(Ile331Ser) GnomAD MAF 0.000008 (2 alleles) 0.00009 (25 alleles) 0.000004 (1 allele) 0 alleles Exon 1 3 5 4 Zygosity homozygous homozygous homozygous homozygous 7 homozygous / 1 compound heterozygous Growth Length/Height Birth: 44 cm (-2.6 SD) 6 months: 60cm (-2.7 SD) Birth 51cm (-0.9 SD) 11 months: 73cm (-0.8 SD) Birth: 50cm (SD) 4 years: 102cm (-0.44 SD) Birth: 54cm (+1.1 SD) 4 years: 104cm (-0.07 SD) Birth: n/a 8 months: 77cm (+2.4 SD) Birth: 49cm (-0.11 SD) 10 years: 110cm (-4.44 SD) Birth: 42cm (-3.16 SD) 7 years: 109cm (-2.38 SD) Birth: 45cm (-2 SD) 7 years: 108cm (-2.57 SD) rather normal birth size with secondary microcephaly Weight Birth: 2105g (-2.2 SD) 6 months: 5920g (-1.9 SD) Birth: 3645g (-0.2 SD) 11 months: 7100g (-2.3 SD) Birth: 3890g (+1.43 SD) 4 years: 19kg (+0.49 SD) Birth: 4290g (+2.4 SD) 4 years: 17.8kg (-0.1 SD) Birth: 4270 (+1.4 SD) 8 month: 9200g (+0.3 SD) Birth: 2900g (-0.54 SD) 10 years: 17kg (-3.58 SD) Birth: 2500g (-1.49 SD) 7 years: 12kg (-4.26 SD) Birth: 2300g (-1.94 SD) 7 years: 13kg (-3.87 SD) Head circumference Birth: 31cm (-2.3 SD) 6months: 37cm (-5.7 SD) Birth: 33.5cm (-1.9 SD) 11 months: 38.8cm (-6.6 SD) Birth: 36cm (+1.65 SD) 4 years: 51.5cm (+1.1 SD) Birth: 36cm (+1.7 SD) 4 years: 47cm (-2.27 SD) Birth: n/a 8 months: 43.3cm (-1.1 SD) Birth: 34cm (-0.02 SD) 10 years: 50cm (-2.19 SD) Birth: 32cm (-1.59 SD) 7 years: 48cm (-3.01 SD) Birth: 31cm (-2.32 SD) 7 years: 46cm (-4.51 SD) Neurodevelopment Developmental delay/Intellectual disability yes, severe yes, severe yes, severe yes, severe yes, moderate yes, severe yes, severe yes, severe Severe developmental delay with absent milestones Motor development delayed delayed delayed delayed delayed delayed delayed delayed Speech no speech babbling delayed delayed babbling no speech no speech no speech Behaviour stereotypies, permanently exhausted, salaam movements stereotypies, agitation stereotypies stereotypies stereotypies, salaam movements stereotypies, agitation stereotypies stereotypies Ataxia yes yes, with stiffness and spasticity yes yes yes yes yes yes yes Epilepsy and EEG started at age of 6 months, therapy resistant no started at age of 4 years, therapy resistant, EEG showed continuous generalized slow spike-waves in sleep no started at age of 4 months, therapy resistant, EEG showed hypsarrhythmia polyspike started at 6 months, polyspike and wave started at 6 months, polyspike and wave 7 of 8 Autism no no n/a yes no no no no not indicated Cranial MRI Pontine hypoplasia yes yes yes yes yes yes yes yes pontocerebellar hypoplasia in all Cerebellar hemispheres hypoplasia yes yes yes yes yes no no no Vermian hypoplasia yes yes yes yes yes yes yes yes Atrophy of caudate nuclei and putamen yes yes, mild no no yes yes no yes atrophy in all Thalamic hypoplasia yes yes, mild yes yes, mild yes no no no hypoplasia/atrophy in all Corpus callosum thinning yes no no no yes yes yes yes thin in 4 from 7 Other white matter abnormalities yes, delayed myelination no no no yes yes (++ frontal) yes (++ frontal) yes (++ frontal) white matter atrophy in 3 of 5 Enlarged ventricles/CSF spaces yes yes, mild yes, mild no yes yes yes yes enlarged in all Other global brain atrophy global brain atrophy anterotemporal arachnoid cyst hypoplasia of frontal lobes and insula - T2 hyperintensity in basal ganglia T2 hyperintensity in basal ganglia T2 hyperintensity in basal ganglia Facial Dysmorphism no no n/a wide nasal bridge blepharoptosis low set ear low set ear Hearing normal, mild hyperacusis mild hyperacusis, easily scared, impressive Moro reflex n/a normal normal normal normal normal Vision n/a at least for light n/a bilateral cataract, convergent strabismus nystagmus, possibly cortical blindness cortical blindness cortical blindness cortical blindness Other muscular hypotonia, which started with epilepsy, before that spasticity, micropenis muscular hypertonia, micropenis muscular hypotonia cataract on both sides muscular hypotonia cataract on both sides hypertonia of extremities, axial hypotonia, micropenis /hypospadias muscular hypotonia muscular hypotonia Any other variants of interest? no no no no AR mutation, described to give micropenis/hypospadias no no no Other Notes PEG, frequent infections of lung, oxygen at home no infections, no tube feeding epileptic encephalopathy epileptic encephalopathy No PEG no no no
| 4.191406
| 0.871582
|
sec[2]/sec[0]/sec[1]/p[0]
|
en
| 0.999999
|
33168985
|
https://doi.org/10.1038/s41431-020-00749-x
|
[
"birth",
"hypoplasia",
"stereotypies",
"hypotonia",
"frontal",
"atrophy",
"muscular",
"homozygous",
"speech",
"basal"
] |
[
{
"code": "QA46.Z",
"title": "Outcome of delivery, unspecified"
},
{
"code": "LD9Z",
"title": "Developmental anomalies, unspecified"
},
{
"code": "LD2Z",
"title": "Multiple developmental anomalies or syndromes, unspecified"
},
{
"code": "KA4Z",
"title": "Birth injury, unspecified"
},
{
"code": "QA46.0",
"title": "Single live birth"
},
{
"code": "LA75.2",
"title": "Congenital hypoplasia of lung"
},
{
"code": "DA0E.0Y&XA51B7",
"title": "Mandibular hypoplasia"
},
{
"code": "LA8B.2Y",
"title": "Other specified congenital anomaly of aorta or its branches"
},
{
"code": "LB9Z",
"title": "Structural developmental anomalies of the skeleton, unspecified"
},
{
"code": "LA10.0",
"title": "Microphthalmos"
}
] |
=== ICD-11 CODES FOUND ===
[QA46.Z] Outcome of delivery, unspecified
Also known as: Outcome of delivery, unspecified | Outcome of delivery | Multiple birth, unspecified | Single birth, unspecified
[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
[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
[KA4Z] Birth injury, unspecified
Also known as: Birth injury, unspecified | childbirth trauma | birth injury nos | birth trauma of fetus | childbirth injury
[QA46.0] Single live birth
Definition: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life.
Also known as: Single live birth | single liveborn | outcome of delivery of single liveborn
[LA75.2] Congenital hypoplasia of lung
Also known as: Congenital hypoplasia of lung | Pulmonary hypoplasia | hypoplasia and dysplasia of lung | congenital small lung | hypoplasia of lobe of lung
[LA8B.2Y] Other specified congenital anomaly of aorta or its branches
Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation
[LB9Z] Structural developmental anomalies of the skeleton, unspecified
Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS
[LA10.0] Microphthalmos
Also known as: Microphthalmos | globe of eye small | Microphthalmia | small eyeball | Hypoplasia of eye
Includes: Dysplasia of eye | Hypoplasia of eye | Rudimentary eye
=== GRAPH WALKS ===
--- Walk 1 ---
[QA46.Z] Outcome of delivery, unspecified
--PARENT--> [QA46] Outcome of delivery
--CHILD--> [QA46.2] Twins, both liveborn
Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life....
--- Walk 2 ---
[QA46.Z] Outcome of delivery, unspecified
--PARENT--> [QA46] Outcome of delivery
--CHILD--> [QA46.2] Twins, both liveborn
Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life....
--- Walk 3 ---
[LD9Z] Developmental anomalies, unspecified
--PARENT--> [20] Developmental anomalies
Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....
--CHILD--> [?] Structural developmental anomalies primarily affecting one body system
Def: A deformation established before birth of an anatomical structure....
--- Walk 4 ---
[LD9Z] Developmental anomalies, unspecified
--PARENT--> [20] Developmental anomalies
Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....
--CHILD--> [?] Multiple developmental anomalies or syndromes
Def: Complex developmental anomalies involving more than one body system...
--- Walk 5 ---
[LD2Z] Multiple developmental anomalies or syndromes, unspecified
--PARENT--> [?] Multiple developmental anomalies or syndromes
Def: Complex developmental anomalies involving more than one body system...
--CHILD--> [LD20] Syndromes with central nervous system anomalies as a major feature
--- Walk 6 ---
[LD2Z] Multiple developmental anomalies or syndromes, unspecified
--PARENT--> [?] Multiple developmental anomalies or syndromes
Def: Complex developmental anomalies involving more than one body system...
--CHILD--> [LD22] Syndromes with dental anomalies as a major feature
|
[
"[QA46.Z] Outcome of delivery, unspecified\n --PARENT--> [QA46] Outcome of delivery\n --CHILD--> [QA46.2] Twins, both liveborn\n Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life....",
"[QA46.Z] Outcome of delivery, unspecified\n --PARENT--> [QA46] Outcome of delivery\n --CHILD--> [QA46.2] Twins, both liveborn\n Def: Live birth is the complete expulsion or extraction from a woman of a fetus, irrespective of the duration of the pregnancy, which, after such separation, shows signs of life....",
"[LD9Z] Developmental anomalies, unspecified\n --PARENT--> [20] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....\n --CHILD--> [?] Structural developmental anomalies primarily affecting one body system\n Def: A deformation established before birth of an anatomical structure....",
"[LD9Z] Developmental anomalies, unspecified\n --PARENT--> [20] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....\n --CHILD--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...",
"[LD2Z] Multiple developmental anomalies or syndromes, unspecified\n --PARENT--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...\n --CHILD--> [LD20] Syndromes with central nervous system anomalies as a major feature",
"[LD2Z] Multiple developmental anomalies or syndromes, unspecified\n --PARENT--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...\n --CHILD--> [LD22] Syndromes with dental anomalies as a major feature"
] |
QA46.Z
|
Outcome of delivery, unspecified
|
[
{
"from_icd11": "QA46.Z",
"icd10_code": "Z379",
"icd10_title": "Outcome of delivery, unspecified"
},
{
"from_icd11": "QA46.Z",
"icd10_code": "Z37",
"icd10_title": "Outcome of delivery"
},
{
"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": "LD2Z",
"icd10_code": "Q8789",
"icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q8781",
"icd10_title": "Alport syndrome"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q871",
"icd10_title": "Congenital malformation syndromes predominantly associated with short stature"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q872",
"icd10_title": "Congenital malformation syndromes predominantly involving limbs"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q870",
"icd10_title": "Congenital malformation syndromes predominantly affecting facial appearance"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q897",
"icd10_title": "Multiple congenital malformations, not elsewhere classified"
}
] |
Z379
|
Outcome of delivery, unspecified
|
An 18-year-old female suffered from chest oppression on effort for a month. She visited a hospital, and her electrocardiogram showed ST-segment depression in leads I, aV L , and V 2–4 . She was suspected of having angina pectoris, and was referred to our hospital. Her laboratory data on admission showed a normal range of creatinine kinase and troponin I as shown in Table 1 . Echocardiography revealed normal left ventricular contraction and mild to moderate aortic regurgitation. Coronary angiography showed severe stenosis in the ostium of both the left main trunk and the right coronary artery . Quantitative coronary angiography analysis was performed with a computerized quantitative analysis system (QAngio XA version 7.3, Medis Medical Imaging System, Leiden, The Netherlands), using a contrast-filled catheter as a calibration source. The percentage of the diameter of the most severe stenosis compared with the reference diameter was defined as % diameter stenosis . % diameter stenosis of the ostial stenosis was 95.0% in the left main trunk and 87.2% in the right coronary artery. Intra-coronary administration of isosorbide dinitrate did not dilate the coronary ostial stenosis, suggesting that the stenosis was an organic lesion. Optimal medical treatment, including beta-blocker, antiplatelet, and statin, was initiated for her coronary artery disease. Contrast-enhanced CT showed no specific abnormality of the aorta . She did not have renal artery stenosis or hypertension. Her right and left ankle-brachial indices were 1.08, and 1.03, respectively. She was examined by an ophthalmologist and did not have vision impairment. Magnetic resonance angiography revealed no significant stenosis of her carotid artery. The patient had no coronary risk factors or signs of infectious disease and congenital heart disease. C-reactive protein, serum amyloid A, and erythrocyte sedimentation rate (1 h) on admission were 2.13 mg/dL (normal range: 0.00–0.30 mg/dL), 479 μg/mL (normal range: 0.0–8.0 μg/mL), and 40 mm (normal range: 3–15 mm), respectively, suggesting systemic inflammation. 18 F-FDG PET/CT showed isolated inflammation of the aortic root . She was therefore diagnosed with Takayasu arteritis, and oral administration of prednisolone was started from 0.56 mg/kg/day. Tocilizumab was added 3 months after the initiation of prednisolone . Follow-up coronary angiography showed regression of the ostial stenosis 4 months after the initiation of prednisolone, and % diameter stenosis was 86.7% in the left main trunk and 72.6% in the right coronary artery . Intravascular ultrasound or optical coherence tomography was not performed for the ostial lesions. Her C-reactive protein and erythrocyte sedimentation rate (1 h) were decreased to 0.03 mg/dL and 5 mm, respectively. The second 18 F-FDG PET/CT showed decreased 18 F-FDG uptake in the aortic root, but still showed inflammation . Her serum amyloid A of 13.8 μg/mL was not normalized, therefore we decided to control the disease activity by combined immunosuppressive treatment including steroid pulse therapy (methylprednisolone 1 g/day for 3 days). Oral methotrexate ranging from 4 to 8 mg/week was administered to decrease corticosteroid dose . The levels of serum amyloid A were not significantly increased and the dose of prednisolone was decreased from 0.28 to 0.21 mg/kg/day after administration of methotrexate. Fig. 1 Electrocardiogram. a . Electrocardiogram showed ST-segment depression in leads I, aV L , and V 2–4 . b . Electrocardiogram showed no ST-segment depression after the treatment Table 1 Laboratory findings on admission Parameters Value Blood count White cell count 10,100 /μL Red blood cell 451 × 10 4 /μL Hemoglobin 12.0 g/dL Hematocrit 37.1% Platelet count 37.4 × 10 4 /μL Biochemistry AST 16 IU/L ALT 13 IU/L LDH 248 IU/L ALP 275 IU/L Total bilirubin 0.7 mg/dL Direct bilirubin < 0.1 mg/dL BUN 9 mg/dL Creatinine 0.71 mg/dL eGFR 91 mL/min/1.73 m 2 Sodium 141 mEq/L Potassium 4.4 mEq/L Chlorine 103 mEq/L Total protein 7.4 g/dL Albumin 3.4 g/dL Uric acid 5.0 mg/dL Creatine kinase 54 IU/L CK-MB < 0.5 IU/L Troponin I 0.035 ng/mL BNP 10.2 pg/mL Triglyceride 143 mg/dL HDL-C 39 mg/dL LDL-C 111 mg/dL CRP 2.13 mg/dL FT3 2.81 pg/mL FT4 1.32 ng/mL TSH 3.510 U/mL Glucose 109 mg/dL HbA1c (NGSP) 5.5% ESR (1 h) 40 mm SAA 479 μg/mL AST aspartate transaminase, ALT alanine aminotransferase, ALP alkaline phosphatase, BNP B-type natriuretic peptide, BUN blood urea nitrogen, CRP C-reactive protein, CK-MB creatine kinase MB, eGFR estimate glomerular filtration rate, ESR erythrocyte sedimentation rate, FT3 free triiodothyronine, FT4 free thyroxine, HbA1c hemoglobin A1c, HDL-C high-density lipoprotein, LDH lactate dehydrogenase, LDL-C low-density lipoprotein, SAA serum amyloid A, TSH thyroid stimulating hormone, NGSP national glycohemoglobin standardization program Fig. 2 Coronary angiography. a , b . Initial coronary angiography showed severe stenosis in the ostium of both the left main trunk and the right coronary artery. c , d . Four months after immunosuppressive treatment, coronary angiography showed significant regression of the right coronary ostial stenosis, but limited regression of the left coronary ostial stenosis Fig. 3 Contrast-enhanced computed tomography. a , b . No significant aortic lesion was detected by contrast-enhanced computed tomography Fig. 4 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT). a , b . 18 F-FDG PET/CT showed isolated inflammation of the aortic root on admission. The maximum standardized uptake value (max SUV) was 6.3. c , d . After immunosuppressive treatment, 18 F-FDG PET/CT showed decreased 8 F-FDG uptake in the aortic root. The max SUV was decreased to 4.3 Fig 5 Clinical course. CAG, coronary angiography; CT, computed tomography; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; FDG, fluorodeoxyglucose; PET, positron emission tomography; PSL, prednisolone, SAA, serum amyloid A; mPSL, methylprednisolone
| 4.054688
| 0.972656
|
sec[0]/sec[0]/p[0]
|
en
| 0.999996
|
30940076
|
https://doi.org/10.1186/s12872-019-1066-7
|
[
"coronary",
"stenosis",
"angiography",
"artery",
"tomography",
"aortic",
"ostial",
"diameter",
"protein",
"serum"
] |
[
{
"code": "BA8Z",
"title": "Diseases of coronary artery, unspecified"
},
{
"code": "BA4Z",
"title": "Acute ischaemic heart disease, unspecified"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "BA5Z",
"title": "Chronic ischaemic heart disease, unspecified"
},
{
"code": "LA8C.2",
"title": "Congenital coronary arterial fistula"
},
{
"code": "DB30.Y",
"title": "Other specified obstruction of large intestine"
},
{
"code": "BB60.Z",
"title": "Mitral valve stenosis, unspecified"
},
{
"code": "BD52.2",
"title": "Stricture of artery"
},
{
"code": "FA82",
"title": "Spinal stenosis"
},
{
"code": "DA40.0",
"title": "Gastric outlet obstruction"
}
] |
=== ICD-11 CODES FOUND ===
[BA8Z] Diseases of coronary artery, unspecified
Also known as: Diseases of coronary artery, unspecified | coronary artery insufficiency | coronary artery heart disease | CAD - [coronary artery disease] | coronary artery disorder
[BA4Z] Acute ischaemic heart disease, unspecified
Also known as: Acute ischaemic heart disease, unspecified | acute coronary syndrome | ACS - [acute coronary syndrome] | Silent myocardial ischaemia | asymptomatic ischemia
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[BA5Z] Chronic ischaemic heart disease, unspecified
Also known as: Chronic ischaemic heart disease, unspecified | Ischaemic heart disease (chronic) NOS | coronary ischaemia | coronary damage NOS | atheroma of heart
[LA8C.2] Congenital coronary arterial fistula
Definition: A congenital cardiovascular malformation in which a coronary artery communicates, through an anomalous channel, with a cardiac chamber or with any segment of the systemic or pulmonary circulation.
Additional information: this communication may be simple and direct or may be tortuous and dilated. In order of frequency the involved coronary artery is the right, the left and, rarely, both coronary arteries. Occasionally multiple fistulas are present.
Also known as: Congenital coronary arterial fistula | coronary fistula | congenital arteriovenous coronary fistula | congenital coronary fistula to pulmonary artery | Congenital coronary arterial fistula to right ventricle
Includes: congenital coronary fistula to pulmonary artery
Excludes: anomalous origin of coronary artery from pulmonary arterial tree
[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
[BB60.Z] Mitral valve stenosis, unspecified
Also known as: Mitral valve stenosis, unspecified | Mitral valve stenosis | MS - [mitral stenosis] | mitral stenosis | mitral valvular stricture
[BD52.2] Stricture of artery
Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery
[FA82] Spinal stenosis
Definition: This is a condition characterised by narrowing of the spinal canal.
Also known as: Spinal stenosis | spinal canal stenosis | Spinal stenosis with no determinant | primary spinal stenosis | Spinal stenosis with determinant
[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 ---
[BA8Z] Diseases of coronary artery, unspecified
--PARENT--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--CHILD--> [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....
--- Walk 2 ---
[BA8Z] Diseases of coronary artery, unspecified
--PARENT--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--CHILD--> [BA83] Coronary artery fistula, acquired
Def: Abnormal communication between a coronary artery and a cardiac chamber or major vessels, acquired after coronary or heart surgery, coronary angioplasty, rupture or coronary artery aneurysm or injury t...
--- Walk 3 ---
[BA4Z] Acute ischaemic heart disease, unspecified
--PARENT--> [?] Acute ischaemic heart disease
--CHILD--> [BA40] Angina pectoris
--- Walk 4 ---
[BA4Z] Acute ischaemic heart disease, unspecified
--PARENT--> [?] Acute ischaemic heart disease
--CHILD--> [BA40] Angina pectoris
--- Walk 5 ---
[BA41.Z] Acute myocardial infarction, unspecified
--PARENT--> [BA41] Acute myocardial infarction
Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...
--CHILD--> [BA41.Z] Acute myocardial infarction, unspecified
--- Walk 6 ---
[BA41.Z] Acute myocardial infarction, unspecified
--PARENT--> [BA41] Acute myocardial infarction
Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...
--EXCLUDES--> [?] Certain current complications following acute myocardial infarction
Def: Secondary conditions which may occur in the course after the heart attack. They include pericarditis, arrhythmia, cardiogenic shock, heart failure, ventricular rupture, ventricular aneurysm (with thro...
|
[
"[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --CHILD--> [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....",
"[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --CHILD--> [BA83] Coronary artery fistula, acquired\n Def: Abnormal communication between a coronary artery and a cardiac chamber or major vessels, acquired after coronary or heart surgery, coronary angioplasty, rupture or coronary artery aneurysm or injury t...",
"[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA40] Angina pectoris",
"[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA40] Angina pectoris",
"[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.Z] Acute myocardial infarction, unspecified",
"[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --EXCLUDES--> [?] Certain current complications following acute myocardial infarction\n Def: Secondary conditions which may occur in the course after the heart attack. They include pericarditis, arrhythmia, cardiogenic shock, heart failure, ventricular rupture, ventricular aneurysm (with thro..."
] |
BA8Z
|
Diseases of coronary artery, unspecified
|
[
{
"from_icd11": "BA4Z",
"icd10_code": "I248",
"icd10_title": "Other forms of acute ischemic heart disease"
},
{
"from_icd11": "BA4Z",
"icd10_code": "I256",
"icd10_title": "Silent myocardial ischemia"
},
{
"from_icd11": "BA4Z",
"icd10_code": "I249",
"icd10_title": "Acute ischemic heart disease, unspecified"
},
{
"from_icd11": "BA4Z",
"icd10_code": "I24",
"icd10_title": "Other acute ischemic heart diseases"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A1",
"icd10_title": "Myocardial infarction type 2"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A9",
"icd10_title": "Other myocardial infarction type"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2109",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2119",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2111",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2102",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2129",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2121",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2101",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I214",
"icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I213",
"icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site"
}
] |
I248
|
Other forms of acute ischemic heart disease
|
In the case we presented, integrated analysis of the clinical manifestations and results of examinations performed during our patient’s NICU stay suggested the diagnosis of CS, which was soon after confirmed by genetic testing. On retrospective evaluation, all the elements of the clinical picture fitted with a diagnosis of CS (Table 1 ), but the first diagnostic clue we had, that triggered all subsequent examinations, was rather non-specific: asymptomatic hypoglycemia. However, although a constitutive origin of the clinical picture presented by the patient could be hypothesized, hypoglycemia is a frequent finding in many genetic syndromes (Table 2 ). Conversely, it is a feature poorly explored in the literature associated with CS. Consequently, CS was not initially considered in the differential diagnosis of a patient with dysmorphic features and persistent hypoglycemia. Table 1 Typical features of CHARGE syndrome and patient’s neonatal manifestations Clinical features of CS Patient’s neonatal manifestations Ocular coloboma Bilateral coloboma Choanal atresia/stenosis n/p Cranial nerve dysfunction/anomaly Agenesis of olfactory bulbs, thinning of optic nerves, bilateral sensorineural hypoacusis, vocal cord adductors and velopharyngeal sphincter hypotonia Ear malformations Dysplastic auricles, middle ear anomalies, absence of semicircular canals Cleft lip and/or palate n/p Tracheoesophageal anomalies n/p Endocrine manifestations Central hypoadrenalism, low gonadotropins and estrogens Genital hypoplasia n/p Cardiovascular malformations Ostium secundum ASD, PDA Brain anomalies Dysmorphic corpus callosum, cerebellum and pons Renal anomalies n/p Developmental delay/intellectual disability n/a Abbreviations : CS CHARGE syndrome, n/p Not present, n/a Not applicable, ASD Atrial septal defect, PDA Patent ductus arteriosus. Table 2 Overview of the main genetic syndromes that can present with neonatal hypoglycemia Genetic Syndrome Inheritance Prevalence Gene/Locus Phenotype Potential causes of HG Incidence of HG Beckwith-Wiedemann AD 1:10,500-13,700 UPD 11p15 Macrosomia, macroglossia, hemihyperplasia, omphalocele, embryonal tumors, visceromegaly, adrenocortical cytomegaly, renal abnormalities, ear creases/pits Hyperinsulinism 30-50% CHARGE AD 1 : 10,000-15,000 CHD7 8q12.2 Coloboma of the eye, heart defects, choanal atresia, growth retardation, genito-urinary and ear anomalies Hyperinsulinism; GHD; feeding difficulties; CAI n.a Costello AD 1:300,000-1:1.25M HRAS 11p15.5 Coarse facial features (full lips, large mouth, full nasal tip); curly or sparse, fine hair; deep palmar and plantar creases; papillomata of the face and perianal region; ulnar deviation of the wrists and fingers; cardiac involvement Hyperinsulinism; GHD; adrenal insufficiency 44% Donohue AR <1:1M INSR 19p13 Small, elfin-like face, protuberant ears, distended abdomen, acromegaly, hypertrichosis, acanthosis nigricans, decreased subcutaneous fat Accelerated fasting state due to insulin resistance n.a Kabuki KS1:AD KS2: XLR 1:32,000-1:86,000 KS1: KMT2D 12q13 KS2: KDM6A Xp11.3 Eversion of the lower lateral eyelid, depressed nasal tip, arched eyebrows, prominent ears; skeletal anomalies, abnormal dermatoglyphic presentation Hyperinsulinism; GHD; CAI 6-8%, more common in KS2 Laron AR 1-9:1M GHR 5p13-12 Clinical hyposomatotropism, sparse hair, protruding and high forehead, shallow orbits, hypoplastic nasal bridge, small chin, hip degeneration Resistance to GH counterregulatory activities 33-42% Perlman AR <1:1M DIS3L2 2q37.1 Hypotonia, inverted V-shaped upper lip, prominent forehead, deep-set eyes, broad and flat nasal bridge, low-set ears, renal anomalies Hyperinsulinism due to Langerhans islets’ hypertrophy n.a Prader-Willi AD 1:25,000 UDP 15q11–q13 Diminished fetal activity, obesity, muscular hypotonia, mental retardation, short stature, hypogonadotropic hypogonadism, small hands and feet Adrenal insufficiency; GHD 12% Rabson-Mendenhall AR n.a INSR 19p13 Milder form of DS, hypertrichosis, acanthosis nigricans, prominent nipples, genital enlargement Hyperinsulinism n.a Silver Russell AD 1:30,000-1:100,000 SRS1: ICR1 11p15.5 SRS2: UPD cr. 7 SRS3: IGF2 11p15 SRS4: PLAG1 8q12 SRS5: HMGA2 12q14 Relative macrocephaly, triangular face, small lower jaw, low-set ears, frontal bossing, body asymmetry Feeding difficulties; GHD; disproportionately large brain mass 27%-60% Simpson-Golabi-Behmel XLR n.a SGBS1: GPC3 Xq26 SGBS2: OFD1 Xp22 Coarse facies, large protruding jaw, widened nasal bridge, upturned nasal tip, enlarged tongue, congenital heart defects Hyperinsulinism n.a Sotos SoS1/2: AD SoS 3: AR 1:10,000-1:14,000 SoS1: NSD1 5q35 SoS2: NFIX 19p13 SoS3: APC2 19p13 Macrocephaly, dolichocephaly, broad and prominent forehead, sparse frontotemporal hair, downslanting palpebral fissures, long and narrow face Hyperinsulinism 2-15% Timothy AD <1:1M CACNA1C 12p13 Hypotonia, round face, depressed nasal bridge, low-set ears, thin vermilion of the upper lip, hypoplastic premaxillary cutaneous syndactyly, congenital hip abnormalities, congenital heart disease, long QT syndrome Hyperinsulinism due to altered influx of Ca 2+ into pancreatic β-cells which triggers insulin secretion 36% Turner Sporadic 1-5:10,000 (1:2,500 F) 45, X0 Webbed neck, low hairline at the back of the neck, low-set ears, small mandible, lymphedema of extremities, multiple pigmented nevi Hyperinsulinism due to increased sensitivity of pancreatic islets to aminoacids and elevated basal cytosolic calcium, possibly caused by haploinsufficiency of KDM6A (disruption of epigenetic changes during pancreatic differentiation); GHD Rare Abbreviations : HG Hypoglycemia, n.a. Data not available, AR Autosomal recessive, AD Autosomal dominant, XLR X-linked recessive, UPD Uniparental disomy, GH Growth hormone, CAI Central adrenal insufficiency, M Million, KS Kabuki syndrome, ACTH Adrenocorticotropic hormone, SoS Sotos syndrome, DS Donohue syndrome, SRS Silver Russell syndrome, SGBS Simpson-Golabi-Behmel, F Females.
| 4.359375
| 0.673828
|
sec[2]/p[1]
|
en
| 0.999998
|
PMC9392907
|
https://doi.org/10.1186/s13052-022-01341-3
|
[
"hyperinsulinism",
"anomalies",
"nasal",
"ears",
"hypoglycemia",
"face",
"small",
"manifestations",
"genetic",
"features"
] |
[
{
"code": "5A4Y",
"title": "Other specified disorders of glucose regulation or pancreatic internal secretion"
},
{
"code": "5A45",
"title": "Persistent hyperinsulinaemic hypoglycaemia of infancy"
},
{
"code": "5C50.AY",
"title": "Other specified disorders of urea cycle metabolism"
},
{
"code": "5A41",
"title": "Hypoglycaemia without associated diabetes"
},
{
"code": "KB60.30",
"title": "Neonatal hyperglycaemia due to insulin deficiency"
},
{
"code": "LD9Z",
"title": "Developmental anomalies, unspecified"
},
{
"code": "LD2Z",
"title": "Multiple developmental anomalies or syndromes, unspecified"
},
{
"code": "LD9Y",
"title": "Other specified developmental anomalies"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "LB22.Z",
"title": "Structural developmental anomalies of spleen, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion
Also known as: Other specified disorders of glucose regulation or pancreatic internal secretion | Other hypoglycaemia | Hyperinsulinaemia | hyperinsulinism | functional hyperinsulinaemia
[5A45] Persistent hyperinsulinaemic hypoglycaemia of infancy
Definition: Congenital isolated hyperinsulinism, or Persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI) is defined by an inappropriate oversecretion of insulin by the endocrine pancreas that is responsible for profound hypoglycaemia, which requires aggressive medical and/or surgical treatment to prevent severe and irreversible brain damage. PHHI is a genetically heterogeneous disorder with two types of histological lesions: diffuse (DiPHHI) and focal (FoPHHI) which are clinically indistinguishable.
Also known as: Persistent hyperinsulinaemic hypoglycaemia of infancy | PHHI - [Persistent hyperinsulinaemic hypoglycaemia of infancy] | hypoglycaemia of infancy | infantile hypoglycaemia | infantile spontaneous hypoglycaemia
[5C50.AY] Other specified disorders of urea cycle metabolism
Also known as: Other specified disorders of urea cycle metabolism | Ornithine carbamoyltransferase deficiency | Ornithine carbamyltransferase deficiency | Ornithine transcarbamoylase deficiency | Ornithine transcarbamylase deficiency
[5A41] Hypoglycaemia without associated diabetes
Also known as: Hypoglycaemia without associated diabetes | low blood sugar | hypoglycaemia NOS | spontaneous hypoglycaemia | nondiabetic hypoglycaemia
Excludes: Hypoglycaemia in the context of diabetes mellitus
[KB60.30] Neonatal hyperglycaemia due to insulin deficiency
Also known as: Neonatal hyperglycaemia due to insulin deficiency
[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
[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
[LD9Y] Other specified developmental anomalies
Also known as: Other specified developmental anomalies | Congenital anomaly or multiple anomalies, without further specification
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[LB22.Z] Structural developmental anomalies of spleen, unspecified
Also known as: Structural developmental anomalies of spleen, unspecified | Structural developmental anomalies of spleen | anomalies of spleen | congenital abnormality of spleen | congenital anomaly of spleen
=== GRAPH WALKS ===
--- Walk 1 ---
[5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion
--PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion
--RELATED_TO--> [?] Somatostatinoma
Def: A rare, usually malignant neuroendocrine tumour arizing from delta cells. This neoplasm produces large amounts of somatostatin, which may result in a syndrome characterised by diarrhea, steatorrhea, w...
--- Walk 2 ---
[5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion
--PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion
--RELATED_TO--> [?] PPoma
Def: A benign or malignant neuroendocrine tumour that arises from the pancreas and secretes pancreatic polypeptide....
--- Walk 3 ---
[5A45] Persistent hyperinsulinaemic hypoglycaemia of infancy
Def: Congenital isolated hyperinsulinism, or Persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI) is defined by an inappropriate oversecretion of insulin by the endocrine pancreas that is responsib...
--PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion
--RELATED_TO--> [?] VIPoma
Def: An often clinically aggressive neuroendocrine tumour located in the pancreas or small intestine. It is composed of cells containing vasoactive intestinal peptide. It may cause intractable diarrhea and...
--- Walk 4 ---
[5A45] Persistent hyperinsulinaemic hypoglycaemia of infancy
Def: Congenital isolated hyperinsulinism, or Persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI) is defined by an inappropriate oversecretion of insulin by the endocrine pancreas that is responsib...
--PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion
--RELATED_TO--> [?] PPoma
Def: A benign or malignant neuroendocrine tumour that arises from the pancreas and secretes pancreatic polypeptide....
