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In 2017 in the Department of Cardiac Surgery, IRCCS San Raffaele Scientific Institute (Milan, Italy), a 70-year-old man underwent coronary artery bypass graft and aortic valve replacement with bioprosthesis, needing extracorporeal circulation. His past medical history included hypertension and chronic kidney disease. In June 2021 he was hospitalized in our Infectious Diseases Unit for pyrexia from more than one month , weight loss and suspected PVE. Transthoracic echocardiography (TTE) had shown mobile vegetations on aortic bioprosthesis, that had not been confirmed at transesophageal echocardiography (TEE). During the hospitalization, TTE and TEE were repeated and did not confirm the diagnosis of PVE. However, total body Fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) detected an accumulation of the tracer near the aortic bioprosthesis . Coronary computed tomography angiography and gadolinium-enhanced cardiac magnetic resonance revealed a periprosthetic aortic abscess. Complete blood count showed anemia, thrombocytopenia, leucopenia and lymphopenia (with a lymphocyte nadir of 400 cells/ยตL, CD4 + T-cell count of 195 cells/ยตL, CD8 + T-cell count of 202 cells/ยตL and CD4 + /CD8 + ratio of 0.97), and blood chemistry tests revealed an elevation in CRP and interleukin (IL)-6 concentrations (with peaks of 65.2 mg/L and 42.2 pg/mL, respectively), hypoalbuminemia and a reduction in estimated glomerular filtration rate. Blood culture series and screening for blood-culture-negative infective endocarditis [including liquid (BD BACTEC Mycobacteria Growth Indicator Tube 960 system; 2 sets) and solid (Lowenstein-Jensen; 2 sets) medium-based mycobacterial blood culture, Wright and Widal seroagglutination reaction, serology for Brucella , Coxiella burnetii , Bartonella henselae , Mycoplasma pneumoniae , and Legionella pneumophila , urine-based antigen detection for Streptococcus pneumoniae and L. pneumophila , plasma-based antigen detection for Aspergillus and Cryptococcus , histology for Whipple disease and real-time polymerase chain reaction (rtPCR) for Tropheryma whipplei on multiple duodenal biopsies] were negative. We also performed screening for non-infective endocarditis (including tests for antinuclear, anticardiolipin, and anti-ฮฒ 2 -glycoprotein1 antibodies and lupus anticoagulant), with a negative result. Because of the persistence of fever despite multiple antibiotic treatments , other causes of pyrexia were considered: screening for viral infections (including severe acute respiratory syndrome coronavirus 2 nasopharyngeal swab) was characterized only by a low-titer positivity of rtPCR for human herpesvirus 8 (HHV8) on plasma samples. The patient had no lymphadenopathies, pleural, pericardial or peritoneal effusions and hepatomegaly, but only moderate splenomegaly and some purple cutaneous nodular lesions localized to both feet , observed for the first time at the third day of hospitalization. Therefore, these nodules were biopsied and both histological analysis and rtPCR for HHV8 were consistent with KS . Fourth generation HIV antigen/antibody combination assay was negative, letting us diagnose Classic KS. Histology and rtPCR for B. henselae on skin biopsies excluded also a possible case of bacillary angiomatosis. No lesions consistent with KS were revealed from esophagogastroduodenoscopy and HHV8 was not detected from duodenal biopsies . Even though HHV8 viremia was < 1000 copies/mL , clinical presentation and hemato-chemistry tests were consistent with KS inflammatory cytokine syndrome (KICS)-like manifestation. We performed bone marrow biopsy, which revealed a reduced T- and B-lymphocyte count and confirmed involvement by HHV8, and a naproxen test, with apyrexia for 5 days . Moreover, although in our Institute no cases of M. chimaera endocarditis following cardiothoracic surgery were reported, in light of the clinical presentation and the previous exposition to heater-cooler systems, mycobacterial urine (BD BACTEC Mycobacteria Growth Indicator Tube 960 system and Lowenstein-Jensen medium), stool (BD BACTEC Mycobacteria Growth Indicator Tube 960 system and Lowenstein-Jensen medium) and bone marrow (BacT/ALERT ยฎ 3D automated culture system) cultures were executed, with isolation of M. chimaera from urine and bone marrow . According to European and international diagnostic criteria, we diagnosed a disseminated M. chimaera infection and oral antimycobacterial therapy was started, composed of a cornerstone with azithromycin 500 mg/day, ethambutol 1200 mg/day, and rifampicin 600 mg/day, plus moxifloxacin 400 mg/day, considering the multiorgan involvement . At day 7 from treatment initiation, the therapy was upgraded adding clofazimine 100 mg/day for persistence of fever . A multidisciplinary evaluation excluded indications to a cardiac surgical intervention, due to the absence of hemodynamic instability and prosthetic dysfunction, and given the high surgical risk. At day 34, with the result of susceptibility test, that showed M. chimaera susceptible to amikacin and clarithromycin, resistant to linezolid and moxifloxacin and with a minimum inhibitory concentration of 4 ยตg/mL for rifampicin and 16 ยตg/mL for ethambutol in absence of Clinical and Laboratory Standards Institute clinical breakpoints, moxifloxacin was stopped . From week 7, the patient became apyretic , blood tests remained stable except for a further reduction in estimated glomerular filtration rate , and the cutaneous lesions did not expand. Oncologic evaluations at week 5, 26 and 40 excluded current indication to chemotherapy or other treatment for KS. At week 9 mycobacterial urine cultures became negative .
4.164063
0.938477
sec[1]/p[0]
en
0.999997
PMC9735029
https://doi.org/10.1186/s12941-022-00547-x
[ "blood", "aortic", "count", "culture", "system", "urine", "rtpcr", "chimaera", "cardiac", "institute" ]
[ { "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": "BD5Z", "title": "Diseases of arteries or arterioles, unspecified" }, { "code": "LA8A.3", "title": "Congenital supravalvar aortic stenosis" }, { "code": "BD40.1", "title": "Atherosclerosis of aorta" }, { "code": "BB71.Z", "title": "Aortic valve insufficiency, unspecified" }, { "code": "LA8B.2Y", "title": "Other specified congenital anomaly of aorta or its branches" } ]
=== 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 [BD5Z] Diseases of arteries or arterioles, unspecified Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS [LA8A.3] Congenital supravalvar aortic stenosis Definition: A congenital cardiovascular malformation with narrowing of the aorta at the level of the sinotubular junction which may extend into the ascending aorta. Additional information: 'Congenital supravalvar aortic stenosis' is described as three forms: an hourglass deformity, a fibrous membrane, and a diffuse narrowing of the ascending aorta. Supravalvar aortic stenosis may involve the coronary artery ostia, and the aortic leaflets may be tethered. The coronary arteries can become tortuous and dilate Also known as: Congenital supravalvar aortic stenosis | stenosis of aorta | supravalvular aortic stenosis | stricture of aorta | congenital narrowed aorta Excludes: Congenital aortic valvar stenosis [BD40.1] Atherosclerosis of aorta Also known as: Atherosclerosis of aorta | aorta atheroma | aorta calcification | aorta arteriosclerosis | aortic degeneration [BB71.Z] Aortic valve insufficiency, unspecified Also known as: Aortic valve insufficiency, unspecified | Aortic valve insufficiency | aortic insufficiency | aortic valve incompetency | AI - [aortic incompetence] [LA8B.2Y] Other specified congenital anomaly of aorta or its branches Also known as: Other specified congenital anomaly of aorta or its branches | Congenital anomaly of ascending aorta | Hypoplasia of ascending aorta | Congenital ascending aorta aneurysm or dilation | congenital ascending aortic aneurysm or dilation === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Anaemias or other erythrocyte disorders --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.4Z] 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 --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Anaemias or other erythrocyte disorders", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] 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 --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
In our institution, 43 STS patients were treated with pazopanib, of which 39 had pulmonary metastases and 36 of these patients had pleural or subpleural pulmonary metastases. Treatment was complicated by a pneumothorax in six (14.0%) patients.The first patient is a 24-year old male, with a malignant peripheral nerve sheath tumour of the left brachial plexus, diagnosed three years before. Initial treatment consisted of local resection and irradiation, repeated one year later because of local recurrence. Pulmonary metastases, some localised pleural, were found seven months later for which six cycles of 3-weekly doxorubicin 75 mg/m2 was initiated. Progressive disease was diagnosed six months after the first doxorubicin cycle and treatment with pazopanib was started. A CT scan at the start of pazopanib showed a necrotizing metastasis in the left lung . A month later a left-sided pneumothorax occurred after a skiing trip at 3000 meters height, persisting after drainage and later also a right sided pneumothorax occurred. The CT scan detecting the pneumothorax on the left side, also showed cystic degeneration of metastases in the right lower lobe . The persistent bilateral pneumothorax was complicated by a pyothorax on the left side. He died six months after the start of pazopanib, which was continued until his death.Patient 2 is a 79-year old male, who was diagnosed two years before with an angiosarcoma of the scalp. Primary treatment was combined paclitaxel and radiotherapy. However, one year later a local recurrence was diagnosed and a CT scan showed pulmonary metastases, of which some were pleural, for which 3-weekly doxorubicin 75 mg/m2 was started. The local recurrence was progressive after six months and pazopanib was initiated, which was stopped three months thereafter because of progressive disease. Some of the pulmonary metastases already showing cavitation at start of pazopanib were increasing in number, size and cavitation during treatment . One week after the start of pazopanib a right sided pneumothorax occurred , which was treated with drainage, but without pleurodesis, however it recurred one week later and again drained. A month thereafter a left-sided pneumothorax was diagnosed, which was left untreated. He died one week later due to disease progression, four months after the start of pazopanib.The third patient is a 34-year old male, three years before diagnosed with a synovial sarcoma of the left femur with synchronous lung metastases, some with a pleural localisation, and malignant pleural effusion. Treatment consisted of resection of the primary tumour and doxorubicin/ifosfamide chemotherapy followed by pulmonary metastasectomy and isolated melphalan lung perfusion. Treatment with trabectedin was started, but stopped after nine cycles because of progressive disease and pazopanib was started. He was treated for a remarkable 15 months when progression occurred and a hydropneumothorax was diagnosed on a routine follow-up CT scan , treated with drainage and talc pleurodesis. Pazopanib was stopped. The CT scan did not show necrotizing metastases. Two weeks later the pleural effusion recurred, and persisted until he died 2 months later.The fourth patient is a 53-year old female, who had resection of a low-grade fibromyxomatoid sarcoma of the left lower extremity 13 years before. Nine years later, pulmonary, liver and lymph node metastases were diagnosed, treated with 2 cycles of liposomal doxorubicin, which was stopped because of toxicity. Some of the pulmonary metastases were localised adjacent to the pleura. Treatment was continued with low dose doxorubicin weekly for 3 months, which was repeated one year later because of progressive disease. Three months after the last doxorubicin treatment progressive disease was diagnosed and pazopanib was prescribed. After seven months treatment with pazopanib she developed a left-sided pneumothorax , successfully treated with drainage. No cavitation of the metastases was found. At the moment, treated for 31 months with pazopanib, she has stable disease.Patient five is a 72-year old female, who presented with a high grade undifferentiated pleomorphic sarcoma of the right lower extremity with pulmonary metastases, of which some are localised next to the pleura, one year before. She was treated with local resection, radiotherapy and 3-weekly doxorubicin 75 mg/m2. Five months after the start of doxorubicin progressive disease was diagnosed and pazopanib was prescribed . After two months of treatment she developed a left-sided pneumothorax, treated with drainage and pleural rubbing . Part of the pulmonary metastases showed cavitation. During admission a right-sided pneumothorax occurred and was drained successfully. However, she died one week later due to progressive disease.The sixth patient is a 40-year old female diagnosed with a low grade endometrial stromal sarcoma, six years before, after a uterus extirpation for uterine myomatosis. When she presented four years later with thoracic pain, CT scan of the thorax showed a large mediastinal mass and pulmonary metastases, also localised next to the pleural space. Treatment with doxorubicin was started and resulted in partial regression of the tumour masses. Eighteen months later pazopanib was started under the supervision of the reference centre because of progression of the pulmonary metastases. Due to liver toxicity the pazopanib dose was tapered to a minimum dose of 200 mg with short pauses in treatment, however treatment was successful . Treatment was permanently stopped after 33 months because of a bilateral pneumothorax and disease progression . She was successfully treated with drainage.
4.125
0.804688
sec[1]/p[0]
en
0.999998
25302110
https://doi.org/10.1186/2045-3329-4-14
[ "pazopanib", "metastases", "pulmonary", "which", "pneumothorax", "diagnosed", "treated", "doxorubicin", "pleural", "because" ]
[ { "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" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" } ]
=== ICD-11 CODES FOUND === [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 [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung === GRAPH WALKS === --- Walk 1 --- [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 2 --- [2E2Z] Malignant neoplasm metastasis, unspecified --PARENT--> [?] Malignant neoplasm metastases Def: Spread of a malignant neoplasm into secondary sites.... --PARENT--> [?] Malignant neoplasms, except primary neoplasms of lymphoid, haematopoietic, central nervous system or related tissues --- Walk 3 --- [2E03] Malignant neoplasm metastasis in bone or bone marrow Def: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas.... --PARENT--> [?] Malignant neoplasm metastasis in other specified sites --CHILD--> [2E01] Malignant neoplasm metastasis in bladder Def: Tumours of the urinary bladder that originate from an extravesical, non-urothelial tract neoplasm... --- Walk 4 --- [2E03] Malignant neoplasm metastasis in bone or bone marrow Def: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas.... --PARENT--> [?] Malignant neoplasm metastasis in other specified sites --CHILD--> [2E00] Malignant neoplasm metastasis in kidney or renal pelvis Def: The spread of the cancer to the kidney. This may be from a primary kidney cancer involving the opposite kidney, or from a cancer at a distant site.... --- Walk 5 --- [2E08] Metastatic malignant neoplasm involving skin Def: 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... --PARENT--> [?] Malignant neoplasm metastasis in other specified sites --CHILD--> [2E02] Malignant neoplasm metastasis in other or unspecified urinary system organs --- Walk 6 --- [2E08] Metastatic malignant neoplasm involving skin Def: 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... --PARENT--> [?] Malignant neoplasm metastasis in other specified sites --PARENT--> [?] Malignant neoplasm metastases Def: Spread of a malignant neoplasm into secondary sites....