--- Walk 5 ---
[5C50.AY] Other specified disorders of urea cycle metabolism
--PARENT--> [5C50.A] Disorders of urea cycle metabolism
--EXCLUDES--> [?] Disorders of ornithine metabolism
--- Walk 6 ---
[5C50.AY] Other specified disorders of urea cycle metabolism
--PARENT--> [5C50.A] Disorders of urea cycle metabolism
--PARENT--> [5C50] Inborn errors of amino acid or other organic acid metabolism
|
[
"[5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion\n --PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion\n --RELATED_TO--> [?] Somatostatinoma\n Def: A rare, usually malignant neuroendocrine tumour arizing from delta cells. This neoplasm produces large amounts of somatostatin, which may result in a syndrome characterised by diarrhea, steatorrhea, w...",
"[5A4Y] Other specified disorders of glucose regulation or pancreatic internal secretion\n --PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion\n --RELATED_TO--> [?] PPoma\n Def: A benign or malignant neuroendocrine tumour that arises from the pancreas and secretes pancreatic polypeptide....",
"[5A45] Persistent hyperinsulinaemic hypoglycaemia of infancy\n Def: Congenital isolated hyperinsulinism, or Persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI) is defined by an inappropriate oversecretion of insulin by the endocrine pancreas that is responsib...\n --PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion\n --RELATED_TO--> [?] VIPoma\n Def: An often clinically aggressive neuroendocrine tumour located in the pancreas or small intestine. It is composed of cells containing vasoactive intestinal peptide. It may cause intractable diarrhea and...",
"[5A45] Persistent hyperinsulinaemic hypoglycaemia of infancy\n Def: Congenital isolated hyperinsulinism, or Persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI) is defined by an inappropriate oversecretion of insulin by the endocrine pancreas that is responsib...\n --PARENT--> [?] Other disorders of glucose regulation or pancreatic internal secretion\n --RELATED_TO--> [?] PPoma\n Def: A benign or malignant neuroendocrine tumour that arises from the pancreas and secretes pancreatic polypeptide....",
"[5C50.AY] Other specified disorders of urea cycle metabolism\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --EXCLUDES--> [?] Disorders of ornithine metabolism",
"[5C50.AY] Other specified disorders of urea cycle metabolism\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --PARENT--> [5C50] Inborn errors of amino acid or other organic acid metabolism"
] |
5A4Y
|
Other specified disorders of glucose regulation or pancreatic internal secretion
|
[
{
"from_icd11": "5A41",
"icd10_code": "E162",
"icd10_title": "Hypoglycemia, unspecified"
},
{
"from_icd11": "5A41",
"icd10_code": "E160",
"icd10_title": "Drug-induced hypoglycemia without coma"
},
{
"from_icd11": "5A41",
"icd10_code": "E15",
"icd10_title": "Nondiabetic hypoglycemic coma"
},
{
"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": "LD2Z",
"icd10_code": "Q8789",
"icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q8781",
"icd10_title": "Alport syndrome"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q871",
"icd10_title": "Congenital malformation syndromes predominantly associated with short stature"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q872",
"icd10_title": "Congenital malformation syndromes predominantly involving limbs"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q870",
"icd10_title": "Congenital malformation syndromes predominantly affecting facial appearance"
}
] |
E162
|
Hypoglycemia, unspecified
|
She was first-born by normal delivery of non-consanguineous parents. Her childhood development and growth were normal. The mother was affected by autoimmune thyroiditis. She had been otherwise well until approximately two years before. In May 2012, after a febrile episode, she became increasingly irritable and reported daily headache and concentration difficulties. One month after, her symptoms worsened presenting with severe headache, sleep problems, and behavior alterations, with several unmotivated crying spells and apathy. Her school performance deteriorated, as reported by her teachers. The mother noted severe halitosis, never suffered before. The patient was referred to a local neuropsychiatric outpatient clinic, where a conversion somatic disorder was diagnosed and a benzodiazepine treatment ( i.e ., bromazepam) was started. In June 2012, during the final school examinations, psychiatric symptoms, occurring sporadically in the previous two months, worsened. Indeed, she began to have complex hallucinations. The types of these hallucinations varied and were reported as indistinguishable from reality. The hallucinations involved vivid scenes either with family members (she heard her sister and her boyfriend having bad discussions) or without (she saw people coming off the television to follow and scare her), and hypnagogic hallucinations when she relaxed on her bed. She also presented weight loss (about 5% of her weight) and gastrointestinal symptoms such as abdominal distension and severe constipation. She was admitted to a psychiatric ward. Detailed physical and neurological examinations, as well as routine blood tests were normal. In order to exclude an organic neuropsychiatric cause of psychosis, the following tests were done: rheumatoid factor, streptococcal antibody tests, autoimmunity profile (including anti-nuclear, anti-double-stranded DNA, anti-neutrophil cytoplasmic, anti-Saccharomyces, anti-phospholipid, anti-mitochondrial, anti-SSA/Ro, anti-SSB/La, anti-transglutaminase IgA (tTG), anti-endomysium (EMA), and anti-gliadin IgA (AGA) antibodies), and screening for infectious and metabolic diseases, but they resulted all within the normal range. The only abnormal parameters were anti-thyroglobulin and thyroperoxidase antibodies (103 IU/mL, and 110 IU/mL; v.n. 0–40 IU/mL). A computed tomography scan of the brain and a blood pressure holter were also performed and resulted normal. Electroencephalogram (EEG) showed mild nonspecific abnormalities and slow-wave activity. Due to the abnormal autoimmune parameters and the recurrence of psychotic symptoms, autoimmune encephalitis was suspected, and steroid treatment was initiated. The steroid led to partial clinical improvement, with persistence of negative symptoms, such as emotional apathy, poverty of speech, social withdrawal and self-neglect. Her mother recalled that she did not return a “normal girl”. In September 2012, shortly after eating pasta, she presented crying spells, relevant confusion, ataxia, severe anxiety and paranoid delirium. Then she was again referred to the psychiatric unit. A relapse of autoimmune encephalitis was suspected and treatment with endovenous steroid and immunoglobulins was started. During the following months, several hospitalizations were done, for recurrence of psychotic symptoms. Cerebral and spinal cord magnetic resonance imaging, lumbar puncture, and fundus oculi examination did not show any pathological signs. Several EEG were performed confirming bilateral slow activity. The laboratory tests showed only mild microcytic anemia with reduced levels of ferritin and a slight increase in fecal calprotectin values (350 mg/dL, normal range: 0–50 mg/dL). In September 2013, she presented with severe abdominal pain, associated with asthenia, slowed speech, depression, distorted and paranoid thinking and suicidal ideation up to a state of pre-coma. The clinical suspicion was moving towards a fluctuating psychotic disorder. Treatment with a second-generation anti-psychotic ( i.e. , olanzapine) was started, but psychotic symptoms persisted. In November 2013, due to gastro-intestinal symptoms and further weight loss (about 15% of her weight in the last year), a nutritionist was consulted, and a gluten-free diet (GFD) was recommended for symptomatic treatment of the intestinal complaints; unexpectedly, within a week of gluten-free diet, the symptoms (both gastro-intestinal and psychiatric) dramatically improved, and the GFD was continued for four months. Despite her efforts, she occasionally experienced inadvertent gluten exposures, which triggered the recurrence of her psychotic symptoms within about four hours. Symptoms took two to three days to subside again. Then, in April 2014 (two years after the onset of symptoms), she was admitted to our pediatric gastroenterology outpatient for suspected NCGS. Previous examinations excluded a diagnosis of CD because serology for CD was negative ( i.e. , EMA, and tTG). A wheat allergy was excluded due to negativity of specific IgE to wheat, prick test, prick by prick and patch test for wheat resulted negative. Therefore, we decided to perform a double-blind challenge test with wheat flour and rice flour (one pill containing 4 g of wheat flour or rice flour for the first day, following two pills in the second day and 4 pills from the third day to 15 days, with seven days of wash-out between the two challenges). During the administration of rice flour, symptoms were absent. During the second day of wheat flour intake, the girl presented headache, halitosis, abdominal distension, mood disorders, fatigue, and poor concentration, and three episodes of severe hallucinations. After the challenge, she tested negative for: (1) CD serology (EMA and tTG); (2) food specific IgE; (3) skin prick test to wheat (extract and fresh food); (4) atopy patch test to wheat; and (5) duodenal biopsy. Only serum anti-native gliadine antibodies of IgG class and stool calprotectin were elevated.
| 4.070313
| 0.978027
|
sec[1]/p[2]
|
en
| 0.999997
|
26184290
|
https://doi.org/10.3390/nu7075235
|
[
"anti",
"wheat",
"psychotic",
"flour",
"hallucinations",
"autoimmune",
"psychiatric",
"weight",
"prick",
"mother"
] |
[
{
"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": "6A2Z",
"title": "Schizophrenia or other primary psychotic disorders, unspecified"
},
{
"code": "6C4B.6",
"title": "Volatile inhalant-induced psychotic disorder"
},
{
"code": "6C4G.6",
"title": "Psychotic disorder induced by unknown or unspecified psychoactive substance"
},
{
"code": "5B5A.11",
"title": "Korsakoff syndrome"
},
{
"code": "6A2Y",
"title": "Other specified primary psychotic disorder"
}
] |
=== 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
[6A2Z] Schizophrenia or other primary psychotic disorders, unspecified
Also known as: Schizophrenia or other primary psychotic disorders, unspecified | Unspecified nonorganic psychosis | nonorganic psychosis | confusional psychosis | atypical psychosis
[6C4B.6] Volatile inhalant-induced psychotic disorder
Definition: Volatile inhalant-induced psychotic disorder is characterised by psychotic symptoms (e.g. delusions, hallucinations, disorganized thinking, grossly disorganized behaviour) that develop during or soon after intoxication with or withdrawal from volatile inhalants. The intensity or duration of the symptoms is substantially in excess of psychotic-like disturbances of perception, cognition, or behaviour that are characteristic of Volatile inhalant intoxication or Volatile inhalant withdrawal. The amo
Also known as: Volatile inhalant-induced psychotic disorder | psychotic disorder due to inhalant
[6C4G.6] Psychotic disorder induced by unknown or unspecified psychoactive substance
Definition: Psychotic disorder induced by unknown or unspecified psychoactive substance is characterised by psychotic symptoms (e.g., delusions, hallucinations, disorganised thinking, grossly disorganised behaviour) that develop during or soon after intoxication with or withdrawal from an unknown or unspecified psychoactive substance. The symptoms are not better explained by a primary mental disorder (e.g., Schizophrenia, a Mood disorder with psychotic symptoms), as might be the case if the psychotic sympto
Also known as: Psychotic disorder induced by unknown or unspecified psychoactive substance | Substances induced psychosis
[5B5A.11] Korsakoff syndrome
Definition: A disease of the nervous system, caused by deficiency of vitamin B1 in the brain. This disease commonly follows Wernicke encephalopathy, and may present with inability to form new memories, amnesia, confabulation, or hallucinations.
Also known as: Korsakoff syndrome | Korsakoff disease | Korsakoff psychosis
Excludes: Amnestic disorder due to use of alcohol
[6A2Y] Other specified primary psychotic disorder
Also known as: Other specified primary psychotic disorder
=== GRAPH WALKS ===
--- Walk 1 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--EXCLUDES--> [?] Labour or delivery complicated by fetal distress
--- Walk 2 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.1] Maternal care for hydrops fetalis
--- Walk 3 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--CHILD--> [MB23.2] Avoidance behaviour
Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....
--- Walk 4 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--RELATED_TO--> [?] Speech dysfluency
Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...
--- Walk 5 ---
[3B4Z] Coagulation defects, unspecified
--PARENT--> [?] Coagulation defects
--CHILD--> [3B4Z] Coagulation defects, unspecified
--- Walk 6 ---
[3B4Z] Coagulation defects, unspecified
--PARENT--> [?] Coagulation defects
--CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects
Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood....
|
[
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress",
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.1] Maternal care for hydrops fetalis",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --RELATED_TO--> [?] Speech dysfluency\n Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...",
"[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [3B4Z] Coagulation defects, unspecified",
"[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects\n Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood...."
] |
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": "6A2Z",
"icd10_code": "F29",
"icd10_title": "Unspecified psychosis not due to a substance or known physiological condition"
}
] |
O26841
| |
Our patient was suspected to have both central hypothyroidism and adrenal insufficiency (AI). Because thyroid hormone replacement alone could exaggerate AI under such a condition , the oral levothyroxine was discontinued on the day of admission. A rapid ACTH stimulation test (Table 2 ) showed incomplete cortisol secretion in the presence of an adequate aldosterone response. A combined anterior pituitary stimulation test (Table 3 ) showed a decreased response of growth hormone (GH) to growth hormone-releasing factor (GRF) and decreased response of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to luteinizing hormone-releasing hormone (LHRH). An apparently adequate response of ACTH was observed following corticotropin-releasing hormone (CRH) administration, but the cortisol response was reduced. Growth hormone-releasing peptide 2 administration (Table 4 ) yielded a decreased GH release but an apparently adequate release of ACTH; however, the cortisol response was insufficient. A prolonged ACTH stimulation test (Table 5 ) showed adequate cortisol secretion. Magnetic resonance imaging (MRI) of the brain revealed a 2.5-cm pituitary tumor with the hypophyseal stalk deformed. The tumor contained a mixed pattern of solid and liquid components with fluid-fluid images on T2-weighted images consistent with the subacute phase of an intratumoral hemorrhage. Brain magnetic resonance angiography detected no abnormalities. These findings indicated a diagnosis of anterior hypopituitarism with PTA due to hemorrhage in a preexisting pituitary adenoma [ 6 – 9 ]. As the patient had no PTA symptoms, such as headache, altered consciousness, visual impairment, or cranial nerve palsy, pituitary surgery was not indicated. Our patient was scheduled to receive medical management with hormone replacement therapy; he started corticosterone replacement therapy with oral hydrocortisone (20 mg/day) for his central AI on day 11 of admission. A thyrotropin-releasing hormone (TRH) stimulation test (Table 6 ) performed on day 21 of admission reveled low release of TSH under conditions of low serum FT 3 and FT 4 levels, confirming the diagnosis of central hypothyroidism. Our patient resumed replacement therapy with oral levothyroxine (75 μg/day) for his central hypothyroidism on day 22 of admission. He regained his appetite and vitality, and was discharged on day 25 after admission. Table 2 Endocrinological investigation: Rapid adrenocorticotropic hormone stimulation test in July 2016 (day 3 after admission) Reference range for basal value Time (min) 0 (Basal) 30 60 Serum cortisol (μg/dL) 4.5–21.1 1.5 6.0 6.8 Aldosterone (ng/dL) 3.0–15.9 6.2 10.1 11.8 Synthetic adrenocorticotropic hormone (ACTH) 1–24 (cosyntropin hydroxide 0.25 mg) was administered intravenously in the morning (9 AM) Table 3 Corticotropin-releasing hormone/growth hormone-releasing factor/luteinizing hormone-releasing hormone stimulation test in July 2016 (day 5 after admission) Reference range for basal value Time (min) 0 (Basal) 15 30 60 90 120 Serum GH (ng/mL) 0–0.17 0.03 0.41 1.11 1.30 0.92 0.35 Plasma ACTH (pg/mL) 7.2–63.3 15.4 90.1 91.7 75.8 66.5 60.4 Serum cortisol (μg/dL) 4.5–21.1 1.1 2.7 4.5 5.1 5.2 4.9 Serum LH (mIU/mL) 0.8–5.7 0.5 1.0 1.4 1.7 2.0 1.9 Serum FSH (mIU/mL) 2.0–8.3 2.0 2.9 3.1 3.8 3.9 4.0 The following were administered intravenously in the morning (9 AM): 100 μg corticotropin-releasing hormone (CRH), 100 μg growth hormone-releasing factor (GRF), and 100 μg luteinizing hormone-releasing hormone (LHRH) Our patient had low serum levels of insulin-like growth factor 1 (15 ng/mL; reference range, 48–177) and free testosterone (<0.1 pg/mL; reference range, 4.6–16.9) ACTH arenocorticotropic hormone, GH growth hormone, FSH follicle-stimulating hormone, LH luteinizing hormone Table 4 Growth hormone-releasing peptide-2 stimulation test in July 2016 (day 7 after admission) Reference range for basal value Time (min) 0 (Basal) 15 30 45 60 Serum GH (ng/mL) 0–0.17 0.03 0.86 0.86 0.51 0.29 Plasma ACTH (pg/mL) 7.2–63.3 11.2 85.5 68.3 48.1 33.8 Serum cortisol (μg/dL) 4.5–21.1 2.0 4.1 5.8 5.7 5.8 Growth hormone-releasing peptide (GHRP)-2 (100 μg) was administered intravenously in the morning (9 AM) ACTH arenocorticotropic hormone, GH growth hormone Table 5 Prolonged arenocorticotropic hormone stimulation test in July 2016 (days 9 to 12 after admission) Reference range Before After 3 days Urinary free cortisol excretion (μg/day) 26.0–187.0 7.7 529.5 Basal serum cortisol (μg/dL) 4.5–21.1 0.8 28.6 Basal plasma ACTH (pg/mL) 7.2–63.3 19.7 <1.0 Blood and urine samples were taken with the patient at the supine position each morning (9 AM) on the 2 days before and after 3 days of intramuscular administration of synthetic ACTH 1–24 (cosyntropin zinc hydroxide 1.0 mg/day) ACTH arenocorticotropic hormone Fig. 1 Magnetic resonance imaging of the brain . Plane T1-weighted images ( a : coronal plain, b : sagittal plain) showing a 2.5-cm pituitary tumor ( arrows ) and deformed hypophyseal stalk, with no compression on the optic chiasm. The physiological high-intensity signal (*) was found in the posterior pituitary gland ( c : sagittal plain). T2-weighted images ( d : coronal plain, e : sagittal plain, f : transverse plain) revealed a mixed pattern of solid and liquid components in the pituitary tumor, with fluid-fluid levels ( short arrows ) Table 6 Thyrotropin-releasing hormone stimulation test in August 2016 (day 21 after admission) Reference range for basal value Time (min) 0 (Basal) 15 30 60 90 120 Serum TSH (μIU/mL) 0.5–5.0 1.78 4.16 5.24 5.52 5.24 4.65 Serum prolactin (ng/mL) 3.6–12.8 23.5 49.4 52.2 50.9 44.8 41.7 Thyrotropin-releasing hormone (TRH; 500 μg) was administered intravenously in the morning (9 AM). The test was conducted 21 days after the discontinuation of oral levothyroxine replacement (100 μg/day). Our patient had low serum levels of free triiodothyronine (1.30 pg/mL) and free thyroxine (0.69 ng/dL) TSH Thyroid-stimulating hormone
| 4.183594
| 0.949219
|
sec[1]/p[2]
|
en
| 0.999997
|
28835258
|
https://doi.org/10.1186/s13256-017-1371-7
|
[
"hormone",
"releasing",
"serum",
"acth",
"growth",
"basal",
"stimulation",
"cortisol",
"pituitary",
"reference"
] |
[
{
"code": "5B3Z",
"title": "Endocrine diseases, unspecified"
},
{
"code": "6C4H.1Z",
"title": "Harmful pattern of use of non-psychoactive substances, unspecified"
},
{
"code": "5A61.3",
"title": "Growth hormone deficiency"
},
{
"code": "5A61.0",
"title": "Hypopituitarism"
},
{
"code": "5A81.1",
"title": "Testicular hypofunction"
},
{
"code": "3B50.Y",
"title": "Other specified inherited fibrinolytic defects"
},
{
"code": "5A61.41",
"title": "Congenital central hypothyroidism"
},
{
"code": "QE42",
"title": "Problem associated with release from prison"
},
{
"code": "2C10.1",
"title": "Neuroendocrine neoplasms of pancreas"
},
{
"code": "9D56",
"title": "Visual release hallucinations"
}
] |
=== ICD-11 CODES FOUND ===
[5B3Z] Endocrine diseases, unspecified
Also known as: Endocrine diseases, unspecified | endocrine disorder NOS | disorder of endocrine gland | disease of endocrine gland | disorder of endocrine system
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies
[5A61.3] Growth hormone deficiency
Definition: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficiency. Includes idiopathic, inborn and acquired forms of growth hormone deficiency.
Also known as: Growth hormone deficiency
Excludes: Hypopituitarism
[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
[5A81.1] Testicular hypofunction
Definition: In pre-puberty, a disorder characterised by atrophied testes and sterility, abnormal height and absence of secondary sex characteristics. In post-puberty, a disorder characterised by depressed sexual function, loss of sex drive and sterility, muscle weakness and osteoporosis (due to loss of the androgen anabolic effect).
Also known as: Testicular hypofunction | hypofunction testicle | gonadal insufficiency of testis | Testicular hypogonadism NOS | undeveloped testis
[3B50.Y] Other specified inherited fibrinolytic defects
Also known as: Other specified inherited fibrinolytic defects | Excessive release of tissue-type plasminogen activator | Excessive release of tPA - [tissue-type plasminogen activator]
[5A61.41] Congenital central hypothyroidism
Also known as: Congenital central hypothyroidism | Congenital central hypothyroidism due to isolated TSH deficiency | isolated TSH deficiency | congenital hypothyroidism due to thyroid-stimulating hormone beta chain deficiency | Congenital central hypothyroidism due to thyrotropin-releasing hormone deficiency
[QE42] Problem associated with release from prison
Also known as: Problem associated with release from prison | problem related to release from prison
[2C10.1] Neuroendocrine neoplasms of pancreas
Definition: A neoplasm with neuroendocrine differentiation that arises from the pancreas. It includes neuroendocrine tumours (low and intermediate grade) and neuroendocrine carcinomas (high grade).
Also known as: Neuroendocrine neoplasms of pancreas | neuroendocrine pancreatic cancer | carcinoma of islet cell of pancreas | malignant islet cell tumour of unspecified site | malignant tumour, islet cell of pancreas
[9D56] Visual release hallucinations
Definition: Visual release hallucinations, also called Charles Bonnet syndrome, refer to the experience of complex visual hallucinations in a person who has experienced partial or complete loss of vision. Hallucinations are exclusively visual, usually temporary, and unrelated to mental and behavioural disorders.
Also known as: Visual release hallucinations | Charles Bonnet syndrome
Excludes: Schizophrenia or other primary psychotic disorders
=== GRAPH WALKS ===
--- Walk 1 ---
[5B3Z] Endocrine diseases, unspecified
--PARENT--> [?] Endocrine diseases
--CHILD--> [?] Diabetes mellitus
Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...
--- Walk 2 ---
[5B3Z] Endocrine diseases, unspecified
--PARENT--> [?] Endocrine diseases
--PARENT--> [05] Endocrine, nutritional or metabolic diseases
Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases....
--- Walk 3 ---
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
--PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances
Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...
--CHILD--> [6C4H.11] Harmful pattern of use of non-psychoactive substances, continuous
Def: A pattern of continuous use of a non-psychoactive substance (daily or almost daily) that has caused damage to a person’s physical or mental health. The pattern of continuous use of the non-psychoactiv...
--- Walk 4 ---
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
--PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances
Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...
--CHILD--> [6C4H.10] Harmful pattern of use of non-psychoactive substances, episodic
Def: A pattern of episodic or intermittent use of a non-psychoactive substance that has caused damage to a person’s physical or mental health. The pattern of episodic or intermittent use of the non-psychoa...
--- Walk 5 ---
[5A61.3] Growth hormone deficiency
Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...
--EXCLUDES--> [?] Hypopituitarism
Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...
--PARENT--> [?] 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 ---
[5A61.3] Growth hormone deficiency
Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...
--PARENT--> [5A61] Hypofunction or certain other specified disorders of pituitary gland
Def: Clinical status with disordered function of the pituitary gland without excessive pituitary hormone production, which is caused by a variety of diseases...
--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....
|
[
"[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --CHILD--> [?] Diabetes mellitus\n Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...",
"[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --PARENT--> [05] Endocrine, nutritional or metabolic diseases\n Def: This chapter includes endocrine diseases, nutritional diseases as well as metabolic diseases....",
"[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified\n --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances\n Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...\n --CHILD--> [6C4H.11] Harmful pattern of use of non-psychoactive substances, continuous\n Def: A pattern of continuous use of a non-psychoactive substance (daily or almost daily) that has caused damage to a person’s physical or mental health. The pattern of continuous use of the non-psychoactiv...",
"[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified\n --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances\n Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...\n --CHILD--> [6C4H.10] Harmful pattern of use of non-psychoactive substances, episodic\n Def: A pattern of episodic or intermittent use of a non-psychoactive substance that has caused damage to a person’s physical or mental health. The pattern of episodic or intermittent use of the non-psychoa...",
"[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --PARENT--> [?] 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...",
"[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --PARENT--> [5A61] Hypofunction or certain other specified disorders of pituitary gland\n Def: Clinical status with disordered function of the pituitary gland without excessive pituitary hormone production, which is caused by a variety of diseases...\n --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...."
] |
5B3Z
|
Endocrine diseases, unspecified
|
[
{
"from_icd11": "5B3Z",
"icd10_code": "E342",
"icd10_title": "Ectopic hormone secretion, not elsewhere classified"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E348",
"icd10_title": "Other specified endocrine disorders"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E349",
"icd10_title": "Endocrine disorder, unspecified"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E20-E35",
"icd10_title": ""
},
{
"from_icd11": "5B3Z",
"icd10_code": "E34",
"icd10_title": "Other endocrine disorders"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E351",
"icd10_title": ""
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F558",
"icd10_title": "Abuse of other non-psychoactive substances"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F552",
"icd10_title": "Abuse of laxatives"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F553",
"icd10_title": "Abuse of steroids or hormones"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F551",
"icd10_title": "Abuse of herbal or folk remedies"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F55",
"icd10_title": "Abuse of non-psychoactive substances"
},
{
"from_icd11": "5A61.0",
"icd10_code": "E230",
"icd10_title": "Hypopituitarism"
},
{
"from_icd11": "5A61.0",
"icd10_code": "Q044",
"icd10_title": "Septo-optic dysplasia of brain"
},
{
"from_icd11": "5A61.0",
"icd10_code": "E231",
"icd10_title": "Drug-induced hypopituitarism"
}
] |
E342
|
Ectopic hormone secretion, not elsewhere classified
|
Here we report the case of a KRAS -mutated lung adenocarcinoma with an early symptomatic PP. PP was characterized by a rapid and massive dimensional increase of all sites of disease and a vigorous activation of the immune system. After few weeks from the first pembrolizumab infusion, symptoms and PS improved and CT scan with a lymph node re-biopsy documented PP of disease. It is crucial to distinguish PP from a true PD and even more challenging is to recognize a symptomatic PP from a HPD, due to the considerable similarities of the respective clinical presentations. Nevertheless these differential diagnoses are of utmost importance, in order to avoid both a premature discontinuation of an effective treatment and the delay of starting a new therapy. Usually the PS deterioration reflects PD or HPD, whilst clinical benefit is a marker of treatment efficacy. Nevertheless, case reports described patients with PP experience clinical deterioration mainly due to two reasons: the mass effect of enlarged sites of disease which are diffusely infiltrated by immune cells and the extensive systemic inflammatory response . The mass effect may be eventually responsible for the onset of dyspnea, cough, dysphagia, dysphonia and pain, depending on the enlarged sites of disease. The hyperactivation of the immune response produces a sort of cytokines storm which may cause fever, hyporexia, asthenia and sweats. Based on these evidences, PS should be considered for clinical decisions but should not be used to definitively judge the efficacy of immunotherapy. Rather PS, biopsy of enlarged lesions, radiographic follow-up and FDG PET represent all complementary references for clinical decision making. Biopsy of enlarged lesions represents certainly the gold standard for PP diagnosis. In fact, the major mechanism of PP is the infiltration of immune cells which can be revealed by the re-biopsy. Pathologic findings may include immune infiltrate with lymphocytes positive for CD3/CD4/CD8 and a decreased CD4/CD8 ratio. Macrophagocytes, tumor necrosis, hemorrhage, edema and no viable tumor cells may be also observed . In our case the first sample of the patient is a biopsy of a right supraclavicular lymph node and is represented by a fragment of fibrous tissue with localization of poorly differentiated adenocarcinoma. On immunohistochemical analysis, the tumor cells are positive for keratin 7 and TTF1, supporting a pulmonary origin of the neoplasm . The PDL-1 expression (clone sp263 Ventana) is present in the 80% of neoplastic cells . The inflammatory component is mainly represented by neutrophilic granulocytes, while T-lymphocyte cells (CD3+; CD8+) are rare and macrophagocytes are absent . There is no evidence of necrotic areas. Two months later, a re-biopsy of the same lymph node was performed . In this case extensive areas of coagulation necrosis were observed. On the periphery of these areas, nests of neoplastic cells were recognized, compatible with poorly differentiated adenocarcinoma. The inflammatory component mainly consists of T-lymphocytes (CD3+; CD8+) with a conserved CD4/CD8 ratio, rare macrophagocytes were observed . About immunohystochemical analysis with PDL-1, still 80% of the neoplastic cells resulted positive . Beside tumor re-biopsy, circulating tumor DNA (ctDNA) seems to be a promising non-invasive tool to monitor tumor response after ICIs [ 17 – 21 ]. Few published studies support the correlation between decreased or low-level ctDNA and PP versus higher ctDNA level in true PD . This observation could allow to differentiate PP from true PD through a non-invasive liquid biopsy. Interestingly, some evidence exists among the correlation between ctDNA in KRAS -mutated lung adenocarcinoma and PP , which is the case of our patient. Guibert et al. , monitored the levels of KRAS -mutated ctDNA in two patients who had experienced PP and compared the variations with those from of a patient who had true PD. Authors found that ctDNA showed rapid and dramatic decrease in patients with PP, whilst it was strongly increased in the patient with true PD. This lead to the conclusion that ctDNA may be an additional non-invasive and promising tool to discriminate PP from true PD for tumors that harbor an oncogenic addiction. Our patient developed such a vigorous immune response that a higher sensibility to the immunotherapic drug can be hypothesized. Some authors suggest that these “hypersensitive” patients may be overtreated when receiving the currently indicated dosage every three weeks . Nevertheless, actually neither the time and the intensity of immune response nor the onset of clinical activity of ICIs are predictable yet. In our case, PP earlier developed either at the supraclavicular level or in the mediastinum, considering the symptoms complained by the patient. But in some cases PP involves only some sites of disease and not the entire tumor burden, it may be delayed or even occur repeatedly during the course of the disease in a totally unpredictable manner [ 22 – 24 ]. Our patient showed early treatment efficacy with a dimensional reduction of tumor burden and also a brilliant metabolic response. This may suggest a better prognosis when comparing this pattern of response, sustained by such a massive inflammatory infiltrate, with respect to stable disease (SD) or PR. Some retrospective evidence exists that patients experiencing PP may carry a better prognosis in terms of 12 months overall survival (OS) with respect to patients developing SD or PR as per RECIST version 1.1 . Actually there is not a consensus upon this issue and further analyses are required. In conclusion, symptomatic PP represents an atypical pattern of response which can be observed after immunotherapy. PP differential diagnosis with true PD and HPD is crucial. PS, tumor re-biopsy, close radiographic follow-up and potentially ctDNA analysis represent complementary references for clinical decision making in such a challenging clinical scenario.
| 4.335938
| 0.899902
|
sec[2]/p[0]
|
en
| 0.999996
|
PMC9400789
|
https://doi.org/10.37349/etat.2020.00022
|
[
"biopsy",
"tumor",
"cells",
"response",
"ctdna",
"immune",
"true",
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] |
[
{
"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": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
}
] |
=== ICD-11 CODES FOUND ===
[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
[2F9Z] Neoplasms of unknown behaviour of unspecified site
Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature
Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules
Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung
Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site
[2F92] Neoplasms of unknown behaviour of skin
Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[JA85.Y] Maternal care for other specified fetal abnormality or damage
--PARENT--> [JA85] Maternal care for fetal abnormality or damage
Def: A condition characterised by the provision of health interventions to the mother due to some abnormality or damage 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 ---
[JA85.Y] Maternal care for other specified fetal abnormality or damage
--PARENT--> [JA85] Maternal care for fetal abnormality or damage
Def: A condition characterised by the provision of health interventions to the mother due to some abnormality or damage that is either suspected or known to be present in the fetus....
--CHILD--> [JA85.0] Maternal care for central nervous system malformation in fetus
--- Walk 3 ---
[KD39.3] Fetus or newborn affected by complications of fetal surgery
Def: A condition in the fetus due to an unfavourable evolution of a condition (complication) associated with a surgical health intervention applied to the fetus....
--PARENT--> [KD39] 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....
--EXCLUDES--> [?] Fetus or newborn affected by other forms of placental separation
Def: A group of conditions characterised by findings in the fetus or newborn due to when the placental separates from the uterus of the mother or when the fetus of newborn is suspected to be affected by pl...
--- Walk 4 ---
[KD39.3] Fetus or newborn affected by complications of fetal surgery
Def: A condition in the fetus due to an unfavourable evolution of a condition (complication) associated with a surgical health intervention applied to the fetus....
--PARENT--> [KD39] 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....
--CHILD--> [KD39.2] Fetus or newborn affected by fetal blood sampling
Def: Fetal blood sampling involves extracting a sample of fetal blood from the umbilical cord using a needle and an ultrasound as a guide. It is used to detect fetal abnormalities and is generally performe...
--- Walk 5 ---
[PK81.5] Biopsy procedure, not elsewhere classified, 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
--CHILD--> [?] Foreign body accidentally left in body without injury or harm
Def: A foreign body is any solid material not normally found in the human body. It is accidentally left in the body if there was no specific intention to keep it in the body....
--- Walk 6 ---
[PK81.5] Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use
--PARENT--> [PK81] Certain medical procedures 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
|
[
"[JA85.Y] Maternal care for other specified fetal abnormality or damage\n --PARENT--> [JA85] Maternal care for fetal abnormality or damage\n Def: A condition characterised by the provision of health interventions to the mother due to some abnormality or damage 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...",
"[JA85.Y] Maternal care for other specified fetal abnormality or damage\n --PARENT--> [JA85] Maternal care for fetal abnormality or damage\n Def: A condition characterised by the provision of health interventions to the mother due to some abnormality or damage that is either suspected or known to be present in the fetus....\n --CHILD--> [JA85.0] Maternal care for central nervous system malformation in fetus",
"[KD39.3] Fetus or newborn affected by complications of fetal surgery\n Def: A condition in the fetus due to an unfavourable evolution of a condition (complication) associated with a surgical health intervention applied to the fetus....\n --PARENT--> [KD39] 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....\n --EXCLUDES--> [?] Fetus or newborn affected by other forms of placental separation\n Def: A group of conditions characterised by findings in the fetus or newborn due to when the placental separates from the uterus of the mother or when the fetus of newborn is suspected to be affected by pl...",
"[KD39.3] Fetus or newborn affected by complications of fetal surgery\n Def: A condition in the fetus due to an unfavourable evolution of a condition (complication) associated with a surgical health intervention applied to the fetus....\n --PARENT--> [KD39] 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....\n --CHILD--> [KD39.2] Fetus or newborn affected by fetal blood sampling\n Def: Fetal blood sampling involves extracting a sample of fetal blood from the umbilical cord using a needle and an ultrasound as a guide. It is used to detect fetal abnormalities and is generally performe...",
"[PK81.5] Biopsy procedure, not elsewhere classified, 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 --CHILD--> [?] Foreign body accidentally left in body without injury or harm\n Def: A foreign body is any solid material not normally found in the human body. It is accidentally left in the body if there was no specific intention to keep it in the body....",
"[PK81.5] Biopsy procedure, not elsewhere classified, associated with injury or harm in therapeutic use\n --PARENT--> [PK81] Certain medical procedures 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"
] |
JA85.Y
|
Maternal care for other specified fetal abnormality or damage
|
[
{
"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"
},
{
"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"
}
] |
O358XX0
| |
A 68-year-old female presented to the dermatologist with a chief complaint of a left axillary cutaneous tumor that had been growing for 2 months. She had no medical history, no surgical history, no family history of cancers or Lynch-syndrome-associated tumors, and was taking no medication. In addition, she had no history of smoking, did not drink alcohol, was 156.0 cm tall, weighed 52.3 kg, and had a body mass index of 21.5. On clinical examination, the tumor was 5 cm in diameter, elastic hard, dark red, non-tender, and with poor mobility at the left axilla . Laboratory examinations showed carcinoembryonic antigen and carbohydrate antigen 19-9 levels of 5.8 ng/ml and 18.0 U/ml, respectively. The patient underwent a cutaneous mass biopsy, and the histopathology showed poorly differentiated adenocarcinoma . Immunohistochemistry (IHC) revealed that the lesion was positive for anti-pan cytokeratin (CK) (AE1/AE3), and CDX2, and negative for CK7, CK20, ER, PgR, and TTF1. Based on these results, the cutaneous tumor was suspected to be a metastatic cutaneous cancer of gastrointestinal origin . Computed tomography (CT) scan of the thorax to the pelvis demonstrated the cutaneous tumor in the left axilla with invasion of the left teres major muscle , circumferential enhancing wall thickening of ascending colon with the invasion to the duodenum , and the presence of swollen left axillary and pericolic lymph, and of lymph nodes along the posterior pancreatoduodenal arcades. Mammography and breast ultrasonography were performed to rule out primary breast cancer, but no breast mass was found. Colonoscopy and esophagogastroduodenoscopy revealed a circumferential type 2 tumor of the ascending colon with invasion of the second part of the duodenum. Endoscopic biopsy revealed adenocarcinoma , and IHC showed the ascending colon cancer had the same expression pattern of CK7, CK20, and CDX2 as the cutaneous tumor . From the above, the left axillary cutaneous tumor was identified as a metastatic lesion from the ascending colon adenocarcinoma based on morphological similarity and immunohistochemical staining patterns. The clinical stage was Stage IVB (T4bN1aM1b) based on the American Joint Committee on Cancer, 8th Edition. Furthermore, mutational analysis found the tumor to be KRAS–NRAS wild type, BRAF V600E-mutant, and MSI-H. The patient received neoadjuvant chemotherapy which consisted of one cycle of modified FOLFOX6 (5-fluorouracil/leucovorin and oxaliplatin) followed by two cycles of FOLFOXIRI (5-fluorouracil/leucovorin, oxaliplatin, and irinotecan). Bevacizumab was not used because of concerns about fistula formation between the ascending colon cancer and the duodenum due to tumor invasion. Pembrolizumab was not used in view of the domestic regulatory approval situation at the time of treatment. After chemotherapy, the axillary cutaneous tumor was markedly reduced grossly , and CT scan showed that the primary tumor in the ascending colon and the axillary cutaneous tumor was reduced in size . The patient was scheduled for a two-stage resection with curative intent to allow intervals to confirm whether another metastasis to other organs and underwent primary resection, i.e., right hemicolectomy with lymph node dissection and partial resection of the duodenum with dissection of lymph nodes along the posterior pancreatoduodenal arcades, approximately 2 months after the initiation of chemotherapy. After the first surgery, the patient received three cycles of modified FOLFOX6, followed by a resection of the axillary cutaneous tumor with axillary lymph node dissection. Postoperative histopathological examination revealed that the ascending colon cancer consisted of poorly differentiated adenocarcinoma that invaded the duodenum with lymph node metastasis, and the axillary cutaneous tumor was almost certainly a metastasis of the colon cancer. After the second surgery, the patient received six courses of modified FOLFOX6 as adjuvant chemotherapy, and tumor markers decreased over time . Two years after the initial surgery, and 1 year and 8 months after the second surgery, the patient is alive without recurrence. Fig. 1 Pre-treatment clinical findings. a Cutaneous tumor measuring 5 cm in diameter located on the left axillary skin (solid arrow). b CT scan of the chest shows the cutaneous tumor in the left axilla with the invasion of the left teres major muscle (solid arrow). c CT scan of the abdomen and pelvis shows the circumferential enhancing wall thickening of the ascending colon (arrowheads) with invasion of the duodenum (open arrow) Fig. 2 Histopathological examination. a Axillary cutaneous tumor consisted of poorly differentiated adenocarcinoma (hematoxylin–eosin, × 10). b Tumor-infiltrating lymphocytes are identified around tumor cells (hematoxylin–eosin, × 40). c Colon cancer consisted of poorly differentiated adenocarcinoma (hematoxylin–eosin, × 10). d Tumor-infiltrating lymphocytes are identified around tumor cells (hematoxylin–eosin, × 40) Fig. 3 Immunohistochemistry (IHC) for CK7, CK20, and CDX2. Axillary cutaneous tumor and colon cancer were negative for CK7 and CK20, and positive for CDX2. a – d IHC analyses of the axillary cutaneous tumor (× 20). e – h IHC analyses of the colon cancer (× 20) Fig. 4 Post-chemotherapy clinical findings. a Axillary cutaneous tumor almost disappeared grossly (solid arrow). b CT scan of the chest shows the decreased size of the cutaneous tumor in the left axilla (solid arrow). c CT scan of the abdomen and pelvis shows the decreased size of the ascending colon cancer (arrowheads) with invasion of the duodenum (open arrow) Fig. 5 Clinical course of disease and changes in tumor marker values. First Operation means right hemicolectomy with lymph node dissection and partial resection of the duodenum with dissection of lymph nodes along the posterior pancreatoduodenal arcades, and Second Operation means resection of the axillary cutaneous tumor with axillary lymph node dissection
| 4.085938
| 0.97168
|
sec[1]/p[0]
|
en
| 0.999998
|
37962682
|
https://doi.org/10.1186/s40792-023-01780-y
|
[
"tumor",
"cutaneous",
"axillary",
"colon",
"cancer",
"ascending",
"lymph",
"duodenum",
"invasion",
"adenocarcinoma"
] |
[
{
"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": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "EB90.40",
"title": "Dystrophic calcification of the skin of uncertain or unspecified aetiology"
},
{
"code": "ND56.0",
"title": "Superficial injury of unspecified body region"
},
{
"code": "ME60.3",
"title": "Keratosis of skin of uncertain or unspecified nature"
},
{
"code": "EB90.1",
"title": "Cutaneous mucinosis"
}
] |
=== 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
[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
[EB90.40] Dystrophic calcification of the skin of uncertain or unspecified aetiology
Definition: Abnormal deposition of calcium in the skin and subcutaneous tissues of unknown (idiopathic) or unspecified cause.
Also known as: Dystrophic calcification of the skin of uncertain or unspecified aetiology | Calcinosis cutis of uncertain or unspecified aetiology | Osteoma cutis | Cutaneous ossification | Subepidermal calcified nodule
Includes: Calcinosis cutis
[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
[ME60.3] Keratosis of skin of uncertain or unspecified nature
Also known as: Keratosis of skin of uncertain or unspecified nature | Keratosis of skin | Cutaneous horn | Keratin horn | Cornu cutaneum
[EB90.1] Cutaneous mucinosis
Definition: Skin disorders characterised by accumulation of mucin in the skin
Also known as: Cutaneous mucinosis | Mucinosis of skin
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F92] Neoplasms of unknown behaviour of skin
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] 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
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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 --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [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
|
In November 2011, a 53-year-old male patient presented to our clinics for chemoradiotherapy after resection of a cerebral lesion that was diagnosed as GBM WHO IV° by histopathology. An epigenetic silencing of O 6 -methylguanine-DNA methyltransferase (MGMT) by promoter methylation was not detected by real-time PCR of tumor DNA. Approximately six weeks after resection, the patient was started on standard combined chemotherapy and radiation (temozolomide 75 mg/m 2 /day and involved-field radiation at a total dose of 60 Gy in 2.0 Gy fractions over a 6-week period). The radiotherapy was well tolerated and the treatment with temozolomide was continued with 150 mg/m 2 d1-5 in the first cycle followed by 200 mg/m 2 d1-5 every 4 weeks. In April 2012, after three courses of temozolomide, the patient presented with intermittent disorientation and a worsened general condition. The native and Gadolinium-enhanced T1-weighted cerebral magnetic resonance imaging (cMRI) showed a tumor involving the right basal ganglia with strong peripheral and irregular contrast enhancement . In the T2-weighted FLAIR a pronounced surrounding edema and mass effect was seen in the area of the basal ganglia . Because of the clinical symptoms, the deteriorated general condition, and the unmethylated MGMT promoter status these radiographic findings were interpreted as GBM relapse. A radiotherapy-induced pseudoprogression is not considered to cause the radiographic findings. To confirm this we performed 18 F-fluoroethyltyrosine-positron emission tomography/computer tomography (FET-PET/CT) scan . The PET/CT showed a focally increased 18 F-FET uptake corresponding to the contrast enhancement described in cMRI, which was emphasized in the fusion of PET and MRI . The mean tumoral uptake (Tu) was evaluated and the ratio to background (Bg) was calculated with Tu/Bg ratio of 2.4. This value exceeds the threshold of 1.6 thereby indicating an active malignancy . Because of the localization of the relapsed GBM and the reduced general performance status, resection was deemed impossible. It was decided to treat the patient with anti-VEGF antibody (bevacizumab) monotherapy (Avastin®) in an off-label setting. Bevacizumab was given at a dose of 10 mg/kg body weight on d1 and d15 every four weeks. Concurrently, the palliative care team was involved in patient’s care because of the poor general performance status. After three courses, a reduction in tumor size from 51 × 21 × 25 mm to 39 × 17 × 17 mm was observed at Gadolinium-enhanced T1-weighted cMRI, and the degree of contrast enhancement within the tumor had decreased . On day one of the forth course of bevacizumab, our patient presented with dyspnoe at the emergency room and the suspected diagnosis of pulmonary embolism was confirmed by CT scan. Therapeutic anticoagulation was started using low molecular weight heparin. Bevacizumab was continued one week later at the initially used dosing regimen. Under low molecular weight heparin, there were no further thromboembolic events or other bevacizumab-related serious adverse reactions until to date. During ongoing therapy with bevacizumab, the patient’s Karnofsky performance status improved steadily from 50% at the beginning of treatment with bevacizumab to 80% after 6 months and the palliative care team stopped patient’s care. Concomitant corticosteroid therapy was reduced continuously and finally stopped. The last cMRI performed after 17 courses of bevacizumab showed a very good partial response to bevacizumab therapy with a tumor size of 35 × 15 × 15 mm in the unenhanced T1-weighted sequences and a lack of contrast enhancement in the lateral portions of the tumor in the Gadolinium-enhanced T1-weighted sequences . T2-weighted FLAIR demonstrated a significant decrease of peritumoral edema . A very low level of 18 F-FET tracer uptake was noted , which was substantially lower than the tracer uptake observed before treatment . Moreover, Tu/Bg ratio in the post treatment PET/CT scan was 1.3 consistent with reactive changes after treatment . After the excellent treatment response observed under bevacizumab treatment, we evaluated to stop monotherapy with bevacizumab. However, since remaining active tumor cannot be fully excluded by the imaging modalities used, we decided together with the interdisciplinary tumor board to further extend the treatment. Figure 1 Relapse of GBM after resection and radiochemotherapy. A Native T1-weighted MRI shows a tumor involving the right basal ganglia. B Gadolinium-enhanced T1-weighted MRI shows strong peripheral and irregular enhancement of the tumor. C T2-weighted FLAIR demonstrates pronounced surrounding edema and mass effect. D In the PET/CT scan and E the fusion of PET and MRI, the lesion described in the MRI corresponds with focal increased 18 F-FET uptake exhibiting Tu/Bg ratio of 2.4. Figure 2 GBM after three courses of bevacizumab. Gadolinium-enhanced T1-weighted MRI shows a reduction in tumor size as well as decreasing and discontinuous tumor enhancement. Figure 3 Treatment response after 17 courses of bevacizumab in cMRI. A Non-enhanced T1-weighted MRI reveals further decrease in lesion size. Hyperintense hemorrhagic changes are present within the medial portion of the tumor. B Gadolinium-enhanced T1-weighted MRI documents lack of contrast enhancement in the lateral portions of the tumor. Only a slight enhancement in addition to the hyperintense hemorrhagic changes in the medial portion of the tumor was observed. C T2-weighted FLAIR demonstrates a decrease of peritumoral edema. Figure 4 Treatment response after 17 courses of bevacizumab in 18 F-FET-PET/CT and fusion of PET with MRI. A The native and B the contrast-enhanced T1 cMRT scans show a decrease of the lesion initially described. C In the PET/CT and D the fusion of PET and MRI, the 18 F-FET uptake is slightly diffuse increased with Tu/Bg uptake ration of 1.3 consitent with reactive changes after treatment and arguing against vital tumor tissue.
| 4.148438
| 0.957031
|
sec[1]/p[0]
|
en
| 0.999997
|
25954595
|
https://doi.org/10.1186/2162-3619-3-29
|
[
"tumor",
"bevacizumab",
"weighted",
"enhanced",
"enhancement",
"uptake",
"courses",
"gadolinium",
"contrast",
"cmri"
] |
[
{
"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": "MG43.5",
"title": "Excessive weight loss"
},
{
"code": "MG43.6",
"title": "Excessive weight gain"
},
{
"code": "MG44.11",
"title": "Failure to thrive in infant or child"
},
{
"code": "5B80.0Z",
"title": "Overweight, unspecified"
},
{
"code": "JA65.2",
"title": "Excessive weight gain in pregnancy"
}
] |
=== ICD-11 CODES FOUND ===
[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
[MG43.5] Excessive weight loss
Definition: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health.
Also known as: Excessive weight loss | abnormal decrease in weight | abnormal weight loss | unintended weight loss | weight loss NOS
[MG43.6] Excessive weight gain
Definition: An increase in total body mass, due to increase in fluid, fat or adipose tissue, or lean (muscle) mass that is outside the expected range for normal growth and development and is sufficient in quantity or rate to create risk to the individual’s health.
Also known as: Excessive weight gain | abnormal increase in weight | abnormal weight gain | unintended weight gain
Excludes: Obesity
[MG44.11] Failure to thrive in infant or child
Definition: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender.
Also known as: Failure to thrive in infant or child | failure to gain weight | failure to thrive NOS | FTT - [failure to thrive] syndrome
Excludes: Failure to thrive in newborn | Anorexia Nervosa | Avoidant-restrictive food intake disorder
[5B80.0Z] Overweight, unspecified
Also known as: Overweight, unspecified | Overweight
[JA65.2] Excessive weight gain in pregnancy
Definition: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy.
Also known as: Excessive weight gain in pregnancy | excessive weight gain in pregnancy, unspecified trimester | maternal obesity syndrome | maternal obesity without hypertension | abnormal weight gain in pregnancy
Excludes: Gestational oedema without hypertension
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--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
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --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 --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...."
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
In China, the anticoagulation compliance rate (INR 2.0–3.0) among the atrial fibrillation patients who are taking the warfarin was only 36% and most of their INR ware remained at <2.0 . In recent years, the anticoagulant treatment has been effectively simplified with the marketing of direct oral anticoagulants. NOAC has been selected by more and more patients with atrial fibrillation in clinical since its efficacy and safety have been confirmed in multiple international clinical trials such as RE-LY . In our case, an embolic stroke still occurred while the patient took dabigatran 110 mg twice daily. There were two causes to be considered: (1) The dose of dabigatran was insufficient, it should be adjusted to 150 mg twice daily after stroke. (2) Although the patient was prescribed with dabigatran, she failed to follow medical advice and took the medicine regularly, which may be the incentive cause for an embolic stroke. Therefore, the dosage of dabigatran should be adjusted according to the happening of the embolization stroke and the compliance of patients should be considered in the selection of anticoagulation. In the process of NOAC, doctors and patients are also concerned about the possible life-threatening bleeding such as acute intracranial hemorrhage and massive gastrointestinal bleeding, or the emergency cases such as acute abdominal disease and fracture requiring emergency surgery/treatment . As a specific antagonist of dabigatran, idarucizumab, which has just been approved in China in February 2019, can bind to dabigatran irreversibly and effectively as it has an affinity for dabigatran 350 times than dabigatran for thrombin, was recommended by the European Heart Rhythm Association for the treatment of patients with bleeding and emergency surgery under oral NOAC . As an exogenous humanized monoclonal antigen–antibody binding fragment (Fab), idarucizumab can quickly intravenous administration and irreversibly bind to dabigatran immediately. Idarucizumab can specifically bind to free dabigatran, dabigatran that has been bound to thrombin, and the active metabolites of dabigatran to form a complex, resulting in the inability of dabigatran to bind to thrombin, reversal the anticoagulant effect of dabigatran. Moreover, idarucizumab has no endogenous target, and no reversal effect on heparin or other anticoagulant drugs, so it does not interfere with the coagulation cascade and has no procoagulant effect . In our case, intravenous infusion of idarucizumab lasted for 16 min, and rt-PA treatment could be initiated immediately 10–15 min later. The European Stroke Organization guidelines provide evidence-based recommendations to assist physicians in their clinical decisions with regard to intravenous thrombolysis for acute ischemic stroke, and recommend intravenous thrombolysis with alteplase to improve functional outcome in patients with acute ischemic stroke within 4.5 h after symptom onset . Idarucizumab could affect immediately that is more suitable for stroke patients within 4.5 h for intravenous thrombolysis or within 6 h for arterial thrombectomy in emergency. However, this case also has the following limitations: (1) the patient failed to initiate thrombolytic therapy within 3 h after the onset as it took a certain amount of time for her to obtain idarucizumab due to the unavailability at emergency department. (2) The time of last dose of dabigatran was between 24 and 48 h. Although coagulation indexes, such as APTT and PT and INR index, had been monitored before and after use, no obvious changes were found. The more important coagulation indexes like ECT, TT, and direct prothrombin activity were unavailable in emergency laboratory. At that point, it was difficult to decide whether rt-PA could be used without reversal of idarucizumab. It shouldbe expected to get improving in similar cases. With the application of idarucizumab, we also needed to be alerted to the occurrence of adverse events. The REVERSE-AD study showed that 0.6% of patients who used idarucizumab had hypersensitivity reactions within 5 days of administration, such as fever and bronchospasm, hyperventilation, skin rash, and itching. And other adverse reactions such as hereditary fructose intolerance, transient proteinuria also had been reported . In a French retrospective research, patients with an acute ischemic stroke treated with dabigatran within 48 h were given intravenous thrombolysis after the reversal of idarucizumab without direct prothrombin activity monitoring . According to the relationship between the onset time of stroke and her last dose for dabigatran, a different treatment plan was thereby recommended, combining with different medical conditions . Caponi reviewed 55 thrombolytic cases after idarucizumab reversal of dabigatran showed that 81.9% (45 cases) of patients had improved NIHSS score (median 5 points), together with follow-up mRS <2 in 56% of patients, suggest that effectiveness for intravenous thrombolysis (IVT) has been preserved. In a retrospective study of 120 patients with acute ischemic/hemorrhagic stroke in Germany, the efficacy and safety of idarucizumab reversal of dabigatran in intravenous thrombolysis with an acute ischemic stroke had been confirmed . There is a new data analysis which has performed a comprehensive review of 251 cases of patients with acute ischemic stroke (AIS) performed IVT after idarucizumab reversal. Regardless of stroke severity and age, there was a significant NIHSS reduction of 6 points post-stroke and linear regression revealed a correlation of admission NIHSS to NIHSS reduction ( p < 0.001). Reassuring evidence about the safety and efficacy of this therapeutic strategy was provided . However, in patients with hemorrhagic stroke, the application of idarucizumab can prevent the expansion of hematoma and improve the prognosis of patients as the bleeding may be caused by dabigatran . These suggest the safety and usability of reversal of dabigatran in IVT.
| 4.3125
| 0.616699
|
sec[2]/p[0]
|
en
| 0.999997
|
34970137
|
https://doi.org/10.3389/fnagi.2021.765037
|
[
"dabigatran",
"stroke",
"patients",
"idarucizumab",
"intravenous",
"reversal",
"emergency",
"that",
"thrombolysis",
"ischemic"
] |
[
{
"code": "8B20",
"title": "Stroke not known if ischaemic or haemorrhagic"
},
{
"code": "8B11.5Z",
"title": "Cerebral ischaemic stroke, unspecified"
},
{
"code": "JB64.4",
"title": "Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium"
},
{
"code": "8B11.2Z",
"title": "Cerebral ischaemic stroke due to embolic occlusion, unspecified"
},
{
"code": "8B25.4",
"title": "Late effects of stroke not known if ischaemic or haemorrhagic"
},
{
"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 ===
[8B20] Stroke not known if ischaemic or haemorrhagic
Definition: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been determined by neuroimaging or other techniques.
Also known as: Stroke not known if ischaemic or haemorrhagic | apoplexy | brain vascular accident | cerebral accident | cerebral apoplexy
Excludes: sequelae of stroke
[8B11.5Z] Cerebral ischaemic stroke, unspecified
Also known as: Cerebral ischaemic stroke, unspecified | Cerebral ischaemic stroke of unknown cause | cryptogenic stroke | occlusion and stenosis of cerebral and precerebral arteries, resulting in cerebral infarction | cerebral infarct
[JB64.4] Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium
Also known as: Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium | Spontaneous coronary artery dissection complicating pregnancy, childbirth or the puerperium | Cerebrovascular disorder in the puerperium | puerperal cerebrovascular disease | Acute puerperal cerebrovascular disease
Excludes: Obstetric embolism | venous complications and cerebrovenous sinus thrombosis in pregnancy | Venous complications in the puerperium
[8B11.2Z] Cerebral ischaemic stroke due to embolic occlusion, unspecified
Also known as: Cerebral ischaemic stroke due to embolic occlusion, unspecified | Cerebral ischaemic stroke due to embolic occlusion | cerebral infarction due to embolic occlusion | embolic stroke NOS | Embolic stroke of undermined source
[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
[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 ---
[8B20] Stroke not known if ischaemic or haemorrhagic
Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...
--EXCLUDES--> [?] Late effects of stroke not known if ischaemic or haemorrhagic
Def: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes....
--PARENT--> [?] Late effects of cerebrovascular disease
Def: Effects of cerebrovascular disease 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episo...
--- Walk 2 ---
[8B20] Stroke not known if ischaemic or haemorrhagic
Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...
--PARENT--> [?] Cerebrovascular diseases
Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi...
--RELATED_TO--> [?] Asymptomatic stenosis of intracranial or extracranial artery
Def: Stenosis of intracranial or extracranial artery that has not caused TIA or cerebral ischemic stroke....
--- Walk 3 ---
[8B11.5Z] Cerebral ischaemic stroke, unspecified
--PARENT--> [8B11.5] Cerebral ischaemic stroke of unknown cause
Def: This is a sudden loss of brain function due to a lack of adequate blood flow. It is of an uncertain nature, and approximately 30% of examined events fall into this category....
--CHILD--> [8B11.51] Cerebral ischaemic stroke due to unspecified occlusion or stenosis of intracranial large artery
Def: This is a sudden loss of brain function due to a lack of adequate blood flow of the large intracranial arteries....
--- Walk 4 ---
[8B11.5Z] Cerebral ischaemic stroke, unspecified
--PARENT--> [8B11.5] Cerebral ischaemic stroke of unknown cause
Def: This is a sudden loss of brain function due to a lack of adequate blood flow. It is of an uncertain nature, and approximately 30% of examined events fall into this category....
--CHILD--> [8B11.5Z] Cerebral ischaemic stroke, unspecified
--- Walk 5 ---
[JB64.4] Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium
--EXCLUDES--> [?] Venous complications in pregnancy
--CHILD--> [?] Superficial thrombophlebitis in pregnancy
--- Walk 6 ---
[JB64.4] Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium
--EXCLUDES--> [?] Obstetric embolism
Def: A condition characterised by the lodging of a blood clot, a fat globule or a gas bubble (embolus) in the bloodstream, which can cause a blockage associated with the physiological and other changes tha...
--CHILD--> [?] Amniotic fluid embolism
Def: Amniotic fluid embolism is a rare obstetric emergency in which it is postulated that amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, causing cardiorespiratory collap...
|
[
"[8B20] Stroke not known if ischaemic or haemorrhagic\n Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...\n --EXCLUDES--> [?] Late effects of stroke not known if ischaemic or haemorrhagic\n Def: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes....\n --PARENT--> [?] Late effects of cerebrovascular disease\n Def: Effects of cerebrovascular disease 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episo...",
"[8B20] Stroke not known if ischaemic or haemorrhagic\n Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...\n --PARENT--> [?] Cerebrovascular diseases\n Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi...\n --RELATED_TO--> [?] Asymptomatic stenosis of intracranial or extracranial artery\n Def: Stenosis of intracranial or extracranial artery that has not caused TIA or cerebral ischemic stroke....",
"[8B11.5Z] Cerebral ischaemic stroke, unspecified\n --PARENT--> [8B11.5] Cerebral ischaemic stroke of unknown cause\n Def: This is a sudden loss of brain function due to a lack of adequate blood flow. It is of an uncertain nature, and approximately 30% of examined events fall into this category....\n --CHILD--> [8B11.51] Cerebral ischaemic stroke due to unspecified occlusion or stenosis of intracranial large artery\n Def: This is a sudden loss of brain function due to a lack of adequate blood flow of the large intracranial arteries....",
"[8B11.5Z] Cerebral ischaemic stroke, unspecified\n --PARENT--> [8B11.5] Cerebral ischaemic stroke of unknown cause\n Def: This is a sudden loss of brain function due to a lack of adequate blood flow. It is of an uncertain nature, and approximately 30% of examined events fall into this category....\n --CHILD--> [8B11.5Z] Cerebral ischaemic stroke, unspecified",
"[JB64.4] Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium\n --EXCLUDES--> [?] Venous complications in pregnancy\n --CHILD--> [?] Superficial thrombophlebitis in pregnancy",
"[JB64.4] Diseases of the circulatory system complicating pregnancy, childbirth or the puerperium\n --EXCLUDES--> [?] Obstetric embolism\n Def: A condition characterised by the lodging of a blood clot, a fat globule or a gas bubble (embolus) in the bloodstream, which can cause a blockage associated with the physiological and other changes tha...\n --CHILD--> [?] Amniotic fluid embolism\n Def: Amniotic fluid embolism is a rare obstetric emergency in which it is postulated that amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, causing cardiorespiratory collap..."
] |
8B20
|
Stroke not known if ischaemic or haemorrhagic
|
[
{
"from_icd11": "8B20",
"icd10_code": "I64",
"icd10_title": ""
},
{
"from_icd11": "JB64.4",
"icd10_code": "O9942",
"icd10_title": "Diseases of the circulatory system complicating childbirth"
},
{
"from_icd11": "JB64.4",
"icd10_code": "O9943",
"icd10_title": "Diseases of the circulatory system complicating the puerperium"
},
{
"from_icd11": "JB64.4",
"icd10_code": "O99411",
"icd10_title": "Diseases of the circulatory system complicating pregnancy, first trimester"
},
{
"from_icd11": "JB64.4",
"icd10_code": "O99412",
"icd10_title": "Diseases of the circulatory system complicating pregnancy, second trimester"
},
{
"from_icd11": "JB64.4",
"icd10_code": "O99413",
"icd10_title": "Diseases of the circulatory system complicating pregnancy, third trimester"
},
{
"from_icd11": "JB64.4",
"icd10_code": "O994",
"icd10_title": "Diseases of the circulatory system complicating pregnancy, childbirth and the puerperium"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I63412",
"icd10_title": "Cerebral infarction due to embolism of left middle cerebral artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I6340",
"icd10_title": "Cerebral infarction due to embolism of unspecified cerebral artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I6310",
"icd10_title": "Cerebral infarction due to embolism of unspecified precerebral artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I63449",
"icd10_title": "Cerebral infarction due to embolism of unspecified cerebellar artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I63421",
"icd10_title": "Cerebral infarction due to embolism of right anterior cerebral artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I6312",
"icd10_title": "Cerebral infarction due to embolism of basilar artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I63132",
"icd10_title": "Cerebral infarction due to embolism of left carotid artery"
},
{
"from_icd11": "8B11.2Z",
"icd10_code": "I63432",
"icd10_title": "Cerebral infarction due to embolism of left posterior cerebral artery"
}
] |
I64
| |
A provisional diagnosis of a lymphoproliferative disorder or a granulomatous disease causing acute kidney injury was made. Further laboratory tests showed parathyroid hormone (PTH) level 9.70 pg/ml (normal range, 17–73), PTH-related peptide (PTH-rp) level < 8.5 pg/ml (normal range, < 13.0), 1.25(OH) 2 D 3 level 32 ng/ml (normal range, 18–71 ng/ml for nondialysis subjects), erythrocyte sedimentation rate 50 mm (normal range, < 20 mm), C-reactive protein (CRP) 148.72 mg/L (normal range, < 6 mg/L), and prostate-specific antigen 0.21 ng/ml (normal range, < 4 ng/ml). Figure 1 shows the curve of concurrent serum protein electrophoresis. Plain x-rays of the skull and chest radiographs revealed an osteolytic lesion in the skull and mediastinal lymph nodes. A resting electrocardiogram confirmed sinus tachycardia as the lone abnormality. Twenty-four hours following admission to the nephrology unit, specific hypercalcemia management was initiated with 4-mg zoledronate once and hydration using intravenous liquids (isotonic saline, 2 L/24 hours and 5% dextrose, 1 L/24 hours) for 3 consecutive days before introduction of oral furosemide 40 mg once daily to correct consequential fluid overload. A symmetric purpura limited to the lower limbs progressively developed from the fourth to sixth days of hospitalization, with temperatures reaching a plateau at 40–40.5 °C. On evaluation 9 days after initiation of specific hypercalcemia management, serum calcium and sodium returned to normal values, with complete recovery of related symptoms and signs, as well as renal function . On the 14th day of hospitalization, although the purpura completely regressed, fever persisted, and lymph node enlargement extended beyond the groins to the cervical region. At this time, results of bacteriological cultures, including urine culture and three serial hemocultures, were all negative, and CRP was 115.61 mg/L. Complete blood count showed red blood cells 2.5 × 10 12 /L, hemoglobin 6.6 g/dl, white blood cells 2 × 10 9 /L, neutrophils 0.6 × 10 9 /L, eosinophils 0.06 × 10 9 /μl, basophils 0, lymphocytes 1.3 × 10 9 /L, monocytes 0.4 × 10 9 /L, and platelets 44 × 10 9 /L. Peripheral blood smear confirmed a low platelet count but showed neither blasts nor flower cells. The reticulocyte count was 22,640/mm 3 . The bone marrow aspirate showed 8.3% normal cellularity with no abnormal infiltrate (including blast cells) or fibrosis. This marrow hypocellularity together with pancytopenia led to the diagnosis of nonsevere aplastic anemia according to the revised Camitta criteria . Inguinal lymph node biopsy showed large cells with distinct nucleoli, dispersed chromatin, and scant cytoplasm with intracytoplasmic CD3 and Ki67 markers, all suggestive of aggressive precursor T-cell lymphoma . Because lymphoblasts were not observed either in bone marrow analysis or in the peripheral blood smear, and considering histopathologic findings of the lymph node biopsy, T-ALL was ruled out, and the diagnosis of T-LBL was retained . An abdominal ultrasound obtained to assess T-LBL extension showed no organ (spleen, liver, kidney) enlargement. Additional examinations evaluating disease prognosis showed serum lactate dehydrogenase 1145.2 IU/L (normal range, 200–400), uric acid 148 mg/L (normal range, < 70 mg/L), serum glutamic oxaloacetic transaminase 72.3 IU/L (normal range, < 37), and serum glutamic pyruvic transaminase 27.6 IU/L (normal range, < 45). The patient was then transferred to the oncology unit, where he immediately received transfusion of 3 U of whole blood within 2 days prior to chemotherapy. The chemotherapy, which was based on the standard cyclophosphamide-doxorubicin-vincristine-prednisolone (CHOP) protocol for NHL , consisted of a 15-minute intravenous infusion of 1250 mg of cyclophosphamide on day 1, a 2-minute intravenous bolus of 80 mg doxorubicin on day 1, a 2-minute intravenous bolus of 2 mg vincristine on day 1, and 100 mg of oral prednisolone once daily on days 1 to 5 of the cycle. Following this CHOP cycle, 1 ml of filgrastim was administered subcutaneously once daily for 3 consecutive days as supportive treatment for aplastic anemia. Resolution of fever and recovery from fatigue and anorexia were noted from the third day of the CHOP cycle. The patient was discharged at the end of the cycle. One week following hospital discharge, he died at home a few hours after fever recurrence. Fig. 1 Serum protein electrophoresis curve. Normal total protein and gamma globulin levels, reduced albumin and beta-1 globulins, as well as increased alpha-1 globulins and beta-2 globulins are observed Fig. 2 Plain x-rays of the skull and chest radiograph. a An osteolytic lesion of the skull (arrow). b Bilateral pulmonary hilar lymph nodes (arrows) Fig. 3 Standard electrocardiogram showing sinus tachycardia at 107 beats per minute Fig. 4 Symmetrical purpura of lower limbs seen during the hypercalcemic crisis, suggestive of nonulcerated peripheral calciphylaxis Fig. 5 Evolution of serum calcium, creatinine, blood urea nitrogen, sodium, and potassium levels in relation to hypercalcemia treatment. a Gradual decrease of serum calcium (total/ionized) from 199.5/101.75 mg/L at beginning of hypercalcemia treatment (D0) to 82/42.84 mg/L 9 days later (D9). b Gradual decrease of serum creatinine from 36.7 mg/L at beginning of hypercalcemia treatment (D0) to 11.42 mg/L 9 days later (D9). c Gradual decrease of serum sodium and potassium from 152 and 3.1 mmol/L, respectively, at beginning of hypercalcemia treatment (D0) to 138 and 3.1 mmol/L, respectively, 9 days later (D9) Fig. 6 Histological and immunohistochemical features of the excisional lymph node biopsy. a Large cells with large nuclei, distinct nucleoli, dispersed chromatin, and scant cytoplasm on hematoxylin and eosin (H&E) staining. b Tumor cells positive for cluster of differentiation 3 (CD3) (arrow). c Tumor cells positive for Ki67 (arrow). d No labeling for cluster of differentiation 20 (CD20)
| 4.179688
| 0.944824
|
sec[1]/p[1]
|
en
| 0.999998
|
31594542
|
https://doi.org/10.1186/s13256-019-2225-2
|
[
"range",
"serum",
"cells",
"blood",
"lymph",
"hypercalcemia",
"protein",
"skull",
"hours",
"intravenous"
] |
[
{
"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": "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 ===
[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
[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 ---
[QA00.6Y] Other specified examination of eyes or vision
--PARENT--> [QA00.6] Examination of eyes or vision
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--- Walk 2 ---
[QA00.6Y] Other specified examination of eyes or vision
--PARENT--> [QA00.6] Examination of eyes or vision
--CHILD--> [QA00.6Y] Other specified examination of eyes or vision
--- Walk 3 ---
[4B00.0Z] Neutropaenia, unspecified
--PARENT--> [4B00.0] Neutropenia
--CHILD--> [4B00.00] Constitutional neutropaenia
Def: This is a granulocyte disorder characterised by an abnormally low number of neutrophils. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defence against in...
--- Walk 4 ---
[4B00.0Z] Neutropaenia, unspecified
--PARENT--> [4B00.0] Neutropenia
--CHILD--> [4B00.00] Constitutional neutropaenia
Def: This is a granulocyte disorder characterised by an abnormally low number of neutrophils. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defence against in...