[ "[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)....", "[2E2Z] Malignant neoplasm metastasis, unspecified\n --PARENT--> [?] Malignant neoplasm metastases\n Def: Spread of a malignant neoplasm into secondary sites....\n --PARENT--> [?] Malignant neoplasms, except primary neoplasms of lymphoid, haematopoietic, central nervous system or related tissues", "[2E03] Malignant neoplasm metastasis in bone or bone marrow\n Def: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas....\n --PARENT--> [?] Malignant neoplasm metastasis in other specified sites\n --CHILD--> [2E01] Malignant neoplasm metastasis in bladder\n Def: Tumours of the urinary bladder that originate from an extravesical, non-urothelial tract neoplasm...", "[2E03] Malignant neoplasm metastasis in bone or bone marrow\n Def: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas....\n --PARENT--> [?] Malignant neoplasm metastasis in other specified sites\n --CHILD--> [2E00] Malignant neoplasm metastasis in kidney or renal pelvis\n Def: The spread of the cancer to the kidney. This may be from a primary kidney cancer involving the opposite kidney, or from a cancer at a distant site....", "[2E08] Metastatic malignant neoplasm involving skin\n Def: 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...\n --PARENT--> [?] Malignant neoplasm metastasis in other specified sites\n --CHILD--> [2E02] Malignant neoplasm metastasis in other or unspecified urinary system organs", "[2E08] Metastatic malignant neoplasm involving skin\n Def: 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...\n --PARENT--> [?] Malignant neoplasm metastasis in other specified sites\n --PARENT--> [?] Malignant neoplasm metastases\n Def: Spread of a malignant neoplasm into secondary sites...." ]
2E2Z
Malignant neoplasm metastasis, unspecified
[ { "from_icd11": "2E2Z", "icd10_code": "C7949", "icd10_title": "Secondary malignant neoplasm of other parts of nervous system" }, { "from_icd11": "2E2Z", "icd10_code": "C7932", "icd10_title": "Secondary malignant neoplasm of cerebral meninges" }, { "from_icd11": "2E2Z", "icd10_code": "C7982", "icd10_title": "Secondary malignant neoplasm of genital organs" }, { "from_icd11": "2E2Z", "icd10_code": "C7940", "icd10_title": "Secondary malignant neoplasm of unspecified part of nervous system" }, { "from_icd11": "2E2Z", "icd10_code": "C7981", "icd10_title": "Secondary malignant neoplasm of breast" }, { "from_icd11": "2E2Z", "icd10_code": "C799", "icd10_title": "Secondary malignant neoplasm of unspecified site" }, { "from_icd11": "2E2Z", "icd10_code": "C76-C80", "icd10_title": "" }, { "from_icd11": "2E2Z", "icd10_code": "C79", "icd10_title": "Secondary malignant neoplasm of other and unspecified sites" }, { "from_icd11": "2E2Z", "icd10_code": "C798", "icd10_title": "Secondary malignant neoplasm of other specified sites" }, { "from_icd11": "2E2Z", "icd10_code": "C793", "icd10_title": "Secondary malignant neoplasm of brain and cerebral meninges" }, { "from_icd11": "2E2Z", "icd10_code": "C794", "icd10_title": "Secondary malignant neoplasm of other and unspecified parts of nervous system" }, { "from_icd11": "2E03", "icd10_code": "C7952", "icd10_title": "Secondary malignant neoplasm of bone marrow" }, { "from_icd11": "2E03", "icd10_code": "C795", "icd10_title": "Secondary malignant neoplasm of bone and bone marrow" }, { "from_icd11": "2E08", "icd10_code": "C792", "icd10_title": "Secondary malignant neoplasm of skin" }, { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" } ]
C7949
Secondary malignant neoplasm of other parts of nervous system
A 29-year-old man visited our department with a complaint of swelling of the upper lip and left cheek. He underwent partial resection after a diagnosis of hemangioma in his late teens. However, a few years later, the lesion gradually increased in size with swelling and erythema of the left upper lip and extension to the cheek, and he was referred to our hospital for treatment. Digital subtraction angiography revealed high-flow AVMs involving the left upper lip and cheek which belong to Schobingerโ€™s stageII. The AVMs were fed by bilateral facial arteries (FA), and the left infraorbital artery and left ophthalmic artery, and the AVMs drained into bilateral facial and angular veins. The lesion was diagnosed in accordance with Choโ€™s classification as type IIIb AVM, indicating multiple shunts between the arterioles and venules, with dilated fistulae . We performed five separate TAE sessions at approximately 4-month intervals with under conscious sedation using dexmedetomidine or general anesthesia. A 5-French guiding sheath (Fubuki: Asahi Intecc, Tokyo, Japan, or Axcelguide: medikit, Tokyo, Japan) was inserted via bilateral femoral arteries simultaneously, and the sheath was advanced into the bilateral external carotid artery (ECA). A 5-F balloon catheter (Cello; Medtronic, Irvine, CA, USA) was placed in the proximal ECA or other feeding arteries for flow control. Thin microcatheters with a 1.5-F tip (Marathon; Medtronic) or 1.3-F tip (DeFrictor; Medicos Hirata, Tokyo, Japan) and microwires (0.010โ€ณ TENROU: Kaneka Medics, Osaka, Japan or 0.008โ€ณ CHIKAI: Asahi Intecc, Tokyo, Japan) were coaxially navigated via the balloon catheter into the feeding artery as far distally as possible. A low-concentration n-BCA-lipiodol mixture was injected through the microcatheter with plug and push technique under flow control using balloon catheter until filling of the draining veins adjacent to the shunted points was achieved. The balloon catheters were positioned at the proximal segment of the bilateral ECA to prevent the retrograde collateral flow via the surrounding arteries and to obtain the sufficient penetration of the n-BCA into the draining venous segments. The embolized feeders in each session were as follows: left infraorbital artery, first session (25% n-BCA) and fifth session (20% n-BCA); left transverse FA and left FA, third session (20% n-BCA); left superior labial artery and lateral nasal artery from the left FA, fourth session (17% n-BCA); and left angular (lateral nasal) artery from the left ophthalmic artery, fifth session (20% n-BCA). After the final embolization session, left ECA angiography showed almost complete disappearance of the AVMs . No complications, such as skin/mucosal necrosis or nerve injury or even any functional deficits of the lip occurred other than transient exacerbation of swelling, erythema and small erosion only required topical nonsteroidal anti-inflammatory drugs. Three months after the final session, T2-weighted magnetic resonance imaging showed regression of the previous soft tissue swelling and disappearance of the flow voids. Swelling and erythema of the lip and cheek had also resolved . There was no regrowth during 20 months of follow-up after the last embolization treatment. Fig. 1 Angiograms in Case 1 showing high-flow AVMs with multiple shunts between the arterioles and venules as a complex vascular network (Choโ€™s classification type IIIb) in the left upper lip and cheek. The AVMs were fed by bilateral FAs and the left ICA and drained into bilateral facial and angular veins. a Right facial arteriogram, lateral view, before the first embolization session. Arrow indicates the right SLabA. b Pre-embolization left external carotid arteriogram before the first session. The microcatheter was navigated to the distal feeder from the right SLab A (arrow). c DSA, lateral view, during injection of nBCA under flow control. The nBCA-lipiodol mixture filled the shunting points and the distal draining veins (arrow). d Left external carotid arteriogram after embolization of the right FA after the second session showing devascularization of the AVM. e External carotid arteriogram, lateral view, after embolization of bilateral Slab As showing residual AVMs fed by the IOA (black arrow), greater palatine artery (white arrow), and transverse FA (arrowhead). f Left external carotid arteriogram after embolization of the left IOA from the left MA during the fifth session showing disappearance of the AVM. g Pre-embolization left internal carotid arteriogram during the fifth session. Arrow indicates the angular (lateral nasal) artery originating from the ophthalmic artery. Microcatheter was navigated into distal segment of the feeding artery (arrowhead). h Post-embolization after the fifth session. Left internal carotid arteriogram showing disappearance of the AVM without distal embolism into the cerebral artery and retinal artery (arrow: preserved retinal blush on a magnified image during the venous phase) Fig. 2 ( a ) Frontal view of the patientโ€™s face in Case 1 before treatment showing swelling and erythema of the left upper lip and cheek, but no ulceration. ( b ) Although a small erosion occurred about a week after treatment then a scar remained on the left upper lip, swelling and erythema of the lip and cheek had resolved 6 months after the fifth embolization session. ( c ) T2WI MRI before treatment showing hyperintensity of the soft tissues, which were permeated by massive flow voids representing enlarged feeding and draining vessels. ( d ) Six months after the final session, fat-suppressed T2WI showing regression of the soft tissue swelling and disappearance of the flow voids
4.125
0.918457
sec[1]/sec[0]/p[0]
en
0.999996
36394701
https://doi.org/10.1186/s42155-022-00335-w
[ "session", "artery", "embolization", "flow", "swelling", "cheek", "avms", "carotid", "arteriogram", "arrow" ]
[ { "code": "QB9Y", "title": "Other specified contact with health services for nonsurgical interventions not involving devices" }, { "code": "QB96", "title": "Contact with health services for radiotherapy session" }, { "code": "QB97", "title": "Contact with health services for chemotherapy session for neoplasm" }, { "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": "DD30.Z", "title": "Acute vascular disorders of intestine, unspecified" }, { "code": "JB42.2", "title": "Obstetric blood-clot embolism" } ]
=== ICD-11 CODES FOUND === [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 [QB96] Contact with health services for radiotherapy session Also known as: Contact with health services for radiotherapy session | admission for radiotherapy [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 [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 [DD30.Z] Acute vascular disorders of intestine, unspecified Also known as: Acute vascular disorders of intestine, unspecified | Acute vascular disorders of intestine | acute intestinal ischemia NOS | acute intestinal ischemic syndrome | acute ischaemic bowel disease [JB42.2] Obstetric blood-clot embolism Definition: A condition characterised by the lodging of a blood clot (a specific type of embolus known as a thrombus) in the bloodstream, which can cause a blockage associated with the physiological and other changes that occur during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after delivery during which the uterus returns to the original size (puerperium). Also known as: Obstetric blood-clot embolism | obstetrical blood-clot embolism | blood clot embolism in pregnancy, childbirth or puerperium | puerperal embolism | Puerperal embolism NOS === GRAPH WALKS === --- Walk 1 --- [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB91] Contact with health services for piercing of body site other than ear --- Walk 2 --- [QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB91] Contact with health services for piercing of body site other than ear --- Walk 3 --- [QB96] Contact with health services for radiotherapy session --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB91] Contact with health services for piercing of body site other than ear --- Walk 4 --- [QB96] Contact with health services for radiotherapy session --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB92] Contact with health services for issue of repeat prescription --- Walk 5 --- [QB97] Contact with health services for chemotherapy session for neoplasm --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB92] Contact with health services for issue of repeat prescription --- Walk 6 --- [QB97] Contact with health services for chemotherapy session for neoplasm --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices --CHILD--> [QB91] Contact with health services for piercing of body site other than ear
[ "[QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB91] Contact with health services for piercing of body site other than ear", "[QB9Y] Other specified contact with health services for nonsurgical interventions not involving devices\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB91] Contact with health services for piercing of body site other than ear", "[QB96] Contact with health services for radiotherapy session\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB91] Contact with health services for piercing of body site other than ear", "[QB96] Contact with health services for radiotherapy session\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB92] Contact with health services for issue of repeat prescription", "[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB92] Contact with health services for issue of repeat prescription", "[QB97] Contact with health services for chemotherapy session for neoplasm\n --PARENT--> [?] Contact with health services for nonsurgical interventions not involving devices\n --CHILD--> [QB91] Contact with health services for piercing of body site other than ear" ]
QB9Y
Other specified contact with health services for nonsurgical interventions not involving devices
[ { "from_icd11": "QB9Y", "icd10_code": "Z5181", "icd10_title": "Encounter for therapeutic drug level monitoring" }, { "from_icd11": "QB96", "icd10_code": "Z510", "icd10_title": "Encounter for antineoplastic radiation therapy" }, { "from_icd11": "QB96", "icd10_code": "Z51", "icd10_title": "Encounter for other aftercare and medical care" }, { "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": "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" } ]
Z5181
Encounter for therapeutic drug level monitoring
A 67-year-old White female (Patient 1 in Table 1 ), an ex-smoker with 30-pack year history, first presented to our centre with acute onset vertigo, vomiting, increased confusion and slurring of speech in February 2020. Initial computed tomography (CT) scanning displayed a right cerebellar infarction. Further to the development of facial droop and impulsiveness, the patient had a magnetic resonance imaging (MRI) scan of her brain which showed hemorrhagic transformation with associated mass effect and distortion of the fourth ventricle alongside acute hydrocephalus, and a decompression craniectomy was then performed. In view of the subtle irregularity noted in her internal carotid arteries from the MRI, the patient proceeded to have a CT angiogram of the intracranial blood vessels which revealed internal carotid artery beading and aneurysms suggestive of fibromuscular dysplasia . A CT renal angiogram confirmed further fibromuscular dysplasia changes such as left renal artery beading . The patient was found to be hypertensive. From September 2020 onward, she has been under annual follow-up in the dedicated multidisciplinary fibromuscular dysplasia clinic at our centre. The patient was commenced on antihypertensive agents including a calcium channel blocker (Amlodipine) and a renin-angiotensin system blocker (Irbesartan). In addition, she was also commenced on a lipid lowering agent (Atorvastatin) and a lifelong antiplatelet agent (Clopidogrel). She is planned for repeat imaging of her renal vessels in 2026. Table 1 Summary of cases of patients aged โ‰ฅ 65 years from the Salford FMD registry Patient Age/gender/ethnicity Clinical symptoms and/or initial diagnosis on presentation Comorbidities Angiographic type and lesions identified on CT and/or MRI scan Diagnosis as per FEIRI a Treatment b 1 67 years Female White Headache, was identified with posterior circulation stroke on presentation to hospital Hypertension Multifocal: left renal artery web and fusiform dilatation, irregularity of bilateral internal carotid artery, dissection of basilar artery, aneurysm of the splenic artery, stenosis at the celiac axis and ectatic common iliac artery FMD Medical treatment 2 69 years Female White Pulsatile tinnitus, neck pain, burning of left side of face, was identified with transient ischaemic attack on presentation to hospital Hypertension, hypothyroidism, hypercholesterolaemia Unifocal: bilateral carotid stenosis, atheromatous stenosis of external iliac artery FMD Medical treatment 3 65 years Female White Headache, Chest pain Hypertension, transient ischaemic attack, SCAD Multifocal: irregularities in renal, internal carotid and vertebral arteries FMD + SCAD Medical treatment and coronary angiogram 4 65 years Female White Headache, pulsatile tinnitus, neck pain Recurrent urinary tract infections Multifocal: irregularities in distal main renal and bilateral carotid artery irregularity and beading. Carotid atherosclerosis FMD Medical treatment 5 75 years Female White Headache, pulsatile tinnitus, was identified with stroke on presentation to hospital Type 2 diabetes, hypertension, atrial fibrillation, stable angina Unifocal: renal artery focal stenosis and previous left internal carotid artery para-ophthalmic aneurysm repair. Subsequently found concertina in right internal carotid artery and left middle carotid artery aneurysm. Diffuse atheroma in aorto-iliac segments FMD Medical treatment A left internal carotid para-ophthalmic aneurysm was treated with pipeline stent 6 66 years Female White Chest pain, palpitations Breast cancer, myocardial infarction Multifocal: Irregularity, beading, dissection in the right renal artery, and left renal artery minor proximal irregularity. Irregularity of the proximal external iliac arteries bilaterally (minor) was noted FMD + SCAD Medical treatment 7 68 years Female White Stroke Hypertension, hyperthyroidism, dyslipidaemia Multifocal: evidence of concertina and irregular vessel walls in bilateral internal carotid artery. Minor calcified disease in the celiac artery and superior mesenteric artery FMD Medical treatment 8 73 years Female White Incidental diagnosis of FMD, patient was asymptomatic on presentation Type 2 diabetes mellitus, hypertension, chronic kidney disease Multifocal: irregular beaded stenosis of the distal right renal artery and irregularity of the left distal renal artery FMD Medical treatment 9 78 years Female White Headache, pulsatile tinnitus Type 2 diabetes mellitus, celiac disease, duodenal ulcer, glaucoma with macular degeneration Multifocal: bilateral renal artery aneurysms. Left internal carotid artery appeared with a beaded appearance. Tortuous and beaded external iliac arteries FMD Medical treatment 10 80 years Female White Incidental diagnosis of FMD, patient was asymptomatic on presentation Aortic stenosis, Transient ischaemic attack, Hypertension Multifocal: beading of right renal artery. Saccular aneurysm of infrarenal aorta. Irregularity of both external iliac arteries FMD Medical treatment FMD fibromuscular dysplasia, SCAD spontaneous coronary artery dissection a Refers to diagnostic criteria recommended by the international consensus guidelines on FMD b Medical treatment refers to the prescription of antiplatelet, antihypertensive and a lipid-lowering agent, which is the standard medical treatment regimen in FMD as per current guidelines Fig. 1 CT findings suggestive of FMD in the clinical case. A Internal carotid artery beading and aneurysms displayed on CT intracranial angiogram. B Left renal artery beading displayed in a 3-dimensional reconstruction model of the CT image. CT computed tomography, FMD fibromuscular dysplasia
4.082031
0.960938
sec[0]/p[1]
en
0.999996
39090388
https://doi.org/10.1007/s40620-024-02039-x
[ "artery", "carotid", "renal", "white", "irregularity", "multifocal", "beading", "hypertension", "stenosis", "iliac" ]