--- 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--> [3B63.10] Secondary thrombocytosis
--- 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--> [3B63.1Z] Acquired thrombocytosis, unspecified
|
[
"[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis",
"[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --CHILD--> [QA00.6Y] Other specified examination of eyes or vision",
"[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --CHILD--> [4B00.00] Constitutional neutropaenia\n Def: This is a granulocyte disorder characterised by an abnormally low number of neutrophils. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defence against in...",
"[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --CHILD--> [4B00.00] Constitutional neutropaenia\n Def: This is a granulocyte disorder characterised by an abnormally low number of neutrophils. Neutrophils usually make up 50-70% of circulating white blood cells and serve as the primary defence against in...",
"[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.10] Secondary thrombocytosis",
"[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.1Z] Acquired thrombocytosis, unspecified"
] |
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": "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"
}
] |
D473
|
Essential (hemorrhagic) thrombocythemia
|
We report a case of primary cervical schwannoma in a 32-year-old woman who was referred to our department with a diagnosis of malignant melanoma of the cervix in pregnancy. Before referral, she underwent a colposcopy with targeted biopsy because of a white, thick, and hardened round lesion of the left upper margin of the cervix detected by vaginal manual exploration. Biopsy pathological exam revealed a minimal fragment of mesenchymal proliferation with areas of myxoid degeneration together with regular round core elements, no apparent mitosis, no necrosis, and further excision recommendation for actual analysis. A pathological slide review was performed, and identification of a neoplastic lesion with spindle and epithelioid cells obtained was performed. In the meantime, the patient became pregnant. The immunophenotypic characterization was consistent with a diagnosis of malignant mucous melanoma. At 8 +5 weeks of gestation, the patient was submitted to a loop electrosurgical excision procedure (LEEP) of the cervix which revealed an ulcerated tumor with spindle and epithelioid cells. Immunocytochemistry stained positive for vimentin and S100 protein and negative for desmin, anti-muscle actin antibody (HHF35), cytokeratins, Estrogen Receptor (ER), Progesterone Receptor (PR), Epithelial Membrane Antigen (EMA), synaptophysin, chromogranin, and smooth muscle actin; a low proliferative activity was detailed; surgical conization margins were positive. An additional pathological review was carried out and obtained at 11 +2 gestational weeks: this revealed a morphological and immunocytochemical framework consistent with infiltrating melanoma of the cervix. Immune reactivity with antiprotein S100 and Melanoma Marker Antibody (anti-HMB45) was positive, while that with antityrosinase1 and anti-MITF was negative. With all this information, the patient, now at 13 +6 weeks of her pregnancy, was referred to our department. On admission, she underwent chest X-ray, colposcopy, complete abdomen Magnetic Resonance Imaging (MRI), psychological counselling, gynaecological oncological ultrasound, obstetric ultrasound, and immunopathological review of the conization specimen. Colposcopy showed a normal cervix , with areas consistent with the recent LEEP procedure; the Squamous-Columnar Junction (SCJ) was fully visible, and no atypical area was detected. Application of 5% acetic acid did not reveal any positive aceto-whitening area; it only detected three yellowish-white nodular round formations, non-aceto-reactive, consistent with a nabothian cysts. A pelvic ultrasound scan showed, at the front cervical lip, in the anterolateral left side, a hypoechoic area with increased vascularization (color score 4) of 10 × 8 × 25 mm. That reached the cervical canal and the left margin. The left parametrium appeared slightly thickened, measuring 30 × 26 mm. An obstetrical ultrasound scan was negative with normal fetal nuchal translucency (NT). The patient decided to perform chorionic villus sampling (CVS) that showed a female 46XX normal karyotype. The abdomen-pelvis MRI scan did not show any morphological changes of the abdominal organs. The cervix did not present patterns suggestive for expansive lesions: a mild hyperintense signal in the posterior-left and front side, which reached the cervical outer border, was recorded, but no aspects of infiltration of the parametrium were observed. The left vaginal fornix was minimally thickened but without any abnormal signal, probably due to the lateral deviation of the cervix. No pelvic and/or lumbar-aortic adenopathy was recorded; both ovaries were normal. On the basis of the complete negativity of all the diagnostic procedures performed, we decided to resubmit the previous pathological specimens to further review. Our pathologist described positive staining for protein S100 and weak Glial Fibrillary Acidic Protein (GFAP) positivity; staining for tyrosinase, melanA, HMB45, pool of cytokeratins, EMA, desmin, and neurofilament was negative. Microscopically, the lesion was characterized by proliferation of irregular fascicles or strands, sometimes intersecting, of cells in a fibro-myxoid or sclerotic stroma; cells were spindle-shaped, with elongated nuclei, and irregular in shape or twisted, with a moderate amount of the cytoplasm at the cellular poles. A small amount of epithelioid cells with a low-malignant potential proliferation index (immunocytochemistry MIB-1 proliferation index < 10% and mitotic index < 2 mitosis for 10 High-Power Fields (HPF) at 400x magnification) was described; no lymphovascular space invasion (LVSI) was detected; morphological and immunocytochemical findings were compatible with a nerve sheath tumor, type schwannoma . According to this last pathological diagnosis and due to the lack of gross clinical information of the primary lesion excised, a pathological staging was not feasible. At 14 +4 weeks, after a detailed counselling, including the hysterectomy option, the patient accepted to be submitted to a vaginal trachelectomy and prophylactic cervical cerclage according to the Shirodkar technique . The pathological report of the trachelectomy specimen was negative for any previously described features of schwannoma, and surgical margins were negative. The patient was then monthly followed at the obstetrical outpatient unit, and the pregnancy proceeded without any issues. At 38 +3 weeks, she surgically delivered by a C-section a female newborn of 3300 g of weight; the Apgar score was 10-10, and the newborn blood tests were all normal. Placental pathology was normal. The patient was discharged from hospital on day 4 after delivery and was enrolled in a follow-up program according to our protocols for cervical diseases: cytology, colposcopy, and pelvic imaging (gynaecological ultrasound and abdomen-pelvis CT scan). After 6 years from the first diagnosis, the patient is healthy and her well-being is good without any evidence of cervical disease.
| 4.101563
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999997
|
34925929
|
https://doi.org/10.1155/2021/6806960
|
[
"cervical",
"cervix",
"pathological",
"cells",
"ultrasound",
"melanoma",
"colposcopy",
"lesion",
"proliferation",
"review"
] |
[
{
"code": "GA04",
"title": "Cervicitis"
},
{
"code": "GA1Z&XA5WW1",
"title": "Noninflammatory disorders of cervix uteri"
},
{
"code": "FB1Y",
"title": "Other specified conditions associated with the spine"
},
{
"code": "GA04&XT5R",
"title": "Acute cervicitis"
},
{
"code": "GA04&XT8W",
"title": "Chronic cervicitis"
},
{
"code": "GA15.1",
"title": "Erosion or ectropion of cervix uteri"
},
{
"code": "JA01.Y",
"title": "Other specified ectopic pregnancy"
},
{
"code": "GA15.7",
"title": "Low grade squamous intraepithelial lesion of cervix uteri"
},
{
"code": "5C64.5",
"title": "Disorders of calcium metabolism"
},
{
"code": "JA04",
"title": "Blighted ovum or nonhydatidiform mole"
}
] |
=== ICD-11 CODES FOUND ===
[GA04] Cervicitis
Also known as: Cervicitis | inflammation of cervix | inflammation of cervix uteri | Ulcer of cervix with cervicitis | Acute cervicitis
[FB1Y] Other specified conditions associated with the spine
Also known as: Other specified conditions associated with the spine | Other recurrent vertebral subluxation | Interspinous ligament syndrome | Spondylitis muscularis | Posterior longitudinal ligament calcification
[GA15.1] Erosion or ectropion of cervix uteri
Definition: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium to stratified squamous epithelium on the cervix uteri. This condition may also present with non-purulent vaginal discharge, post-coital bleeding, or may be asymptomatic.
Also known as: Erosion or ectropion of cervix uteri | Cervical ectropion | cervical eversion | eversion of cervix | ectropion of cervix
Excludes: Cervicitis
[JA01.Y] Other specified ectopic pregnancy
Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy
[GA15.7] Low grade squamous intraepithelial lesion of cervix uteri
Definition: A condition of the cervix uteri caused by chronic infection. This condition is characterised by premalignant transformation and abnormal cell growth and behaviour of the cervical squamous epithelial tissue.
Also known as: Low grade squamous intraepithelial lesion of cervix uteri | cervical dysplasia | cervical dysplasia nos | intraepithelial neoplasia of cervix | intraepithelial neoplasia of the cervix uteri
Excludes: Carcinoma in situ of cervix uteri | High grade squamous intraepithelial lesion of cervix uteri | Cervical Intraepithelial neoplasia grade III
[5C64.5] Disorders of calcium metabolism
Definition: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important consequences for health.
Also known as: Disorders of calcium metabolism | Calcinosis | general calcification | heterotopic calcification | metastatic calcification
Excludes: Hyperparathyroidism | Chondrocalcinosis
[JA04] Blighted ovum or nonhydatidiform mole
Definition: A condition caused by genetic abnormality, abnormal cell division, or poor quality ovum or sperm. This condition is characterised by a failed pregnancy, implantation of a fertilized egg without development into an embryo, haemorrhage into the decidua, and adjacent tissue necrosis.
Also known as: Blighted ovum or nonhydatidiform mole | anembryonic pregnancy | blighted ovum | blood mole | carneous mole
Includes: Pathological ovum
=== GRAPH WALKS ===
--- Walk 1 ---
[GA04] Cervicitis
--RELATED_TO--> [?] Tuberculosis of cervix uteri
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....
--PARENT--> [?] Tuberculosis of female reproductive organs
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the female reproductive organs....
--- Walk 2 ---
[GA04] Cervicitis
--RELATED_TO--> [?] Tuberculosis of cervix uteri
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....
--PARENT--> [?] Tuberculosis of female reproductive organs
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the female reproductive organs....
--- Walk 3 ---
[FB1Y] Other specified conditions associated with the spine
--PARENT--> [?] Conditions associated with the spine
Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....
--CHILD--> [?] Degenerative condition of spine
Def: This is a disease characterised by degenerative changes in the intervertebral disc, vertebral end-plates and spinal joints due to aging or structural change....
--- Walk 4 ---
[FB1Y] Other specified conditions associated with the spine
--PARENT--> [?] Conditions associated with the spine
Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....
--CHILD--> [?] Degenerative condition of spine
Def: This is a disease characterised by degenerative changes in the intervertebral disc, vertebral end-plates and spinal joints due to aging or structural change....
|
[
"[GA04] Cervicitis\n --RELATED_TO--> [?] Tuberculosis of cervix uteri\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....\n --PARENT--> [?] Tuberculosis of female reproductive organs\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the female reproductive organs....",
"[GA04] Cervicitis\n --RELATED_TO--> [?] Tuberculosis of cervix uteri\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....\n --PARENT--> [?] Tuberculosis of female reproductive organs\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the female reproductive organs....",
"[FB1Y] Other specified conditions associated with the spine\n --PARENT--> [?] Conditions associated with the spine\n Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....\n --CHILD--> [?] Degenerative condition of spine\n Def: This is a disease characterised by degenerative changes in the intervertebral disc, vertebral end-plates and spinal joints due to aging or structural change....",
"[FB1Y] Other specified conditions associated with the spine\n --PARENT--> [?] Conditions associated with the spine\n Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....\n --CHILD--> [?] Degenerative condition of spine\n Def: This is a disease characterised by degenerative changes in the intervertebral disc, vertebral end-plates and spinal joints due to aging or structural change...."
] |
GA04
|
Cervicitis
|
[
{
"from_icd11": "FB1Y",
"icd10_code": "M5126",
"icd10_title": "Other intervertebral disc displacement, lumbar region"
},
{
"from_icd11": "GA15.1",
"icd10_code": "N86",
"icd10_title": "Erosion and ectropion of cervix uteri"
},
{
"from_icd11": "GA15.7",
"icd10_code": "N879",
"icd10_title": "Dysplasia of cervix uteri, unspecified"
},
{
"from_icd11": "GA15.7",
"icd10_code": "N870",
"icd10_title": "Mild cervical dysplasia"
},
{
"from_icd11": "GA15.7",
"icd10_code": "N871",
"icd10_title": "Moderate cervical dysplasia"
},
{
"from_icd11": "GA15.7",
"icd10_code": "N87",
"icd10_title": "Dysplasia of cervix uteri"
},
{
"from_icd11": "GA15.7",
"icd10_code": "N872",
"icd10_title": ""
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8352",
"icd10_title": "Hypercalcemia"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8351",
"icd10_title": "Hypocalcemia"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8359",
"icd10_title": "Other disorders of calcium metabolism"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8350",
"icd10_title": "Unspecified disorder of calcium metabolism"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E835",
"icd10_title": "Disorders of calcium metabolism"
},
{
"from_icd11": "JA04",
"icd10_code": "O020",
"icd10_title": "Blighted ovum and nonhydatidiform mole"
},
{
"from_icd11": "JA04",
"icd10_code": "O02",
"icd10_title": "Other abnormal products of conception"
}
] |
M5126
|
Other intervertebral disc displacement, lumbar region
|
A 67-year-old Japanese woman was admitted to our hospital after one week of a remittent fever exceeding 37 °C and systemic erythema with pruritus, which did not improve after treatment with acetaminophen and topical steroids. On initial examination, her temperature was 38.5 °C, her blood pressure was 90/60 mmHg, her pulse rate was 110 beats/min, and her SpO 2 was 96% without oxygen support. The blood tests indicated a high inflammatory response with a white blood cell count of 11,700 cells/μL and a C-reactive protein level of 8.24 mg/dL, renal dysfunction with urea nitrogen at 27.3 mg/dL, creatinine at 1.31 mg/dL, and an estimated glomerular filtration rate of 31.9 mL/min/1.73 m 2 . The plain computed tomography (CT) imaging revealed numerous lymphadenopathies, with a maximum diameter of approximately 8 mm, generalized from the neck to the inguinal region. Although the repeated blood cultures were negative, the Sequential Organ Failure Assessment score was six, so we initially administered 1 g of intravenous (IV) meropenem every 12 h and noradrenaline to stabilize her blood pressure because we suspected septic shock. However, the plasma cell number was visibly increased in the peripheral blood and the generalized erythema worsened. Thus, meropenem was discontinued to avoid the possibility of drug eruption. After six days of admission, the platelet and fibrinogen levels decreased, leading to disseminated intravascular coagulation and requiring the administration of fresh-frozen plasma (FFP). The blood tests revealed positive EBV DNA and elevated soluble interleukin-2 receptor and interleukin-6 levels. The polyclonal immunoglobulins were also elevated (except M-protein) and a free light chain restriction was not observed ( Table 1 ). Contrast-enhanced chest and abdominal CT revealed the appearance of bilateral pleural effusions and ascites. Compared with that during the initial examination, the size of the lymphadenopathy remained unaltered, whereas the liver, spleen, and kidneys appeared to be swollen . A bone marrow biopsy was performed on the same day, which appeared to be normocellular with no increase in the megakaryocytes or reticulin fibers and MF-0 fibrosis. Plasma cells accounted for approximately 30% of the nucleated cells, and eosinophils and histiocytes were also abundant. Megakaryocytes with nuclear atypia exhibiting hypersegmentation were also observed . The flow cytometry did not reveal any light chain-restricted or abnormal cells, and the G-band examination indicated a normal karyotype. The generalized erythema with pruritus did not improve despite the topical use of steroids . The skin biopsy revealed dilated small blood vessels in the papillary dermis with a surrounding infiltration of the lymphocytes, plasma cells, and histiocytes with edema . Although no tick bites were observed, we considered a possible rickettsial infection and started a levofloxacin and minocycline treatment which was administered for eight days. However, this treatment was terminated when the PCR results were negative for rickettsiosis. The general condition and blood coagulation abnormalities of the patient continued to worsen; therefore, she was continued on platelet and FFP transfusions. Additionally, she was treated with high-dose steroid therapy (methylprednisolone 500 mg/day for three days) to treat the generalized indurated edema. This treatment resulted in a decrease in the percentage of plasma cells in the peripheral blood. Echocardiography indicated diffusely left ventricular hypokinesis with a 20–30% ejection fraction and pericardial effusion. Consequently, the patient was started on dobutamine (4.5 μg/kg·min). Furthermore, the renal function and thrombocytopenia deteriorated gradually, fulfilling the Japanese diagnostic criteria for TAFRO syndrome at this point. Therefore, we started a rituximab treatment at a dose of 375 mg/m 2 and subsequently repeated it every seven days. The fever and the skin rash rapidly disappeared; the renal failure, heart failure, and blood coagulation abnormalities improved; and the patient no longer depended on transfusions. Upon stabilization, we performed inguinal lymph node and myocardial biopsies. The inguinal lymph node biopsy was negative for human herpesvirus-8 latency-associated nuclear antigen . The histopathological analysis revealed a hypervascular type of iMCD. The lymphoid follicles were markedly atrophic, with dense hyper endothelial vessels between the follicles . CD23 staining barely identified lymphoid follicles. The network of follicular dendritic cells was disorganized, with follicular dendritic cells extending outside the germinal center . The perivascular area was infiltrated with CD38-positive plasma cells and small lymphocytes . The immunoglobulin G4/CD38 ratio in the plasma cells was less than 1%. The immunoglobulin heavy chain and T-cell receptor rearrangements were negative. Furthermore, the EBV-encoded RNA in situ hybridization (EBER-ISH) was positive for an infection . The myocardial biopsy exhibited atrophic myocardial fibers, edema between myocardial fibers, myocardial fiber degeneration, and hemorrhage. No fibrosis was evident in the interstitium but it was accompanied by a mild lymphocytic and histiocytic infiltrate . The EBER-ISH was negative in this sample . Since the patient developed a fever even after the rituximab treatment, we started the patient on 2 g of IV cefepime every 12 h and switched to 1 g of IV meropenem every 12 h, with no resolution of the fever. The plasma cytomegalovirus DNA was later found to be positive, thus 5 mg/kg of IV ganciclovir every 12 h was concurrently added, which successfully relieved the fever. The patient was discharged 50 days after their admission. Finally, she completed eight cycles of rituximab treatment in the outpatient ward and remained alive with a good performance as of December 2022. Figure 6 depicts the complete clinical course of the patient during hospitalization.
| 4.109375
| 0.974121
|
sec[1]/p[0]
|
en
| 0.999998
|
36837418
|
https://doi.org/10.3390/medicina59020216
|
[
"blood",
"cells",
"plasma",
"fever",
"every",
"myocardial",
"which",
"biopsy",
"this",
"erythema"
] |
[
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
},
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
[MA12.4] Finding of steroid agent in blood
Also known as: Finding of steroid agent in blood | steroid in blood
[MA12.2] Finding of hallucinogen in blood
Also known as: Finding of hallucinogen in blood | hallucinogen in blood
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues
Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--CHILD--> [?] Diseases of spleen
--- 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...
--PARENT--> [MF50] Abnormal micturition
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.2] Finding of hallucinogen in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.2] Finding of hallucinogen in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Diseases of spleen",
"[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 --PARENT--> [MF50] Abnormal micturition",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
With the rapid advancement of minimally invasive surgical techniques, Natural Orifice Specimen Extraction Surgery (NOSES) has evolved from its nascent stages to a more refined practice. An international consensus on transnatural orifice specimen extraction for gastric neoplasms is progressively being formulated ( 9 ). In gastric NOSES, the primary pathways for specimen retrieval are the transanal and transvaginal routes. Furthermore, certain researchers have investigated the feasibility of transoral specimen extraction in NOSES procedures, utilizing both animal models and clinical patients. This approach has been applied in surgeries such as cholecystectomy, sleeve gastrectomy, hepatic cystectomy, adrenal mass excision, early gastric tumor resection, and leiomyoma excision ( 11 – 17 ). The viability of transoral specimen retrieval for GISTs has been substantiated by pertinent scholarly publications ( 18 , 19 ). In transoral NOSES, the esophagus serves as the sole conduit for specimen retrieval, endowing this procedure with distinct uniqueness. Compared to the rectum and vagina, the esophagus presents a narrower and less elastic lumen, which heightens the complexity of the operation and imposes stricter criteria for specimen extraction. Surgeons must rigorously adhere to the principles of “asepsis and tumor-free” and possess proficient mastery of NOSES surgical protocols. Typically, the indications for transoral NOSES in gastric tumors include: ① Gastric wall neoplasms, either benign or malignant, that are not amenable to complete endoscopic resection; ② lesions ideally measuring less than 2.0 cm in maximum diameter; ③ appropriate for tumors classified as T2 or T3 stage. Relative contraindications include: ① neoplasms with advanced local staging and larger dimensions; ② patients with obesity (body mass index ≥30.0 kg/m²); ③ individuals experiencing acute gastrointestinal obstruction, tumor perforation, or hemorrhage necessitating urgent surgical intervention ( 9 ). Owing to its distinctive characteristics, there remains a scarcity of scholarly work on this topic, especially regarding robot-assisted gastric GIST resection with endoscopic transoral specimen extraction (GC-NOSES type IX). In this case, the patient is an elderly female with a mass located on the posterior wall of the lower body of the stomach. She has a strong preference for minimally invasive surgery and has no prior history of oral or esophageal diseases or surgeries. The moderate size of the mass provides feasibility for surgical intervention. Following a preoperative discussion, we identified several surgical options: robotic-assisted resection of the GIST combined with endoscopic transoral specimen retrieval, non-exposed endoscopic wall-inversion surgery (NEWS), and traditional laparoscopic surgery. After extensive deliberation, we concluded that: ① The patient’s BMI >30 kg/m², which complicates endoscopic inversion; the tumor is relatively large and situated on the posterior wall of the lower stomach near the lesser curvature. If NEWS were employed for resection, the limited endoscopic working space and suboptimal visualization would complicate the procedure, increasing the risk of excessive manipulation and potential tumor rupture, thereby jeopardizing the possibility of achieving an R0 resection. ② Literature indicates that even experienced operators may require over five hours to complete a NEWS procedure ( 20 ). Based on our previous experiences, we believe that this technique is time-consuming and may hinder postoperative recovery, while also increasing the risk of symptoms such as throat discomfort and complications. ③ The NEWS technique poses challenges in achieving precise apposition of the serosal layer during suturing, with a risk of delayed perforation. Additionally, closure of the mucosal defect under endoscopic guidance necessitates the use of clips, which can delay resumption of oral intake. ④ Our approach integrates the advantages of the Da Vinci robotic surgical system with endoscopy. Compared to NEWS and traditional laparoscopic surgery, it offers several benefits: ① The Da Vinci system allows for precise and flexible manipulation, enabling access to areas that are difficult to reach with conventional endoscopy, facilitating complete tumor resection and improving the R0 resection rate. ② It can reduce operative time and lower the incidence of complications; furthermore, suturing is more meticulous and accurate, resulting in less damage to the gastric wall and quicker recovery of gastrointestinal function, allowing for early resumption of feeding. ③ During the transoral specimen retrieval, we can accurately assist in placing the specimen into a retrieval bag, ensuring a completely non-exposed procedure to prevent tumor cell seeding.④ While adhering to the principle of tumor-free margins, we also strive to minimize gastric fluid spillage to avoid contamination of the gastric cavity, employing iodine-impregnated gauze strategically. ⑤ The implementation of this technique is based on a comprehensive assessment to ensure surgical safety and facilitate patient recovery. By overcoming the traditional dilemma of tumor size versus minimally invasive surgery, we have achieved a one-stop solution that encompasses radical treatment, aesthetic considerations, and rapid recovery. Consequently, we decided to proceed with robotic-assisted resection of the gastrointestinal stromal tumor combined with endoscopic transoral specimen retrieval. Following successful anesthesia, we conducted a thorough endoscopic evaluation of the patient’s esophageal condition, determining that her esophageal elasticity was relatively good, with a patent lumen, thus confirming the feasibility of the procedure. The specimen retrieval was performed under continuous visualization and proceeded smoothly; upon completion, a follow-up endoscopic examination revealed that the esophagus and oral cavity were intact without any damage.
| 4.339844
| 0.53125
|
sec[2]/p[0]
|
en
| 0.999995
|
40365338
|
https://doi.org/10.3389/fonc.2025.1580558
|
[
"specimen",
"tumor",
"endoscopic",
"gastric",
"resection",
"retrieval",
"transoral",
"that",
"noses",
"this"
] |
[
{
"code": "MD40.Y",
"title": "Other specified clinical findings in specimens from respiratory organs and thorax"
},
{
"code": "MF6Y",
"title": "Other specified clinical findings in specimens from female genital organs"
},
{
"code": "ME20.Z",
"title": "Clinical findings in specimens from digestive organs or abdominal cavity, unspecified"
},
{
"code": "MF6Z",
"title": "Clinical findings in specimens from female genital organs, unspecified"
},
{
"code": "MF8Z",
"title": "Clinical findings in specimens from the urinary system, unspecified"
},
{
"code": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
}
] |
=== ICD-11 CODES FOUND ===
[MD40.Y] Other specified clinical findings in specimens from respiratory organs and thorax
Also known as: Other specified clinical findings in specimens from respiratory organs and thorax | Abnormal findings in bronchial washings | Abnormal findings in nasal secretions | Abnormal findings in pleural fluid | abnormal pleural fluid
[MF6Y] Other specified clinical findings in specimens from female genital organs
Also known as: Other specified clinical findings in specimens from female genital organs | Abnormal specimen of vagina | Abnormal findings in secretions and smears from vagina | Vaginal fluid abnormal | Abnormal specimen of vulva
[ME20.Z] Clinical findings in specimens from digestive organs or abdominal cavity, unspecified
Also known as: Clinical findings in specimens from digestive organs or abdominal cavity, unspecified | Clinical findings in specimens from digestive organs or abdominal cavity | abnormal specimen from digestive organs
[MF6Z] Clinical findings in specimens from female genital organs, unspecified
Also known as: Clinical findings in specimens from female genital organs, unspecified | abnormal specimen of female genital organs
[MF8Z] Clinical findings in specimens from the urinary system, unspecified
Also known as: Clinical findings in specimens from the urinary system, unspecified
[2F9Z] Neoplasms of unknown behaviour of unspecified site
Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature
Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules
Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung
Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site
[2F92] Neoplasms of unknown behaviour of skin
Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[MD40.Y] Other specified clinical findings in specimens from respiratory organs and thorax
--PARENT--> [MD40] Clinical findings in specimens from respiratory organs and thorax
--CHILD--> [MD40.0] Abnormal level of enzymes in specimens from respiratory organs and thorax
--- Walk 2 ---
[MD40.Y] Other specified clinical findings in specimens from respiratory organs and thorax
--PARENT--> [MD40] Clinical findings in specimens from respiratory organs and thorax
--CHILD--> [MD40.1] Abnormal level of hormones in specimens from respiratory organs and thorax
--- Walk 3 ---
[MF6Y] Other specified clinical findings in specimens from female genital organs
--PARENT--> [?] Clinical findings in specimens from female genital organs
--EXCLUDES--> [?] Carcinoma in situ of other or unspecified genital organs
--- Walk 4 ---
[MF6Y] Other specified clinical findings in specimens from female genital organs
--PARENT--> [?] Clinical findings in specimens from female genital organs
--EXCLUDES--> [?] Low grade squamous intraepithelial lesion of vulva
Def: A condition of the vulva, characterised by lesion of the squamous vulvar intraepithelial cells, leading to unspecified grade or severity of dysplasia and varying degrees of atypia of the cells. This c...
--- Walk 5 ---
[ME20.Z] Clinical findings in specimens from digestive organs or abdominal cavity, unspecified
--PARENT--> [ME20] Clinical findings in specimens from digestive organs or abdominal cavity
--CHILD--> [ME20.2] Abnormal level of drugs, medicaments or biological substances in specimens from digestive organs of abdominal cavity
--- Walk 6 ---
[ME20.Z] Clinical findings in specimens from digestive organs or abdominal cavity, unspecified
--PARENT--> [ME20] Clinical findings in specimens from digestive organs or abdominal cavity
--EXCLUDES--> [?] Other faecal abnormalities
|
[
"[MD40.Y] Other specified clinical findings in specimens from respiratory organs and thorax\n --PARENT--> [MD40] Clinical findings in specimens from respiratory organs and thorax\n --CHILD--> [MD40.0] Abnormal level of enzymes in specimens from respiratory organs and thorax",
"[MD40.Y] Other specified clinical findings in specimens from respiratory organs and thorax\n --PARENT--> [MD40] Clinical findings in specimens from respiratory organs and thorax\n --CHILD--> [MD40.1] Abnormal level of hormones in specimens from respiratory organs and thorax",
"[MF6Y] Other specified clinical findings in specimens from female genital organs\n --PARENT--> [?] Clinical findings in specimens from female genital organs\n --EXCLUDES--> [?] Carcinoma in situ of other or unspecified genital organs",
"[MF6Y] Other specified clinical findings in specimens from female genital organs\n --PARENT--> [?] Clinical findings in specimens from female genital organs\n --EXCLUDES--> [?] Low grade squamous intraepithelial lesion of vulva\n Def: A condition of the vulva, characterised by lesion of the squamous vulvar intraepithelial cells, leading to unspecified grade or severity of dysplasia and varying degrees of atypia of the cells. This c...",
"[ME20.Z] Clinical findings in specimens from digestive organs or abdominal cavity, unspecified\n --PARENT--> [ME20] Clinical findings in specimens from digestive organs or abdominal cavity\n --CHILD--> [ME20.2] Abnormal level of drugs, medicaments or biological substances in specimens from digestive organs of abdominal cavity",
"[ME20.Z] Clinical findings in specimens from digestive organs or abdominal cavity, unspecified\n --PARENT--> [ME20] Clinical findings in specimens from digestive organs or abdominal cavity\n --EXCLUDES--> [?] Other faecal abnormalities"
] |
MD40.Y
|
Other specified clinical findings in specimens from respiratory organs and thorax
|
[
{
"from_icd11": "ME20.Z",
"icd10_code": "R8581",
"icd10_title": "Anal high risk human papillomavirus (HPV) DNA test positive"
},
{
"from_icd11": "ME20.Z",
"icd10_code": "R859",
"icd10_title": "Unspecified abnormal finding in specimens from digestive organs and abdominal cavity"
},
{
"from_icd11": "ME20.Z",
"icd10_code": "R83-R89",
"icd10_title": ""
},
{
"from_icd11": "ME20.Z",
"icd10_code": "R85",
"icd10_title": "Abnormal findings in specimens from digestive organs and abdominal cavity"
},
{
"from_icd11": "ME20.Z",
"icd10_code": "R858",
"icd10_title": "Other abnormal findings in specimens from digestive organs and abdominal cavity"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R87810",
"icd10_title": "Cervical high risk human papillomavirus (HPV) DNA test positive"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R8789",
"icd10_title": "Other abnormal findings in specimens from female genital organs"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R87820",
"icd10_title": "Cervical low risk human papillomavirus (HPV) DNA test positive"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R87811",
"icd10_title": "Vaginal high risk human papillomavirus (HPV) DNA test positive"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R879",
"icd10_title": "Unspecified abnormal finding in specimens from female genital organs"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R87",
"icd10_title": "Abnormal findings in specimens from female genital organs"
},
{
"from_icd11": "MF6Z",
"icd10_code": "R878",
"icd10_title": "Other abnormal findings in specimens from female genital organs"
},
{
"from_icd11": "MF8Z",
"icd10_code": "E7522",
"icd10_title": "Gaucher disease"
},
{
"from_icd11": "MF8Z",
"icd10_code": "E7529",
"icd10_title": "Other sphingolipidosis"
},
{
"from_icd11": "MF8Z",
"icd10_code": "E7521",
"icd10_title": "Fabry (-Anderson) disease"
}
] |
R8581
|
Anal high risk human papillomavirus (HPV) DNA test positive
|
The 58-year-old patient was female and visited our hospital for one-month hemoptysis with no history of chronic diseases, smoking, and alcohol use . The X-ray and enhanced computed tomography (CT) demonstrated a mass in the upper lobe of the right lung (about 3.7 cm × 3.4 cm × 3.5 cm) with lobulated border and burrs, partially-occluded bronchial branches, and there were no obvious enlargement of mediastinal and bilateral hilar lymph nodes, and partial calcification. Central lung cancer was considered . Carcinoembryonic antigen (CEA) was 86.98 ng/ml and the cytokeratin 19 fragment (CY21-1) was 4.06 ng/ml. Fiberoptic bronchoscopy indicated neoplasms in the posterior segment of the right upper lung, endoscopic biopsy suggested NSCLC , and immunohistochemistry showed P40(+) and TTF-1 (–), suggestive of squamous cell carcinoma . A few dyskaryotic cells were detected in bronchoalveolar lavage fluid (BALF). No significant metastasis was identified via upper abdominal enhanced CT scan, contrast-enhanced magnetic resonance imaging (MRI) of the head, and whole-body bone emission CT (ECT) scan. Taken together, the patient was classified as cT2aN0M0, stage IB. The patient’s tumor was closely related to the right upper pulmonary artery branch , and the possibility of angioplasty during direct surgery was high, increasing the risk of surgery. There is also the possibility of conversion to thoracotomy, which would be more traumatic for the patient. Considering that the patient was a squamous carcinoma with a low possibility of having driver mutations, the multidisciplinary consultation recommended that neoadjuvant immune combination chemotherapy treatment should be performed first followed by surgery while waiting for NGS test and immunohistochemistry results. After signing the informed consent, the patient received anti-PD-1 therapy plus platinum-based neoadjuvant therapy (intravenous injection of 200 mg Pembrolizumab, 30 mg/m 2 lobaplatin + 260 mg/m 2 nab-paclitaxel, D1, q3w). The patient developed grade 2 myelosuppression during therapy, which was treated with an injection of polyethylene glycol recombinant human granulocyte colony-stimulating factor (rhG-CSF) with no grade 3-5 adverse events (AEs) observed. In the meantime, next-generation sequencing (NGS) and immunohistochemical(IHC) detected EGFR p.L858R mutations (abundance 72.2%), PD-L1 expression (TPS=80%, CPS(Combined Positive Score)=80), and tumor mutational burden (TMB, 5.03Mut/Mb), accompanied by EGFR copy-number amplification as well as multiple gene mutations, such as NKX2-1 and TP53 . Considering the occurrence of EGFR mutation, the followed therapy was dilemma, which dependent on the outcome of the first treatment session as informed before. After one course of neoadjuvant immunochemotherpy, CEA and CY21-1 were 23.17 ng/ml and 2.43 ng/ml, respectively, significantly lower than the pre-treatment levels. In the meantime, chest digital radiography (DR) showed a reduction of the right upper lung occupancy , implying partial radiographical response. So, the second cycle immunochemotherapy was perfomed as plan. Three weeks later, subsequent to the application of the second course of neoadjuvant therapy, a chest X-ray and enhanced CT scan were performed, indicating a marked reduction of the lesion in the right upper lung(about 1.9 cm × 1.4 cm) with partially bronchial stricture. At this point, CEA and CY21-1 were 3.06 ng/ml and 1.81 ng/ml respectively. Besides, positron emission tomography-computed tomography (PET-CT) illustrated an irregular patchy hyperdense shadow (2.76 cm × 2.18 cm × 1.59 cm) near the hilum of the right lung upper lobe and a mild increase in radioactivity uptake (maximum SUV = 2.57, mean SUV = 2.37), indicating that the tumor activity was remarkably suppressed . Partial response (PR) was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. In the fifth week after the neoadjuvant therapy, the single-port right upper thoracoscopic lobectomy + mediastinal lymph node dissection was successfully performed, during which the blood loss was approximately 50 ml. Postoperative pathology showed that the mass was 2.5 cm × 2 cm × 1.5 cm and that the fibrous tissue of the tumor bed exhibited hyperplasia with degeneration. Lymphocytes infiltrated the areas containing multinucleated giant cells and foam cells without residual disease; the bronchial mucosa manifested chronic inflammation without residualdisease. Efficacy assessment of neoadjuvant therapy showed that pCR was achieved. The lymph nodes of 2R (0/2), 3A (0/2), 4R (0/1), group 7 (0/1), group 10 (0/1), group 11 (0/7), and group 12 (0/1) were disease-free. The bronchial stump of the right upper lung was also free of cancer cells. The patient recovered well and was discharged without any operation-related complications. Biopsy tissues and surgical samples were examined using multiplex immunohistochemistry (mIHC) to reveal the alterations of the tumor microenvironment (TME) after the application of neoadjuvant therapy, especially the inflammatory and immune cells. mIHC of biopsy tissues illustrated intratumoral presence of CD8+ T cells (111/mm2), and high infiltration of FoxP3 (244/mm 2 ) and CD68 + CD163 + M2 macrophages (139/mm 2 ). In the surgical samples , large amounts of CD8+ T cells (511/mm 2 ) and tertiary lymphoid structures were observed, while the number of CD68 + CD163 + M2 macrophages (32/mm 2 ) and FoxP3+ (60/mm 2 ) were substantially decreased. No genetic mutation was detected in the ctDNA of peripheral blood at the fourth postoperative week. The patient started receiving two cycles of adjuvant immuno-chemotherapy (intravenous injection of 200 mg Pembrolizumab, 30 mg/m 2 lobaplatin + 260 mg/m 2 nab-paclitaxel, D1, q3w) at the fifth week after surgery. The patient was in good physical condition at the 5-month follow-up visit and refused to accept the one-year single-agent immunotherapy due to financial factors.
| 4.097656
| 0.96875
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC9627657
|
https://doi.org/10.3389/fonc.2022.1008932
|
[
"lung",
"cells",
"neoadjuvant",
"that",
"tumor",
"enhanced",
"bronchial",
"which",
"group",
"tomography"
] |
[
{
"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": "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 ===
[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
[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 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--RELATED_TO--> [?] Alpha-1-antitrypsin deficiency
Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...