[ { "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": "8D88.Y", "title": "Other specified autonomic neuropathies" }, { "code": "8B10.Y", "title": "Other specified transient ischaemic attack" }, { "code": "2F9A", "title": "Neoplasms of unknown behaviour of endocrine glands" }, { "code": "BD55", "title": "Asymptomatic stenosis of intracranial or extracranial artery" }, { "code": "NA60.00", "title": "Laceration of carotid artery, minor" } ]
=== 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 [8D88.Y] Other specified autonomic neuropathies Also known as: Other specified autonomic neuropathies | Autonomic neuropathy due to Fabryโ€™s Disease | Autonomic neuropathy due to Refsumโ€™s Disease | Autonomic neuropathy due to Allgrove syndrome | Autonomic neuropathy due to Tangierโ€™s disease [8B10.Y] Other specified transient ischaemic attack Also known as: Other specified transient ischaemic attack | Vertebrobasilar artery syndrome | vertebrobasilar arterial insufficiency | vertebrobasilar insufficiency | vertebro-basilar artery syndrome, course of resolution unspecified [2F9A] Neoplasms of unknown behaviour of endocrine glands Also known as: Neoplasms of unknown behaviour of endocrine glands | endocrine gland tumour NOS | Neoplasms of unknown behaviour of thyroid gland | thyroid gland tumour NOS | Neoplasms of unknown behaviour of adrenal gland [BD55] Asymptomatic stenosis of intracranial or extracranial artery Definition: Stenosis of intracranial or extracranial artery that has not caused TIA or cerebral ischemic stroke. Also known as: Asymptomatic stenosis of intracranial or extracranial artery | stenosis of carotid artery NOS | stenosis of internal carotid artery NOS | stenosis of precerebral arteries, not resulting in cerebral infarction | narrowing of basilar, carotid or vertebral arteries, not resulting in cerebral infarction Includes: narrowing of basilar, carotid or vertebral arteries, not resulting in cerebral infarction Excludes: Transient ischaemic attack | Cerebral ischaemic stroke [NA60.00] Laceration of carotid artery, minor Also known as: Laceration of carotid artery, minor | incomplete transection of carotid artery | laceration of carotid artery NOS | superficial laceration of carotid artery Includes: incomplete transection of carotid artery | laceration of carotid artery NOS | superficial laceration of carotid artery === GRAPH WALKS === --- Walk 1 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD30] Acute arterial occlusion --- Walk 2 --- [BD5Z] Diseases of arteries or arterioles, unspecified --PARENT--> [?] Diseases of arteries or arterioles --CHILD--> [BD30] Acute arterial occlusion --- Walk 3 --- [BD52] Certain specified disorders of arteries or arterioles --CHILD--> [BD52.0] Segmental arterial mediolysis Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys... --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --- Walk 4 --- [BD52] Certain specified disorders of arteries or arterioles --CHILD--> [BD52.0] Segmental arterial mediolysis Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys... --PARENT--> [BD52] Certain specified disorders of arteries or arterioles --- Walk 5 --- [BD52.3] Rupture of artery --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --EXCLUDES--> [?] Stress fracture, not elsewhere classified --- Walk 6 --- [BD52.3] Rupture of artery --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --EXCLUDES--> [?] Pathological fracture
[ "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion", "[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion", "[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.0] Segmental arterial mediolysis\n Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys...\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles", "[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.0] Segmental arterial mediolysis\n Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys...\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles", "[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Stress fracture, not elsewhere classified", "[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Pathological fracture" ]
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 65โ€yearโ€old man with diabetic nephropathy and on triweekly maintenance dialysis presented to our hospital with complaints of fever and cough. Oropharyngeal swabs collected on the same day tested positive by the reverse transcriptaseโ€polymerase chain reaction (RTโ€PCR), while computed tomography of the chest revealed infiltrative shadows in the inferior lobe of the left lung . COVIDโ€19 was thus diagnosed, and the patient was admitted to a specialized COVIDโ€19 ward where a team of specialists commenced treatment. All rooms in the specialized COVIDโ€19 ward were private rooms with constant pressure control. Zoning was also strictly enforced for control of infection transmission . Treatment for COVIDโ€19 was provided according to Japan's guidelines for novel coronavirus infection and composed of favipiravir, which has also been reported to be effective for COVIDโ€19 in China for 14 days from the day of admission. 7 After administration, we observed no marked change in the patient's subjective symptoms or vital signs, including his respiratory status. However, on day 21 of admission, we observed a sudden decrease in blood pressure, a large volume of blackish feces, and progression of anemia. We had avoided an endoscopy until then, but the patient's condition suggested possible hemorrhagic shock due to upper gastrointestinal bleeding. Thus, after deliberation, an emergency endoscopy was performed in the patient's hospital room (located in the contamination zone of a specialized COVIDโ€19 ward) after informed consent was obtained. We estimated that the endoscopy would pose an extremely high risk of transmission to the medical staff and undertook the procedure in full PPE including a respirator, double gloves, hairnet, water disposable gown, and shoe covers as recommended by various academic societies (Asianโ€Pacific Society for Digestive Endoscopy, World Endoscopy Organization, American Society for Gastrointestinal Endoscopy, British Society of Gastroenterology, and others). 2 In addition, we employed closerโ€fitting protective masks with integrated respirators and face shields . The endoscopeโ€related components used, including the light source and scope, were taken from an endoscopy room where routine examinations were performed, although the light source was covered entirely in plastic before introducing it to the COVIDโ€19 ward to minimize exposure to aerosols . Two experienced physicians, who were certified endoscopy specialists, and one physician from the special COVIDโ€19 treatment team were selected to perform the examination. An oral endoscope was chosen for the examination because procedural tools would be required in the case of active bleeding. We performed the examination while the patient was awake because shock vital signs were observed. No barriers were used on the patient side during the examination. Recently, several ideas for improving barriers to be placed on the patient side have been reported. 8 , 9 However, no reports on such ideas were available when we performed the endoscopy. The examination was performed in the patient's room with the layout shown in Figure 2b . The examination was completed approximately 3 min after no active bleeding was found from the oral cavity to the horizontal part of the duodenum. Zoning was also strictly enforced after completing the examination, and the PPE were removed with the medical staff observing each other to ensure that no unclean surfaces touched clean surfaces. Regarding the endoscopeโ€related components used in the examination, small components and plastics were destroyed in the contamination zone, while the scope and light source were wiped thoroughly with 80% ethanol wipes followed by 0.5% accelerated hydrogen peroxide solution wipes. The light source was then transferred to the routine examination room; the scope was sealed in a bag, taken to the cleaning room, washed as usual (according to the โ€˜WGO Practice Guidelineโ€”Endoscope Disinfectionโ€™ issued by the World Gastroenterology Organization) by staff wearing full PPE, and then sterilized using 0.3% peracetic acid. The physicians who performed the examination and staff who washed the scope were considered as noncontacts because they were wearing full PPE. They started working as usual from the next day, and they measured and reported their temperature and conditions strictly for 2 weeks. The patient's vital signs subsequently improved with fluid replacement therapy alone. Although the possibility of small intestinal hemorrhage could not be ruled out, due to the anticipated length of time needed to perform an enteroscopy, the associated risk of transmission was deemed too high even with proper measures in place; hence, we decided to monitor the patient's progress. In addition, after the examination, aspirin and heparin calcium, which had been administered before examination, were discontinued, and the dose of vonoprazan fumarate, which had also been administered before examination, was increased from 10 to 20 mg. It was fortunate that following the examination, no findings were observed that would otherwise suggest gastrointestinal bleeding. On day 5 after examination, meals were resumed. A PCR test on day 38 was negative, but a PCR test on day 39 returned a positive result. While another PCR test on day 41 also returned a positive result, based on the high threshold value of this test, we decided that the quantity of RNA was small and posed a minimal risk of transmission; the patient was discharged on day 43. In addition, we closely monitored the health status of all attending medical staff as stipulated by various academic societies and noted no symptoms suggestive of COVIDโ€19.
4.007813
0.961914
sec[1]/p[0]
en
0.999998
35310147
https://doi.org/10.1002/deo2.2
[ "covid", "endoscopy", "room", "that", "staff", "while", "ward", "transmission", "bleeding", "endoscope" ]
[ { "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": "PK93.1Y", "title": "Other specified gastroenterology or urology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices" }, { "code": "PK93.0", "title": "Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices" }, { "code": "QE50.3", "title": "Relationships with neighbours, tenant or landlord" }, { "code": "PL14.E", "title": "Fall in health care" }, { "code": "PA40.1&XE98K", "title": "Unintentional water transport injury event due to excessive heat in engine room" } ]
=== 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 [PK93.1Y] Other specified gastroenterology or urology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices Also known as: Other specified gastroenterology or urology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices | Gastroenterology or urology devices associated with injury or harm, gastrostomy tube | Gastroenterology or urology devices associated with injury or harm, therapeutic nasogastric or nasojejunal tube | NG -[nasogastric] tube | NJ - [nasojejunal] tube [PK93.0] Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices Also known as: Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices | Gastroenterology or urology devices associated with injury or harm, cystoscope | Gastroenterology or urology devices associated with injury or harm, rectal manometer | Gastroenterology or urology devices associated with injury or harm, capsule endoscopy | Gastroenterology or urology devices associated with injury or harm, esophageal manometer Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [QE50.3] Relationships with neighbours, tenant or landlord Also known as: Relationships with neighbours, tenant or landlord | discord with tenant | discord with room-mate | discord with neighbours | discord with lodgers [PL14.E] Fall in health care Also known as: Fall in health care | fall in hospital | Fall from chair in health care or hospital | Fall from stretcher in health care or hospital | Fall from hospital bed === GRAPH WALKS === --- Walk 1 --- [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Coronavirus infection, unspecified site --EXCLUDES--> [?] COVID-19, virus not identified --- Walk 2 --- [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Coronavirus infection, unspecified site --EXCLUDES--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to... --- Walk 3 --- [RA02] Post COVID-19 condition Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont... --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use --CHILD--> [RA02] Post COVID-19 condition Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont... --- Walk 4 --- [RA02] Post COVID-19 condition Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont... --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use --CHILD--> [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --- Walk 5 --- [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --CHILD--> [RA01.1] COVID-19, virus not identified --EXCLUDES--> [?] Coronavirus infection, unspecified site --- Walk 6 --- [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --CHILD--> [RA01.0] COVID-19, virus identified --PARENT--> [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--> [?] Coronavirus infection, unspecified site\n --EXCLUDES--> [?] COVID-19, virus not identified", "[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site\n --EXCLUDES--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...", "[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...", "[RA02] Post COVID-19 condition\n Def: Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms, and that last for at least 2 mont...\n --PARENT--> [?] International provisional assignment of new diseases of uncertain aetiology and emergency use\n --CHILD--> [RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...", "[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --CHILD--> [RA01.1] COVID-19, virus not identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site", "[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --CHILD--> [RA01.0] COVID-19, virus identified\n --PARENT--> [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": "PK93.0", "icd10_code": "Y730", "icd10_title": "Diagnostic and monitoring gastroenterology and urology devices associated with adverse incidents" }, { "from_icd11": "QE50.3", "icd10_code": "Z592", "icd10_title": "Discord with neighbors, lodgers and landlord" } ]
Z1159
Encounter for screening for other viral diseases
This case presented with the uncommon clinical signs of inflammatory breast involvement similarly described by Samli et al. ( 5 ). In this age group, the common inflammatory breast pathologies are cellulitis, mastitis or breast abscess. However, apart from the breast edema and skin erythema, the patient displayed no other signs of infection such as fever, chills or leukocytosis. She also did not have risk factor for mastitis such as lactation. Furthermore, the axillary lymphadenopathy, with loss of fatty hilum seen on ultrasound was highly suspicious of a malignant etiology. Reactive nodes due to infection, though enlarged, should have preservation of the fatty hilum. Among those cases reported in the literature, mammographic findings have been frequently described ( 3 , 4 , 6 - 13 ), but ultrasonographic findings have been reported in a few studies only ( 4 , 7 - 11 ). Mammographically, this condition has been reported as a dense, lobulated mass with a partially ill-defined margin ( 4 , 10 , 11 , 13 ). Calcification and a spiculated border are also other documented mammographic findings ( 8 , 11 ). Mammography was not performed in this case because of the patientโ€™s young age and the high reliability of ultrasound in characterizing and detecting both solid and cystic components ( 4 ). The subsequent ultrasonographic findings reported by Rubini et al. also showed a cyst-containing mass with intracystic tracts ( 7 ). However, in the more recent papers, the lesions were generally described as solid hypoechoic masses with well or ill-defined borders and microlobulations of the tumor margin ( 8 - 11 ). Posterior acoustic shadowing, a sonographic feature typically associated with breast carcinoma, was not documented in previous literature. On the other hand, posterior acoustic enhancement was a common feature described by few authors ( 9 - 11 ). Mizukami et al. explained that the posterior acoustic enhancement reflects the high cellularity of the tumor cells ( 10 ). Our ultrasound examination revealed a solid, mildly lobulated hypoechoic mass with partially well-delineated borders. The mass contained few small cystic areas and few echogenic foci. The mass exhibited normal sound transmission (no acoustic phenomena). The cystic areas were probably the result of tissue necrosis which was revealed histologically, while the internal echogenic foci most likely represent air or hemorrhagic spots following the core biopsy performed just prior to the ultrasound examination. Doppler sonography has been helpful in differentiating between benign and malignant breast lesions. The greater number of vessels and presence of penetrating vessels are characteristic patterns of vascularity that are more commonly seen in malignant lesions ( 14 , 15 ). However, these malignant characteristics were not elicited in the color-Doppler study of this case. Instead, we noted poor vascularity within the tumor and absence of penetrating vessels. The flow signals seen surrounding the tumor reflects increased vascularity of the surrounding breast stroma. To date, literature on Doppler sonography of the neuroendocrine tumor of the breast is not available for comparison or review and there has been only one reported MR finding of this rare tumor in the English literature. Bilgen et al. in their retrospective review of an MR examination performed on a non-palpable histologically proven primary neuroendocrine carcinoma of the breast, described the lesion as having irregular margins and showing homogeneous contrast enhancement with a time-intensity curve that showed early enhancement suggestive of malignancy ( 11 ). Immunohisto chemically, the cells of neuroendocrine tumor will show immunore activity for specific markers of endocrine differentiation. However, there is no consistent pattern of neuroendocrine marker expression in primary neuroendocrine breast carcinoma ( 2 ). In this case, the tumor showed a positive reaction to synaptophysin, chromogranin and cytokeratin MNF116. It also showed a high nuclear-to-cytoplasmic ratio, hyperchromatic nuclei and a high mitotic rate. Histologically, it is not possible to distinguish a metastatic and primary neuroendocrine tumor of the breast ( 6 ). The diagnosis of primary breast tumor is made on the basis of radiologic findings that exclude other non-mammary tumors and presence of an in situ component demonstrated within the breast histopathologically ( 2 , 10 ). Generally, this tumor is considered clinically aggressive with dismal prognosis. As observed in this case, previous authors have also reported rapid progression or recurrence of this disease locally and distally, and a short survival period ( 1 , 4 , 6 , 15 ). However, as in breast carcinoma of the usual type, size is a very important prognostic factor for this tumor ( 3 ). In more recent reports, it seems that the prognosis is better if the tumors are detected early and if there is no lymph node metastasis ( 3 , 8 ). As for the management, there is still no established standard treatment protocol because so few cases have been described. As this entity resembles small cell lung carcinoma in morphology, clinical behavior and histiogenesis, it seems reasonable that their treatment should be similar ( 2 ). Thus, our patient was given chemotherapy using protocol for small cell lung carcinoma. Surgical excision may be implemented if the tumor responds well to chemotherapy and becomes operable. Unfortunately, in the presented case, chemotherapy failed to control the tumor and the disease followed a rapid and fatal course. The prognosis in this case is governed by the clinical stage of the disease at presentation.