--- Walk 2 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--RELATED_TO--> [?] 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--> [LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped 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 ...
--EXCLUDES--> [?] Pneumonitis
Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly....
--- Walk 6 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii
Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...
|
[
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency\n Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...",
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --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--> [LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped 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 --EXCLUDES--> [?] Pneumonitis\n Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly....",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o..."
] |
CB40.Y
|
Other specified diseases of the respiratory system
|
[
{
"from_icd11": "LA75.1",
"icd10_code": "Q333",
"icd10_title": "Agenesis of lung"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J189",
"icd10_title": "Pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J181",
"icd10_title": "Lobar pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J188",
"icd10_title": "Other pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J168",
"icd10_title": "Pneumonia due to other specified infectious organisms"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J180",
"icd10_title": "Bronchopneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J17",
"icd10_title": "Pneumonia in diseases classified elsewhere"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J182",
"icd10_title": "Hypostatic pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J16",
"icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J171",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J173",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J178",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J18",
"icd10_title": "Pneumonia, unspecified organism"
},
{
"from_icd11": "CB41",
"icd10_code": "J9622",
"icd10_title": "Acute and chronic respiratory failure with hypercapnia"
},
{
"from_icd11": "CB41",
"icd10_code": "J9620",
"icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia"
}
] |
Q333
|
Agenesis of lung
|
We present a case of a 49-year-old woman with renal and heart failure following a long-term (lasting from 13 years of age) SLE prepared for kidney transplantation. Due to LN (class III, then IV), starting at childhood, she was treated with steroids, together with cyclophosphamide, replaced later by methotrexate and then azathioprine. Hence, the partial remission of nephrotic syndrome was achieved and from 2002 the patient did not receive any immunosuppressive therapy. She was also HBV and HCV positive. SLE involvement of circulatory system presented with early coronary atherosclerosis, ischemic heart disease, and myocardial infarction at the age of 20. In 2007, because of deterioration of kidney function with a serum creatinine concentration of 2.2 mg/dL and proteinuria of 2 g/day, the kidney biopsy was performed. The biopsy showed active and sclerotic focal proliferative lupus nephritis nevertheless immunosuppressive therapy was not introduced for the reason of active replication of HCV. The kidney function was gradually deteriorating over time. Despite cardiac intervention (PCI RCA), the patient developed severe post-infarction and dilated cardiomyopathy and required ICD implantation in primary prevention in 2009. Later, on lupus and secondary cardiomyopathic background, the patient developed severe MV and TV regurgitation. For this reason, the patient underwent mitral and tricuspid valve repair and left ventricle volume reduction surgery complicated by low cardiac output syndrome with a need for intra-aortic balloon pump use . In the postoperative period, the kidney function deteriorated, requiring the initiation of renal replacement therapy. The patient has been on dialysis for 4 years. While being on active waiting list for kidney transplantation presented remission of laboratory indices of lupus (complement splits within normal limits: C3–0,93 g/l, C4–0,4 g/l, ANA negative) and persisting circulatory insufficiency with markedly reduced stair-climbing capacity (to one flight of stairs) with elevated BNP 619 pg/ml (n. 0–100). In transthoracic echocardiography, performed before renal transplantation, the left ventricle and the left atrium were significantly enlarged and the left ventricular systolic function was significantly reduced with LVEF 26% and GLS -3 . Due to the implantation of the mitral ring, it was not possible to assess the left ventricular diastolic function. The high tricuspid regurgitant flow gradient with widened and poorly respiratory mobile inferior vena cava indicated a high probability of pulmonary hypertension. Furthermore, while preparing the patient for the surgical procedure, it was decided to include cardioprotective therapy with Levosimendan. Due to the time frame associated with the transplantation procedure, the drug infusion was started as soon as possible after cross-match results were known, immediately after the dialysis session. The infusion at a dose of 0.1 μg/kg/min was continued after surgery for a total of 24 h. The patient’s anesthesia for kidney transplantation and perioperative care included the aspect of optimizing transplanted kidney perfusion, avoiding the use of renal toxic drugs and those excreted by properly functioning kidneys, as well as the use of nephroprotective agents. Because of the patient’s cardiological burden, including recurrent episodes of extrasystole proceeding with decompensation of the circulatory system, together with the need of ICD turning off for the transplantation period, the Swan-Ganz catheter for hemodynamic assessment was not used. Anesthesia monitoring was limited the to ECG, central catheter with CVP assessment, direct blood pressure measurement from the cannula inserted into the radial artery, and cardiac ultrasound. In the perioperative period the CVP parameter was used to assess the volatility, and in the postoperative period, a cardiac ultrasound was used along with the assessment of VCI respiratory fill and motility. The therapy was aimed at the standard of fluid therapy called Goal Directed Therapy (GDT) . During general anesthesia, fentanyl, triacrium, propofol, desflurane, antibiotic therapy, and standard immunosuppressive treatment were used as well as 25 g of mannitol infusion was administered as a nephroprotective treatment and 0.9% NaCl as a fluid therapy . In the course of postoperative immunosuppression, she received steroids, tacrolimus with mycophenolate mofetil which was stopped due to persistent leukopenia and cytomegalovirus infection. Furthermore delayed graft function was observed with a need for hemodialysis for almost 6 weeks (mostly due to fluid retention). BNP levels raised to 2996 pg/ml and then slowly decreased. The kidney biopsy performed 2 weeks after transplantation revealed acute rejection with ATN. Finally, the patient was discharged from the hospital on the 67th POD with the serum creatinine concentration of 1.4 mg/dL and BNP level of 1794 pg/ml. One month after kidney transplantation, there was a reduction in left ventricular dimensions, improved systolic function in the EF (increase to 30%) and GLS (decrease to − 6) assessment . In addition, there was a decrease in the tricuspid regurgitant flow gradient with normal width and respiratory motility of the IVC, which indicates a low probability of pulmonary hypertension. The improvement of echocardiographic parameters also reflected the simultaneous improvement of exercise capacity in the recipient from NYHA III/IV to NYHA II. In the 5-month observation, further improvement of heart function with a drop of BNP to 1066 pg/ml and normal kidney function were noted. Fig. 1 Global and segmental longitudinal strain before ( a ) and after ( b ) kidney transplantation. The bull’s eye plot displays the regional value of peak systolic strain in all 17 left ventricle segments. Their average value is defined as a global longitudinal strain (GLS). Red colours indicate shortening strains and blue indicates lengthening strains
| 4.089844
| 0.973633
|
sec[1]/p[0]
|
en
| 0.999996
|
30572818
|
https://doi.org/10.1186/s12882-018-1185-x
|
[
"kidney",
"transplantation",
"function",
"renal",
"cardiac",
"period",
"used",
"heart",
"immunosuppressive",
"circulatory"
] |
[
{
"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": "QB63.Z",
"title": "Presence of transplanted organ or tissue, unspecified"
},
{
"code": "QB63.Y",
"title": "Presence of other transplanted organ or tissue"
},
{
"code": "NE84",
"title": "Failure or rejection of transplanted organs or tissues"
},
{
"code": "QB63.4",
"title": "Presence of transplanted skin"
},
{
"code": "QE00",
"title": "Acculturation difficulty"
}
] |
=== 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
[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
[QB63.Y] Presence of other transplanted organ or tissue
Also known as: Presence of other transplanted organ or tissue | Presence of transplanted heart and lungs | heart and lungs transplant status | Presence of transplanted intestine | intestinal transplant
[NE84] Failure or rejection of transplanted organs or tissues
Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection
[QB63.4] Presence of transplanted skin
Also known as: Presence of transplanted skin | skin transplant status | autogenous skin transplant status | skin transplantation
[QE00] Acculturation difficulty
Definition: Problems resulting from the inability to adjust to a different culture or environment.
Also known as: Acculturation difficulty | acculturation problem | cultural shock | social migrant difficulty | migration
Excludes: Disorders specifically associated with stress
=== GRAPH WALKS ===
--- Walk 1 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--CHILD--> [GB6Z] Kidney failure, unspecified
--- Walk 2 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--EXCLUDES--> [?] Hypertensive renal disease
Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....
--- Walk 3 ---
[LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or both kidneys....
--EXCLUDES--> [?] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--PARENT--> [?] Chronic tubulo-interstitial nephritis associated with familial or genetic diseases
--- 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....
--PARENT--> [?] Structural developmental anomalies of the urinary system
Def: Any condition caused by failure of the urinary system to correctly develop during the antenatal period....
--- Walk 5 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.01] Contusion of kidney, major
--- Walk 6 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.02] Laceration of kidney, minor
|
[
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --CHILD--> [GB6Z] Kidney failure, unspecified",
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --EXCLUDES--> [?] Hypertensive renal disease\n Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....",
"[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --PARENT--> [?] Chronic tubulo-interstitial nephritis associated with familial or genetic diseases",
"[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 --PARENT--> [?] Structural developmental anomalies of the urinary system\n Def: Any condition caused by failure of the urinary system to correctly develop during the antenatal period....",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.01] Contusion of kidney, major",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.02] Laceration of kidney, minor"
] |
GC2Z&XA6KU8
|
Disease of kidney, not elsewhere classified
|
[
{
"from_icd11": "GB6Z",
"icd10_code": "N19",
"icd10_title": "Unspecified kidney failure"
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17-N19",
"icd10_title": ""
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17",
"icd10_title": "Acute kidney failure"
},
{
"from_icd11": "LB30.1",
"icd10_code": "Q614",
"icd10_title": "Renal dysplasia"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q632",
"icd10_title": "Ectopic kidney"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q63",
"icd10_title": "Other congenital malformations of kidney"
},
{
"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"
}
] |
N19
|
Unspecified kidney failure
|
A 26-year-old female computer programming engineer with no previous medical or psychiatric history visited the psychiatric hospital on December 4, 2021, following a 3-day episode characterized by irritability, babbling, stiffness of the limbs, sleepwalking, hallucinations and paroxysmal mania, all of which had a significant impact on her life. The parents of the patient attributed the episode partially to her recent work stress and breakup. The patient had no history of headache, dizziness, fever, seizures, and dyskinesia, and was diagnosed with schizophrenia by a psychiatrist. During hospitalization, the patient was prescribed olanzapine 5mg twice daily, and sertraline 50mg once daily, but the symptoms were poorly controlled. On the 8th day after initial symptoms, a head computed tomography (CT) scan was performed, and no significant abnormalities were observed. An electroencephalogram (EEG) revealed a diffused slow wave. On the 17th day after initial symptoms, the abnormal signals of the SCC were characterized by slight hypo-intensity on T1-weighted image (T1WI), hyper-intensity on T2-weighted image (T2WI), FLAIR, and diffusion-weighted imaging (DWI) imaging, and hypo-intensity on apparent diffusion coefficient (ADC) map . Despite the treatment, the condition of the patient progressed and was transferred to the department of the neurological department on the 20th day after initial symptoms (Admission Day). Neurological examination showed drowsiness, difficulty with attention, or difficulty with serial 7s. The muscle strength of her limbs was approximately graded 5/5, with normal muscle tone and tendon reflexes; the remaining physical and neurological examination results were not significant. On admission day, a lumbar puncture was performed, showing homogeneous and uniform light red CSF in the anterior and posterior canals, normal opening pressure and glucose levels, increased CSF protein levels , normal white cell count (4×10^6/L), and high red blood cell count (1.2×10^9/L). After centrifugation, the supernatant of the CSF remained light red, and was positive for an occult blood test; crenocytes could be observed under a light microscope (×800 magnification) ( Supplementary Material ). No abnormalities were observed in the CSF bacteriological tests, CSF Gram stain, and CSF virus tests (herpes simplex virus, varicella-zoster virus, enterovirus, cytomegalovirus, rubella virus, and Epstein-Barr virus). Furthermore, we performed additional hospital-related examinations, including a coagulation function test. As a consequence, the mild elevation of D-Dimer was 2.93 mg/L (normal range, 0-0.55 mg/L) and the mild elevation of fibrinogen degradation products was 7.58 mg/L (normal range, 0-5 mg/L). Besides, alanine aminotransferase 56 U/L (normal range, 8-40 U/L), other biochemical indicators, complete blood cell count (including a white blood cell count of 8.5×10^6/L and red blood cell count of 5×10^12/L), routine urine and stool tests, homocysteine, thyroid-stimulating hormone, antithyroglobulin, antithyroperoxidase antibodies, cortisol, vitamin B12, erythrocyte sedimentation rate, and female tumor markers were normal. Serology for syphilis, hepatitis B, mycoplasma, human immunodeficiency virus antibody, herpes simplex virus, hepatitis C virus antibody, varicella, cytomegalovirus, mumps, measles, and Epstein-Barr virus was negative. Moreover, anti-nuclear, anti-SM, anti-SSB, anti-double-stranded DNA, anti-SSA, anti-JO-1, and all other auto-antibody tests were negative. Considering the probability of AE, an antibody test of CSF using a cell-based assay combined with a tissue-based assay (EUROIMMUN Medical Diagnostics company) was also performed on the second day of admission . The anti-NMDAR (titer of 1:3.2) antibody was positive. Serum analysis revealed positive anti-NMDAR (titer of 1:32), and anti-mGluR5 (titer of 1:10) antibodies, but negative anti-AMPA1, anti-AMPA2, anti-GABA-B, anti-LGI 1, anti-GAD65, anti-CASPR2, anti-DPPX, and anti-IgLON5 antibodies. In addition, CNS demyelinating antibodies, including AQP4, MOG, and MBP were also negative. Given the concern for AE, the patient was administered intravenous methylprednisolone (1 g per day, intravenously, for 5 days, 500 mg per day for 3 days, 250 mg per day for 3 days) and intravenous immunoglobulin (0.4 g/kg body weight for 5 days) on the 2nd day after admission. At the same time, olanzapine improved psychiatric symptoms. After 5 days of treatment, the symptoms gradually improved, her mental state improved, and could communicate. One month after the initial symptoms, the patient had not experienced sleepwalking, her mental and behavioral symptoms had largely disappeared, her memory had gradually recovered, and her arithmetic skills had improved significantly unlike before. The Mini-Mental State Examination (MMSE) scores and Montreal Cognitive Assessment (MoCA) scores were 22 and 18, respectively. We further examined for tumor evidence and a gynecological ultrasound revealed a mixed echogenic mass in the left ovary . Malignancy screening, including a CT of the chest, abdomen, and pelvis was performed to further assess the tumors, which demonstrated an irregular cystic mass (10.2 cm × 8.4 cm) with a few calcifications and fatty components in the posterior region of the bladder; ovarian teratoma was suspected . Subsequently, a gynecologist recommended surgical removal of the pelvic mass, however, the patient temporarily postponed the surgical treatment for personal reasons, and thus was discharged from the hospital on the 19nd day after admission. At this time, the patient had transitioned to prednisone 60 mg, reduced by 5 mg every 2 weeks, with anticipated treatment lasting 6 months. At 1 month follow-up, her mental and behavioral symptoms improved completely, with a score of 30 for both MMSE score and MoCA scores. A follow-up MRI scan indicated that the lesion in SCC had completely resolved 2 weeks after discharge.
| 4.089844
| 0.966797
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC9878315
|
https://doi.org/10.3389/fimmu.2022.1029294
|
[
"anti",
"virus",
"cell",
"count",
"blood",
"antibody",
"improved",
"including",
"antibodies",
"mental"
] |
[
{
"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": "1D9Z",
"title": "Unspecified viral infection of unspecified site"
},
{
"code": "1E1Z",
"title": "Unspecified viral disease"
},
{
"code": "1E1Y",
"title": "Other specified viral diseases"
},
{
"code": "1D85.Z",
"title": "Viral carditis, unspecified"
},
{
"code": "KA62.Z",
"title": "Viral infection in the fetus or newborn, 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
[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
[1E1Z] Unspecified viral disease
Also known as: Unspecified viral disease
[1E1Y] Other specified viral diseases
Also known as: Other specified viral diseases | Acute infectious lymphocytosis
[1D85.Z] Viral carditis, unspecified
Also known as: Viral carditis, unspecified | Viral carditis
[KA62.Z] Viral infection in the fetus or newborn, unspecified
Also known as: Viral infection in the fetus or newborn, unspecified | Viral infection in the fetus or newborn | congenital virus disorder | congenital virus disease
=== 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....
--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
--CHILD--> [MB23.0] Aggressive behaviour
Def: 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 app...
--- Walk 4 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--RELATED_TO--> [?] Speech dysfluency
Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...
--- Walk 5 ---
[3B4Z] Coagulation defects, unspecified
--PARENT--> [?] Coagulation defects
--CHILD--> [3B4Z] Coagulation defects, unspecified
--- Walk 6 ---
[3B4Z] Coagulation defects, unspecified
--PARENT--> [?] Coagulation defects
--CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects
Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood....
|
[
"[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 --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 --CHILD--> [MB23.0] Aggressive behaviour\n Def: 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 app...",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --RELATED_TO--> [?] Speech dysfluency\n Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...",
"[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [3B4Z] Coagulation defects, unspecified",
"[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects\n Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood...."
] |
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": "1D9Z",
"icd10_code": "B348",
"icd10_title": "Other viral infections of unspecified site"
}
] |
O26841
| |
In 2006, when this patient was diagnosed with metastatic breast cancer, treatment guidelines were less stringent and CDK4/6 inhibitors were not available. In this young patient we preferred to start treatment with chemotherapy because of the young age, the PgR status (0% in the bone biopsy), the high grade of the tumor (G3) and the high proliferative index (Ki67 35% in the primary tumor), despite only the bones were involved by the presence of metastases. Given that in the metastatic subset of patients the primary goal is to maintain long disease control with good quality of life, after 6 cycles of chemotherapy and evidence of disease response we switched to a hormonal treatment. According to the literature data, that show better progression-free and overall survival in patients receiving combined therapy with Luteinizing Hormone-Releasing Hormone (LHRH) analog plus tamoxifen, respect to patients treated with tamoxifen alone or LHRH analog alone, we chose this type of treatment for our young patient. Given the bone metastatic involvement, our patient started also treatment with zoledronic acid. Bisphosphonates impact on the rate of skeletal events, reducing the risk of pathological fractures and the need for radiotherapy to control pain and to avoid medullary compression. Before starting this therapy, given that these drugs may be associated with the risk of osteonecrosis of the jaw, it is strongly advised to perform a dental examination for an oral hygiene session and an orthopantomography, even if in recent prospective studies the incidence of this complication was very low (1%–2%). To date, the optimal duration of bisphosphonates therapy has not been definitely established. The National and International Guidelines indicate to administer therapy for a period of at least 1 to 2 years, up to the entire duration of therapy for metastatic breast cancer, until there is a substantial decline in the patient's conditions. However, our patient permanently interrupted zoledronic acid due to the need to perform invasive dental procedures, given the possible onset of osteonecrosis of the jaw, in the context of an improved bone metastatic disease after approximately 12 months of therapy. Our report exemplifies a case of exceptional response with long-term survival of a patient with oligometastatic HR-positive breast cancer. The concept of metastatic cancer as a chronic disease has now been embraced by both physicians and patients. In rare cases, survival extends beyond what usually expected, raising the issue of curability of metastatic disease, as pointed out in recent reviews. Reports from chemotherapy studies conducted for metastatic breast cancer, such as those from the MD Anderson or from the Eastern Cooperative Oncology Group, suggest that a small fraction of patients, perhaps in the order of 1% to 2%, may achieve long-term (≥10 years) disease-free survival. This occurs more frequently in cases of oligometastatic disease, where up to 50% of the patients have been reported to achieve long-term survival after systemic therapy, sometimes combined with a local therapy. We cannot obviously establish if the chemotherapy, administered at our patient as first-line treatment, contributed in some way to the achievement of a long-term survival. The Cochrane's review comparing the effects of chemotherapy alone with endocrine therapy alone in metastatic breast cancer found that while initial treatment with chemotherapy rather than endocrine therapy may be associated with a higher response rate, the 2 initial treatments had a similar effect on overall survival. The impact of chemotherapy in case of oligometastatic disease, a condition closer to that of micrometastatic disease in radically operated breast cancer, cannot in principle be excluded, but there are no data supporting this hypothesis. Radiation therapy is delivered with some frequency to oligometastatic sites in patients with breast cancer. Although there are some hints of potential impact on long-term disease control, and although advanced techniques, such as conformal radiotherapy and hypofractionation, may reduce toxicity and improve the feasibility of treatment, demonstration of benefit from prospective randomized clinical trials is still lacking. Given the lack of symptoms and of risks of skeletal events, we did not prescribe radiotherapy to the metastatic lesions. A further question arising is if it is possible to hypothesize a treatment interruption after a long period of response to endocrine treatment for advanced breast cancer. Literature reports of treatment interruption after durable complete response can be found for trastuzumab, [ 22 – 24 ] with some patients maintaining prolonged progression-free survival also after trastuzumab interruption, although data are quite scanty and this strategy is not endorsed by current guidelines. To our knowledge, there are no reports of successful experiences involving suspension of endocrine therapy after prolonged remission in metastatic breast cancer and continuing endocrine therapy until disease progression is the current standard of care. Intermittent treatment proved to be inferior to continuous treatment in metastatic breast cancer, and the Dutch Breast Cancer Research Group “Stop & Go study” study concluded that intermittent first-line treatment cannot be considered in patients with HER2-negative advanced breast cancer. Developing reliable methods to define the presence of microscopic residual disease could perhaps in the future help to identify patients suitable for treatment interruption after the achievement of clinical complete response. In our patient, CTC investigation was performed through a DEPArray-based assay as previously reported implemented with antibodies directed towards epithelial-mesenchymal transition and stemness markers. No actual CTC was detected in the blood of the patient with this approach, in accordance with the lasting response to therapy.
| 4.234375
| 0.930664
|
sec[2]/p[0]
|
en
| 0.999996
|
32541460
|
https://doi.org/10.1097/MD.0000000000020396
|
[
"cancer",
"metastatic",
"breast",
"patients",
"this",
"survival",
"chemotherapy",
"that",
"long",
"response"
] |
[
{
"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": "GB23",
"title": "Certain specified disorders of breast"
},
{
"code": "GB21.Z",
"title": "Inflammatory disorders of breast, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[2D4Z] Unspecified malignant neoplasms of unspecified sites
Also known as: Unspecified malignant neoplasms of unspecified sites | malignancy of unspecified site | malignancy unspecified primary site | malignant growth of unspecified site | malignant mass of unspecified site
[2C0Z] Malignant neoplasms of intestine, unspecified
Also known as: Malignant neoplasms of intestine, unspecified | cancer of intestine | malignant neoplasm of intestine NOS | malignant tumour of intestine NOS | intestinal cancer NOS
[2B5Z] Malignant mesenchymal neoplasm of unspecified type
Also known as: Malignant mesenchymal neoplasm of unspecified type | calvarium cancer | ethmoid bone cancer | facial bone cancer | frontal bone cancer
[2E2Z] Malignant neoplasm metastasis, unspecified
Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases
[2D42] Malignant neoplasms of ill-defined sites
Definition: Malignant neoplasms of ill defined sites is used for cases where the documentation refers to a site that includes multiple organ systems and tissue types that should be coded separately.
Also known as: Malignant neoplasms of ill-defined sites | Malignant neoplasm of ill-defined site of head, face or neck | Malignant neoplasm of nose NOS | Primary malignant neoplasm of cheek | malignant neoplasm of cheek NOS
[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
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[2D4Z] Unspecified malignant neoplasms of unspecified sites
--PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites
--CHILD--> [2D41] Unspecified carcinoma of unspecified site
--- Walk 2 ---
[2D4Z] Unspecified malignant neoplasms of unspecified sites
--PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites
--CHILD--> [2D41] Unspecified carcinoma of unspecified site
--- Walk 3 ---
[2C0Z] Malignant neoplasms of intestine, unspecified
--PARENT--> [?] Malignant neoplasms of intestine
--CHILD--> [?] Malignant neoplasms of large intestine
--- Walk 4 ---
[2C0Z] Malignant neoplasms of intestine, unspecified
--PARENT--> [?] Malignant neoplasms of intestine
--CHILD--> [2B80] Malignant neoplasms of small intestine
Def: A primary malignant neoplasm involving the small intestine....
--- Walk 5 ---
[2B5Z] Malignant mesenchymal neoplasm of unspecified type
--PARENT--> [?] Malignant mesenchymal neoplasms
Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...
--CHILD--> [2B51] Osteosarcoma, primary site
Def: A usually aggressive malignant bone-forming mesenchymal tumour, predominantly affecting adolescents and young adults. It usually involves bones and less frequently extraosseous sites. It often involve...
--- Walk 6 ---
[2B5Z] Malignant mesenchymal neoplasm of unspecified type
--PARENT--> [?] Malignant mesenchymal neoplasms
Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...
--EXCLUDES--> [?] Mesenchymal tumours of meninges
|
[
"[2D4Z] Unspecified malignant neoplasms of unspecified sites\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --CHILD--> [2D41] Unspecified carcinoma of unspecified site",
"[2D4Z] Unspecified malignant neoplasms of unspecified sites\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --CHILD--> [2D41] Unspecified carcinoma of unspecified site",
"[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 --CHILD--> [2B80] Malignant neoplasms of small intestine\n Def: A primary malignant neoplasm involving the small intestine....",
"[2B5Z] Malignant mesenchymal neoplasm of unspecified type\n --PARENT--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...\n --CHILD--> [2B51] Osteosarcoma, primary site\n Def: A usually aggressive malignant bone-forming mesenchymal tumour, predominantly affecting adolescents and young adults. It usually involves bones and less frequently extraosseous sites. It often involve...",
"[2B5Z] Malignant mesenchymal neoplasm of unspecified type\n --PARENT--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...\n --EXCLUDES--> [?] Mesenchymal tumours of meninges"
] |
2D4Z
|
Unspecified malignant neoplasms of unspecified sites
|
[
{
"from_icd11": "2D4Z",
"icd10_code": "C802",
"icd10_title": "Malignant neoplasm associated with transplanted organ"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7650",
"icd10_title": "Malignant neoplasm of unspecified lower limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7642",
"icd10_title": "Malignant neoplasm of left upper limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7640",
"icd10_title": "Malignant neoplasm of unspecified upper limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7652",
"icd10_title": "Malignant neoplasm of left lower limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7651",
"icd10_title": "Malignant neoplasm of right lower limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C7641",
"icd10_title": "Malignant neoplasm of right upper limb"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C801",
"icd10_title": "Malignant (primary) neoplasm, unspecified"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C768",
"icd10_title": "Malignant neoplasm of other specified ill-defined sites"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C761",
"icd10_title": "Malignant neoplasm of thorax"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C762",
"icd10_title": "Malignant neoplasm of abdomen"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C763",
"icd10_title": "Malignant neoplasm of pelvis"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C800",
"icd10_title": "Disseminated malignant neoplasm, unspecified"
},
{
"from_icd11": "2D4Z",
"icd10_code": "C76-C80",
"icd10_title": ""
},
{
"from_icd11": "2D4Z",
"icd10_code": "C76",
"icd10_title": "Malignant neoplasm of other and ill-defined sites"
}
] |
C802
|
Malignant neoplasm associated with transplanted organ
|
The patient, a 53-year-old healthy male, was admitted to the Emergency Department of Nantong Third People’s Hospital on April 14, 2024. The patient experienced a sudden loss of consciousness, urinary incontinence, and dilated pupils after exercising at 07:20 that same day. His friends immediately began chest compressions . The patient’s ECG was still a flat line when the ambulance arrived and emergency doctors continued compressions using the LUCAS device without interruption upon arrival and during transportation . Before arriving at the hospital, the patient did not receive defibrillation but was given 1mg intravenous doses of epinephrine twice. The patient arrived at the emergency department of the hospital at ≈07:55 am. At that point, the patient was unconscious and did not breathe spontaneously; cardiac monitoring revealed ventricular fibrillation. Two rounds of 200-J biphasic wave defibrillation and intravenous adrenaline were administered, and he was intubated for mechanical ventilation; however, cardiac rhythm was not restored. It remained a ventricular fibrillation rhythm. Consequently, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. ECMO was initiated at 08:55, with a centrifugal pump speed of 3025 rpm, an oxygen concentration of 100%, an airflow rate of 3 L/min, and a blood flow rate of ≈1.73 L/min. Owing to the ventricular fibrillation rhythm of the patient , multiple 200-J biphasic defibrillation shocks were administered. Autonomous cardiac rhythm was restored at 09:52, and the color of the lips and nails gradually turned ruddy. Electrocardiography revealed sinus rhythm, elevated ST segments (aVR), significant ST-T changes, and prolonged Q-T intervals , and the troponin I was 50 ng/mL. Blood pressure was ≈80/50 mm Hg while receiving norepinephrine at 30-µg/min norepinephrine. However, spontaneous breathing was absent; therefore, mechanical ventilation was continued. Subsequent coronary angiography revealed 70% stenosis in the proximal right coronary artery, no stenosis in the main left coronary artery, 90% stenosis in the distal circumflex artery, and 40% to 50% stenosis in the proximal left anterior descending artery, with a thrombolysis in myocardial infarction flow grade of 3. Therefore, no coronary artery stent was placed. The CA of the patient may have been triggered by excessive sympathetic stimulation and coronary spasms following intense exercise. After the procedure, the patient was transferred to the intensive care unit (ICU) for further treatment. Upon ICU admission, the patient was in a moderate coma, with a heart rate of 58 beats/min and arterial blood pressure of 146/98 mm Hg (with 8 µg/min of norepinephrine). Blood gas analysis revealed a pH of 7.00, PCO 2 of 75.60 mm Hg, PO 2 of 58.00 mm Hg, HCO 3 - of 13.40 mmol/L, base excess of −14.20, and anion gap of 32.40 mmol/L, indicating a combination of metabolic and respiratory acidosis. His lactate was 9.0mmol/L. The mechanical ventilation settings included synchronized intermittent mandatory ventilation, FiO2 50%, a respiratory rate of 12 breaths per minute, pressure control at 12-cm H 2 O, and positive end-expiratory pressure at 8-cm H 2 O, with a monitored tidal volume of ≈425 mL. Unfortunately, EtCO2 was not monitored. The patient also received continuous venoarterial ECMO treatment, active brain protection through sedation and analgesia with midazolam 5 mg/h + remifentanil 1 µg/min, a hibernation mixture (chlorpromazine 5 mg/h + promethazine 5 mg/h) combined with an ice blanket and ECMO heater to maintain a body temperature at ≈35 °C within 1 hour after send to ICU, and negative fluid balance of 100-300 mL/d to manage intracranial pressure (ICP). Owing to the acute kidney injury (urea, 8.00 mmol/L and creatinine, 146.0 µmol/L with oliguria) and metabolic acidosis of the patient, oXiris continuous renal replacement therapy (CRRT) was performed to remove inflammatory mediators and stabilize the internal environment at 13:30. Bedside echocardiography revealed a left ventricular ejection fraction of 24.44% and cardiac output (CO) of 1.442 L/min, indicating decreased CO and an optic nerve sheath diameter of 0.33 cm. The right middle cerebral artery showed peak systolic and end-diastolic velocities of 67.83 and 40.32 cm/s, respectively, a resistive index of 0.41, and a pulsatility index of 0.56, indicating no significant intracranial hypertension, but reduced cerebral blood flow. Following treatment, the patient’s hemodynamics gradually stabilized. By April 16, norepinephrine was discontinued, the left ventricular ejection fraction improved to 40.44%, and the CO increased to 2.77 L/min. The optic nerve sheath diameter was 0.34 cm, the peak systolic was 91.40 cm/s, the end diastolic was 39.52 cm/s, the resistive index was 0.57, and the pulsatility index was 1.01, indicating that no increase exists in ICP or cerebral blood flow. The ECMO tube was removed on April 18. After 2 days of oXiris-CRRT treatment, the internal balance stabilized, the interleukin (IL)-6 levels fluctuated between 12.4 and 18.5 pg/mL, and the neuron-specific enolase concentration decreased from 65.55 ng/mL (24 hours after CPR) to 61.16 ng/mL (48 hours), 28.54 ng/mL (72 hours), and 13.5 ng/mL (96 hours). During the treatment, there was no hemolysis or mesenteric ischemia. On April 19, the subhypothermia treatment was discontinued, the temperature gradually returned to ≈37 °C, and the consciousness of the patient improved, shifting from coma to drowsiness. By April 20, the tracheal tube was removed, and high-flow oxygen therapy was administered. By April 21, the patient became conscious and exhibited appropriate responses, and the limbs could move upon request. Breathing, oxygenation, and blood pressure levels were stable. By April 22, 2024, the patient was transferred from the ICU to the cardiology department. On April 29, the patient was discharged with full recovery and no neurological deficit.
| 3.886719
| 0.978516
|
sec[1]/p[0]
|
en
| 0.999998
|
39889195
|
https://doi.org/10.1097/MD.0000000000041298
|
[
"april",
"blood",
"pressure",
"artery",
"ventricular",
"rhythm",
"ecmo",
"flow",
"coronary",
"cardiac"
] |
[
{
"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....
--RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Certain conditions originating in the perinatal period
Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.41] Microscopic haematuria
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
A 66-year-old male patient was admitted with cough, purulent and blood-mixed sputum, and increased shortness of breath. His medical history included COPD for the last 5 years and total thyroidectomy performed 3 years ago with the diagnosis of multinodular goiter. When questioned about prescriptions, he was under inhaled formoterol, ipratropium bromide, and levothyroxine sodium, administered orally at 100 μ g/day. He had not been hospitalized in the last year. Physical examination revealed blood pressure of 110/70 mmHg and pulse of 89/minute; his temperature was 36.8°C and fingertip-measured oxygen saturation (SpO 2 ) was 89% on room air. He presented with decreased breath sounds and prolongation of expiratory time. In addition, rales were present on auscultation of the mid and lower zones of the lungs. Laboratory investigation revealed C-reactive protein of 85 mg/dL, leukocytosis, with a white blood cell (WBC) count of 12.000/mm 3 , and increased erythrocyte sedimentation rate (35 mm/hour). The chest X-ray showed increased bronchovascular shadows of the lungs. Treatment of an inhaler bronchodilator, intravenous theophylline, and 40 mg/day methylprednisolone was started. An antibiotic combination of intravenous ampicillin sulbactam (4 g/day) and oral levofloxacin (500 mg/day) was administered. On the 4th day of treatment, the administered antibiotics were discontinued due to a deterioration in clinical features together with progression of infection parameters and cefoperazone sodium/sulbactam sodium combination (4 g/day) and moxifloxacin (400 mg/day) were started as new antibiotics. Computerized tomography (CT) of the chest was performed where emphysema and a small infiltration of right upper lobe posterior part were identified ( Figure 1(a) ). As the patient's clinical condition was getting worse and the infection parameters were not improving despite the treatment, a chest X-ray was obtained, which showed an increase of nonhomogeneous density on the left upper lobe. Additionally, flexible bronchoscopy was performed with normal findings except increased bronchial submucosal vascularity on the tenth day of being admitted to the hospital. Streptococcus mitis and Candida species were produced in the bronchoalveolar lavage obtained by left upper lobe. Therefore, the antibiotics were discontinued and linezolid 800 mg/day and fluconazole 200 mg/day were started intravenously. Meanwhile, an increase in blood sugar level was detected, which was considered to be related to intravenous corticosteroid. Therefore, the corticosteroid dosage was reduced and discontinued on the 12th day, after which the blood sugar level returned to normal. Since SpO 2 continued to remain below 88% despite administration of 5 L/min oxygen and tachycardia and tachypnea were present, the patient was admitted to the intensive care unit and bilevel positive airway pressure (BPAP) treatment was applied. Despite this treatment, no improvement was observed in the patient. A further chest CT was obtained which showed a pneumonic appearance with patchy necrotic areas in the left upper lobe (Figures 1(b) and 1(c) ). Flexible bronchoscopy was performed again on the 25th day of being admitted to the hospital and it revealed a view consistent with diffuse white Candida plaques in sites starting from the vocal cords and covering the entire trachea and both bronchial systems ( Figure 2(a) ). Bronchial biopsies and lavage of the left upper lobe were obtained. The bronchial biopsy revealed no fungus or similar pathology in the tissue. Because Candida spp. is reproduced in bronchoalveolar lavage taken at both 10th and 25th days, and Candida plaque is compatible with macroscopic appearance on bronchoscopy done at 25th day, it has been thought to be resistant Candida spp. and voriconazole treatment has been started. The bronchoalveolar lavage sample that Candida spp. reproduced on Candida plaques that are taken from BAL sample was sent to “Refik Saydam National Public Health Agency” for classification and antibiogram. Fluconazole resistant C. glabrata reproduced on the fungi culture that is done in this institution. The MIC90S value was reported as ≥32 μ g/mL for fluconazole and 1 μ g/mL and for voriconazole. We could not obtain Candida specific antibodies and mannan antigen tests that are used for the diagnosis of Candida infections, because it is not performed in our hospital. The fluconazole was discontinued and intravenous voriconazole 400 mg/day was started. Following this treatment, the clinical status of the patient gradually ameliorated, hemoptysis stopped, and infection parameters improved. The patient, who no longer required BPAP, was admitted to the clinical ward. Intravenous voriconazole was continued for 23 days. Control bronchoscopy performed on the 15th day of voriconazole treatment revealed almost complete recovery of the previously observed Candida plaques. Following significant improvement of his general status and dyspnea, the patient was discharged from the hospital with a prescription for oral voriconazole. Blood and urine cultures obtained during the hospitalization did not manifest any Candida growth. During ambulatory treatment with voriconazole, E. coli grew once in the urine culture and this was treated with ertapenem administered for 10 days. The voriconazole treatment was continued for 6 months. The appearance of air-fluid level at the left upper lobe and traction of the trachea to the left were identified during treatment. Left upper lobectomy was recommended because of this radiological appearance, but the patient refused surgery and so was continued to be followed up clinically and radiologically. The clinical situation of the patient did not worsen. Radiological and bronchoscopic recovery ( Figure 2(b) ) was seen on the last obtained CT ( Figure 1(d) ). Therefore, the idea of surgery was abandoned and the ambulatory follow-up of the patient currently continues uneventfully.
| 3.929688
| 0.97998
|
sec[1]/p[0]
|
en
| 0.999996
|
27882253
|
https://doi.org/10.1155/2016/4737321
|
[
"candida",
"voriconazole",
"blood",
"lobe",
"intravenous",
"this",
"chest",
"discontinued",
"which",
"bronchoscopy"
] |
[
{
"code": "1F23.1Z",
"title": "Candidosis of skin or mucous membranes, unspecified"
},
{
"code": "1F23.14",
"title": "Chronic mucocutaneous candidosis"
},
{
"code": "1F23.0",
"title": "Candidosis of lips or oral mucous membranes"
},
{
"code": "1F23.13",
"title": "Candidosis of nail or paronychium"
},
{
"code": "1F23.Z",
"title": "Candidosis, unspecified"
},
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
}
] |
=== ICD-11 CODES FOUND ===
[1F23.1Z] Candidosis of skin or mucous membranes, unspecified
Also known as: Candidosis of skin or mucous membranes, unspecified | Candidosis of skin or mucous membranes | Thrush | candidiasis of skin | skin candidiasis
[1F23.14] Chronic mucocutaneous candidosis
Definition: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, mainly C. albicans.
Also known as: Chronic mucocutaneous candidosis | Chronic mucocutaneous candidiasis | candida granuloma | mucocutaneous candidiasis | candidiasis granuloma
[1F23.0] Candidosis of lips or oral mucous membranes
Definition: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheilitis, or dysphagia. Transmission is by opportunistic transmission. Confirmation is by identification of Candida in an oral or skin sample.
Also known as: Candidosis of lips or oral mucous membranes | Candida of mouth | Candida stomatitis | Candidal stomatitis | Mouth candidiasis
Excludes: Neonatal candidosis
[1F23.13] Candidosis of nail or paronychium
Definition: Infection of the nail and/or paronychium (nail fold) with Candida yeasts
Also known as: Candidosis of nail or paronychium | candidiasis of nails | candidosis of nail | candidosis of nail fold | candidiasis of nail fold
[1F23.Z] Candidosis, unspecified
Also known as: Candidosis, unspecified | Candidosis | moniliasis | candidiasis | candida infection
[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 ---
[1F23.1Z] Candidosis of skin or mucous membranes, unspecified
--PARENT--> [1F23.1] Candidosis of skin or mucous membranes
--RELATED_TO--> [?] Neonatal mucocutaneous candidosis
Def: Widespread neonatal infection of skin and mucous membranes by Candida yeasts. Typically, discrete vesicles or pustules on an erythematous base are seen initially on the face and chest but then extendi...
--- Walk 2 ---
[1F23.1Z] Candidosis of skin or mucous membranes, unspecified
--PARENT--> [1F23.1] Candidosis of skin or mucous membranes
--EXCLUDES--> [?] Candidosis of lips or oral mucous membranes
Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...
--- Walk 3 ---
[1F23.14] Chronic mucocutaneous candidosis
Def: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, ...
--PARENT--> [1F23.1] Candidosis of skin or mucous membranes
--EXCLUDES--> [?] Candidosis of lips or oral mucous membranes
Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...
--- Walk 4 ---
[1F23.14] Chronic mucocutaneous candidosis
Def: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, ...
--PARENT--> [1F23.1] Candidosis of skin or mucous membranes
--EXCLUDES--> [?] Candidosis of lips or oral mucous membranes
Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...
--- Walk 5 ---
[1F23.0] Candidosis of lips or oral mucous membranes
Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...
--EXCLUDES--> [?] Neonatal candidosis
Def: A condition affecting neonates, caused by an infection with the fungi Candida. This condition is characterised by apnoea, thrombocytopenia, or decreasing respiratory function or other symptoms dependi...
--CHILD--> [?] Invasive neonatal candidosis
Def: This is a fungal infection (mycosis) of any of the Candida species (all yeasts), of which Candida albicans is the most common. Invasive neonatal candidosis is a serious infection that can affect the b...
--- Walk 6 ---
[1F23.0] Candidosis of lips or oral mucous membranes
Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...
--PARENT--> [1F23] Candidosis
Def: Candidosis is an infection caused by yeasts of the genus Candida. Superficial infections of the mucous membranes and skin are common, but deep invasive disease including fungal sepsis, endocarditis an...
--CHILD--> [1F23.2] Candidosis of gastrointestinal tract
|
[
"[1F23.1Z] Candidosis of skin or mucous membranes, unspecified\n --PARENT--> [1F23.1] Candidosis of skin or mucous membranes\n --RELATED_TO--> [?] Neonatal mucocutaneous candidosis\n Def: Widespread neonatal infection of skin and mucous membranes by Candida yeasts. Typically, discrete vesicles or pustules on an erythematous base are seen initially on the face and chest but then extendi...",
"[1F23.1Z] Candidosis of skin or mucous membranes, unspecified\n --PARENT--> [1F23.1] Candidosis of skin or mucous membranes\n --EXCLUDES--> [?] Candidosis of lips or oral mucous membranes\n Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...",
"[1F23.14] Chronic mucocutaneous candidosis\n Def: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, ...\n --PARENT--> [1F23.1] Candidosis of skin or mucous membranes\n --EXCLUDES--> [?] Candidosis of lips or oral mucous membranes\n Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...",
"[1F23.14] Chronic mucocutaneous candidosis\n Def: Chronic Mucocutaneous Candidiasis is a primary immune deficiency characterised by persistent and/or recurrent infections of skin, nails and mucous membranes, caused by organisms of the genus Candida, ...\n --PARENT--> [1F23.1] Candidosis of skin or mucous membranes\n --EXCLUDES--> [?] Candidosis of lips or oral mucous membranes\n Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...",
"[1F23.0] Candidosis of lips or oral mucous membranes\n Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...\n --EXCLUDES--> [?] Neonatal candidosis\n Def: A condition affecting neonates, caused by an infection with the fungi Candida. This condition is characterised by apnoea, thrombocytopenia, or decreasing respiratory function or other symptoms dependi...\n --CHILD--> [?] Invasive neonatal candidosis\n Def: This is a fungal infection (mycosis) of any of the Candida species (all yeasts), of which Candida albicans is the most common. Invasive neonatal candidosis is a serious infection that can affect the b...",
"[1F23.0] Candidosis of lips or oral mucous membranes\n Def: A disease of the lips and oral mucous membranes, caused by an infection with the fungi Candida. This disease commonly presents with white patches or plaques on the oral mucous membranes, angular cheil...\n --PARENT--> [1F23] Candidosis\n Def: Candidosis is an infection caused by yeasts of the genus Candida. Superficial infections of the mucous membranes and skin are common, but deep invasive disease including fungal sepsis, endocarditis an...\n --CHILD--> [1F23.2] Candidosis of gastrointestinal tract"
] |
1F23.1Z
|
Candidosis of skin or mucous membranes, unspecified
|
[
{
"from_icd11": "1F23.1Z",
"icd10_code": "B372",
"icd10_title": "Candidiasis of skin and nail"
},
{
"from_icd11": "1F23.0",
"icd10_code": "B370",
"icd10_title": "Candidal stomatitis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B3789",
"icd10_title": "Other sites of candidiasis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B3781",
"icd10_title": "Candidal esophagitis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B3783",
"icd10_title": "Candidal cheilitis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B3782",
"icd10_title": "Candidal enteritis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B379",
"icd10_title": "Candidiasis, unspecified"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B377",
"icd10_title": "Candidal sepsis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B37",
"icd10_title": "Candidiasis"
},
{
"from_icd11": "1F23.Z",
"icd10_code": "B378",
"icd10_title": "Candidiasis of other sites"
},
{
"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"
}
] |
B372
|
Candidiasis of skin and nail
|
A 46-year-old Japanese male patient was referred to our hospital with pain and swelling of the right wrist that had persisted for approximately 3 months. A plain radiograph , though hard to discern, and a computed tomography (CT) scan of the forearm revealed a periosteal reaction at the dorsal site of the right distal radius. Gadolinium contrast magnetic resonance imaging (MRI) revealed a large soft tissue extension between the radius and the ulna, which was strongly enhanced and continued to an intramedullary enhanced lesion, suggesting that the high-grade malignant tumor arising from intramedullary bone extended widely to the soft tissue. There was no clear bone infiltration into the ulna . No distant metastasis was detected. The pathological diagnosis from the open biopsy was conventional osteosarcoma , and six courses of neoadjuvant chemotherapy with intravenous cisplatin (120 mg/m2) and doxorubicin (30 mg/m2/day × 2 days) were administered according to our chemotherapy regimen . As chemotherapy progressed, the swelling and restricted range of motion (ROM) of the forearm was reduced, with the difference between the left and right wrists disappearing completely after six courses. Preoperatively, the extraosseous lesion appeared greatly shrunken, represented by only a slight signal contrast within the intraosseous membrane. This was confirmed by CT and MRI , and the response to chemotherapy was considered complete. Wide tumor excision and reconstruction with a tumor bearing frozen autograft was performed. Briefly, a longitudinal dorsal incision was performed and an osteotomy of the distal part of the radius was made 1 cm proximal from the epiphysis to preserve the joint with securing the bony margin according to the preoperative planning using MRI gadolinium enhancement analyses . The osteotomy of the proximal part of the radius was made 2 cm proximal from the tumor on the basis of the preoperative MRI and an intercalary resection of the tumor-bearing bone was performed . The soft tissue, including the complete pronator quadratus muscle, intraosseous membrane, and periosteum of the ulna where the soft-tissue extension of the tumor originally existed before chemotherapy, was peeled from the ulna and excised with the tumor bearing bone. After stripping the soft tissue, the tumor bearing bone was frozen in liquid nitrogen for 20 min , thawed at room temperature for 15 min, rinsed in distilled water for 15 min, and then returned to its original site. The frozen autograft was reconstructed with a long volar plate approached from a dorsal incision (Acu-Loc 2 extension plate, Acumed, LLC., OR., USA), and a small volar incision was made in order to insert the distal screws . Postoperative partial bone union was detected at 3 months and complete bone union was detected at 9 months, both of which were confirmed by plural direction radiography . Following the surgery, ROM training of both the wrist and fingers commenced immediately and the patient achieved normal ROM with active dorsiflexion of the affected wrist to 85° , palmar flexion to 80° , and both pronation and supination of the affected forearm to 90° within 9 months after the surgery . Postoperative functional results were as follows: 100% in the Musculoskeletal Tumor Society (MSTS) score, 12.5 in the Disabilities of the Arm, Shoulder and Hand (DASH) score and 93.5 in the Toronto Extremity Salvage Score (TESS). The Short Form-36 (SF-36) scores accounted for 39.5 of the Physical component summary, 66.6 of the Mental component summary, and 33.4 of the Role/Social component summary at the final postoperative follow-up of 41 months. The patient was discharged after 3 courses of adjuvant chemotherapy. These were administered as neoadjuvant chemotherapy, as the histological evaluation of surgical specimens diagnosed the patient as a good responder (classified as grade III/IV in the Rosen and Huvos evaluation system). At the final follow-up, the patient was found to be disease free. Fig. 1 Before neoadjuvant chemotherapy. a Plain radiography. Mild cortical irregularity was detected at the ulnar side of the radius. b , c CT: ( b ) sagittal and ( c ) axial images (bone condition). A periosteal reaction was detected at the dorsal radius. d , e Gadolinium contrast MRI: ( d ) axial and ( e ) coronal images. A huge extraskeletal tumor surrounding the radius was strongly enhanced. f Hematoxylin-Eosin staining of the specimen from open biopsy. Highly dense tumor cells with strong nuclear atypia or atypical mitosis, and tumoral osteoid were detected. No cartilage formation was detected Fig. 2 After neoadjuvant chemotherapy. a CT axial image (bone condition). Periosteal reaction was detected prior to chemotherapy. b , c Gadolinium contrast MRI; ( b ) axial and ( c ) coronal images. The soft tissue extension of the tumor shrunk remarkably and a small enhanced lesion was detected in the radius and intraosseous membrane. The dotted arrow indicates the resection range including the radius, intraosseous membrane, and pronator quadratus muscle. The dotted line indicates the osteotomy line of the radius Fig. 3 Intraoperative photos ( a ) The dorsal approach at the flexible side of the radiocarpal joint. The tumor bearing bone was resected with a biopsy tract, pronator quadratus muscle, and intraosseous membrane. The main extensor and flexor tendons were preserved. b Intraoperative radiograph of the tumor bearing bone resected along the planned osteotomy line. c The tumor bearing bone was frozen in liquid nitrogen. d After freezing Fig. 4 a , b Postoperative radiographs. Arrows indicate the osteotomy line. c , d Radiographs of the final follow-up. The bone was completely united and the osteotomy line was obscured Fig. 5 Range of motion of the wrist and forearm at the final follow-up. a Dorsiflexion of the right wrist was 85°; ( b ) palmar flexion was 80°; ( c ) pronation of the right forearm was 90°; and ( d ) supination was 90°
| 4.097656
| 0.961914
|
sec[1]/p[0]
|
en
| 0.999997
|
29490656
|
https://doi.org/10.1186/s12893-018-0346-y
|
[
"tumor",
"bone",
"radius",
"chemotherapy",
"bearing",
"soft",
"tissue",
"osteotomy",
"wrist",
"forearm"
] |
[
{
"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": "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 ===
[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
[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 ---
[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 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--CHILD--> [?] Localised lymph node enlargement
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] 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--> [2E61] Carcinoma in situ of other or unspecified digestive organs
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --CHILD--> [?] Localised lymph node enlargement",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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--> [2E61] Carcinoma in situ of other or unspecified digestive organs",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...."
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
In the emergency room, the patient’s vital signs were blood pressure of 107/63 mmHg, heart rate of 98 bpm with regular pulse, body temperature of 38.5°C, respiratory rate of 19 breaths/min, and blood oxygen saturation of 97% in room air. The patient was alert and oriented. Physical examination revealed tenderness of the left buttock with no palpable crepitus. Intense left gluteal and leg pain was evoked by passive extension and elevation of straight leg flexion with the knee. No heart murmur, abnormal lung sounds, or generalized lymphadenopathy was observed. He had no abdominal tenderness but showed left costovertebral angle (CVA) tenderness. Skin lesion was not also remarkable. Laboratory findings on admission were as follows: white blood count of 10,100 cells/μL, C-reactive protein (CRP) levels of 12.02 mg/dL, procalcitonin level of 0.68 ng/mL, sodium concentration of 137 mmol/L, and D-dimer level of 1.55 μg/dL ( Table 1 ). Screening results were negative for human immunodeficiency virus (HIV) infection or diabetes as an underlying disease. The presence of left CVA tenderness recalled obstructive pyelonephritis due to a urinary stone, and an abdominal aortic dissection had to be ruled out as a differential diagnosis. Imaging studies showed no specific findings on contrast-enhanced computed tomography (CT); however, MRI showed a high signal on diffusion-weighted imaging (DWI) localized within the left piriformis muscle , with a low-signal apparent diffusion coefficient (ADC) map in the same area . In contrast, T2 weighted image (T2WI) showed increased signal and irregularity in part of the left piriformis muscle , thought to be a finding of acute pyomyositis. The patient was referred to our department for further examination and treatment of the suspected piriformis pyomyositis. The patient was administered intravenous cephazolin 6 g daily. On day 3 after admission, a blood culture showed growth of Salmonella species. The antibiotic was switched to ceftriaxone 2 g intravenously daily. Blood cultures were performed a total of three times, including surveillance cultures; only the first blood culture was positive. Transthoracic echocardiography did not reveal vegetation and was negative for infective endocarditis. Additionally, stool culture results were positive for Salmonella species, non-pathogenic Escherichia coli and Enterococcus species. Spinal MRI was negative for pyogenic spondylitis, a metastatic infection. During this period, the patient experienced significant and persistent left buttock pain that was poorly managed. Due to pain, the patient was bedridden during hospitalization. A follow-up MRI of the pelvis was performed to reevaluate the disease status on the 9th day of the hospitalization. The high DWI high signal in the left piriformis muscle tended to shrink slightly . The signal at the left sacroiliac joint was decreased on T1 weighted imaging (T1WI), and a high-signal area was revealed on a fat-suppressed T2WI. In addition, the iliac and sacral signals across the left sacroiliac joint increased on fat suppressed T2WI , which suggested sacroiliac arthritis, and fluid collection was noted on the ventral side, suggestive of bursitis. A puncture of the lesion for culture and drainage was reserved for high-risk cases due to its small size, narrow lesion, and limited fluid collection. At this time, the patient’s spiking fever had improved, with only a low-grade fever in the 37°C range, and the patient was weaned off the bed with pain management and rehabilitation. On the 16th hospital day of hospitalization, the antibiotic was switched from ceftriaxone to oral levofloxacin 500 mg daily. Subsequently, Salmonella serotyping confirmed Salmonella Kentucky, which was detected in his blood and stool culture. Stool cultures were also examined from the patient’s pets, a dog and a cat; however, Salmonella spp. were not detected. GI endoscopy was performed to identify Salmonella bacteremia entry on the 25th hospital day. It could not be performed in the early days of hospitalization because the patient had significant buttock pain and could not be repositioned or held, which is essential for examination. Upper GI endoscopy revealed no abnormal findings; in contrast, lower GI endoscopy revealed a longitudinal ulcer covered with creamy white moss in the sigmoid colon , which were considered findings of the healing process of Salmonella enteritis. The condition of the ulcer just prior to its closure was consistent with the presumption that the onset of the disease was probably around the time of admission. The ulcer lesion was confined to the sigmoid colon, and the pathology was later revealed to be nonspecific inflammatory cell infiltrate consisting mainly of lymphocytes and there were no findings suggestive of malignancy. Based on these results, the patient was diagnosed with NTS bacteremia associated with bacterial translocation from sigmoid colon ulcers caused by NTS enteritis, leading to pyogenic myositis of the piriformis muscle and sacroiliitis. Pre-discharge MRI showed resolution of the piriformis muscle lesion and reduced ventral fluid retention; however, the fat-suppressed T2WI high-signal area around the left sacroiliac joint became more defined. Rather than focusing on the worsening MRI findings, our team focused on improving the clinical symptoms; it was considered that the patient was in a condition to be discharged from the hospital. The patient completed a seven week course of antimicrobial therapy, including the post-discharge outpatient clinic, until the patient was relieved of symptoms and the patient’s erythrocyte sedimentation rate and CRP levels were normalized. At the outpatient visit, the patient’s pyogenic sacroiliitis had improved on follow-up pelvic MRI. He was instructed to return for subsequent outpatient visits in case of another fever or gastrointestinal symptoms, and he returned to daily life without any residual disability.
| 3.884766
| 0.977539
|
sec[1]/p[1]
|
en
| 0.999998
|
38873212
|
https://doi.org/10.3389/fmed.2024.1381555
|
[
"blood",
"signal",
"salmonella",
"piriformis",
"pain",
"lesion",
"muscle",
"culture",
"tenderness",
"daily"
] |
[
{
"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": "5A00.01",
"title": "Permanent congenital hypothyroidism without goitre"
},
{
"code": "4A00.2",
"title": "Genetic susceptibility to particular pathogens"
},
{
"code": "1A09.Z",
"title": "Salmonella infection, unspecified"
},
{
"code": "KA61.Z",
"title": "Bacterial infection of the fetus or newborn, unspecified"
},
{
"code": "1A0Z&XN0QE",
"title": "Intestinal infections due to Salmonella"
}
] |
=== 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
[5A00.01] Permanent congenital hypothyroidism without goitre
Definition: 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.
Also known as: Permanent congenital hypothyroidism without goitre | congenital hypothyroidism without goitre | aplasia of thyroid | congenital subthyroidism | congenital thyroid aplasia
[4A00.2] Genetic susceptibility to particular pathogens
Also known as: Genetic susceptibility to particular pathogens | Idiopathic CD4 lymphocytopenia | Immunodeficiency due to interleukin-1 receptor-associated kinase-4 deficiency | IRAK4 - [interleukin-1 receptor-associated kinase-4 deficiency] | Lung fibrosis - immunodeficiency - gonadal dysgenesis
[1A09.Z] Salmonella infection, unspecified
Also known as: Salmonella infection, unspecified | Infections due to other Salmonella | NTS - [nontyphoidal salmonella] | Sepsis due to Salmonella infection without mention of septic shock | Salmonella sepsis
[KA61.Z] Bacterial infection of the fetus or newborn, unspecified
Also known as: Bacterial infection of the fetus or newborn, unspecified | Other bacterial infections of the fetus or newborn | congenital bacterial infections of newborn | Congenital clostridium infection | congenital clostridial infection
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues
Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.40] Macroscopic haematuria
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] 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 --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] 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 86-year-old man was observed to have skin erosion and high levels of bilirubin in the urine, after which he visited our hospital. Obstructive jaundice was referred and both of liver mass and biliary mass were diagnosed. He underwent a left hepatectomy, a left caudal lobectomy (with a medial hepatic vein preservation), an extrahepatic bile duct resection, and a right hepatic cholangiojejunostomy. During operation, the root of LHV and the branch of MHV were ligated twice. The 4Fr silicon tube (Atom Medical, Tokyo, Japan) was placed as internal biliary stent. The operation time was 349 min and the intraoperative bleeding was 720 ml. A 19 Fr closed, low-pressure, continuous suction silicone drain (Johnson & Johnson, New Jersey, USA) was placed on the transected liver surface. Histological diagnosis of liver mass was adenocarcinoma (moderately differentiated type, tub2), and that of biliary mass was papillary adenocarcinoma (pup) and adenocarcinoma (moderately differentiated type, tub2). Therefore, we diagnosed as double primary cancers of intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma. On the seventh postoperative day, a computed tomography (CT) scan showed the presence of fluid collection at the transected liver surface . We then diagnosed the bile leakage caused by injury of peripheral bile duct and abscess under the right diaphragm had formed. The drain was exchanged for a 12 Fr silicone drain (Create Medic, Kanagawa, Japan) by using a 0.035 in angle-stiff type guidewire (TERUMO, Tokyo, JAPAN) under fluoroscopy. The bile leakage was under control by the drainage. Therefore, we did not consider biliary drainage with ENBD or ERBD via ERCP. However, a fever then occurred, due to the poor drainage of an abscess under the right diaphragm. The tip of the drain was reduced, and the drain was replaced with a 12 Fr silicone drain by using a guidewire on the 15th postoperative day. The tip of the drain was deeply inserted in order for the drain to enter into the cavity . At that time, the guidewire insertion operation was difficult, and the guidewire was vigorously inserted. When inserting the drain, there was a high degree of resistance, but the drain was finally inserted. Afterwards, the blood was discharged from the drain, and the drain was closed on the same day. When the drain was opened the next day, blood was again discharged. A contrast-enhanced CT scan showed that the tip of the drain had pierced the inferior vena cava (IVC) from the root of the middle hepatic vein and had become placed into the right RA . Because 1 month had not passed after the operation, a high degree of adhesion at the surgical site was expected. Therefore, the operation was assessed to be difficult. Additionally, there were risks of intraabdominal hemorrhage and of bleeding into the cavity of the abscess. There was also the risk of a fibrin embolism that may have occurred due to the presence of fibrin. Thus, after consultation with the cardiovascular surgeon about hemostasis, and the risk of performing a thrombectomy, due to the sudden changes, the tip of the drain was removed from the IVC by using fluoroscopy under general anesthesia. At that time, it was confirmed by the use of transesophageal echocardiography that the tip of the drain had been removed to the outside of the area of the IVC. Afterwards, there was no incidence bleeding from the drain, but a persistent fever of 39 °C continued to occur. Echocardiography was performed to investigate the heat source, and a 3.0 × 1.4 cm mass with good mobility was discovered, extending from the IVC to the RA. A contrast-enhanced CT scan demonstrated a series of low density areas, extending from the abscess cavity to the transected liver surface and to the RA. Although removal by the use of interventional radiology was considered, it was decided that there was a risk of a complication of pulmonary embolism due to the large and movable mass, and it was decided that emergency open heart surgery should be performed for the removal of the tumor . A right atrial incision, thrombus removal, and a middle hepatic vein merging section closure surgery were performed. When the RA incision was performed and the lumen was confirmed, and approximately 5 mm of the perforated portion was located near the root of the middle hepatic vein, and at the same site approximately 3 cm of a yellow-brown mass was discovered. The drain and the mass was removed and the middle hepatic vein was sutured and closed . The operation time was 142 min, and the intraoperative bleeding was 400 ml. Histologically, the mass was primarily composed of fibrin thrombus, and a collection of neutrophils were primarily observed at the peripheral portion of the mass . A tissue culture examination detected the presence of Enterobacter aerogenes . Fig. 1 An enhanced abdominal CT scan showed fluid collection at the transected liver surface (arrow) Fig. 2 An enhanced abdominal CT scan before exchanging the drain showed the tip of the drain pointed to the bifurcation of the MHV (arrow, a ). Schema ( b ). MHV middle hepatic vein, Rt . CL right caudate lobe, RA right atrium Fig. 3 Fluoroscopy showed the drainage tube before exchange ( a ) and after ( b ). The drainage tube is thought to have strayed into the MHV after that. MHV middle hepatic vein Fig. 4 An enhanced abdominal CT scan showed the tip of the drain perforating the IVC and straying into the RA (arrow). IVC inferior vena cava, RA right atrium Fig. 5 An enhanced abdominal CT scan showed the low density area continuous from the abscess to the RA (arrow). RA right atrium Fig. 6 Intraoperative findings: the yellow-brown tumor originated from the IVC and had a size of 3 × 1 cm (arrow). IVC inferior vena cava Fig. 7 The tumor was yellow tone, measuring 3 × 1 × 0.7 cm ( a ). Histological findings HE × 40: most of the tissue was fibrin thrombus, and a collection of neutrophils was recognized mainly from the margin ( b )
| 3.888672
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999997
|
31388780
|
https://doi.org/10.1186/s40792-019-0685-7
|
[
"drain",
"that",
"hepatic",
"vein",
"scan",
"liver",
"enhanced",
"middle",
"abscess",
"drainage"
] |
[
{
"code": "QB85",
"title": "Attention to surgical dressings, drains or sutures"
},
{
"code": "FB84.4",
"title": "Chronic osteomyelitis with draining sinus"
},
{
"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": "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 ===
[QB85] Attention to surgical dressings, drains or sutures
Also known as: Attention to surgical dressings, drains or sutures | Change of dressing | Change of suture | Removal of drain | Removal of dressing
[FB84.4] Chronic osteomyelitis with draining sinus
Also known as: Chronic osteomyelitis with draining sinus | chronic osteomyelitis with draining sinus, unspecified site | bone fistula with chronic osteomyelitis | Chronic osteomyelitis with draining sinus, multiple sites | Chronic osteomyelitis with draining sinus, shoulder region
[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
[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 ---
[QB85] Attention to surgical dressings, drains or sutures
--PARENT--> [?] Contact with health services for specific surgical interventions
--PARENT--> [?] Reasons for contact with the health services
--- Walk 2 ---
[QB85] Attention to surgical dressings, drains or sutures
--PARENT--> [?] Contact with health services for specific surgical interventions
--PARENT--> [?] Reasons for contact with the health services
--- Walk 3 ---
[FB84.4] Chronic osteomyelitis with draining sinus
--PARENT--> [FB84] Osteomyelitis or osteitis
--PARENT--> [?] Osteopathies or chondropathies
--- Walk 4 ---
[FB84.4] Chronic osteomyelitis with draining sinus
--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 5 ---
[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 6 ---
[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...
|
[
"[QB85] Attention to surgical dressings, drains or sutures\n --PARENT--> [?] Contact with health services for specific surgical interventions\n --PARENT--> [?] Reasons for contact with the health services",
"[QB85] Attention to surgical dressings, drains or sutures\n --PARENT--> [?] Contact with health services for specific surgical interventions\n --PARENT--> [?] Reasons for contact with the health services",
"[FB84.4] Chronic osteomyelitis with draining sinus\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --PARENT--> [?] Osteopathies or chondropathies",
"[FB84.4] Chronic osteomyelitis with draining sinus\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...",
"[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...",
"[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..."
] |
QB85
|
Attention to surgical dressings, drains or sutures
|
[
{
"from_icd11": "QB85",
"icd10_code": "Z481",
"icd10_title": "Encounter for planned postprocedural wound closure"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4821",
"icd10_title": "Encounter for aftercare following heart transplant"
},
{
"from_icd11": "QB85",
"icd10_code": "Z483",
"icd10_title": "Aftercare following surgery for neoplasm"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4823",
"icd10_title": "Encounter for aftercare following liver transplant"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4822",
"icd10_title": "Encounter for aftercare following kidney transplant"
},
{
"from_icd11": "QB85",
"icd10_code": "Z48298",
"icd10_title": "Encounter for aftercare following other organ transplant"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4802",
"icd10_title": "Encounter for removal of sutures"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4803",
"icd10_title": "Encounter for change or removal of drains"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4801",
"icd10_title": "Encounter for change or removal of surgical wound dressing"
},
{
"from_icd11": "QB85",
"icd10_code": "Z4800",
"icd10_title": "Encounter for change or removal of nonsurgical wound dressing"
},
{
"from_icd11": "QB85",
"icd10_code": "Z48",
"icd10_title": "Encounter for other postprocedural aftercare"
},
{
"from_icd11": "QB85",
"icd10_code": "Z480",
"icd10_title": "Encounter for attention to dressings, sutures and drains"
},
{
"from_icd11": "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"
}
] |
Z481
|
Encounter for planned postprocedural wound closure
|
A preoperative examination showed trismus (Mallampati grade IV), brevicollis, posterior cervical flexure disturbance, and megaloglossia. Coronal sections on magnetic resonance imaging (MRI) indicated similar findings, suggesting that airway management is difficult. Preanesthetic medication was not performed. After the patient was admitted to the operating room, a percutaneous oxygen saturation monitor, electrocardiograph, non-invasive blood pressure monitor, Bispectral Index monitor, and near infrared ray brain tissue oxygen saturation monitor were attached. In addition to the intravenous administration of fentanyl at a total dosage of 200 μg and midazolam at 2.5 mg, propofol at 1.0 mg/kg/h and remifentanil at 2.0 μg /kg/h were continuously administered under oxygen administration. The Richmond Agitation Scale Score (RASS) ranged between − 1 and − 2. Under spontaneous respiration, a 22G needle was inserted into the right radial artery, and continuous arterial pressure monitoring was started. The sedation level reached the degree of mouth opening in response to a strong call, and 8% lidocaine spray was sprayed into the oral cavity for local anesthesia. A McGrath® X blade™ was inserted to spread the larynx; however, difficulties were associated with inserting it into the oral cavity due to trismus. It was exchanged for a McGrath® #3 blade, facilitating an approach to the epiglottis. However, the Cormack grade was evaluated as III. After applying lidocaine jelly to the bilateral nasal cavities, a cuffed tracheal tube measuring 7.0 mm in inner diameter was transnasally inserted from the left nasal cavity to the pharynx. The larynx was spread using a McGrath® #3 blade and examined by inserting a soft type of fiber optic bronchoscope (FOB) (Olympus) into the tube, facilitating visual recognition of the glottis. After spraying 8% lidocaine onto the glottis, the FOB was inserted from the subglottic area into the trachea, and FOB-guided intubation was attempted; however, difficulties were associated with inserting the tube into the subglottic area due to the stimulation of the site of the fissure and a reflex to it. Symptoms of airway obstruction appeared. Since percutaneous oxygen saturation decreased to 60%, sevoflurane (1%) was administered, followed by the intravenous administration of succinylcholine at 0.9 mg/kg, facilitating positive-pressure ventilation. While spreading the larynx again, FOB-guided intubation was attempted. Even in the state of muscle relaxation, it was difficult to insert the cuffed tracheal tube for adults, measuring 7.0 mm in inner diameter, into the trachea. A cuff-free tracheal tube measuring 6.0 mm in inner diameter was transnasally inserted into the trachea and exchanged for a cuffed tube measuring 6.5 mm in inner diameter using a soft tip-type catheter for endotracheal tube exchange (Cook Medical Corporation). The cuffed tube was fixed. The interval from the start of anesthesia until intubation was 35 min. The oral insertion of a gastric tube was then possible; however, it was impossible to insert a transesophageal echocardiographic probe. Since the cervical shape made internal jugular vein puncture impossible, a central venous catheter was inserted by 20 cm through the right femoral vein. A pulmonary artery catheter was not inserted, and an arterial pressure cardiac output monitor (Flo Trac Sensor®) (Edwards Lifesciences Corporation) was used. The surgery progressed without complications. The aortic valve was resected under cardiopulmonary bypass and substituted for a 19-mm mechanical valve. The operative time was 3 h and 5 min. The duration of cardiopulmonary bypass was 1 h and 31 min. The duration of aortic blockage was 1 h and 10 min. The volume of blood loss was approximately 2000 g. Two units of packed autologous red blood cells and 2 units of frozen fresh autologous plasma were used for blood transfusion. After surgery, artificial respiratory care was performed under continuous sedation with propofol at 0.4 to 3.0 mg/kg/h in the intensive care unit (ICU). On the first postoperative day, awakening was achieved, and the artificial respirator was removed. Laryngeal development was attempted before extubation; however, the strong pharyngeal reflex made the visual recognition of the larynx impossible. After confirming mouth opening and tongue motility, extubation was conducted while inserting a tube exchanger . After extubation, there were no symptoms of upper airway obstruction or nasal hemorrhage. Since intubation was more difficult than expected, the airway was reassessed after surgery. Cervical/thoracic computed tomography (CT) was performed. The nasopharynx and larynx were subsequently examined using a transnasal fiberscope by an otorhinolaryngologist. Transnasal fiberscopy indicated adenoid vegetation, pharyngolaryngeal narrowing, and favorable glottic mobility; however, the subglottic area was difficult to observe . On a three-dimensional (3D) cervical CT, the airway was patent and the cervical vertebrae comprised a straight neck. The glottis was present at the level of the sixth cervical vertebra. Furthermore, displacement/circumflex of the airway axis involving the upper airway to the subglottic area was noted . Fig. 1 At first postoperative day, after confirming mouth opening and tongue motility, extubation was conducted. Patient revealed trismus, brevicollis, and megaloglossia Fig. 2 After surgery, the larynx was examined using an endoscope. a Soft tissue outgrowth at the site of the fissure. b Difficulties were associated with visually recognizing the glottis and subglottic area Fig. 3 Cervical CT revealed that cervical vertebrae comprised a straight neck, glottis were present at the level of the sixth cervical vertebra, and the airway patency was maintained Fig. 4 Postoperative 3D CT image of the upper airway. a Lateral view of the upper airway on 3D CT. b On a dorsal view, circumflex of the upper airway was noted
| 3.962891
| 0.970215
|
sec[1]/p[1]
|
en
| 0.999998
|
29527552
|
https://doi.org/10.1186/s40981-018-0162-5
|
[
"airway",
"tube",
"cervical",
"larynx",
"however",
"monitor",
"glottis",
"subglottic",
"area",
"difficult"
] |
[
{
"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": "GA07.Z&XA3EF0",
"title": "Inflammatory disease of fallopian tube"
},
{
"code": "JA01.1",
"title": "Tubal pregnancy"
},
{
"code": "GB90.Y",
"title": "Other specified disorders of kidney or ureter"
},
{
"code": "GB54",
"title": "Tubulo-interstitial nephritis, not specified as acute or chronic"
},
{
"code": "AB10.Z",
"title": "Disorders of Eustachian tube, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[CB40.Y] Other specified diseases of the respiratory system
Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum
[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
[JA01.1] Tubal pregnancy
Definition: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy.