4.300781
0.714844
sec[2]/p[1]
en
0.999996
23408015
https://doi.org/10.5812/iranjradiol.8517
[ "breast", "tumor", "this", "carcinoma", "that", "neuroendocrine", "however", "ultrasound", "malignant", "literature" ]
[ { "code": "GB23", "title": "Certain specified disorders of breast" }, { "code": "GB21.Z", "title": "Inflammatory disorders of breast, unspecified" }, { "code": "GB21.Y", "title": "Other specified inflammatory disorders of breast" }, { "code": "QF01.0", "title": "Acquired absence of breast" }, { "code": "GB23.3", "title": "Atrophy of breast" }, { "code": "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 === [GB23] Certain specified disorders of breast Definition: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere. Also known as: Certain specified disorders of breast | disease of breast | mastopathy [GB21.Z] Inflammatory disorders of breast, unspecified Also known as: Inflammatory disorders of breast, unspecified | Inflammatory disorders of breast | breast inflammation | inflammatory breast disease | mastitis NOS [GB21.Y] Other specified inflammatory disorders of breast Also known as: Other specified inflammatory disorders of breast | Breast antibioma | Infective mastitis | acute infective mastitis | nonpuerperal infective mastitis [QF01.0] Acquired absence of breast Also known as: Acquired absence of breast | absence of breast | mastectomy status | Acquired absence of breast, partial | Acquired absence of breast, total [GB23.3] Atrophy of breast Definition: A condition of the breast, caused by apoptosis of the cells commonly due to prolonged estrogen reduction, diminished cellular proliferation, decreased cellular volume, decreased function, ischaemia, malnutrition, disease, or mutation. This condition is characterised by a partial or complete decrease in size and function of the breast tissue. Also known as: Atrophy of breast | Hypoplasia of breast | hypoplastic breast | mammary hypoplasia [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 --- [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --CHILD--> [GB23.1] Fissure or fistula of nipple Def: A condition characterised by the formation of a deep furrow or crack-like lesion on the nipple and an abnormal passage between the nipple and adjacent tissues or surfaces.... --PARENT--> [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --- Walk 2 --- [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --CHILD--> [GB23.0] Mammary duct ectasia Def: A condition of the breast, caused by lipid and cellular debris or secretory (such as colostrum) stasis, or a nonspecific duct widening process. This condition is characterised by obstruction and subse... --PARENT--> [GB23] Certain specified disorders of breast Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.... --- Walk 3 --- [GB21.Z] Inflammatory disorders of breast, unspecified --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --CHILD--> [GB21.0] Breast abscess Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ... --- Walk 4 --- [GB21.Z] Inflammatory disorders of breast, unspecified --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --CHILD--> [GB21.0] Breast abscess Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ... --- Walk 5 --- [GB21.Y] Other specified inflammatory disorders of breast --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --PARENT--> [?] Disorders of breast Def: Any disorder characterised by pathological changes to the breast or breast tissue.... --- Walk 6 --- [GB21.Y] Other specified inflammatory disorders of breast --PARENT--> [GB21] Inflammatory disorders of breast Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function.... --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth
[ "[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --CHILD--> [GB23.1] Fissure or fistula of nipple\n Def: A condition characterised by the formation of a deep furrow or crack-like lesion on the nipple and an abnormal passage between the nipple and adjacent tissues or surfaces....\n --PARENT--> [GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....", "[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --CHILD--> [GB23.0] Mammary duct ectasia\n Def: A condition of the breast, caused by lipid and cellular debris or secretory (such as colostrum) stasis, or a nonspecific duct widening process. This condition is characterised by obstruction and subse...\n --PARENT--> [GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....", "[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.0] Breast abscess\n Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...", "[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.0] Breast abscess\n Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...", "[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --PARENT--> [?] Disorders of breast\n Def: Any disorder characterised by pathological changes to the breast or breast tissue....", "[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth" ]
GB23
Certain specified disorders of breast
[ { "from_icd11": "GB23", "icd10_code": "N6459", "icd10_title": "Other signs and symptoms in breast" }, { "from_icd11": "GB23", "icd10_code": "N6489", "icd10_title": "Other specified disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N6481", "icd10_title": "Ptosis of breast" }, { "from_icd11": "GB23", "icd10_code": "N6482", "icd10_title": "Hypoplasia of breast" }, { "from_icd11": "GB23", "icd10_code": "N6452", "icd10_title": "Nipple discharge" }, { "from_icd11": "GB23", "icd10_code": "N6451", "icd10_title": "Induration of breast" }, { "from_icd11": "GB23", "icd10_code": "N6453", "icd10_title": "Retraction of nipple" }, { "from_icd11": "GB23", "icd10_code": "N64", "icd10_title": "Other disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N648", "icd10_title": "Other specified disorders of breast" }, { "from_icd11": "GB23", "icd10_code": "N645", "icd10_title": "Other signs and symptoms in breast" }, { "from_icd11": "GB21.Z", "icd10_code": "N610", "icd10_title": "Mastitis without abscess" }, { "from_icd11": "GB21.Z", "icd10_code": "N611", "icd10_title": "Abscess of the breast and nipple" }, { "from_icd11": "GB21.Z", "icd10_code": "N61", "icd10_title": "Inflammatory disorders of breast" }, { "from_icd11": "QF01.0", "icd10_code": "Z9012", "icd10_title": "Acquired absence of left breast and nipple" }, { "from_icd11": "QF01.0", "icd10_code": "Z9011", "icd10_title": "Acquired absence of right breast and nipple" } ]
N6459
Other signs and symptoms in breast
A 3-year-old boy presented to the emergency department with an episode of melena and black tarry stools. He had experienced similar symptoms a year prior and had undergone several examinations, including colonoscopy and Tc-99m pertechnetate scintigraphy . The colonoscopy findings were normal, and scintigraphy revealed nonspecific findings with some parts of the small intestine enhanced but not spotted. We suspected it was a small intestinal hemorrhage. The patient was discharged from the hospital and scheduled to undergo esophagogastroscopy and capsule endoscopy to identify the root cause. After readmission to the emergency department, his blood analysis revealed a hemoglobin level of 9.6 mg/dL (from 13 mg/dL), leukocyte count of 9.2 ร— 10 9 /L, and creatinine level of 0.28 mg/dL, and a urea nitrogen level of 20.7 mg/dL. Enhanced abdominal CT revealed an edematous small intestine with extravasation into the lumen of the small intestine . Although angiography via the femoral artery was performed immediately and the hypervascular lesion was detected in the area consistent with that on the enhanced CT, the extravasation resolved by that time . The patient received an overnight transfusion of 240 mL of red blood cells (RBCs), but his hemoglobin level did not increase. We performed trans-anal double-balloon enteroscopy under general anesthesia because the hypervascular lesion was located in the ileum on the enhanced CT. Although no specific findings were observed from the Bauhin valve to the 100 cm ileum on the mucosal side, the poor operability of the endoscope indicated that an extramural disease could be present. Exploratory laparotomy was immediately performed through an umbilical incision. The tubular duplication was adjacent to a 40- to 200-cm portion of the small intestine and connected at one end . The relation between the duplication and the normal intestine and the length of the intestines were checked from both directions: from the Treitz ligament to terminal ileum and terminal ileum to the Treitz ligament, and the normal intestines without the duplication were 40 cm jejunum and 130 cm ileum . The classifications of the relationship to the mesenteric vessels and duplication were mostly type 1b, with some types 1c and 2a . We first encircled the mucosa of the center of the type 1b duplication and dissected the oral side with incisions to the mesentery and the muscular layer of the duplication . The mucosa of the 2a duplications (10 cm) was cored from the same incision without mesenteric injury. The remaining intestine was dissected along the anal side. For the type 1c duplication, we resected the duplication with the adjacent intestine (5 cm) and performed end-to-end anastomosis using simple interrupted sutures because it was challenging to preserve the adjacent intestine . The operative time was 6 h (without endoscopy), and there was 200 mL of additional blood loss. The transfusions included RBCs (150 mL) and fresh frozen plasma (FFP; 140 mL). The pathological findings indicated that most duplications involved the gastric mucosa . The type 1b duplication site was dissected on the submucosal layer . The anal side of the duplication was connected to the adjacent intestine, and an ulcer was located at the center of the two orifices . The ulcer contained a ruptured arterial vessel, similar to a Dieulafoy ulcer . The patient was extubated on postoperative day (POD) 0, and normal feeding was started on POD 4. The hemoglobin level remained stable at 13 mg/dL. No surgical complications were observed, and the patient was discharged on POD 7. Two months postoperatively, follow-up found that the patient had no symptoms or complications. Fig. 1 Preoperative images: a Tc-99m pertechnetate scintigraph. A part of the intestine is diffusely contrasted. b Enhanced CT showing extravasation into the small intestine (arrow) and the hypervascular lesion (dotted circle). c Arterial angiography indicating no remarkable extravasation. d Tran-sanal double-balloon enteroscopy showing no obvious abnormality on the mucosal side from the Bauhin valve up to 100 cm into the small intestine Fig. 2 Operative findings: a the long tubular duplication located beside the intestine (160 cm). The classifications in the relation to the mesenteric vessels are primarily type 1b, with some type 1c and type 2a. b The schema of the duplication and intestine. The duplication is adjacent to a 40- to 200-cm portion of the small intestine and connected at one end. c Wrenn procedure, in which the mucosa of the duplication was stripped. d The mucosa of type 1b and type 2a duplications were resected using the Wrenn procedure (mucosal stripping of the duplication) and the type 1c duplication was resected with the adjacent intestine (5 cm) and end-to-end anastomosis Fig. 3 The pathological findings from the duplications. a The type 1b and type 2a duplications. Almost all the duplications include gastric mucosa. The duplication is on the dissected submucosal layer. b The macroscopic (left) and microscopic (right) findings of the anal side of the duplication. The duplication connects to the adjacent intestine via two orifices (asterisks). An ulcer is located in the center of the orifices (arrow). Most of the duplication contains gastric mucosa (black triangle) while the adjacent intestine has normal mucosa (white triangle). c The ruptured arterial vessel in the ulcer (high-power field). The ruptured vessel opens to the lumen of the intestine with fibrin clots (left, hematoxylinโ€“eosin staining). Elastic Van Gieson staining showing that the ruptured vessel contains elastic fibers as an arterial vessel (right)
4.0625
0.971191
sec[1]/p[0]
en
0.999998
38302853
https://doi.org/10.1186/s40792-024-01829-6
[ "duplication", "intestine", "type", "small", "adjacent", "mucosa", "that", "side", "duplications", "enhanced" ]
[ { "code": "LB30.5", "title": "Accessory kidney" }, { "code": "LD2G", "title": "Conjoined twins" }, { "code": "LB12.Y", "title": "Other specified structural developmental anomalies of oesophagus" }, { "code": "LB14", "title": "Structural developmental anomalies of duodenum" }, { "code": "LB17.Y", "title": "Other specified structural developmental anomalies of anal canal" }, { "code": "DA96.05", "title": "Intestinal failure" }, { "code": "DB30.Y", "title": "Other specified obstruction of large intestine" }, { "code": "DD3Z", "title": "Ischaemic vascular disorders of intestine, unspecified" }, { "code": "DD30.Z", "title": "Acute vascular disorders of intestine, unspecified" }, { "code": "DA93.0", "title": "Paralytic ileus" } ]
=== ICD-11 CODES FOUND === [LB30.5] Accessory kidney Also known as: Accessory kidney | extra kidney | supernumerary kidney | kidney duplication | triple kidneys [LD2G] Conjoined twins Definition: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth. Also known as: Conjoined twins | siamese twin | twin fusion | Thoracopagus | thorax-joined twins [LB12.Y] Other specified structural developmental anomalies of oesophagus Also known as: Other specified structural developmental anomalies of oesophagus | Absence of oesophagus | Agenesis of oesophagus | Congenital displacement of oesophagus | Duplication of oesophagus [LB14] Structural developmental anomalies of duodenum Definition: Any congenital defect of duodenum that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in type and severity, and are caused by a wide variety of determining factors, including genetic mutations, chromosomal aberrations, teratogenic agents, and environmental factors. Most developmental defects are apparent at birth, especially any structural malformation, but some become evident later. Also known as: Structural developmental anomalies of duodenum | Malformations of duodenum | congenital abnormality of duodenum | duodenal deformity | Atresia of duodenum [LB17.Y] Other specified structural developmental anomalies of anal canal Also known as: Other specified structural developmental anomalies of anal canal | Rectal duplication | Rectal duplication cyst | Congenital fistula of rectum | Congenital fistula of anus [DA96.05] Intestinal failure Definition: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth. Also known as: Intestinal failure [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 [DD3Z] Ischaemic vascular disorders of intestine, unspecified Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS [DD30.Z] Acute vascular disorders of intestine, unspecified Also known as: Acute vascular disorders of intestine, unspecified | Acute vascular disorders of intestine | acute intestinal ischemia NOS | acute intestinal ischemic syndrome | acute ischaemic bowel disease [DA93.0] Paralytic ileus Definition: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need to be complete, but the intestinal muscles must be so inactive that it leads to a functional blockage of the intestine. Also known as: Paralytic ileus | adynamic ileus | Paralytic ileus of bowel | ileus NOS | paralysis of bowel Excludes: Obstructive ileus of small intestine due to impaction | Gallstone ileus of small intestine === GRAPH WALKS === --- Walk 1 --- [LB30.5] Accessory kidney --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 2 --- [LB30.5] Accessory kidney --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 3 --- [LD2G] Conjoined twins Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth.... --PARENT--> [?] Multiple developmental anomalies or syndromes Def: Complex developmental anomalies involving more than one body system... --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.... --- Walk 4 --- [LD2G] Conjoined twins Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth.... --PARENT--> [?] Multiple developmental anomalies or syndromes Def: Complex developmental anomalies involving more than one body system... --CHILD--> [LD21] Syndromes with eye anomalies as a major feature Def: Any syndrome caused by failure of one or both eyes to correctly develop during the antenatal period.... --- Walk 5 --- [LB12.Y] Other specified structural developmental anomalies of oesophagus --PARENT--> [LB12] Structural developmental anomalies of oesophagus Def: Any congenital defect of oesophagus that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly i... --CHILD--> [LB12.0] Congenital oesophageal web or ring Def: A rare form of incomplete oesophageal obstruction due to a developmental defect of the primitive foregut that presents as a mucosal lesion forming an incomplete diaphragm. Symptoms (apparent from birt... --- Walk 6 --- [LB12.Y] Other specified structural developmental anomalies of oesophagus --PARENT--> [LB12] Structural developmental anomalies of oesophagus Def: Any congenital defect of oesophagus that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly i... --CHILD--> [LB12.2] Oesophageal fistula without atresia Def: This is a birth defect (congenital anomaly) of oesophagus, and one type of EA/TEF, namely isolated "H"-shaped atresia. Tracheoesophageal fistula in which there is no oesophageal atresia because the oe...
[ "[LB30.5] Accessory kidney\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....", "[LB30.5] Accessory kidney\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....", "[LD2G] Conjoined twins\n Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth....\n --PARENT--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...\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....", "[LD2G] Conjoined twins\n Def: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth....\n --PARENT--> [?] Multiple developmental anomalies or syndromes\n Def: Complex developmental anomalies involving more than one body system...\n --CHILD--> [LD21] Syndromes with eye anomalies as a major feature\n Def: Any syndrome caused by failure of one or both eyes to correctly develop during the antenatal period....", "[LB12.Y] Other specified structural developmental anomalies of oesophagus\n --PARENT--> [LB12] Structural developmental anomalies of oesophagus\n Def: Any congenital defect of oesophagus that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly i...\n --CHILD--> [LB12.0] Congenital oesophageal web or ring\n Def: A rare form of incomplete oesophageal obstruction due to a developmental defect of the primitive foregut that presents as a mucosal lesion forming an incomplete diaphragm. Symptoms (apparent from birt...", "[LB12.Y] Other specified structural developmental anomalies of oesophagus\n --PARENT--> [LB12] Structural developmental anomalies of oesophagus\n Def: Any congenital defect of oesophagus that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly i...\n --CHILD--> [LB12.2] Oesophageal fistula without atresia\n Def: This is a birth defect (congenital anomaly) of oesophagus, and one type of EA/TEF, namely isolated \"H\"-shaped atresia. Tracheoesophageal fistula in which there is no oesophageal atresia because the oe..." ]
LB30.5
Accessory kidney
[ { "from_icd11": "LB30.5", "icd10_code": "Q630", "icd10_title": "Accessory kidney" }, { "from_icd11": "LB30.5", "icd10_code": "Q63", "icd10_title": "Other congenital malformations of kidney" }, { "from_icd11": "LD2G", "icd10_code": "Q894", "icd10_title": "Conjoined twins" }, { "from_icd11": "LB14", "icd10_code": "Q410", "icd10_title": "Congenital absence, atresia and stenosis of duodenum" }, { "from_icd11": "LB14", "icd10_code": "Q434", "icd10_title": "Duplication of intestine" }, { "from_icd11": "DD3Z", "icd10_code": "K559", "icd10_title": "Vascular disorder of intestine, unspecified" }, { "from_icd11": "DD3Z", "icd10_code": "K558", "icd10_title": "Other vascular disorders of intestine" }, { "from_icd11": "DD3Z", "icd10_code": "K55-K64", "icd10_title": "" }, { "from_icd11": "DD3Z", "icd10_code": "K55", "icd10_title": "Vascular disorders of intestine" }, { "from_icd11": "DD30.Z", "icd10_code": "K55019", "icd10_title": "Acute (reversible) ischemia of small intestine, extent unspecified" }, { "from_icd11": "DD30.Z", "icd10_code": "K55029", "icd10_title": "Acute infarction of small intestine, extent unspecified" }, { "from_icd11": "DD30.Z", "icd10_code": "K55069", "icd10_title": "Acute infarction of intestine, part and extent unspecified" }, { "from_icd11": "DD30.Z", "icd10_code": "K55021", "icd10_title": "Focal (segmental) acute infarction of small intestine" }, { "from_icd11": "DD30.Z", "icd10_code": "K55039", "icd10_title": "Acute (reversible) ischemia of large intestine, extent unspecified" }, { "from_icd11": "DD30.Z", "icd10_code": "K55059", "icd10_title": "Acute (reversible) ischemia of intestine, part and extent unspecified" } ]
Q630
Accessory kidney
A 71-year-old man with diabetes mellitus presented with severe claudication of both lower limbs. The patientโ€™s ankleโ€“brachial index (ABI) was 0.41 on the right side and 0.43 on the left side. Contrast-enhanced computed tomography (CT) showed severe stenosis of the right external iliac artery (EIA) and total occlusion of the superficial femoral artery (SFA) . On the left side, there was a long segment of total occlusion from the common iliac artery (CIA) ostium to the distal EIA . The right EIA was initially treated by BNS, followed by EVT to the left iliac CTO using a TRA . A 120-cm 6Fr guiding sheath (Destination Slenderยฎ guiding sheath; Terumo, Tokyo) was inserted into the left radial artery. After insertion of the guiding sheath, 5000 units of heparin were administered, and an additional 1000 units were provided every hour, throughout the procedure. Control angiography showed total occlusion of the left proximal CIA . First, a 0.014-inch guidewire (Halberdยฎ guidewire; Asahi Intec, Aichi, Japan) and a 150-cm 2.6Fr microcatheter (Zizaiยฎ microcatheter; Terumo) with a 130-cm 5Fr support catheter (Glidecathยฎ diagnostic catheter; Terumo) was advanced into the CIA to the EIA CTO . After the guidewire reached the distal EIA, small balloon dilation was performed, and intravascular ultrasonography (IVUS) (Navifocus WRยฎ IVUS; Terumo) was used to observe the position of the guidewire in the CTO lesion . The IVUS showed that the guidewire was in the true lumen of the CIA to the middle EIA, but in the subintimal space of the distal EIA . The left CFA was punctured using a 21-G needle (Merit Advanceยฎ angiography needle; Merit Medical, Tokyo, Japan), and a 0.014-inch guidewire (Gladius MGESยฎ guidewire; Asahi Intec) was inserted. Then the needle was exchanged for a 2.6Fr microcatheter (Ichibanyari PAD2ยฎ microcatheter; Kaneka, Tokyo, Japan) for a sheathless retrograde technique. Next, a 0.014-inch CTO guidewire (Halberdยฎ guidewire; Asahi Intec) was inserted to perform the IVUS-guided parallel-wiring technique using antegrade IVUS and a retrograde guidewire . While observing the antegrade IVUS images , the retrograde guidewire was advanced into the lumen of the EIA, and guidewire externalization was finally achieved by the rendezvous technique in the CTO . After dilation with a small balloon, a 300-cm 0.014-inch guidewire (Gladius MGESยฎ guidewire; Asahi Intec) was advanced into the SFA, and the lesion was pre-dilated with a 6.0 ร— 40-mm balloon (Senriยฎ balloon; Terumo). Then, intravascular balloon occlusion using a 6.0 ร— 40-mm balloon in the CFA and manual compression were performed for hemostasis of the retrograde puncture site . Manual compression was also used during lesion preparation, and stenting was performed after confirming hemostasis by angiography. An 8.0 ร— 100-mm BNS (Misagoยฎ stent; Terumo) was deployed in the EIA, and a 10.0 ร— 60-mm BNS (Misagoยฎ stent; Terumo) was deployed in the just-proximal CIA . The final angiography showed good antegrade flow with sufficient expansion . The procedural time for EVT was 90 min, the dose of radiation exposure in terms of doseโ€“area product was 17.0 Gycm 2 , and the amount of contrast medium was 125 ml. Postoperatively, tape was applied to the puncture site, and the patient was released from bed rest after 30 min. The urinary balloon was removed immediately after the EVT. The patient was ambulatory 30 min after the EVT and was discharged the following day. There were no complications, including postoperative radial artery (RA) occlusion, and the ABI value was 0.97 on the right side and 1.08 on the left side. Subsequent duplex ultrasonography (DUS) confirmed patency 12 months postoperatively. Fig. 1 Case 1. A, B Preprocedural enhanced computed tomography images. C The transradial approach. The black arrow shows the 0.035-inch guidewire used to introduce the guiding sheath. D Control angiography showed a total occlusion of the left common iliac artery. E A 0.014-inch guidewire with a 5Fr angled support catheter and a 6Fr guiding sheath was advanced into the chronic total occlusion lesion. The white arrow on upper right shows the tip of the guiding sheath. The black arrow on upper left shows the 5Fr angled support catheter. The white arrow on lower left shows the 2.6Fr microcatheter. The black arrow on lower right shows the antegrade guidewire. F An antegrade guidewire was advanced to the distal external iliac artery (EIA). G The black arrow shows the antegrade guidewire with intravascular ultrasound (IVUS). H IVUS findings in the distal EIA. The white arrow shows the antegrade IVUS in the subintimal space. The yellow arrow shows the true lumen. The green arrow shows the subintimal space. I IVUS findings in the proximal EIA. The white arrow shows the antegrade IVUS. The yellow arrow shows the true lumen Fig. 2 Case 1. A IVUS guided parallel wiring. The white arrow shows the antegrade intravascular ultrasound (IVUS). The red arrow shows the retrograde guidewire. The yellow arrow shows the retrograde microcatheter as a microsheath. The black arrow shows the retrograde puncture site. B IVUS findings in the distal EIA. The white arrow shows the antegrade IVUS in the subintimal space in the true lumen. The yellow arrow shows the true lumen. The red arrow shows the retrograde guidewire. C A retrograde guidewire was advanced into the antegrade support catheter to achieve guidewire externalization. The white arrow shows the antegrade support catheter. The red arrow shows the retrograde guidewire. D Two Misago stents were deployed in the iliac artery. The white arrow shows a Misago stent. E The final angiography showed good antegrade flow
4.027344
0.967773
sec[1]/sec[0]/p[0]
en
0.999997
PMC9590498
https://doi.org/10.1186/s42155-022-00334-x
[ "guidewire", "arrow", "ivus", "antegrade", "retrograde", "artery", "white", "occlusion", "terumo", "balloon" ]
[ { "code": "MB21.10", "title": "Anterograde amnesia" }, { "code": "BC62", "title": "Accessory pathway" }, { "code": "BC81.71", "title": "Atrioventricular reciprocating tachycardia, antidromic" }, { "code": "GA20.1Z", "title": "Abnormal frequency of uterine bleeding, unspecified" }, { "code": "MF40.3", "title": "Retrograde ejaculation" }, { "code": "MB21.11", "title": "Retrograde amnesia" }, { "code": "2B58.0&XS56", "title": "Leiomyosarcoma of retroperitoneum or peritoneum [Grade I]" }, { "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" } ]
=== ICD-11 CODES FOUND === [MB21.10] Anterograde amnesia Definition: An inability to recall past experiences, especially where recall is to be expected, occurring after an event (psychological or physical) presumed to be responsible for the amnesia. Also known as: Anterograde amnesia | antegrade amnesia [BC62] Accessory pathway Definition: An additional electrical connection which typically bypasses the AV node, typically inserting directly into atrial and ventricular myocardium, but may also connect to the specialised conduction system (e.g., the bundle of His, right or left bundles, or one of the fascicles). Also known as: Accessory pathway | anomalous AV pathway | anomalous AV connection | anomalous AV bypass pathway | anomalous AV bypass tract [BC81.71] Atrioventricular reciprocating tachycardia, antidromic Definition: An atrioventricular reciprocating tachycardia that uses the atrioventricular node for retrograde conduction and the accessory pathway for anterograde conduction resulting in a wide complex tachycardia. Also known as: Atrioventricular reciprocating tachycardia, antidromic | Atrioventricular reciprocating tachycardia, antidromic (typically wide QRS) | Atrioventricular reentry tachycardia, antidromic | Atrioventricular reciprocating tachycardia, antidromic utilizing accessory pathway with bidirectional conduction | Atrioventricular reentry tachycardia, antidromic utilizing accessory pathway with bidirectional conduction [GA20.1Z] Abnormal frequency of uterine bleeding, unspecified Also known as: Abnormal frequency of uterine bleeding, unspecified | Abnormal frequency of uterine bleeding | Other specified irregular menstruation | Latent menstruation | Membranous menstruation [MF40.3] Retrograde ejaculation Definition: Retrograde Ejaculation is a condition in which semen that is normally ejaculated via the urethra is redirected to the urinary bladder. Retrograde Ejaculation is typically accompanied by subjective orgasm, though the man may notice that release of semen is limited or absent. Retrograde Ejaculation most commonly occurs as a complication of transurethral prostatic resection, but may also be caused by other surgery of the pelvic area, nervous system dysfunction, or use of pharmacological agents. Con Also known as: Retrograde ejaculation [MB21.11] Retrograde amnesia Definition: 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. Also known as: Retrograde amnesia [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 === GRAPH WALKS === --- Walk 1 --- [MB21.10] Anterograde amnesia Def: An inability to recall past experiences, especially where recall is to be expected, occurring after an event (psychological or physical) presumed to be responsible for the amnesia.... --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 --- [MB21.10] Anterograde amnesia Def: An inability to recall past experiences, especially where recall is to be expected, occurring after an event (psychological or physical) presumed to be responsible for the amnesia.... --PARENT--> [MB21.1] Amnesia Def: An inability to recall past experiences, especially where recall is to be expected.... --CHILD--> [MB21.12] Transient global amnesia Def: A time-limited episode (lasting up to two days) of short-term memory loss without other signs or symptoms of neurological impairment.... --- Walk 3 --- [BC62] Accessory pathway Def: An additional electrical connection which typically bypasses the AV node, typically inserting directly into atrial and ventricular myocardium, but may also connect to the specialised conduction system... --PARENT--> [?] Cardiac arrhythmia Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular.... --CHILD--> [BC61] Junctional premature depolarization Def: Cardiac electrical depolarization arising from the compact atrioventricular node or His bundle occurring earlier than the expected sinus beat.... --- Walk 4 --- [BC62] Accessory pathway Def: An additional electrical connection which typically bypasses the AV node, typically inserting directly into atrial and ventricular myocardium, but may also connect to the specialised conduction system... --PARENT--> [?] Cardiac arrhythmia Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular.... --RELATED_TO--> [?] Cardiac arrhythmias in the neonate Def: Abnormal electrical rhythm, both tachyarrhythmias and bradyarrhythmias, in neonate... --- Walk 5 --- [BC81.71] Atrioventricular reciprocating tachycardia, antidromic Def: An atrioventricular reciprocating tachycardia that uses the atrioventricular node for retrograde conduction and the accessory pathway for anterograde conduction resulting in a wide complex tachycardia... --PARENT--> [BC81.7] Atrioventricular reciprocating tachycardia Def: A macro-reentrant tachycardia involving the atria and ventricles in series that uses the atrioventricular node or an accessory pathway for one limb of the circuit and an accessory pathway for the othe... --CHILD--> [BC81.70] Atrioventricular reciprocating tachycardia, orthodromic Def: An atrioventricular reciprocating tachycardia that uses an accessory pathway for retrograde conduction and the atrioventricular node for anterograde conduction resulting in a narrow or usual complex t... --- Walk 6 --- [BC81.71] Atrioventricular reciprocating tachycardia, antidromic Def: An atrioventricular reciprocating tachycardia that uses the atrioventricular node for retrograde conduction and the accessory pathway for anterograde conduction resulting in a wide complex tachycardia... --PARENT--> [BC81.7] Atrioventricular reciprocating tachycardia Def: A macro-reentrant tachycardia involving the atria and ventricles in series that uses the atrioventricular node or an accessory pathway for one limb of the circuit and an accessory pathway for the othe... --CHILD--> [BC81.70] Atrioventricular reciprocating tachycardia, orthodromic Def: An atrioventricular reciprocating tachycardia that uses an accessory pathway for retrograde conduction and the atrioventricular node for anterograde conduction resulting in a narrow or usual complex t...