Also known as: Tubal pregnancy | Fallopian pregnancy | fallopian tube pregnancy | Tubal abortion | Rupture of fallopian tube due to pregnancy
Includes: Fallopian pregnancy | Tubal abortion
[GB90.Y] Other specified disorders of kidney or ureter
Also known as: Other specified disorders of kidney or ureter | Other secondary disorders of kidney or ureter | Other disorders of kidney and ureter NEC | Inflammatory diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis | Infectious diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis
[GB54] Tubulo-interstitial nephritis, not specified as acute or chronic
Definition: A disease characterised by inflammation of and damage to tubules or the interstitium of the kidney while sparing the glomeruli secondary to immune reaction or toxic agent.
Also known as: Tubulo-interstitial nephritis, not specified as acute or chronic | tubulo-interstitial nephritis | renal disease with interstitial nephritis | Congenital pyelitis | Cystopyelitis
Excludes: calculous pyelonephritis
[AB10.Z] Disorders of Eustachian tube, unspecified
Also known as: Disorders of Eustachian tube, unspecified | Disorders of Eustachian tube | auditory tube disorder | disease of Eustachian tube | Eustachian tube dysfunction
=== GRAPH WALKS ===
--- Walk 1 ---
[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...
--- 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 ---
[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 ...
--EXCLUDES--> [?] Emphysema
Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro...
--- 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 ...
--EXCLUDES--> [?] Chronic bronchitis
--- 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 --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...",
"[CB40.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",
"[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 --EXCLUDES--> [?] Emphysema\n Def: Emphysema is defined by abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles. This is accompanied by destruction of the airspace walls, without obvious fibro...",
"[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 --EXCLUDES--> [?] Chronic bronchitis",
"[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": "JA01.1",
"icd10_code": "O00102",
"icd10_title": "Left tubal pregnancy without intrauterine pregnancy"
}
] |
J449
|
Chronic obstructive pulmonary disease, unspecified
|
The patient received standard supportive care after admission, including Nasal Continuous Positive Airway Pressure (NCPAP), continuous intravenous midazolam, methylprednisolone (2 mg/kg·d), mannitol, and 3% saline. Six hours after transfer to the PICU, the patient underwent intubation and mechanical ventilation for paradoxical respiration and worsening oxygen saturation with cyanosis. The patient exhibited significant elevations of creatine kinase and myoglobin (247.8 ng/ml; reference range, 0–140 ng/ml), and the diagnosis of rhabdomyolysis was confirmed accordingly. Other enzymes were measured, including alanine transaminase, aspartate transaminase, pancrelipases, pancreatic amylase, amylase, lactate dehydrogenase, which all were elevated and details were listed in Table 1 . Detailed laboratory results were also listed in Table 1 . On hospital Day 2, cerebrospinal fluid (CSF) analysis revealed that protein levels were significantly increased by nearly 3 times the upper limit of the reference range , and glucose levels were slightly elevated (6.29 mmol/L; reference range, 2.8–4.5 mmol/L), while Gram staining of the CSF was negative. Considering autoimmune encephalitis, intravenous immunoglobulin (IVIG) was administered. On hospital Day 3, the patient’s situation deteriorated, and she developed hypotension and hypovolemia. Blood analysis revealed decreased WBC counts and elevated C-reactive protein levels (CRP). Her PCT level was 157.97 ng/L. Cytokine levels were examined, and the results showed elevated levels of IL-6 (388.67 pg/ml [reference range < 5.40 pg/ml]), IL-8 , IL-10 (17.88 pg/ml [reference range < 12.90 pg/ml]), and IFN-γ (38.21 pg/ml [reference range < 23.10 pg.ml]). In combination of her laboratory results, proven pathogen infection by PCR assay and clinical manifestation, she was diagnosed with septic shock, and anti-shock therapy was initiated. Meropenem and linezolid were prescribed to control an infection. Doses of methylprednisolone were increased to 10 mg/kg. On physical examination, her pupils were dilated, and pupillary light reflexes were prolonged, findings suggestive of intracranial hypertension. Because the patient had progressively increased creatine levels and mixed metabolism and respiratory acidosis, continuous renal replacement therapy (CRRT) with continuous venovenous haemofiltration was started. On hospital Day 4, she developed coagulation disorder and pancytopenia. Haemophagocytic syndrome was considered, but the laboratory results did not meet the criteria to support the diagnosis until hospital Day 17 (pancytopenia, elevated serum ferritin [777.4 ng/ml, reference range 6–159 ng/ml], SCD25, decreased NK cell counts and phagocytosis in bone marrow). Bloody fluid was visible in the indwelling gastrointestinal decompression tube with decreased haemoglobin levels of 7.1 g/dl, and the patients had bloody and watery diarrhoea, which prompted active gastrointestinal bleeding. After medical interventions and supportive care, the symptoms of intracranial hypertension were mitigated, and the patient’s awareness improved on hospital Day 6. Computed tomography shows improvement of encephaledema . We monitored her blood enzymes, which returned to the normal range. On hospital Day 12, the patient was awake, and spontaneous breathing was restored. Levels of CRP and PCT dropped to the reference range. CSF analysis showed normal cell count and chemistries. However, the patient still experienced persistent diarrhoea and haematuria. When her gastrointestinal condition improved, we performed video capsule endoscopy on hospital Day 37, uncovering diffuse intestinal abnormalities with a gross appearance characterized by continuous lesions, ulcerations, erythema, oedema, and inflammatory hyperplasia . We performed endoscopy on hospital Day 44, and endoscopic biopsy suggested diffuse nonspecific inflammation of the intestine. Haematuria stopped on hospital Day 42. The patient had gradual improvement in digestive tract function, and diarrhoea mitigated gradually. She could tolerate enteral nutrition on hospital Day 38, and parenteral nutrition was stopped on hospital Day 51. She recovered well. After 75 days in hospital, she was discharged. Table 1 Patient laboratory data Variable On admission Hospital day 3 Hospital day 12 Reference range, children* Haematocrit (%) 38.1 30.8 16.2 36–46 Haemoglobin (g/L) 134 109 59 118–156 White blood cells (×10 9 /L) 14.39 2.77 7.23 4.3–11.3 Differential count (per µl) Neutrophils 13.16 2.27 4.79 1.6–7.8 Neutrophils (%) 91.4 82 66.2 31–70 Lymphocytes 0.69 0.4 1.27 1.5–4.6 Lymphocytes (%) 4.8 14.4 17.6 23–59 Platelets (×10 12 /L) 200 120 66 167–453 Prothrombin time (sec) – > 300 16.8 14.3–18.8 Activated partial-thromboplastin time (sec) – > 180 32.9 25.1–38.4 Prothrombin-time international normalized ratio – 1.48 1.07 Total bilirubin (mmol/L) 49.7 56.15 170.59 3.42–20.5 Direct bilirubin (µmol/L) 38.87 47.87 129.84 0–3.42 Indirect bilirubin (µmol/L) 10.2 8.28 40.75 0–17.10 Alanine transaminase (U/L) 94.1 52.4 58.2 7–30 Aspartate transaminase (U/L) 111.5 120.2 48.1 14–44 Pancrelipases (U/L) 1683 2810 106 0–125 Pancreatic amylase (U/L) 27 94.4 82.2 0–39 Amylase (U/L) 184 232 63 17–115 Creatine kinase (U/L) 1345 1551 105 25–200 Lactate dehydrogenase (U/L) 620 648 392 110–295 C-reactive protein (mg/L) 14 154 57 < 8 Procalcitonin (ng/mL) 19.78 157.97 0.77 < 0.25 Blood urea nitrogen (µmol/L) 12.15 13.29 10.15 2.5–6.5 Creatine (µmol/L) 93.6 159.1 55.4 27–66 Myoglobin (ng/mL) 247.8 – 77.2 0–140 * Reference values are affected by many variables, including the patient population and the laboratory methods used. The ranges used at Beijing Children’s Hospital are for children. They may, therefore, not be appropriate for all patients –The laboratory test was not performed on that day Fig. 2 Images of video capsule endoscopy on hospital Day 37. A Gastric antrum; B duodenum; C jejunum; D ileum; E terminus of ileum; F colon
| 3.958984
| 0.972656
|
sec[1]/p[3]
|
en
| 0.999997
|
PMC9034649
|
https://doi.org/10.1186/s12985-022-01799-x
|
[
"reference",
"range",
"laboratory",
"continuous",
"creatine",
"transaminase",
"amylase",
"blood",
"including",
"which"
] |
[
{
"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"
},
{
"code": "BD11.1",
"title": "Left ventricular failure with mid range ejection fraction"
},
{
"code": "QA00.C",
"title": "Laboratory examination"
},
{
"code": "MG71.Z",
"title": "Abnormal laboratory results, not elsewhere classified, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[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
[QA00.C] Laboratory examination
Also known as: Laboratory examination | laboratory test
[MG71.Z] Abnormal laboratory results, not elsewhere classified, unspecified
Also known as: Abnormal laboratory results, not elsewhere classified, unspecified | Abnormal laboratory results, not elsewhere classified
=== GRAPH WALKS ===
--- Walk 1 ---
[6B22.Z] Olfactory reference disorder, unspecified
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.Z] Olfactory reference disorder, unspecified
--- Walk 2 ---
[6B22.Z] Olfactory reference disorder, unspecified
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.0] Olfactory reference disorder with fair to good insight
Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...
--- Walk 3 ---
[MB26.03] Delusion of reference
Def: 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....
--PARENT--> [MB26.0] Delusion
Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...
--CHILD--> [MB26.01] Delusion of being controlled
Def: A delusion that involves an external force or person controlling one's feelings, impulses, thoughts, or behaviour....
--- Walk 4 ---
[MB26.03] Delusion of reference
Def: 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....
--PARENT--> [MB26.0] Delusion
Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...
--PARENT--> [MB26] Symptoms or signs involving content of thought
Def: Symptoms and signs involving content of thought include delusions, experiences of influence, passivity, and control, grandiosity, homicidal ideation, identity disturbance, obsessions, overvalued ideas...
--- Walk 5 ---
[6B22.1] Olfactory reference disorder with poor to absent insight
Def: 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...
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.Z] Olfactory reference disorder, unspecified
--- Walk 6 ---
[6B22.1] Olfactory reference disorder with poor to absent insight
Def: 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...
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.Z] Olfactory reference disorder, unspecified
|
[
"[6B22.Z] Olfactory reference disorder, unspecified\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.Z] Olfactory reference disorder, unspecified",
"[6B22.Z] Olfactory reference disorder, unspecified\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.0] Olfactory reference disorder with fair to good insight\n Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...",
"[MB26.03] Delusion of reference\n Def: 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....\n --PARENT--> [MB26.0] Delusion\n Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...\n --CHILD--> [MB26.01] Delusion of being controlled\n Def: A delusion that involves an external force or person controlling one's feelings, impulses, thoughts, or behaviour....",
"[MB26.03] Delusion of reference\n Def: 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....\n --PARENT--> [MB26.0] Delusion\n Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...\n --PARENT--> [MB26] Symptoms or signs involving content of thought\n Def: Symptoms and signs involving content of thought include delusions, experiences of influence, passivity, and control, grandiosity, homicidal ideation, identity disturbance, obsessions, overvalued ideas...",
"[6B22.1] Olfactory reference disorder with poor to absent insight\n Def: 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...\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.Z] Olfactory reference disorder, unspecified",
"[6B22.1] Olfactory reference disorder with poor to absent insight\n Def: 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...\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.Z] Olfactory reference disorder, unspecified"
] |
6B22.Z
|
Olfactory reference disorder, unspecified
|
[
{
"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"
},
{
"from_icd11": "QA00.C",
"icd10_code": "Z017",
"icd10_title": ""
}
] |
F428
|
Other obsessive-compulsive disorder
|
A 61-year-old man presented to our general ophthalmology clinic at “Imam Khomeini hospital complex (IKHC)” with left blepharoptosis and periorbital pain of 2 months duration. His past medical history was unremarkable, and he denied using any medications or illicit drugs. His past ocular history included uncomplicated cataract surgery of the left eye 4 years before presentation. He denied any past ocular trauma, chemical or thermal burn. A comprehensive ophthalmic examination was performed. The best corrected visual acuity (BCVA) was 20/22 in either eye. External examination revealed mild eyelid swelling and moderate blepharoptosis of the left eye. Enophthalmos of the left eye was also noted. Hertel exophthalmometry was performed which revealed 2 mm of left enophthalmos. On ocular motility examination, moderate limitation of movement of the left eye was noted in adduction and downgaze, along with minimal limitation of abduction and normal upgaze, and there was almost 30 prism left exotropia. Further examination was performed using slit lamp biomicroscopy. Anterior segment examination revealed 300 degrees of limbal ischemia. The cornea was clear and no epithelial defect was noted. Conjunctival injection was noted. The patient was pseudophakic and the intraocular lens was well in place with no significant posterior capsular opacity. The rest of the anterior segment examination was within normal limits. A posterior segment examination using a + 90 diopter lens was performed, which only revealed a blunted foveal reflex. Examination of the right eye was normal, apart from a blunted foveal reflex . Spiral orbital computed tomography (CT) revealed an intraconal mass so for further evaluation of the mass we performed Magnetic resonance imaging (MRI) which confirmed the mass involving the left sclera and tenon . We decided to perform a transconjunctival orbitotomy to biopsy the lesion using a superotemporal approach, in the operating room because the mass was infiltrative and not circumscribed by capsule we performed a diagnostic biopsy (debulking the tumor as much as possible) and the specimen was sent for histopathological analysis. Histopathology revealed nests of squamous and spindle cells (mostly spindle) with cellular atypia, abundant mitotic figures and foci of necrosis . Immunohistochemistry was also performed which was positive for smooth muscle antigen (SMA), vimentin and CD 99 but negative for S100. General physical examination and further evaluation with positron emission tomography and abdominopelvic CT revealed no other neoplastic lesions. A diagnosis of primary spindle cell sarcoma of the orbit was made and the patient was referred to “Imam Khomeini hospital complex (IKHC)”. The patient underwent 6 cycles of chemotherapy using the AIM regimen consisting of 50 mg of doxorubicin and 2 g of ifosfamide in the first 3 days and 600 mg of MESNA in the next 5 days. The interval between each cycle was 3 weeks. The patient was followed 9 months later. He complained of a recent reduction of vision in the left eye of almost 2 months duration, along with photophobia. A comprehensive ophthalmic examination was performed once again. BCVA was 20/22 and 20/200 in the right eye and the left eye, respectively. Examination of the right eye was within normal limits. External examination of the left eye revealed blepharoptosis of the left eye. No swelling was noted in the periocular region. Hertel exophthalmometry revealed less than 1 mm of left enophthalmos. On ocular motility examination, 30 prism diopters of exotropia were noted in the left eye, with severe limitation of movement in adduction and upgaze and mild limitation in downgaze and normal abduction. Slit lamp biomicroscopy revealed a corneal stromal opacity in the inferonasal quadrant without any corneal epithelial defect. No limbal ischemia was noted. The rest of the anterior segment examination was normal. Posterior segment examination revealed moderate vitritis and vitreous haze along with inferior macula-sparing retinal detachment with serous subretinal fluid and areas of pigment epithelial change in a leopard pattern suggesting chronicity. No retinal break was found. Fluorescein angiography revealed early hyperfluorescence secondary mostly to leakage, with later pooling and leopard pattern of hyperfluorescence. A decision was made to perform another imaging procedure. MRI of orbit and brain with and without contrast was done and there was no evidence of any abnormal lesion in the brain, on the other hand in orbit there was 17*10*9mm left intraconal mass, abnormally enhancing, hypointense in T1 and hyperintense in T2 medial to the left globe with involvement of medial rectus and globe . A diagnosis of exudative retinal detachment secondary to the orbital mass was made. A decision was made to closely follow the patient and treat the underlying cause of the detachment. The patient was referred for further evaluation and management by the oncologist. Fig. 1 External photograph of the patient before (left) and after (right) operation. Notice the left ptosis and exotropia on the left Fig. 2 Slit photo and Fundus photo of the left eye before (top) and after (bottom) operation. Note improvement of limbal ischemia (yellow arrows) and vitritis (white arrows) Fig. 3 CT scan & MRI of patient revealing left intraconal mass before and after operation (Top right-CT scan before operation. Top left-CT scan after operation. Bottom right-T1 MRI before operation (Note the Lateral recuts: yellow arrow, Medial recuts and tumor compressing the globe: blue arrow, globe: green arrow). Bottom left-T2 MRI before operation). Because of the diagnostic nature of the operation the size of the tumor is not changed significantly Fig. 4 Biopsy sections of the mass show hypercellular spindle cell neoplasm with cellular atypia and some mitotic features. H& E staining, right: low (*10) and left: high (*40) magnification. Note size scales
| 4.015625
| 0.978027
|
sec[1]/p[0]
|
en
| 0.999998
|
37684567
|
https://doi.org/10.1186/s12886-023-03125-7
|
[
"using",
"segment",
"ocular",
"which",
"limitation",
"spindle",
"globe",
"blepharoptosis",
"past",
"enophthalmos"
] |
[
{
"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": "ME93.0",
"title": "Segmental and somatic dysfunction"
},
{
"code": "8A06.1",
"title": "Segmental myoclonus"
},
{
"code": "EC23.0",
"title": "Non-syndromic genetically-determined hypermelanosis or lentiginosis"
},
{
"code": "GB40/MF8Y&XT8W",
"title": "Chronic nephritic syndrome : focal and segmental glomerular lesions"
},
{
"code": "LB73.24",
"title": "Segmentation anomalies of vertebrae"
}
] |
=== 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
[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
[LB73.24] Segmentation anomalies of vertebrae
Definition: Any condition caused by failure of the vertebrae to correctly develop during the antenatal period. These conditions are characterised by an abnormal number of fully developed vertebrae. Confirmation is through verification of absent or improperly formed vertebrae by imaging.
Also known as: Segmentation anomalies of vertebrae | Isolated hemivertebra | Multiple segmentation anomalies of vertebrae
=== 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--> [QE11.0] 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 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...
--CHILD--> [6C40] Disorders due to use of alcohol
Def: Disorders due to use of alcohol are characterised by the pattern and consequences of alcohol use. Alcohol—more specifically termed ethyl alcohol or ethanol—is an intoxicating compound produced by ferm...
--- Walk 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...
--EXCLUDES--> [?] Disorders due to use of cocaine
Def: Disorders due to use of cocaine are characterised by the pattern and consequences of cocaine use. Cocaine is a compound found in the leaves of the coca plant, Erythroxylum coca, which is indigenous to...
--CHILD--> [?] Episode of harmful use of cocaine
Def: An episode of use of cocaine that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. Harm to health of the individual occur...
--- 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--> [QE11.1] 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...
|
[
"[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...",
"[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 --CHILD--> [6C40] Disorders due to use of alcohol\n Def: Disorders due to use of alcohol are characterised by the pattern and consequences of alcohol use. Alcohol—more specifically termed ethyl alcohol or ethanol—is an intoxicating compound produced by ferm...",
"[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 --EXCLUDES--> [?] Disorders due to use of cocaine\n Def: Disorders due to use of cocaine are characterised by the pattern and consequences of cocaine use. Cocaine is a compound found in the leaves of the coca plant, Erythroxylum coca, which is indigenous to...\n --CHILD--> [?] Episode of harmful use of cocaine\n Def: An episode of use of cocaine that has caused damage to a person’s physical or mental health or has resulted in behaviour leading to harm to the health of others. Harm to health of the individual occur...",
"[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--> [QE11.1] 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
|
[
{
"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 49-year-old Japanese man had splenic infarction with unknown cause 2 years ago. He had continued to take warfarin as anticoagulant therapy, but stopped taking the medication as self-judgment several months ago. He had no classical arteriosclerosis factors (hypertension, dyslipidemia, diabetes mellitus, and smoking status). He had sudden-onset rest chest dorsalgia and was transported to our hospital. Immediately after arrival, his pain temporarily improved. On initial examination, his blood pressure was 130/83 mmHg, pulse rate 110 beats/min, respiratory rate 30 cycles/min, and oxygen saturation 100% on room air. His physical examination showed a regular heart rhythm and no murmur, normal respiratory sounds in both lungs, and no edema in his lower extremities. On initial laboratory test, his high-sensitivity troponin I level was 1453.1 pg/mL (normal range: 0.0–26.2), creatinine kinase (CK) 261 U/L (59–248), CK-MB 26 U/L (0–6), platelets 31.5 × 10 4 /μL (15.8–34.8 × 10 4 ), fibrinogen 237 mg/dL (190–390), and D-dimer 1.7 μg/ml (0–0.9). Initial electrocardiography showed normal sinus rhythm and no ST-T change. Transthoracic echocardiography revealed normal wall motion and no asynergy. Contrast computed tomography (CT) showed a small PE and no aortic dissection . However, he complained of chest pain again following CT. Emergent coronary angiography (CAG) showed no severe stenosis in the right coronary artery and left circumflex artery, but a large thrombus with Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow from the proximal to mid portion of the left anterior descending (LAD) artery . A 7-Fr guiding catheter was advanced through the left radial artery to the left coronary artery ostium, and a guidewire was advanced to the distal LAD artery. Near-infrared spectroscopy–intravascular ultrasonography (NIRS–IVUS) showed a large amount of thrombus from the proximal to the mid LAD artery, and the max lipid core burden index (LCBI) was 81 . Thrombectomy was performed using a 7-Fr aspiration catheter and intracoronary thrombolysis by urokinase 60,000 U. Angiography and NIRS–IVUS revealed decreased thrombus in the LAD artery . The procedure was completed at this time because additional angioplasty with or without stent was at high risk of slow-flow phenomenon. In the pathological findings, the collected thrombus using an aspiration catheter had many fibrin precipitates. We suspected paradoxical embolism because the ultrasonography revealed a DVT in the bilateral lower leg, but contrast CT and transesophageal echocardiography showed no right-to-left short circuit including a patent foramen ovale, atrial septal defect, and ventricular septal defect, and pulmonary arteriovenous fistula. Further examination of coagulation abnormality revealed hyperhomocysteinemia (total homocysteine level: 140.8 nmol/mL [6.3–18.9], vitamin B12: 121 pg/mL [180–914], folate: 2.3 ng/mL [> 4.0], protein C activity: 111% [70–140], and free protein S: 131.7% [60–150]). Therefore, he was diagnosed with ACS complicated with PE and DVT simultaneously induced by hyperhomocysteinemia. He continued antithrombotic therapy using aspirin, warfarin (his international normalized ratio was controlled from 2 to 3), and heparin (1.5–2.5 times the reference value activated partial thromboplastin time) for 1 week. Peak CK was 347 U/L, and NIRS–IVUS and optical coherence tomography (OCT) revealed decreased thrombus and no significant residual organic stenosis in the LAD artery following 1 week of antithrombotic therapy . He was discharged from our hospital continuing antithrombotic therapy with aspirin and warfarin. Follow-up CAG and OCT after 9 months revealed complete thrombus disappearance in the LAD artery . His total homocysteine level had decreased to 85.1 nmol/mL by the dietary therapy. He had no cardiovascular event or major bleeding for 1 year. Fig. 1 Contrast computed tomography showing small pulmonary embolism. Contrast computed tomography revealed small pulmonary embolism in the right segmental pulmonary artery (yellow arrow in a and b ) Fig. 2 Baseline coronary angiography and near-infrared spectroscopy–intravascular ultrasonography. Coronary angiography (CAG) revealed severe stenosis from mid to proximal left anterior descending (LAD) artery and no severe stenosis in the right coronary artery and circumflex artery ( A-C ). Near-infrared spectroscopy–intravascular ultrasonography (NIRS–IVUS) findings in the culprit lesion showed a low echoic component suspecting thrombus continuing from mid to proximal LAD ( D -a, b, c) and organic fibrous plaque behind the thrombus. The lipid plaque is shown as a yellow region on the chemogram. NIRS chemogram map presented the maximal lipid core burden index (4 mm) = 81 ( D -d) Fig. 3 The collected thrombus using an aspiration catheter and final coronary angiography. The collected thrombus using a repeated aspiration thrombectomy ( a , yellow arrow; thrombus). Final coronary angiography revealed thrombolysis in myocardial infarction (TIMI) grade 3 flow and reducing thrombus in the left anterior descending artery ( b, c ) Fig. 4 The findings of near-infrared spectroscopy–intravascular ultrasonography and optical coherence tomography in 1 week. Coronary angiography showed further reduced thrombus without severe stenosis in the left anterior descending (LAD) artery. The findings of near-infrared spectroscopy–intravascular ultrasonography ( A -a, b, c) and optical coherence tomography ( A -a´, b´, c´) revealed a small amount of residual thrombus in the short segment and mild fibrous plaque in the proximal left anterior descending artery Fig. 5 Coronary angiography and optical coherence tomography in 9 months. Coronary angiography showed no severe stenosis and no thrombus ( A ). Findings of optical coherence tomography ( A -a, b, c) revealed mild fibrous plaque and complete withdrawal of thrombus in the proximal left anterior descending artery
| 4.011719
| 0.977051
|
sec[1]/p[0]
|
en
| 0.999997
|
33161897
|
https://doi.org/10.1186/s13256-020-02531-5
|
[
"artery",
"thrombus",
"coronary",
"angiography",
"tomography",
"stenosis",
"descending",
"ultrasonography",
"near",
"infrared"
] |
[
{
"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": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "PL12.3",
"title": "Obstruction of device, as mode of injury or harm"
},
{
"code": "BD5Y",
"title": "Other specified diseases of arteries or arterioles"
},
{
"code": "BA60.7&XA91S4",
"title": "Atrial thrombus as current complication following acute myocardial infarction"
},
{
"code": "BA60.7&XA7XU8",
"title": "Ventricular thrombus as current complication following acute myocardial infarction"
}
] |
=== 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
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[PL12.3] Obstruction of device, as mode of injury or harm
Definition: Obstruction associated with prosthetic devices, grafts or implants
Also known as: Obstruction of device, as mode of injury or harm | occlusion shunt | blockage of device causing obstruction as mode of injury | blocked tube causing obstruction as mode of injury | occlusion of device causing obstruction as mode of injury
Excludes: Obstruction of device without injury or harm
[BD5Y] Other specified diseases of arteries or arterioles
Also known as: Other specified diseases of arteries or arterioles | Arterial or microvascular embolism classified by source | Cardiac embolism | heart embolism | Thrombotic cardiac embolism
=== 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
--CHILD--> [?] Chronic arterial occlusive disease
--- Walk 3 ---
[BD52] Certain specified disorders of arteries or arterioles
--CHILD--> [BD52.1] Arteriovenous fistula, acquired
--EXCLUDES--> [?] 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....
--- Walk 4 ---
[BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Acute arterial occlusion
--CHILD--> [?] Acute upper limb arterial occlusion
--- 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...
--CHILD--> [?] Injuries to the thorax
--- Walk 6 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--EXCLUDES--> [?] Stress fracture, not elsewhere classified
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease",
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease",
"[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.1] Arteriovenous fistula, acquired\n --EXCLUDES--> [?] 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....",
"[BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Acute arterial occlusion\n --CHILD--> [?] Acute upper limb arterial occlusion",
"[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 --CHILD--> [?] Injuries to the thorax",
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Stress fracture, not elsewhere classified"
] |
BD5Z
|
Diseases of arteries or arterioles, unspecified
|
[
{
"from_icd11": "BD5Z",
"icd10_code": "I7389",
"icd10_title": "Other specified peripheral vascular diseases"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7419",
"icd10_title": "Embolism and thrombosis of other parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7411",
"icd10_title": "Embolism and thrombosis of thoracic aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7410",
"icd10_title": "Embolism and thrombosis of unspecified parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7381",
"icd10_title": "Erythromelalgia"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I745",
"icd10_title": "Embolism and thrombosis of iliac artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I789",
"icd10_title": "Disease of capillaries, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I748",
"icd10_title": "Embolism and thrombosis of other arteries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I749",
"icd10_title": "Embolism and thrombosis of unspecified artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I781",
"icd10_title": "Nevus, non-neoplastic"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I788",
"icd10_title": "Other diseases of capillaries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I744",
"icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I70-I79",
"icd10_title": ""
},
{
"from_icd11": "BD5Z",
"icd10_code": "I74",
"icd10_title": "Arterial embolism and thrombosis"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I73",
"icd10_title": "Other peripheral vascular diseases"
}
] |
I7389
|
Other specified peripheral vascular diseases
|
A 57-year-old non-smoking woman presented to our hospital with dyspnea in July 2017. Physical examination and laboratory test results showed no significant abnormalities. The chest Computer tomography (CT) scan revealed a 3.2 cm × 3.9 cm solid nodule in the left upper lung and a 2.3 × 1.6 cm ground glass nodule in the left lower lobe . The patient consequently underwent a LUL resection, a left lower lobe wedge resection, and VATS lymphadenectomy on July 27, 2017. Invasive adenocarcinoma in the LUL lesion was confirmed by the histopathologic examination, with mixed solid and cribriform patterns . The results of Immunohistochemistry and fluorescent in situ hybridization revealed that ALK rearrangement was positive. EGFR mutation was not detected by using the amplification refractory mutation system–polymerase chain reaction . The LLL nodule also diagnosed as invasive adenocarcinoma, with predominant papillary patterns and EGFR mutation-positive , whereas ALK rearrangement was negative . In addition, the results of 4/7/10/11 lymph nodes pathology confirmed tumor metastasis. NGS–based analysis displayed an ALK rearrangement and EGFR 19 exon deletion in LLL lesion . According to the 8th edition American Joint Committee on Cancer (AJCC) and American College of Chest Physicians Evidence-Based Clinical Practice (ACCP, 3rd edition), the lesions in LUL and LLL were defined as multiple primary adenocarcinomas. Therefore, the tumor classification should be determined separately (LUL: pT2a, LLL: pT1c). Considering the status of lymph node metastasis as N2, the patient was treated as stage 3A non-small cell lung cancer. Initially, the first-line chemotherapy with pemetrexed and nedaplatin (pemetrexed 750 mg/m 2 with nedaplatin 110 mg/m 2 ) was carried out on August 26, 2017. After 6 cycles, the CT scan showed no signs of recurrence and lymphadenectasis. Then the patient received chest radiotherapy with a dose of 54 Gy in 27 fractions. The pulmonary lesions were well controlled. Until February 11, 2019, the patient developed headache, dizziness and thoracodynia. Brain MRI detected a cranial lesion in the right occipital lobe and CT scan detected a bone destruction in the right posterior 12th rib , which indicated tumor metastasis. Based on the molecular finding, the patient was delivered the EGFR TKI gefitinib (250 mg daily) at the first. However, the headache and thoracodynia were improved after first month of target therapy. The brain lesion increased to 16 mm and bone destruction worsened . The therapeutic outcome was considered as progressive disease (PD) and Gefitinib therapy was stopped. As the tumor was positive for ALK rearrangement, the patient was started on crizotinib 250 mg orally twice daily in April 2019. A local tomotherpy was administered to control the brain metastatic lesion contemporary, while no radiotherapy was given to the rib lesion. Three months after the initiation of crizotinib therapy, imaging examinations revealed obvious decreasing of the size of the brain metastases . Furthermore, the rib lesion almost disappeared and showed bony restoration , which was evaluated as partial remission. At the last follow-up , no evidence of disease progression was found and she still received crizotinib therapy. The treatment of the case suggested that the brain and rib metastasis tumor were both probably driven by ALK gene rather than EGFR. Therefore, we were very interested in the status of the driven gene in the lymph node metastasis of this case. Several tests were performed on metastatic lymph nodes, such as Immunohistochemistry, FISH and ARMS-PCR, and the results showed that all of the metastatic lymph nodes revealed a cribriform growth pattern . The pattern suggested that the positive genetic alterations was ALK rearrangement rather than EGFR mutation . The histomorphology and oncogene alteration of metastatic carcinoma in lymph nodes are consistent with those in the LUL. Fig. 1 Imaging, pathologic and molecular characteristics of the multifocal adenocarcinoma. Computed tomography showing a solid nodule in the LUL ( a ) and a Ground-Glass Nodule in the LLL(F) . Microscopic showed mixed solid and cribriform patterns in the LUL nodule ( b ) and a Papillary Pattern in the LLL nodule ( g ) (HE; original magnification, × 100). c ALK protein was positively expressed in LUL nodule ( c ) but negative for LLL nodule ( h ) (immunohistochemistry; original magnification, × 100). The break-apart fluorescence in situ hybridization assay verified ALK receptor tyrosine kinase gene (ALK) rearrangement in LUL nodule ( d ) but not in LLL nodule ( i ) . EGFR mutations were not found in LUL nodule ( e ), but a deletion of EGFR exon 19 presented in LLL nodule ( j ) by the ARMS-PCR method. NGS test confirmed the ALK fusion(E13;A20, relative abundance 6.42%) in LUL nodule ( k ) and EGFR 19 exon deletion in LLL lesion ( l ) Fig. 2 Management of brain and rib metastasis treatment. Head MRI showed a 13 mm cranial lesion (upper panel: T2-weighted MRI) ( a ) and bone destruction in the right posterior 12th rib was detected by an CT scan ( d and g ). After 1 months of EGFR tyrosine kinase inhibitor treatment, a slight enlargement (to 16 cm) of the brain metastasis lesion ( b ) and bone destruction in 12th rib worsened( e and h ). The patient was treated with crizotinib, brain metastatic lesion received a local tomotherpy contemporary but the rib lesion without radiotherapy. Three months after the therapy, imaging examinations revealed obvious decrease in the size of the brain metastases ( c ). The rib lesion almost disappeared and showed bony restoration ( f and 2 i ) Fig. 3 The molecular characteristics in metastatic lymph nodes. Results of H&E Staining ( a ), showed mixed solid and cribriform patterns, Ventana IHC ALK (clone D5F3) ( b ) and ALK gene break apart probe in FISH ( c ), showed positive results, and negative for EGFR mutation by ARMS-PCR analysis ( d )
| 4.039063
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999995
|
32375829
|
https://doi.org/10.1186/s13000-020-00969-1
|
[
"nodule",
"lesion",
"egfr",
"brain",
"lymph",
"metastasis",
"rearrangement",
"metastatic",
"solid",
"mutation"
] |
[
{
"code": "2E88",
"title": "Benign endometrial stromal nodule"
},
{
"code": "FA20.0",
"title": "Seropositive rheumatoid arthritis"
},
{
"code": "1F20.Z",
"title": "Aspergillosis, unspecified"
},
{
"code": "MF30",
"title": "Breast lump or mass female"
},
{
"code": "5A01.1",
"title": "Nontoxic single thyroid nodule"
},
{
"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 ===
[2E88] Benign endometrial stromal nodule
Also known as: Benign endometrial stromal nodule | benign endometrial stromal tumour | Endometrial node | Stromal nodule
[FA20.0] Seropositive rheumatoid arthritis
Also known as: Seropositive rheumatoid arthritis | high positive rheumatoid factor | low positive rheumatoid factor | high positive anticitrullinated protein antibody | low positive anticitrullinated protein antibody
[1F20.Z] Aspergillosis, unspecified
Also known as: Aspergillosis, unspecified | Aspergillosis | aspergilloma | aspergillus nodule | simple aspergilloma
[MF30] Breast lump or mass female
Also known as: Breast lump or mass female | breast irregular nodularity | breast node | lump in breast | lump or mass in breast NOS
[5A01.1] Nontoxic single thyroid nodule
Definition: Single tumour of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis
Also known as: Nontoxic single thyroid nodule | colloid goitre (in part) | follicular goitre | struma follicularis | parenchymatous goitre
[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 ---
[2E88] Benign endometrial stromal nodule
--PARENT--> [?] Benign mesenchymal neoplasms
Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels....