[ "[MB21.10] Anterograde amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected, occurring after an event (psychological or physical) presumed to be responsible for the amnesia....\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....", "[MB21.10] Anterograde amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected, occurring after an event (psychological or physical) presumed to be responsible for the amnesia....\n --PARENT--> [MB21.1] Amnesia\n Def: An inability to recall past experiences, especially where recall is to be expected....\n --CHILD--> [MB21.12] Transient global amnesia\n Def: A time-limited episode (lasting up to two days) of short-term memory loss without other signs or symptoms of neurological impairment....", "[BC62] Accessory pathway\n Def: An additional electrical connection which typically bypasses the AV node, typically inserting directly into atrial and ventricular myocardium, but may also connect to the specialised conduction system...\n --PARENT--> [?] Cardiac arrhythmia\n Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular....\n --CHILD--> [BC61] Junctional premature depolarization\n Def: Cardiac electrical depolarization arising from the compact atrioventricular node or His bundle occurring earlier than the expected sinus beat....", "[BC62] Accessory pathway\n Def: An additional electrical connection which typically bypasses the AV node, typically inserting directly into atrial and ventricular myocardium, but may also connect to the specialised conduction system...\n --PARENT--> [?] Cardiac arrhythmia\n Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular....\n --RELATED_TO--> [?] Cardiac arrhythmias in the neonate\n Def: Abnormal electrical rhythm, both tachyarrhythmias and bradyarrhythmias, in neonate...", "[BC81.71] Atrioventricular reciprocating tachycardia, antidromic\n Def: An atrioventricular reciprocating tachycardia that uses the atrioventricular node for retrograde conduction and the accessory pathway for anterograde conduction resulting in a wide complex tachycardia...\n --PARENT--> [BC81.7] Atrioventricular reciprocating tachycardia\n Def: A macro-reentrant tachycardia involving the atria and ventricles in series that uses the atrioventricular node or an accessory pathway for one limb of the circuit and an accessory pathway for the othe...\n --CHILD--> [BC81.70] Atrioventricular reciprocating tachycardia, orthodromic\n Def: An atrioventricular reciprocating tachycardia that uses an accessory pathway for retrograde conduction and the atrioventricular node for anterograde conduction resulting in a narrow or usual complex t...", "[BC81.71] Atrioventricular reciprocating tachycardia, antidromic\n Def: An atrioventricular reciprocating tachycardia that uses the atrioventricular node for retrograde conduction and the accessory pathway for anterograde conduction resulting in a wide complex tachycardia...\n --PARENT--> [BC81.7] Atrioventricular reciprocating tachycardia\n Def: A macro-reentrant tachycardia involving the atria and ventricles in series that uses the atrioventricular node or an accessory pathway for one limb of the circuit and an accessory pathway for the othe...\n --CHILD--> [BC81.70] Atrioventricular reciprocating tachycardia, orthodromic\n Def: An atrioventricular reciprocating tachycardia that uses an accessory pathway for retrograde conduction and the atrioventricular node for anterograde conduction resulting in a narrow or usual complex t..." ]
MB21.10
Anterograde amnesia
[ { "from_icd11": "MB21.10", "icd10_code": "R411", "icd10_title": "Anterograde amnesia" }, { "from_icd11": "BC62", "icd10_code": "I498", "icd10_title": "Other specified cardiac arrhythmias" }, { "from_icd11": "BC62", "icd10_code": "I49", "icd10_title": "Other cardiac arrhythmias" }, { "from_icd11": "MF40.3", "icd10_code": "Z0489", "icd10_title": "Encounter for examination and observation for other specified reasons" }, { "from_icd11": "MF40.3", "icd10_code": "Z048", "icd10_title": "Encounter for examination and observation for other specified reasons" }, { "from_icd11": "MB21.11", "icd10_code": "R412", "icd10_title": "Retrograde amnesia" }, { "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" } ]
R411
Anterograde amnesia
The incidence of gastrointestinal stromal tumors is approximately 1 to 1.5 per 100,000 people per year ( 15 ). In the early stage, there are no clinical manifestations. However, in the middle and late stages, symptoms such as early satiety, dysphagia, abdominal distension, obstruction, epigastric pain, vomiting of blood or black stools, and self-palpation of an abdominal mass may occur, along with other digestive symptoms. These symptoms can be accompanied by anemia, weight loss, liver metastasis, abdominal implantation spread metastasis, etc. In some cases, gastrointestinal stromal tumors are incidentally discovered during physical examinations or while diagnosing and treating other diseases ( 16 ). Endoscopy and ultrasound endoscopy (EUS) play a crucial role in diagnosing GISTs, especially for GISTs with a diameter of less than 2 cm. These techniques can detect malignant features such as irregular tumor margins, ulcer formation, and cystic changes. Additionally, EUS can guide puncture biopsy procedures. CT, particularly enhanced CT, is the preferred diagnostic tool for GIST, as well as for evaluating and monitoring the condition. Benign foci typically appear as lesions with a diameter of less than 5 cm, clear boundaries, homogeneous density, and calcification. On the other hand, malignant lesions exhibit contrasting characteristics. MRI offers excellent tissue resolution and is advantageous for GISTs in specific locations without exposing the patient to ionizing radiation. Benign lesions generally display regular morphology and relatively uniform signals, while most malignant lesions show the opposite. PET-CT scanning is recommended for the early evaluation of targeted drug efficacy, tumor resistance, and recurrence ( 17 ). In this case, the mother presented with gastrointestinal bleeding, anemia, and weight loss as her main symptoms. However, she did not exhibit any other symptoms, making the preliminary diagnosis challenging. Gastroscopy was performed to rule out the stomach as the most common site of GIST. The patientโ€™s resection specimen revealed that the tumor was located in the beginning of the jejunum and was less than 2 cm in size. This made it difficult to detect the tumor using enhanced CT and ultrasound. To further confirm the diagnosis, the patient underwent a double balloon-enteroscopy examination. This examination revealed multiple bulges at the beginning of the jejunum, leading to the initial consideration of a gastrointestinal stromal tumor. GISTs can be classified into different types based on their growth mode, including submucosal, intramural, subserosal, and extragastrointestinal types. Typically, GISTs are solitary tumors with well-defined boundaries within the intestinal wall. However, in this particular case, both intraoperative and postoperative pathology revealed the presence of multiple tumors in the small intestine, primarily located in the mucosal and submucosal layers of the intestinal wall. This observation suggests that the tumors were growing at an accelerated rate, which could have resulted in necrosis and shedding. Consequently, the patient experienced recurrent gastrointestinal bleeding, black stools, and anemia. These symptoms can be attributed to the rapid growth and subsequent complications of the tumors. Gene mutation analysis is crucial in planning treatment with targeted agents such as tyrosine kinase inhibitors. The latest 2020 World Health Organization (WHO) STS and Osteosarcoma Classification codes classify all GISTs as malignant for the purpose of classification ( 18 ). GISTs are less likely to metastasize, with the liver and peritoneum being common sites of metastasis and lymph node metastasis being rare ( 9 , 19 ). Approximately 30% of GISTs are malignant, and the 5-year postoperative survival rates range from 50% to 65%, with recurrence or metastasis occurring in 40% to 90% of operated patients ( 19 , 20 ). Prognostic factors such as tumor site, size, nuclear schizophrenia, and the presence of rupture are important considerations. The treatment of GIST typically involves surgery and systemic therapy. Surgery is usually the initial choice for localized tumors. For smaller GISTs (less than 2 cm in diameter), the surgical approach can vary depending on the tumorโ€™s location, with options including laparoscopic surgery, endoscopic resection, or open surgery. In cases where the tumor is larger and difficult to remove due to the involvement of nearby organs, neoadjuvant therapy may be considered if the tumor is responsive to TKIs ( 21 ). During surgery, it is important to avoid tumor rupture, and lymph node dissection is generally not recommended. Our case report focuses on a patient who underwent surgery as the most effective treatment due to gastrointestinal bleeding and a tumor diameter of less than 2 cm. Postoperative treatment for GIST often involves adjuvant therapy, with imatinib being the first-line therapeutic agent for locally advanced, inoperable, and metastatic patients, as well as for surgical adjuvant therapy. This drug is effective in treating most GISTs ( 22 , 23 ), except for GISTs without KIT/PDGFRA mutations. Additionally, avatinib, sunitinib, and rosutinib are available as second-, third-, and fourth-line drugs. The patient underwent one genetic test, which did not detect any mutations in KIT or PDGFRA . Since the mother did not receive tyrosine kinase inhibitor treatment, regular follow-up was crucia. Three months after surgery, the reexamination showed no signs of recurrence, but long-term re-examination and observation are necessary. Some patients may require chemotherapy-assisted therapy.
4.359375
0.556152
sec[3]/p[0]
en
0.999996
PMC10615565
https://doi.org/10.3389/fonc.2023.1206991
[ "gists", "tumor", "tumors", "gastrointestinal", "less", "this", "metastasis", "malignant", "diameter", "gist" ]
[ { "code": "2B5B.Z", "title": "Gastrointestinal stromal tumour of unspecified gastrointestinal sites" }, { "code": "2E87", "title": "Benign gastrointestinal stromal tumour" }, { "code": "2B5B.0", "title": "Gastrointestinal stromal tumour of stomach" }, { "code": "2B5B.1", "title": "Gastrointestinal stromal tumour of small intestine" }, { "code": "2B5B.Y", "title": "Gastrointestinal stromal tumour of other gastrointestinal sites" }, { "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 === [2B5B.Z] Gastrointestinal stromal tumour of unspecified gastrointestinal sites Also known as: Gastrointestinal stromal tumour of unspecified gastrointestinal sites | Gastrointestinal stromal tumour, primary site | GIST - [gastrointestinal stromal tumour] [2E87] Benign gastrointestinal stromal tumour Also known as: Benign gastrointestinal stromal tumour | Benign gastrointestinal stromal tumour of stomach | Benign GIST - [gastrointestinal stromal tumour] of stomach | Benign gastrointestinal stromal tumour of duodenum | Benign GIST - [gastrointestinal stromal tumour] of duodenum [2B5B.0] Gastrointestinal stromal tumour of stomach Definition: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and tumours formerly called gastrointestinal autonomic nerve tumours. Also known as: Gastrointestinal stromal tumour of stomach | Malignant GIST - [gastrointestinal stromal tumour] of stomach | Gastrointestinal stromal tumour of cardia of stomach | Gastrointestinal stromal tumour of body of stomach | Gastrointestinal stromal tumour of pyloric antrum of stomach [2B5B.1] Gastrointestinal stromal tumour of small intestine Definition: A gastrointestinal stromal tumour that arises from the small intestine. It usually affects adults over fifty years of age. The majority of cases have spindle cell morphology. The prognosis depends on the tumour size and the mitotic activity. Also known as: Gastrointestinal stromal tumour of small intestine | Malignant GIST - [gastrointestinal stromal tumour] of small intestine | Gastrointestinal stromal tumour of jejunum | Gastrointestinal stromal tumour of ileum | Gastrointestinal stromal tumour of Meckel diverticulum [2B5B.Y] Gastrointestinal stromal tumour of other gastrointestinal sites Also known as: Gastrointestinal stromal tumour of other gastrointestinal sites | Gastrointestinal stromal tumour of other gastrointestinal sites | Gastrointestinal stromal tumour of oesophagus | Gastrointestinal stromal tumour of rectum | Gastrointestinal stromal tumour of colon [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 --- [2B5B.Z] Gastrointestinal stromal tumour of unspecified gastrointestinal sites --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat... --CHILD--> [2B5B.Y] Gastrointestinal stromal tumour of other gastrointestinal sites --- Walk 2 --- [2B5B.Z] Gastrointestinal stromal tumour of unspecified gastrointestinal sites --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat... --CHILD--> [2B5B.1] Gastrointestinal stromal tumour of small intestine Def: A gastrointestinal stromal tumour that arises from the small intestine. It usually affects adults over fifty years of age. The majority of cases have spindle cell morphology. The prognosis depends on ... --- Walk 3 --- [2E87] Benign gastrointestinal stromal tumour --PARENT--> [?] Benign mesenchymal neoplasms Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels.... --CHILD--> [2E82] Benign chondrogenic tumours --- Walk 4 --- [2E87] Benign gastrointestinal stromal tumour --PARENT--> [?] Benign mesenchymal neoplasms Def: Bening neoplasms of muscle, fat, fibrous tissue, bone, cartilage, and blood vessels.... --CHILD--> [2E82] Benign chondrogenic tumours --- Walk 5 --- [2B5B.0] Gastrointestinal stromal tumour of stomach Def: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and... --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat... --CHILD--> [2B5B.0] Gastrointestinal stromal tumour of stomach Def: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and... --- Walk 6 --- [2B5B.0] Gastrointestinal stromal tumour of stomach Def: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and... --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat... --CHILD--> [2B5B.1] Gastrointestinal stromal tumour of small intestine Def: A gastrointestinal stromal tumour that arises from the small intestine. It usually affects adults over fifty years of age. The majority of cases have spindle cell morphology. The prognosis depends on ...
[ "[2B5B.Z] Gastrointestinal stromal tumour of unspecified gastrointestinal sites\n --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site\n Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat...\n --CHILD--> [2B5B.Y] Gastrointestinal stromal tumour of other gastrointestinal sites", "[2B5B.Z] Gastrointestinal stromal tumour of unspecified gastrointestinal sites\n --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site\n Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat...\n --CHILD--> [2B5B.1] Gastrointestinal stromal tumour of small intestine\n Def: A gastrointestinal stromal tumour that arises from the small intestine. It usually affects adults over fifty years of age. The majority of cases have spindle cell morphology. The prognosis depends on ...", "[2E87] Benign gastrointestinal stromal tumour\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", "[2E87] Benign gastrointestinal stromal tumour\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", "[2B5B.0] Gastrointestinal stromal tumour of stomach\n Def: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and...\n --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site\n Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat...\n --CHILD--> [2B5B.0] Gastrointestinal stromal tumour of stomach\n Def: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and...", "[2B5B.0] Gastrointestinal stromal tumour of stomach\n Def: A gastrointestinal stromal tumour that arises from the stomach. It covers a spectrum of benign to malignant mesenchymal neoplasms and includes most gastric smooth muscle tumours, leiomyoblastomas, and...\n --PARENT--> [2B5B] Gastrointestinal stromal tumour, primary site\n Def: This is the most common mesenchymal tumour that arises in the gastrointestinal tract. It is generally immunohistochemically positive for CD117 (KIT), phenotypically paralleling Cajal-cell differentiat...\n --CHILD--> [2B5B.1] Gastrointestinal stromal tumour of small intestine\n Def: A gastrointestinal stromal tumour that arises from the small intestine. It usually affects adults over fifty years of age. The majority of cases have spindle cell morphology. The prognosis depends on ..." ]
2B5B.Z
Gastrointestinal stromal tumour of unspecified gastrointestinal sites
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
The revised pedigree of the MRX78 family is depicted in Figure 1A and a summary with clinical findings is presented in Table 1 . Individual I-2 had mild ID and was illiterate. She had a stroke at age 71 and developed dementia thereafter. She passed away at age 80. She gave birth to 15 children; two were stillborn. Two sons and a daughter died in childhood, they were said to be โ€œhandicappedโ€, one son had spina bifida. All children were placed in foster homes. She had two brothers with normal cognition and three sisters. II-2 had mild ID with difficulty reading and writing. II-6 has ID. II-8 has learning difficulties and is unable to read or write. Her chromosome studies were normal and urine analysis was negative for MAO-A deficiency. Her husband (II-7) also had learning difficulties/ID. II-9 has severe ID, intractable epilepsy and does not speak, or interact socially. He does like physical contact (e.g., holding hands) and responds to his name. He developed walking difficulties in his fifties, with unstable gait (โ€œas a drunk personโ€) and is now wheelchair bound. There is no tremor and his vision and hearing are good. III-1 and III-2: These brothers both have severe ID. They do not seem to recognize a familiar person and have no speech. They can be physically aggressive towards caretakers, and both are on levomepromazine therapy. Vision and hearing are normal. Urine metabolic investigations were normal, and there was no MAO-A deficiency. Subject III-1 has had one seizure as a teenager. III-3 has moderate ID and no seizures. His height is 176.5 cm, occipital frontal circumference (OFC) 55 cm, and he has no dysmorphic features. Urine metabolic investigations were normal, and MAO-A deficiency was excluded. III-4 had learning difficulties. III-5 was born at term after an uncomplicated pregnancy with birth weight 4400 grams. Developmental delay was evident from early age. At age 12 extensive investigations were performed. At this time he had a moderate to severe ID and severe behavioral problems, refractory to treatment, including Haldol and valproic acid. An EEG showed a diffuse encephalopathy, without epileptic discharges, a brain CT-scan was normal (data not shown). IQ testing age 16 years showed verbal IQ (VIQ) compatible to age 4.7 years, and performance IQ (PIQ) compatible to 4.1 years. He showed minor regression when he was retested at 28 years with the Wechsler Intelligence Scale (WISC) when his cognitive abilities were compatible to a 3.5 year-old. His social-emotional functioning was lower, at the level of a 6โ€“18-month-old. Currently, at age 43 years, he is physically healthy, height is 181 cm and weight 90 kg. Neurological examination showed no abnormalities. He has good hearing and vision, with only mild hypermetropia (1.25 dpt). He is independent in basic daily activities such as dressing and eating, but needs incentive. He is on risperidone treatment (0.5 mg twice daily) and laxantia. He communicates mostly through pictograms. He is quiet and introverted, with occasional verbal aggression, but not physical. He likes puzzles. He is easily distracted. He is suspected of autism spectrum disorder but has not been formally tested. Laboratory investigations in the past, including metabolic screen, Fragile X and chromosome studies were normal. III-6: During pregnancy her mother had several hospital admissions due to vaginal bleeding and premature contractions. Chromosome studies in chorion villi biopsy were normal (46, XX). She was born at term, with cleft lip/palate, her birth weight was 2785 grams and length 50 cm. She has mild learning difficulties, her OFC is 54 cm. She has three daughters, in whom no molecular testing was performed. She has had two first trimester miscarriages. The eldest daughter (IV:1) was born at 38 weeks of gestation, BW 2900 gram. She has learning difficulties and receives special education, her OFC is 57 cm. She is overweight. Her second daughter (IV:2) was born with ventricular septal defect, her BW was 2700 grams after 38 weeks of gestation. She has normal development, and no learning difficulties. Chromosome studies in chorion villi biopsy in the middle and youngest daughter were normal (46, XX). The youngest is still too young to assess her development. III-8: the pregnancy was complicated with episodes of vaginal bleeding and premature contractions. Developmental delay became evident in the first year of life. He had psychiatric consultation at age 11, due to problematic and aggressive behavior. Two years later he was diagnosed with a pervasive developmental disorder. Currently, at age 36, he has severe ID and autism spectrum disorder. He has a fixation on mirrors and sunshades, and will go around and close them. He has shown severe aggressive outbursts with destructive behavior towards furniture and other objects. He receives risperidone 2.5 mg daily. WISC testing age 20 years showed VIQ compatible to age 4.7 years, and PIQ compatible to 4.1 years. He was last tested at age 34 (Vineland Adaptive Behavior Scale) and he had shown mild regression over a 3-year period. His adaptive skills are now at a level for communication of a 1 year 7 month old, for daily activities at a 3-year-old level, for motor skills at a 1 year 5 month old level, and socialization skills compatible to a 10 month old. He is physically in good health. He underwent adenotomy, strabismus surgery, and excision of a follicular jaw cyst. His current height is 177 cm, and weight 82 kg. Neurological examination showed only brisk reflexes of the lower extremities. He has normal hearing and myopia, with normal media and fundi. Fragile X testing was negative.
4.136719
0.699707
sec[2]/sec[0]/p[0]
en
0.999996
26793055
https://doi.org/10.3389/fnmol.2015.00085
[ "difficulties", "learning", "compatible", "daughter", "chromosome", "hearing", "investigations", "born", "weight", "testing" ]
[ { "code": "MG43.3Z", "title": "Feeding difficulties, unspecified" }, { "code": "MF50.6Z", "title": "Difficulties with micturition, unspecified" }, { "code": "MA80.1", "title": "Dysphasia" }, { "code": "MF50.6Y", "title": "Other specified difficulties with micturition" }, { "code": "6A03.Z", "title": "Developmental learning disorder, unspecified" }, { "code": "QF20", "title": "Difficulty or need for assistance with learning" }, { "code": "6A01.2", "title": "Developmental language disorder" }, { "code": "6A03.3", "title": "Developmental learning disorder with other specified impairment of learning" }, { "code": "6A03.0", "title": "Developmental learning disorder with impairment in reading" }, { "code": "4A01.11", "title": "Major histocompatibility complex class I deficiency" } ]
=== ICD-11 CODES FOUND === [MG43.3Z] Feeding difficulties, unspecified Also known as: Feeding difficulties, unspecified | Feeding difficulties | difficult feeding | faulty feeding | Feeding difficulties and mismanagement [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 [MA80.1] Dysphasia Definition: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. Also known as: Dysphasia | loss of power of expression or comprehension | Alalia | Aphemia | Semantic dysphasia Excludes: progressive isolated aphasia | Developmental speech or language disorders [MF50.6Y] Other specified difficulties with micturition Also known as: Other specified difficulties with micturition | Residual urine [6A03.Z] Developmental learning disorder, unspecified Also known as: Developmental learning disorder, unspecified | Developmental learning disorder | specific developmental disorders of scholastic skills | academic skills disorder | developmental learning disability [QF20] Difficulty or need for assistance with learning Also known as: Difficulty or need for assistance with learning | need for assistance with learning | learning difficulty [6A01.2] Developmental language disorder Definition: Developmental language disorder is characterised by persistent deficits in the acquisition, understanding, production or use of language (spoken or signed), that arise during the developmental period, typically during early childhood, and cause significant limitations in the individualโ€™s ability to communicate. The individualโ€™s ability to understand, produce or use language is markedly below what would be expected given the individualโ€™s age. The language deficits are not explained by another neu Also known as: Developmental language disorder | language development disorder | language learning impairment | specific language impairment Excludes: Autism spectrum disorder | Diseases of the nervous system | Deafness not otherwise specified [6A03.3] Developmental learning disorder with other specified impairment of learning Definition: Developmental learning disorder with other specified impairment of learning is characterised by significant and persistent difficulties in learning academic skills other than reading, mathematics, and written expression. The individualโ€™s performance in the relevant academic skill is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individualโ€™s academic or occupational functioning. Developmental learning Also known as: Developmental learning disorder with other specified impairment of learning Excludes: Disorders of intellectual development [6A03.0] Developmental learning disorder with impairment in reading Definition: Developmental learning disorder with impairment in reading is characterised by significant and persistent difficulties in learning academic skills related to reading, such as word reading accuracy, reading fluency, and reading comprehension. The individualโ€™s performance in reading is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individualโ€™s academic or occupational functioning. Developmental learnin Also known as: Developmental learning disorder with impairment in reading | specific reading disorder | reading disability | Specific learning disorder with impairment in reading | developmental disorder of reading Excludes: Disorders of intellectual development [4A01.11] Major histocompatibility complex class I deficiency Also known as: Major histocompatibility complex class I deficiency | Bare lymphocyte syndrome type 1 | Immunodeficiency by defective expression of HLA - [human leukocyte antigen] class 1 | SCID - [severe combined immunodeficiency] due to absent class 2 HLA antigens | BLS - [bare lymphocyte syndrome] NOS === GRAPH WALKS === --- Walk 1 --- [MG43.3Z] Feeding difficulties, unspecified --PARENT--> [MG43.3] Feeding difficulties --EXCLUDES--> [?] Feeding problems of newborn Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn.... --- Walk 2 --- [MG43.3Z] Feeding difficulties, unspecified --PARENT--> [MG43.3] Feeding difficulties --CHILD--> [MG43.32] Feeding problem of adult --- Walk 3 --- [MF50.6Z] Difficulties with micturition, unspecified --PARENT--> [MF50.6] Other difficulties with micturition --CHILD--> [MF50.60] Hesitancy of micturition Def: Difficulty in beginning the flow of urine or maintaining a urinary stream... --- Walk 4 --- [MF50.6Z] Difficulties with micturition, unspecified --PARENT--> [MF50.6] Other difficulties with micturition --CHILD--> [MF50.60] Hesitancy of micturition Def: Difficulty in beginning the flow of urine or maintaining a urinary stream... --- Walk 5 --- [MA80.1] Dysphasia Def: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant... --EXCLUDES--> [?] Circumscribed brain atrophy Def: This is a condition of brain shrinkage limited to a specific region.... --CHILD--> [?] Progressive isolated aphasia --- Walk 6 --- [MA80.1] Dysphasia Def: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant... --EXCLUDES--> [?] Developmental speech or language disorders Def: Developmental speech or language disorders arise during the developmental period and are characterised by difficulties in understanding or producing speech and language or in using language in context... --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...
[ "[MG43.3Z] Feeding difficulties, unspecified\n --PARENT--> [MG43.3] Feeding difficulties\n --EXCLUDES--> [?] Feeding problems of newborn\n Def: A lack of interest in feeding or a problem receiving the proper amount of nutrition in a newborn....", "[MG43.3Z] Feeding difficulties, unspecified\n --PARENT--> [MG43.3] Feeding difficulties\n --CHILD--> [MG43.32] Feeding problem of adult", "[MF50.6Z] Difficulties with micturition, unspecified\n --PARENT--> [MF50.6] Other difficulties with micturition\n --CHILD--> [MF50.60] Hesitancy of micturition\n Def: Difficulty in beginning the flow of urine or maintaining a urinary stream...", "[MF50.6Z] Difficulties with micturition, unspecified\n --PARENT--> [MF50.6] Other difficulties with micturition\n --CHILD--> [MF50.60] Hesitancy of micturition\n Def: Difficulty in beginning the flow of urine or maintaining a urinary stream...", "[MA80.1] Dysphasia\n Def: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant...\n --EXCLUDES--> [?] Circumscribed brain atrophy\n Def: This is a condition of brain shrinkage limited to a specific region....\n --CHILD--> [?] Progressive isolated aphasia", "[MA80.1] Dysphasia\n Def: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant...\n --EXCLUDES--> [?] Developmental speech or language disorders\n Def: Developmental speech or language disorders arise during the developmental period and are characterised by difficulties in understanding or producing speech and language or in using language in context...\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..." ]
MG43.3Z
Feeding difficulties, unspecified
[ { "from_icd11": "MG43.3Z", "icd10_code": "R633", "icd10_title": "Feeding difficulties" }, { "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": "MA80.1", "icd10_code": "R4702", "icd10_title": "Dysphasia" }, { "from_icd11": "MA80.1", "icd10_code": "R470", "icd10_title": "Dysphasia and aphasia" }, { "from_icd11": "6A03.Z", "icd10_code": "F8189", "icd10_title": "Other developmental disorders of scholastic skills" }, { "from_icd11": "6A03.Z", "icd10_code": "F8181", "icd10_title": "Disorder of written expression" }, { "from_icd11": "6A03.Z", "icd10_code": "F819", "icd10_title": "Developmental disorder of scholastic skills, unspecified" } ]
R633
Feeding difficulties
A 49-year-old man with no medical or drug history worked for a transport company and returned to the office after completing his delivery duties. He suddenly collapsed in front of his colleagues. Upon arrival at our hospital, the patient exhibited severe right-hand hemiplegia and aphasia (National Institutes of Health Stroke Scale 22). Magnetic resonance imaging (MRI) revealed occlusion of the left ICA, intramural hematoma, and moderate infarction in the left insular cortex, centrum semiovale, and left parietal lobe . During diagnostic angiography, we confirmed a tapered, flame-like occlusion at the cervical level, typical of an acute dissection of the left ICA . We also observed a large vessel occlusion (LVO) . However, arterial dissection was not observed at that point. The first treatment goal was to remove the thrombus and open the arteries. A 9-French (Fr) introducer was placed in the right femoral artery. After systemic heparinization , a 9-Fr guiding catheter (Optimo FLEX, Tokai Medical Products, Aichi, Japan) was introduced into the left ICA. Initially, aspiration was conducted using balloon catheter dilatation, but the thrombus could not be removed. With a microcatheter (Trak21, Stryker, California, USA) and microwire (Synchro2 standard, Stryker, California, USA), the Synchro made several U-turns at the left ICA prepetrous portion before crossing . After several attempts to rotate the J-shaped wire, we guided the microcatheter to the M2 segment of the left middle cerebral artery (MCA). Thrombectomy was conducted using a stent retriever (4ร—41TrevoNXT, Stryker, California, USA) and an aspiration catheter (Vecta71, Stryker, California, USA). A significant number of soft, dark red thrombi were retrieved . Subsequent angiography revealed reperfusion of the left MCA. However, significant stenosis was noted in the more proximal left ICA prepetrous portion, along with peripheral blood flow stagnation . Based on vascular morphology, patient age, and the absence of other risk factors, the diagnosis was dissection. A secondary thrombus had formed at the dissection site that caused occlusion of the ICA . Therefore, angioplasty and stenting were imperative. Aspirin (200 mg) and prasugrel (20 mg) were administered via a gastric tube before stent implantation. However, an appropriately-sized stent for the diameter of the petrous portion of the vessel was not in stock, which caused a delay of approximately 90 min. This delay was due to the time it would take for a messenger to bring the appropriate device from another facility, prolonging cerebral hypoperfusion and potentially leading to an expansion of the cerebral infarction. This situation raised concerns about the availability of an appropriate device and the critical impact of such delays on patient outcomes. To maintain blood flow in the ICA during this time, the stent retriever used for thrombus retrieval was deployed again in the dissection. A stent was placed during the dissection to prevent reocclusion. To maintain blood flow in the ICA while waiting, a 300-cm microwire (CHIKAI) was passed parallel to the distal left M2 region of the MCA to secure the true lumen. Another catheter (Trak21MC + Synchro Standard) was then placed in the dissection with a 4 ร— 41 mm stent (Trevo) deployed . Although the stent was undersized for the vessel, anterior cerebral artery (ACA) was visualized after stenting. it successfully restored blood flow and improved peripheral blood flow . After the arrival of the stent, a precise 6 ร— 30-mm stent was placed. However, due to the inability of the shaft to surpass the curvature of the petrous portion, stenosis remained. The deployment of the flexible 4.5 ร— 30 mm-stent (Neuroform Atlas) from the stenosis to the periphery significantly improved vascular patency. Imaging of the left ICA confirmed improvement in cerebral blood flow. After a 30-min observation period, repeated imaging confirmed the absence of reocclusion, and the final left ICA angiography revealed complete reperfusion . No postoperative complications were observed, and no new lesions were identified on follow-up MRI. The patient was discharged with mild aphasia and was transferred to a rehabilitation hospital. Fig. 1 Preprocedure magnetic resonance imaging (MRI) of dissection of the internal carotid artery (ICA). (A and B) MRI revealed a subacute intramural hematoma in the wall of the right ICA (arrow). (C) MRI showed an acute ischemic lesion in the left cortex. Fig 1 Fig. 2 (A) A flame-like occlusion, typical of an acute dissection, is visible in the lateral view digital subtraction angiography (DSA) of the left carotid artery. (B) The microwire made several U-turns at the left ICA prepetrous portion before crossing (arrow). (C) After several attempts, the microwire crossed the prepetrous portion (arrow). Fig 2 Fig. 3 (A) Left ICA angiography confirmed MCA occlusion. (B) Thrombectomy was conducted. (C) A large clot was retrieved. (D) After thrombectomy, MCA occlusion was recanalized and the presence of the extracranial ICA dissection with a high-grade stenosis was confirmed (double arrow). Fig 3 Fig. 4 (A) A high-grade stenosis (double arrow) with poor peripheral perfusion is seen in the dissection of the left ICA. (B) A 4 ร— 41mm stent retriever was deployed at the dissection, including the high-grade stenosis segment (double arrow). (C) The stent retriever successfully restored clear flow (double arrow) and improved peripheral blood flow. Fig 4 Fig. 5 (A and B) The final angiography after stenting using a 6 ร— 30 mm stent and a 4.5 ร— 30 mm stent revealed sufficient reperfusion of the left ICA (double arrow). Fig 5
3.990234
0.974121
sec[1]/p[0]
en
0.999996
39170774
https://doi.org/10.1016/j.radcr.2024.06.077
[ "stent", "dissection", "flow", "arrow", "occlusion", "blood", "angiography", "portion", "stenosis", "artery" ]
[ { "code": "PK93.2", "title": "Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "QB51.1", "title": "Presence of urogenital implants" }, { "code": "QB51.Y", "title": "Presence of other specified devices other than cardiac or vascular implants" }, { "code": "QB51.3", "title": "Presence of otological or audiological implants" }, { "code": "PL12.3", "title": "Obstruction of device, as mode of injury or harm" }, { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "BA82", "title": "Coronary artery dissection" }, { "code": "BD50.Z", "title": "Aortic aneurysm or dissection, unspecified" }, { "code": "8B22.0&XA2K99", "title": "Dissection of basilar artery" }, { "code": "BD50.3Z", "title": "Thoracic aortic aneurysm, without mention of perforation or rupture" } ]
=== ICD-11 CODES FOUND === [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Surgical operation with implant of artificial internal gastroenterology or urology device associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Surgical operation with gastroenterological or urological bypass or graft associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Gastroenterology or urology devices associated with injury or harm, urethral or ureteral stents | Incrustation or calcification of indwelling ureteral stents Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [QB51.1] Presence of urogenital implants Also known as: Presence of urogenital implants | Presence of bladder implant | bladder replaced by other means | replacement of bladder by artificial or mechanical device or prosthesis | Presence of urethral stent [QB51.Y] Presence of other specified devices other than cardiac or vascular implants Also known as: Presence of other specified devices other than cardiac or vascular implants | Presence of bone or tendon implants other than orthopaedic joint implants | replacement of tendon by artificial or mechanical device or prosthesis | presence of tendon implant | Presence of skull plate [QB51.3] Presence of otological or audiological implants Also known as: Presence of otological or audiological implants | presence of audiological implant | presence of hearing device implant | presence of hearing-aid implant | presence of otological implant [PL12.3] Obstruction of device, as mode of injury or harm Definition: Obstruction associated with prosthetic devices, grafts or implants Also known as: Obstruction of device, as mode of injury or harm | occlusion shunt | blockage of device causing obstruction as mode of injury | blocked tube causing obstruction as mode of injury | occlusion of device causing obstruction as mode of injury Excludes: Obstruction of device without injury or harm [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 [BA82] Coronary artery dissection Definition: Coronary artery dissection results from a tear in the inner layer of the coronary artery, the tunica intima. This allows blood to penetrate and cause an intramural hematoma in the central layer, the tunica media, and restriction in the size of lumen. Also known as: Coronary artery dissection | spontaneous coronary artery dissection | Acute coronary artery dissection | Chronic coronary artery dissection Includes: spontaneous coronary artery dissection Excludes: Injury or harm arising from a procedure, not elsewhere classified | Injury of blood vessels of thorax [BD50.Z] Aortic aneurysm or dissection, unspecified Also known as: Aortic aneurysm or dissection, unspecified | Aortic aneurysm or dissection | Perforation of dissecting aneurysm of aorta | Aortic aneurysm syndrome, Loeys-Dietz type | Loeys-Dietz syndrome type 1 [BD50.3Z] Thoracic aortic aneurysm, without mention of perforation or rupture Also known as: Thoracic aortic aneurysm, without mention of perforation or rupture | Thoracic aortic aneurysm | aneurysm of thoracic aorta | intrathoracic aneurysm | thoracic aorta aneurysm === GRAPH WALKS === --- Walk 1 --- [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm --CHILD--> [?] Functional device failure without injury or harm Def: A device not working or operating correctly, or that has stopped functioning after a period of function, but without documented injury or harm to the patient.... --- Walk 2 --- [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --PARENT--> [PK93] Gastroenterology or urology devices, implants or grafts associated with injury or harm --PARENT--> [?] Surgical or other medical devices, implants or grafts associated with injury or harm in therapeutic use Def: Medical devices could be associated with injury or harm in therapeutic use through different mechanisms: failure, malfunction, dislodgement, misconnection, removal, unclean/unsterile, use error, inapp... --- Walk 3 --- [QB51.1] Presence of urogenital implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --CHILD--> [QB51.2] Presence of intraocular lens --- Walk 4 --- [QB51.1] Presence of urogenital implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --EXCLUDES--> [?] Fitting, adjustment or management of devices --- Walk 5 --- [QB51.Y] Presence of other specified devices other than cardiac or vascular implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --PARENT--> [?] Presence of device, implants or grafts --- Walk 6 --- [QB51.Y] Presence of other specified devices other than cardiac or vascular implants --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants --EXCLUDES--> [?] Fitting, adjustment or management of devices