--CHILD--> [2E82] Benign chondrogenic tumours
--- Walk 2 ---
[2E88] Benign endometrial stromal nodule
--PARENT--> [?] Benign mesenchymal neoplasms
Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels....
--CHILD--> [2E80] Benign lipomatous neoplasm
Def: A benign tumour composed of adipose (fatty) tissue. The most common representative of this category is the lipoma....
--- Walk 3 ---
[FA20.0] Seropositive rheumatoid arthritis
--PARENT--> [FA20] Rheumatoid arthritis
Def: Rheumatoid arthritis (RA) is persistent and/or erosive disease that is defined as the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the ...
--RELATED_TO--> [?] Respiratory disorders in rheumatoid arthritis
Def: This encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi,...
--- Walk 4 ---
[FA20.0] Seropositive rheumatoid arthritis
--PARENT--> [FA20] Rheumatoid arthritis
Def: Rheumatoid arthritis (RA) is persistent and/or erosive disease that is defined as the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the ...
--RELATED_TO--> [?] Respiratory disorders in rheumatoid arthritis
Def: This encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi,...
--- Walk 5 ---
[1F20.Z] Aspergillosis, unspecified
--PARENT--> [1F20] Aspergillosis
Def: Aspergillosis is a disease caused by fungi of the genus Aspergillus. The organism is ubiquitous, being found in soil and water or in decaying vegetation. While Aspergillus is entirely harmless for mos...
--RELATED_TO--> [?] Neonatal aspergillosis
Def: A disease affecting neonates, caused by an infection with the fungi Aspergillus. This disease presents with clinical symptoms depending on the site of infection. Transmission is by inhalation of Asper...
--- Walk 6 ---
[1F20.Z] Aspergillosis, unspecified
--PARENT--> [1F20] Aspergillosis
Def: Aspergillosis is a disease caused by fungi of the genus Aspergillus. The organism is ubiquitous, being found in soil and water or in decaying vegetation. While Aspergillus is entirely harmless for mos...
--CHILD--> [1F20.1] Non-invasive aspergillosis
|
[
"[2E88] Benign endometrial stromal nodule\n --PARENT--> [?] Benign mesenchymal neoplasms\n Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels....\n --CHILD--> [2E82] Benign chondrogenic tumours",
"[2E88] Benign endometrial stromal nodule\n --PARENT--> [?] Benign mesenchymal neoplasms\n Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels....\n --CHILD--> [2E80] Benign lipomatous neoplasm\n Def: A benign tumour composed of adipose (fatty) tissue. The most common representative of this category is the lipoma....",
"[FA20.0] Seropositive rheumatoid arthritis\n --PARENT--> [FA20] Rheumatoid arthritis\n Def: Rheumatoid arthritis (RA) is persistent and/or erosive disease that is defined as the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the ...\n --RELATED_TO--> [?] Respiratory disorders in rheumatoid arthritis\n Def: This encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi,...",
"[FA20.0] Seropositive rheumatoid arthritis\n --PARENT--> [FA20] Rheumatoid arthritis\n Def: Rheumatoid arthritis (RA) is persistent and/or erosive disease that is defined as the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the ...\n --RELATED_TO--> [?] Respiratory disorders in rheumatoid arthritis\n Def: This encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi,...",
"[1F20.Z] Aspergillosis, unspecified\n --PARENT--> [1F20] Aspergillosis\n Def: Aspergillosis is a disease caused by fungi of the genus Aspergillus. The organism is ubiquitous, being found in soil and water or in decaying vegetation. While Aspergillus is entirely harmless for mos...\n --RELATED_TO--> [?] Neonatal aspergillosis\n Def: A disease affecting neonates, caused by an infection with the fungi Aspergillus. This disease presents with clinical symptoms depending on the site of infection. Transmission is by inhalation of Asper...",
"[1F20.Z] Aspergillosis, unspecified\n --PARENT--> [1F20] Aspergillosis\n Def: Aspergillosis is a disease caused by fungi of the genus Aspergillus. The organism is ubiquitous, being found in soil and water or in decaying vegetation. While Aspergillus is entirely harmless for mos...\n --CHILD--> [1F20.1] Non-invasive aspergillosis"
] |
2E88
|
Benign endometrial stromal nodule
|
[
{
"from_icd11": "FA20.0",
"icd10_code": "M0569",
"icd10_title": "Rheumatoid arthritis of multiple sites with involvement of other organs and systems"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0579",
"icd10_title": "Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M05612",
"icd10_title": "Rheumatoid arthritis of left shoulder with involvement of other organs and systems"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0570",
"icd10_title": "Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0560",
"icd10_title": "Rheumatoid arthritis of unspecified site with involvement of other organs and systems"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0500",
"icd10_title": "Felty's syndrome, unspecified site"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0639",
"icd10_title": "Rheumatoid nodule, multiple sites"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M0630",
"icd10_title": "Rheumatoid nodule, unspecified site"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M05",
"icd10_title": "Rheumatoid arthritis with rheumatoid factor"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M050",
"icd10_title": "Felty's syndrome"
},
{
"from_icd11": "FA20.0",
"icd10_code": "M063",
"icd10_title": "Rheumatoid nodule"
},
{
"from_icd11": "1F20.Z",
"icd10_code": "B4489",
"icd10_title": "Other forms of aspergillosis"
},
{
"from_icd11": "1F20.Z",
"icd10_code": "B4481",
"icd10_title": "Allergic bronchopulmonary aspergillosis"
},
{
"from_icd11": "1F20.Z",
"icd10_code": "B441",
"icd10_title": "Other pulmonary aspergillosis"
},
{
"from_icd11": "1F20.Z",
"icd10_code": "B449",
"icd10_title": "Aspergillosis, unspecified"
}
] |
M0569
|
Rheumatoid arthritis of multiple sites with involvement of other organs and systems
|
A 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 and liver cirrhosis associated with hepatitis B virus (HBV) infection underwent LDLT for HCC, with his 48-year-old elder brother as the living donor, in November 2004. He had received transarterial chemoembolization (TACE) 5 months before liver transplantation and was assessed as having a partial response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) . The patient had no history of other diseases, and there were also no diseases of note in his family history. The right lobe of the donor was harvested and weighed 710 g (graft-to-recipient weight ratio, 1.09). The donor and recipient had the same blood type. Preoperative abdominal computed tomography (CT) revealed liver cirrhosis with three hypervascular nodules, diagnosed as HCC, which were 2.0, 2.5, and 2.8 cm in diameter and met the Milan criteria . Preoperative tumor marker levels were as follows: α-fetoprotein (AFP), 5 ng/ml; and des-ɤ-carboxy prothrombin (DCP), 327 mAU/ml. Pathological examination of the resected liver revealed one moderately differentiated HCC with necrotic change in a 2.4-cm area, and multiple well-differentiated HCC lesions measuring a few millimeters that appeared to indicate multicentric occurrence. Microvascular invasion was not seen . We used tacrolimus and mycophenolate mofetil (MMF) as posttransplant immunosuppressive agents; no steroids were employed. The early postoperative course was uneventful, and the patient was discharged 74 days postoperatively. He received epirubicin at a dose of 10 mg/m 2 during surgery, but did not receive postoperative chemotherapy. He was followed up by abdominal ultrasonography (US) every 3 months and by abdominal CT at 1, 3, 6, and 12 months after surgery, and every 6 months thereafter. The AFP and DCP levels were checked monthly. Lamivudine was administered to control HBV virus, and HBV DNA was consistently negative after transplantation. In September 2006, 22 months after LDLT, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx , and biopsy revealed HCC metastasis. Cervical CT revealed a pharyngeal polyp on the right side of the epiglottis; also, faint fluorodeoxyglucose (FDG) accumulation was recognized, consistent with a pharyngeal polyp on FDG positron emission tomography (PET)-CT examination . Polypectomy was performed on October 2006. Histological examination revealed that the tumor cells were positive for anti-hepatocyte antigen staining and a diagnosis of metastasis of HCC was made . He was administered tegafur/gimeracil/oteracil (TS-1) after polypectomy. Two years after pharyngeal polypectomy, recurrence in neck lymph nodes was detected , and neck lymph node dissection was performed. Recurrence subsequently occurred three times in the graft liver, and local treatment with TACE and radiofrequency ablation therapy was performed. The patient was started on oral sorafenib 3 years ago, is still alive 12 years and 10 months after recurrence of pharyngeal metastasis, and is now a tumor-free outpatient in good health continuing to take a low dose of sorafenib . Fig. 1 Computed tomography (CT) images before living-donor liver transplantation and histopathological findings of the resected native liver. a Preoperative abdominal CT showing liver cirrhosis with three hypervascular nodules that were 20, 25, and 28 mm in diameter. Embolism deposits due to transarterial chemoembolization (TACE) were observed in one of the three S1 tumors. b Macroscopic examination of the resected liver revealed the presence of a tumor 28 mm in diameter with partial necrosis due to preoperative TACE in segment 1, but no tumors were observed in other areas, only regenerated nodules. c , d Microscopic view of moderately differentiated hepatocellular carcinoma (HCC) with necrotic changes in segment 1 and multiple well-differentiated HCC lesions with trabecular and pseudoglandular structures measuring a few millimeters in diameter Fig. 2 Pharyngeal metastasis and cervical lymph node metastasis following living-donor liver transplantation for hepatocellular carcinoma (HCC). a Macroscopic findings of a pedunculated polyp-shaped pharyngeal metastatic lesion. b Cervical computed tomography (CT) revealing a pharyngeal polyp on the right side of the epiglottis. c Faint fluorodeoxyglucose (FDG) accumulation consistent with the pharyngeal polyp as observed using FDG positron emission tomography (PET)-CT. d Histological examination showing polygonal dysplastic epithelial cells with a trabecular or pseudotubular structure that had proliferated under the mucous membrane covered with the squamous epithelium. e These tumor cells stained positively for anti-hepatocyte-specific antigen and were diagnosed as indicative of HCC metastasis. f Cervical CT showing regional neck lymph node swelling at 2 years after pharyngeal polypectomy. g PET-CT scan indicating that there was almost no FDG accumulation in the enlarged cervical lymph node Fig. 3 Clinical course of patient with pharyngeal metastasis after living-donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC). Tacrolimus and mycophenolate mofetil were used as posttransplant immunosuppressive agents, with no steroid administration. Epirubicin was administered during surgery. Pharyngeal metastasis occurred at 1 year and 10 months after LDLT. In addition, at 2 years after pharyngeal polypectomy, recurrence of HCC was detected in the regional neck lymph nodes. Recurrence subsequently occurred three times in the grafted liver, and local treatment with transcatheter arterial chemoembolization and radiofrequency ablation therapy were performed. The patient took TS-1 orally after pharyngeal polypectomy for approximately 1 year and 6 months, and oral administration of sorafenib was started after the second liver graft recurrence
| 4.066406
| 0.973145
|
sec[1]/p[0]
|
en
| 0.999998
|
32466780
|
https://doi.org/10.1186/s12957-020-01873-0
|
[
"liver",
"pharyngeal",
"metastasis",
"donor",
"polyp",
"polypectomy",
"recurrence",
"lymph",
"transplantation",
"tomography"
] |
[
{
"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": "CA0Y",
"title": "Other specified upper respiratory tract disorders"
},
{
"code": "CA02.Z",
"title": "Acute pharyngitis, unspecified"
},
{
"code": "2F90.Y&XA93V5",
"title": "Neoplasm of unknown behaviour of the pharynx"
},
{
"code": "NA20.2&XJ1C6&XA93V5",
"title": "Haematoma of pharynx"
},
{
"code": "BD75.Y&XA93V5",
"title": "Pharyngeal varices"
}
] |
=== 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
[CA0Y] Other specified upper respiratory tract disorders
Also known as: Other specified upper respiratory tract disorders | Acute adenoiditis | adenoid infection | Pharyngotonsillitis | tonsillopharyngitis
[CA02.Z] Acute pharyngitis, unspecified
Also known as: Acute pharyngitis, unspecified | Acute pharyngitis | acute pharyngitis NOS | acute sore throat NOS | acute sore throat
=== GRAPH WALKS ===
--- Walk 1 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--RELATED_TO--> [?] Metabolic or transporter liver disease
--- Walk 2 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--RELATED_TO--> [?] Viral hepatitis
Def: A group of liver diseases caused by infection with one or more of the five hepatitis viruses, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E viruses. The in...
--- Walk 3 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified
--- Walk 4 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--CHILD--> [DB97.0] Idiopathic granulomatous hepatitis
--- Walk 5 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--CHILD--> [DB99.2] Hepatorenal syndrome
--- Walk 6 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--RELATED_TO--> [?] Cirrhotic cardiomyopathy
Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation...
|
[
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Metabolic or transporter liver disease",
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Viral hepatitis\n Def: A group of liver diseases caused by infection with one or more of the five hepatitis viruses, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E viruses. The in...",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.0] Idiopathic granulomatous hepatitis",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.2] Hepatorenal syndrome",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Cirrhotic cardiomyopathy\n Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation..."
] |
DB9Z
|
Diseases of liver, unspecified
|
[
{
"from_icd11": "DB9Z",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7689",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K769",
"icd10_title": "Liver disease, unspecified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K77",
"icd10_title": "Liver disorders in diseases classified elsewhere"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K762",
"icd10_title": "Central hemorrhagic necrosis of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K70-K77",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K778",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K72",
"icd10_title": "Hepatic failure, not elsewhere classified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K76",
"icd10_title": "Other diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K768",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7581",
"icd10_title": "Nonalcoholic steatohepatitis (NASH)"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7589",
"icd10_title": "Other specified inflammatory liver diseases"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K759",
"icd10_title": "Inflammatory liver disease, unspecified"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K752",
"icd10_title": "Nonspecific reactive hepatitis"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K75",
"icd10_title": "Other inflammatory liver diseases"
}
] |
K7681
|
Hepatopulmonary syndrome
|
The patient was in follow up in the Pediatric Diabetological Center of our Department because developed type 1 diabetes at the age of 1 year and 5 months with the signs of ketoacidosis preceded by polyuria, polydipsia, weight loss and progressive weakness. Blood tests and laboratory revealed on that occasion: pH 7.16, pCO2 35.4 mmHg, O 2 saturation 66%, base excess - 14.8, bicarbonate 12.5 mEq/L, glucose 587 mg/dl, HbA 1c 11.4% (101 mmol/mol), serum C-peptide 0.2 ng/ml (n.v. 0.6 -3.7) weakly positive ICA, GADA 0.1 AU/ml (n.v. <3), IA-2 autoantibodies 33 AU/ml (n.v. <1). The family history revealed that a maternal uncle was suffering from diabetes mellitus since the age of 31 years old, treated initially with oral hypoglycemic drugs and later with insulin. AHT was diagnosed at the age of 6 years and 9 months because the presence of autoantibodies (anti-TgAbs 181,80 IU/ml and anti-TPOAbs 578.90 IU/ml) and because of the findings of the ultrasound (US) and Doppler-US that showed respectively a heterogeneous echogenicity of the thyroid with multinodular hypoechoic areas and a widespread hypervascularization. It was necessary to introduce replacement therapy with L-thyroxine 9 months later for the onset of hypothyroidism (fT3 4.18 pg/ml, fT4 6.11 pg/ml; TSH 64.41 μIU/mL). At the age of 11 years and 2 months old she was referred to the Pediatric Rheumatological Center of our Department for persistence, from approximately 6 months, of diffuse arthralgia, morning stiffness lasting about an hour and lameness. The insulin and thyroid replacement therapy had been adequate up to that moment: in fact, her reference percentiles for height (145 cm), weight (39.5 kg) and BMI (18,8 ) were all included between the 25th and the 50th percentile and the path of her growth curve had always continued along this channel, without showing deflections despite the medical history revealed that the patient suffered from the joint symptoms since at least 6 months and her metabolic state was very altered (HbA1c 10.4%; insulin dose of 1.2 Units/Kg/day). Pubertal development was appropriate to sex and age (P 2 B 2 ) . Physical examination showed the presence of all the signs of arthritis of the elbows, wrists, hips, knees, left ankle, metacarpophalangeal joints of the third and fifth finger of the left hand and first and third finger of the right hand. Laboratory tests found inflammatory anemia (hemoglobin 8.1 g/dl, ESR 125 mm/hour, CRP 25.8 mg/dl, fibrinogen 682 mg/dl, serum iron 8 mcg/dl, ferritin 210 ng/ml) and bone marrow aspirate excluded malignancies. The serological tests for celiac and connective tissue disease (ENA) were negative, but positive for rheumatoid factor (52 umol/L) and for ANA (1:160); the eye examination excluded the presence of concomitant iridocyclitis. Considering 2 further test for rheumatoid factor (RF) resulted positive (28 umol/L, 33 umol/L; n.v. 0-20) at 3 months apart during the first 6 months of disease, the diagnosis of RF positive polyarthritis was made according with International League of Associations for Rheumatology (ILAR) classification criteria and treatment with anti-inflammatory drugs (Naproxen, 15 mg/kg/day) and MTX at a dose of 15 mg/m 2 /week was assigned according to 2011 American College of Rheumatology (ACR) reccomandation . After about a year of relatively good control of the arthritis, the patient had a progressive clinical deterioration: the physical examination showed limitation of flexion and extension of both wrists, elbows and the left ankle which was also swollen. In view of this clinical picture and the persistence of inflammatory anemia (9.8 g/dl, ESR 50 mm/hour, CRP 13.6 mg/dl) we decided to start anti-TNF therapy (etanercept 0.4 mg/kg, subcutaneously, twice in a week). We have decided not to suspend MTX, the effectiveness of which is sustained by good-quality studies , because the patient had always shown to tolerate it well in combination with conventional therapy based on NSAIDs although over time this treatment proved insufficient to control arthritis, and to associate it with the etanercept to enhance their mutual anti-inflammatory and immunomodulatory activities . The functional limitation of the affected joints was progressively reduced and the current examination show only a slight functional limitation of both wrists in the absence of further clinical and biochemical signs of acute inflammation (ESR 13 mm/hour; CRP 0.1 mg/dl) . Also the metabolic control of diabetes improved and the HbA1c after three months from the starting of biological therapy was 8.7% (71 mmol/mol) and after 6 months was 8.3% (67 mmol/mol) while the insulin dose decreased respectively to 1.0 and 0.8 units/Kg/day . The patient continues to get the beneficial effects of etanercept treatment and at the moment both the daily requirement of exogenous insulin (0.8 U/kg/day), and the HbA 1c (7.8%, 61 mmol/mol) are significantly reduced compared to those found at the diagnosis of arthritis. The current blood levels of fasting C-peptide remains unchanged compared to those found at onset of diabetes (0.07 ng/mL). Furthermore, the daily requirement of L-thyroxine is stable (1.7 mg/kg/ day) and the arthritis is under control thanks to etanercept. Until now, laboratory tests performed during follow-up for celiac disease (ATA-IgA 2.5 U/ml; anti-gliadin peptides IgG 3.1 U/ml, anti-gliadin peptides IgA 1 U/ml), Addison's disease (cortisol 7.3 mcg /dl, ACTH 16.9 pg/ml) were normal, as well as the current thyroid profile (fT3 3.2 pg/ml, fT4 12.2 pg/ml; TSH 0,305 μUI /mL). From the clinical onset of joint symptoms to date, the patient has grown regularly along its growth channel (25th - 50th percentile) and pubertal development is continued normally. Currently, she shows no signs of nephropathy or neuropathy, does not suffer from high blood pressure and eye examination has ruled out so far the presence of diabetic retinopathy or iridocyclitis.
| 4.078125
| 0.967773
|
sec[1]/p[0]
|
en
| 0.999996
|
24124913
|
https://doi.org/10.1186/1824-7288-39-64
|
[
"anti",
"that",
"insulin",
"arthritis",
"because",
"diabetes",
"mmol",
"presence",
"hour",
"inflammatory"
] |
[
{
"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": "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 ===
[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
[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 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--EXCLUDES--> [?] Labour or delivery complicated by fetal distress
--- Walk 2 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.0] Maternal care for red cell antibodies
Def: Maternal care for rhesus or other isoimmunization...
--- 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--> [MB23.0] Aggressive behaviour
Def: 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 app...
--- 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 --CHILD--> [JA86.0] Maternal care for red cell antibodies\n Def: Maternal care for rhesus or other isoimmunization...",
"[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--> [MB23.0] Aggressive behaviour\n Def: 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 app...",
"[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": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
}
] |
O26841
| |
This clinical case describes the post-traumatic rupture of an asymptomatic microcystic SL causing hemorrhagic shock. Although no consensus has yet been reached on whether lymphangioma is a neoplasm or a hamartoma, most researches support the latter opinion. Its formation would be due to abnormal congenital development of lymphatic vessel or attributed to bleeding or inflammation in the lymphatic system, which causes obstruction and consequent lymphangiectasia. Based on the size of the dilated lymphatic channels, lymphangioma can be classified as capillary (supermicrocystic), cavernous (microcystic) or cystic (macrocystic) ; the microcystic type, discovered in our patient, isn’t the most common . Lymphangiomas can be characterized pathologically by a flat epithelial endothelium and a wall containing alternatively lymphoid tissue, small lymphatic spaces, smooth muscle and foam cells . SL can presents as a unique subcapsular cyst or multiple cystic lesions that can be intraparenchymal or sometimes replace the entire normal splenic parenchyma (splenic lymphangiomatosis). The typical histological aspect of SL after splenectomy shows cystic structures filled with eosinophilic, proteinaceous material and lined by flattened endothelial cells . Most lymphangiomas are discovered in children, with 80–90% being diagnosed before the age of 2 . Isolated SL is a very rare entity because of others organs are often involved as part of the so-called lymphangiomatosis syndrome. As isolated SL is often asymptomatic and represents an incidental radiological finding, especially if the lesion is small, preoperative diagnosis is very difficult; instead large cystic lesions can attain sufficient size to cause significant symptoms and signs which at the same time aren’t pathognomonic. In the case of a large SL, the symptomatology may include left upper quadrant pain with splenomegaly, nausea, vomiting, loss of appetite, shortness of breath, abdominal distention, further generalized symptoms secondary to compression of adjacent viscera or an acute abdomen, as in our patient, in case of complications like as rupture or infection . The differential diagnosis is broad including hemangioma, splenic infarction, pseudocyst, epidermoid cyst, mesothelial cyst, parasitic or hydatid cysts, septic embolism, old hematomas, lymphoma or metastasis . Preoperative diagnosis is difficult like as for other pathologies , depending on the non specificity of symptoms and signs; however it’s improved by medical imaging including abdominal ultrasound (US), abdominal CT scan and magnetic resonance imaging (MRI) . The variability of lymphatic vessel caliber associated with some degree of fibrosis and calcification, provides a wide range of imaging aspects. Because lymphangiomas more commonly involve many organs at one time, the diagnostic evaluation must be extended to search for other sites affected by the disease . US may reveal the presence of well-defined hypoechoic or anechoic cystic lesions with occasional internal septations or calcifications . CT scan is the diagnostic technique of choice and shows multiple, low-density cysts without enhancement or with only slight enhancement of the thin septa, with or without mural calcification . The cystic lesions are hypointense on T1-weighted MRI scans and hyperintense on T2-weighted MRI scans. MRI can facilitate the detection of solid areas into the lumen of cystic spaces suggesting malignant degeneration . On angiography, these lesions are avascular . PET-CT is rarely used for the diagnosis, excluding a malignant tumor where the other imaging techniques are inconclusive . In our case abdominal CT scan, performed in emergency, wasn’t diagnostic for microcystic SL that was revealed only at pathological examination. Lymphangioma rarely regresses spontaneously and, if untreated, it persists and often expands (being locally invasive or even malignant), potentially damaging vital structures . Complications of SL include rupture with hemorrhage and peritonitis, infection, abscess formation, pleural effusion, lung atelectasis, pneumonia, empyema, intestinal obstruction, diaphragmatic immobility, hypertension, tumor enlargement and a low risk of malignant transformation to lymphangiosarcoma . Excessive growth of SL can lead to complications such as consumptive coagulopathy, hypersplenism and portal hypertension . According to literature, in our case unknown microcystic SL represented a risk factor for post-traumatic splenic rupture, so diagnosis was made after detection of a complication. The treatment of SL depends on the lesion size and the presence of complications. Some investigators prefer conservative treatment in the case of small and asymptomatic lesions detected incidentally, reserving splenectomy for large, multiple or symptomatic lesions. Conservative management (aspiration, drainage or sclerosis) is associated with high risk of recurrence . Medical treatment was described by Reinhardt using the alpha interferon in children with good tolerance, however the optimal dose and duration of this curative therapy is not known . Although partial splenectomy has been used in case of limited disease, in order to avoid the overwhelming post-splenectomy infection , total splenectomy is the preferable definitive treatment to avoid complications. Laparoscopic splenectomy is emerging as the procedure of choice in patients with a normal to moderately enlarged spleen but it has multiples contraindications including portal hypertension with high hemorrhagic risk and massive splenomegaly. Accessory spleen must be removed because they can be concomitantly affected . The prognosis of SL after splenectomy is favorable, but it has a high risk of splenic rupture and can recur after incomplete surgical resection (9.5% of patients) . In our case open splenectomy was performed as life-saving treatment for the patient that had no complications after surgery.
| 4.320313
| 0.921875
|
sec[2]/p[0]
|
en
| 0.999996
|
32987290
|
https://doi.org/10.1016/j.ijscr.2020.09.045
|
[
"splenectomy",
"cystic",
"lesions",
"complications",
"rupture",
"microcystic",
"lymphatic",
"splenic",
"risk",
"abdominal"
] |
[
{
"code": "BB01.4",
"title": "Pulmonary hypertension with multifactorial mechanism"
},
{
"code": "3B81.Y",
"title": "Other specified acquired disorders of spleen"
},
{
"code": "CA25.Z",
"title": "Cystic fibrosis, unspecified"
},
{
"code": "CB40.Y",
"title": "Other specified diseases of the respiratory system"
},
{
"code": "GB71.0",
"title": "Calculus in bladder"
},
{
"code": "DB99.1Z",
"title": "Hepatic cyst, unspecified"
},
{
"code": "5A01.2",
"title": "Nontoxic multinodular goitre"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[BB01.4] Pulmonary hypertension with multifactorial mechanism
Also known as: Pulmonary hypertension with multifactorial mechanism | Pulmonary hypertension in haematological disorders | Pulmonary hypertension due to myeloproliferative disorders | Pulmonary hypertension due to splenectomy | Pulmonary hypertension in systemic disorders
[3B81.Y] Other specified acquired disorders of spleen
Also known as: Other specified acquired disorders of spleen | Peliosis of spleen | Congestion of spleen | splenic congestion | Lymphoid hyperplasia of spleen
[CA25.Z] Cystic fibrosis, unspecified
Also known as: Cystic fibrosis, unspecified | Cystic fibrosis | mucoviscidosis | CF - [cystic fibrosis] | cystic fibrosis 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
[GB71.0] Calculus in bladder
Definition: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is characterised by urinary calculi located in the bladder. This condition may also present with haematuria, dysuria, or pain in the flank, lower abdomen, or groin. Confirmation is by abdominal radiography, to determine the presence and location of calculi.
Also known as: Calculus in bladder | Urinary bladder stone | bladder calculi | bladder stone | urinary bladder calculus
Includes: Urinary bladder stone
Excludes: Calculus in a bowel segment for urinary diversion (e.g. neobladder, pouch) (NFBC)
[DB99.1Z] Hepatic cyst, unspecified
Also known as: Hepatic cyst, unspecified | Hepatic cyst | cyst of liver | cystic liver | liver cyst
[5A01.2] Nontoxic multinodular goitre
Definition: Multiple nodules of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis
Also known as: Nontoxic multinodular goitre | non-toxic multinodular goitre | multinodular nontoxic struma | cystic goitre | Cystic goitre NOS
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[BB01.4] Pulmonary hypertension with multifactorial mechanism
--PARENT--> [BB01] Pulmonary hypertension
Def: Pulmonary hypertension (PH) is a haemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure (PAP) 25 mmHg at rest as assessed by right heart catheterizati...
--CHILD--> [BB01.1] Pulmonary hypertension due to left heart disease
--- Walk 2 ---
[BB01.4] Pulmonary hypertension with multifactorial mechanism
--PARENT--> [BB01] Pulmonary hypertension
Def: Pulmonary hypertension (PH) is a haemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure (PAP) 25 mmHg at rest as assessed by right heart catheterizati...
--CHILD--> [BB01.1] Pulmonary hypertension due to left heart disease
--- Walk 3 ---
[3B81.Y] Other specified acquired disorders of spleen
--PARENT--> [3B81] Acquired disorders of spleen
Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....
--RELATED_TO--> [?] Injury of spleen
--- Walk 4 ---
[3B81.Y] Other specified acquired disorders of spleen
--PARENT--> [3B81] Acquired disorders of spleen
Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....
--CHILD--> [3B81.1] Postsurgical asplenia
Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept...
--- Walk 5 ---
[CA25.Z] Cystic fibrosis, unspecified
--PARENT--> [CA25] Cystic fibrosis
Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...
--CHILD--> [CA25.0] Classical cystic fibrosis
--- Walk 6 ---
[CA25.Z] Cystic fibrosis, unspecified
--PARENT--> [CA25] Cystic fibrosis
Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...
--CHILD--> [CA25.0] Classical cystic fibrosis
|
[
"[BB01.4] Pulmonary hypertension with multifactorial mechanism\n --PARENT--> [BB01] Pulmonary hypertension\n Def: Pulmonary hypertension (PH) is a haemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure (PAP) 25 mmHg at rest as assessed by right heart catheterizati...\n --CHILD--> [BB01.1] Pulmonary hypertension due to left heart disease",
"[BB01.4] Pulmonary hypertension with multifactorial mechanism\n --PARENT--> [BB01] Pulmonary hypertension\n Def: Pulmonary hypertension (PH) is a haemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure (PAP) 25 mmHg at rest as assessed by right heart catheterizati...\n --CHILD--> [BB01.1] Pulmonary hypertension due to left heart disease",
"[3B81.Y] Other specified acquired disorders of spleen\n --PARENT--> [3B81] Acquired disorders of spleen\n Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....\n --RELATED_TO--> [?] Injury of spleen",
"[3B81.Y] Other specified acquired disorders of spleen\n --PARENT--> [3B81] Acquired disorders of spleen\n Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....\n --CHILD--> [3B81.1] 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...",
"[CA25.Z] Cystic fibrosis, unspecified\n --PARENT--> [CA25] Cystic fibrosis\n Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...\n --CHILD--> [CA25.0] Classical cystic fibrosis",
"[CA25.Z] Cystic fibrosis, unspecified\n --PARENT--> [CA25] Cystic fibrosis\n Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...\n --CHILD--> [CA25.0] Classical cystic fibrosis"
] |
BB01.4
|
Pulmonary hypertension with multifactorial mechanism
|
[
{
"from_icd11": "BB01.4",
"icd10_code": "I2720",
"icd10_title": "Pulmonary hypertension, unspecified"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I2722",
"icd10_title": "Pulmonary hypertension due to left heart disease"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I2729",
"icd10_title": "Other secondary pulmonary hypertension"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I2721",
"icd10_title": "Secondary pulmonary arterial hypertension"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I2724",
"icd10_title": "Chronic thromboembolic pulmonary hypertension"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I2723",
"icd10_title": "Pulmonary hypertension due to lung diseases and hypoxia"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I272",
"icd10_title": "Other secondary pulmonary hypertension"
},
{
"from_icd11": "BB01.4",
"icd10_code": "I27",
"icd10_title": "Other pulmonary heart diseases"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E8419",
"icd10_title": "Cystic fibrosis with other intestinal manifestations"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E848",
"icd10_title": "Cystic fibrosis with other manifestations"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E849",
"icd10_title": "Cystic fibrosis, unspecified"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E84",
"icd10_title": "Cystic fibrosis"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E841",
"icd10_title": "Cystic fibrosis with intestinal manifestations"
},
{
"from_icd11": "GB71.0",
"icd10_code": "N210",
"icd10_title": "Calculus in bladder"
},
{
"from_icd11": "5A01.2",
"icd10_code": "E042",
"icd10_title": "Nontoxic multinodular goiter"
}
] |
I2720
|
Pulmonary hypertension, unspecified
|
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