[ "[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Functional device failure without injury or harm\n Def: A device not working or operating correctly, or that has stopped functioning after a period of function, but without documented injury or harm to the patient....", "[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --PARENT--> [PK93] Gastroenterology or urology devices, implants or grafts associated with injury or harm\n --PARENT--> [?] Surgical or other medical devices, implants or grafts associated with injury or harm in therapeutic use\n Def: Medical devices could be associated with injury or harm in therapeutic use through different mechanisms: failure, malfunction, dislodgement, misconnection, removal, unclean/unsterile, use error, inapp...", "[QB51.1] Presence of urogenital implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --CHILD--> [QB51.2] Presence of intraocular lens", "[QB51.1] Presence of urogenital implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --EXCLUDES--> [?] Fitting, adjustment or management of devices", "[QB51.Y] Presence of other specified devices other than cardiac or vascular implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --PARENT--> [?] Presence of device, implants or grafts", "[QB51.Y] Presence of other specified devices other than cardiac or vascular implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --EXCLUDES--> [?] Fitting, adjustment or management of devices" ]
PK93.2
Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices
[ { "from_icd11": "PK93.2", "icd10_code": "T83711A", "icd10_title": "Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83718A", "icd10_title": "Erosion of other implanted mesh to organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83728A", "icd10_title": "Exposure of other implanted mesh into organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83719A", "icd10_title": "Erosion of other prosthetic materials to surrounding organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83718S", "icd10_title": "Erosion of other implanted mesh to organ or tissue, sequela" }, { "from_icd11": "PK93.2", "icd10_code": "T83712A", "icd10_title": "Erosion of implanted urethral mesh to surrounding organ or tissue, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83721A", "icd10_title": "Exposure of implanted vaginal mesh into vagina, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85590A", "icd10_title": "Other mechanical complication of bile duct prosthesis, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83490A", "icd10_title": "Other mechanical complication of implanted penile prosthesis, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85598A", "icd10_title": "Other mechanical complication of other gastrointestinal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85528A", "icd10_title": "Displacement of other gastrointestinal prosthetic devices, implants and grafts, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T85520A", "icd10_title": "Displacement of bile duct prosthesis, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83193A", "icd10_title": "Other mechanical complication of other urinary stent, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83123A", "icd10_title": "Displacement of other urinary stents, initial encounter" }, { "from_icd11": "PK93.2", "icd10_code": "T83111A", "icd10_title": "Breakdown (mechanical) of implanted urinary sphincter, initial encounter" } ]
T83711A
Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter
In subsequent treatment, the patient received four sessions of hepatic artery chemoembolization (D-TACE): the first time D-TACE was treated with pirarubicin 60 mg-loaded 300โ€“500 ฮผm CalliSpheresยฎ; the second time, gemcitabine 800 mg perfusion + pirarubicin 60 mg-loaded 300โ€“500 ฮผm CalliSpheresยฎ; the third time, pirarubicin 60 mg-loaded 300โ€“500 ฮผm CalliSpheresยฎ; and the fourth time, HepaSphere microspheres 30โ€“60 ฮผm containing pirarubicin 30 mg. Concurrently, immunotherapy (Sintilimab, 200 mg) and targeted therapy (Lenvatinib 8 mg, QD) were combined with primary liver tumor. After treatment, the AFP level of the patient remained generally within the normal range during the treatment, with a notable increase observed after April .Meanwhile,the patient showed a reduction in the size of the primary liver tumor lesions (By measuring the long and short diameters of the largest tumor area, the tumor size area was calculated for comparison: V T = 1/2(L * W * W) , and the diameter of the hepatic artery gradually decreased . However, during a follow-up CT scan two months after the procedure, thrombus formation was detected within the main trunk of the portal vein stent. Oral administration of 10 mg QD rivaroxaban was promptly initiated for anticoagulant therapy. Subsequent CT scans in March and April revealed an increase in thrombi within the stent compared to before, and an increasing trend in coagulation function (D-dimer and FDP). Six months after the procedure, the patient was readmitted due to "esophageal variceal rupture and bleeding". After anticoagulation, portal blood flow increased and thrombus was reduced. Repeat examination revealed a gradual increase in stent thrombosis and a decrease in portal vein flow . Endoscopic variceal ligation and pharmacological hemostatic treatment were performed, and bleeding was successfully stopped. Half a month later, the patient was readmitted due to "sudden severe upper abdominal pain". Examination upon admission showed refractory hypotension accompanied by a sharp and progressive elevation in AST, ALT and T-BIL levels , blood NH3 increased , coagulation function (D-dimer, FDP) decreased . Abdominal CT scan revealed a decrease in thrombi within the stent compared to previous scans, liver parenchymal necrosis, and the previously enhanced lesion within the liver shows no obvious blood supply . The patient developed acute liver failure and liver coma. After communicating with the patientโ€™s family, they opted to discontinue follow-up treatment, resulting in the patientโ€™s demise one-week post-discharge. Fig. 3 The change of AFP before and after TACE treatment: The AFP level of the patient remained generally within the normal range during the treatment, with a notable increase observed after April Fig. 4 The change size of tumor before and after TACE treatment: CT scans showed pronounced enhancement in the tumor area pre-TACE ( A ), which weakened or disappeared post-TACE treatment ( B, C, D ), and reappeared after 4 months ( E ). The tumor size changes pre- and post-treatment were shown in panel F Fig. 5 Hepatic artery angiography at 1 months ( A ), 3 months ( B ) and CT scan at 5 months ( C ), 7 months ( D ) after stent implantation showing a gradual decrease in the diameter of the hepatic artery. After stent implantation showing a gradual decrease in the diameter of the hepatic artery Fig. 6 The curve graph of hepatic artery diameter changes demonstrates a gradual reduction in the diameter of the hepatic artery Fig. 7 Thrombus formation after stent implantation: No thrombosis was found in the stent 2 weeks after particle stent implantation ( A ). One month after the stent implantation, thrombosis developed in the main portal vein, and blood flow in the portal vein was reduced ( B ). After anticoagulation, portal blood flow increased ( C ) and thrombus was reduced. Repeat examination revealed a gradual increase in stent thrombosis and a decrease in portal vein flow ( D and E ). Changes in portal vein flow and thrombus diameter are shown in panel F Fig. 8 Time-course graph showing changes in liver function and before blood NH3 after stent implantation: Liver function exhibited no significant change pre- and post-TACE treatment, but acute liver failure and hepatic coma (AST, ALT, T-BIL ( A ), NH3 ( B ) increased significantly) occurred, following a 2-month interruption of immune targeted therapy due to gastrointestinal bleeding. After communicating with the patientโ€™s family, they opted to discontinue follow-up treatment, resulting in the patientโ€™s demise one-week post-discharge Fig. 9 Time-course graph showing changes in coagulation function before and after stent implantation: D-dimer increased and then decreased (red part) Fig. 10 CT imaging findings: In the plain scan, a nodular low-density lesion with indistinct borders is observed in the right lobe of the liver ( A , green arrow). Contrast-enhanced scan shows no significant enhancement in the arterial phase ( B, green arrow), and reduced enhancement in the venous phase, with lower enhancement degree compared to the surrounding liver parenchyma. Patchy low-density lesions are visible within the lesion ( C , green arrow). Multiple patchy and slightly low-density lesions are observed within the liver parenchyma, with no significant enhancement on the contrast-enhanced scan. The previously enhanced lesion within the liver shows no obvious arterial blood supply. A patchy dense shadow is seen in the left lobe of the liver ( A, B, C, D , black arrow). In the portal vein phase, a crescent-shaped filling defect is observed (reduced compared to previous scans) ( C , yellow arrow)
3.992188
0.971191
sec[1]/p[1]
en
0.999997
38884802
https://doi.org/10.1007/s00432-024-05826-y
[ "liver", "stent", "within", "portal", "hepatic", "artery", "tace", "tumor", "vein", "blood" ]
[ { "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": "PK93.2", "title": "Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "QB51.1", "title": "Presence of urogenital implants" }, { "code": "QB51.Y", "title": "Presence of other specified devices other than cardiac or vascular implants" }, { "code": "QB51.3", "title": "Presence of otological or audiological implants" }, { "code": "PL12.3", "title": "Obstruction of device, as mode of injury or harm" } ]
=== 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 [PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Surgical operation with implant of artificial internal gastroenterology or urology device associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Surgical operation with gastroenterological or urological bypass or graft associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Gastroenterology or urology devices associated with injury or harm, urethral or ureteral stents | Incrustation or calcification of indwelling ureteral stents Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [QB51.1] Presence of urogenital implants Also known as: Presence of urogenital implants | Presence of bladder implant | bladder replaced by other means | replacement of bladder by artificial or mechanical device or prosthesis | Presence of urethral stent [QB51.Y] Presence of other specified devices other than cardiac or vascular implants Also known as: Presence of other specified devices other than cardiac or vascular implants | Presence of bone or tendon implants other than orthopaedic joint implants | replacement of tendon by artificial or mechanical device or prosthesis | presence of tendon implant | Presence of skull plate [QB51.3] Presence of otological or audiological implants Also known as: Presence of otological or audiological implants | presence of audiological implant | presence of hearing device implant | presence of hearing-aid implant | presence of otological implant [PL12.3] Obstruction of device, as mode of injury or harm Definition: Obstruction associated with prosthetic devices, grafts or implants Also known as: Obstruction of device, as mode of injury or harm | occlusion shunt | blockage of device causing obstruction as mode of injury | blocked tube causing obstruction as mode of injury | occlusion of device causing obstruction as mode of injury Excludes: Obstruction of device without injury or harm === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --PARENT--> [13] Diseases of the digestive system --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --PARENT--> [13] Diseases of the digestive system --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.0] Idiopathic granulomatous hepatitis --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Fibropolycystic liver disease --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Drug-induced or toxic liver disease Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent....
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --PARENT--> [13] Diseases of the digestive system", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --PARENT--> [13] Diseases of the digestive system", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.0] Idiopathic granulomatous hepatitis", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.2] Chronic hepatitis, not elsewhere classified", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Fibropolycystic liver disease", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Drug-induced or toxic liver disease\n Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent...." ]
DB9Z
Diseases of liver, unspecified
[ { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" }, { "from_icd11": "DB9Z", "icd10_code": "K76", "icd10_title": "Other diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB97.Z", "icd10_code": "K7581", "icd10_title": "Nonalcoholic steatohepatitis (NASH)" }, { "from_icd11": "DB97.Z", "icd10_code": "K7589", "icd10_title": "Other specified inflammatory liver diseases" }, { "from_icd11": "DB97.Z", "icd10_code": "K759", "icd10_title": "Inflammatory liver disease, unspecified" }, { "from_icd11": "DB97.Z", "icd10_code": "K752", "icd10_title": "Nonspecific reactive hepatitis" }, { "from_icd11": "DB97.Z", "icd10_code": "K75", "icd10_title": "Other inflammatory liver diseases" } ]
K7681
Hepatopulmonary syndrome
Between February 2012 and July 2015, the patient presented with several episodes of recurrent fever with myalgia after coming back from his journeys in Egypt. He had no diarrhea, nor any urinary symptoms or respiratory complaints, and reported no insect or dog bites. His physical examination was normal, but each episode of fever and myalgia was accompanied by high C-reactive protein (CRP) blood levels , while liver enzyme concentrations remained normal. At each episode, both the inflammatory syndrome and the clinical complaints decreased partially or completely within less than 1 month, as illustrated in Fig. 1 , without any explanation or specific treatment. The patient was hospitalized at each episode for exhaustive infectious evaluations, and blood cultures were sampled at each HD session, as well as during chills and/or peaks of temperature. All bacteriological blood cultures remained negative, as well as viral serologies for HIV, hepatitis A, B and C. Chest radiography did not show any infiltrate, cavity or calcification, whereas a Computed Tomography (CT) scan demonstrated a pulmonary infiltrate in the left lower lobe, and a mediastinal adenopathy. Ultrasounds of the arterio-venous graft excluded a collection near the prosthetic material. Given the impaired immunity related to the ESRD, the frequent travels to Egypt and the past history of schistosomiasis, a recurrence of parasitic infection was suspected and the patient received an empirical treatment based on praziquantel, despite the absence of parasitological proof of Shistosomiasis. A second CT scan performed 3 months later confirmed the presence of a pulmonary infiltrate in the left lower lobe and demonstrated several mediastinal lymphadenopathies. A multitude of differential diagnoses were evoked, including infectious diseases ( M. tuberculosis or atypical mycobacteria, herpes virus, histoplasmosis, toxoplasmosis, leishmaniosis, trypanosomiasis, filariasis, rickettsiosis), systemic diseases (sarcoidosis, systemic lupus erythematosus, dermatomyositis, Sjogren, Sharp, Castelman syndrome, histiocytosis, anthraco-silicosis) and neoplastic diseases (Hodgkin disease or other lymphoma, leukemia, metastasis of a solid cancer). Viral, parasitic and auto-immune serologies were all negative as were several searches for parasites in the feces. An endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS) of a mediastinal lymph node was performed, but provided no element in favor of any infectious or neoplastic disease, although sinus histiocytosis was demonstrated. To exclude M. tuberculosis infection, PCR and cultures were performed on broncho-alveolar lavage fluid and on the mediastinal lymph node aspiration, and they were negative. A TST was not performed because of its poor negative predictive value in HD patients . Instead, we performed two well-standardized home-made IGRA on peripheral blood mononuclear cells (PBMC) and compared the IFN-ฮณ secretion induced by ESAT-6 with that induced by HBHA. The secretion of IFN-ฮณ upon stimulation with purified protein derivative (PPD or tuberculin) was used as a positive control of mycobacterial infection [ 22 โ€“ 24 ]. In addition, staphylococcal enterotoxin B (SEB) was used as a positive control for T cell reactivity, while the negative control contained no added stimulant. These IGRA performed in October 2012 resulted in a very high level of IFN-ฮณ secretion in response to ESAT-6 and a low level in response to HBHA (Table 1 ). Combined with the clinical presentation, these results were highly suggestive of aTB, but this diagnosis was at that time not retained because of the negative microbiological results. In October 2012, after the same recurrent complaints, a 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18FDG PET-CT) was performed with the hope to identify a lesion accessible for biopsy. It only confirmed the existence of several FDG-active mediastinal lymphadenopathies accompanied by a small subpleural infiltrate in the left lower lobe. Several lymph nodes were removed by mediastinoscopy but Ziehl-Neelsen acid-fast stain was negative as were M. tuberculosis cultures and PCR. Fig. 1 Evolution of CRP levels from January 2012 until January 2017. CRP concentrations were measured in blood at multiple time-points and are reported in mg/L. Each dot indicates a result of CRP concentration, and the different results are linked by a line. The vertical arrow indicates the time point of the start of the anti-TB quadritherapy Table 1 evolution of the symptoms, the treatment and IGRA results Dates October 2012 April 2013 July 2015 January 2016 February 2018 May 2018 Symptoms Fever, myalgia Fever, myalgia Fever, myalgia Absent Absent absent PET-CT Mediastinal adenopathies Mediastinal adenopathies+ pulmonary nodules Cervical, retro-clavicular, mediastinal, retroperitoneal, hepatic hilar adenopathies + pulmonary nodule NA NA NA M. tuberculosis culture/PCR Negative Negative Positive NA NA NA Treatment Anti-TB No No Yes Yes No No Kidney graft No No No No Yes Yes Immuno-suppression No No No No Yes Yes IGRA results (pg/ml) Neg control 0 NA NA 0 NA 0 Pos control 27,464 34,803 4767 PPD 28,164 23,611 202 HBHA 2862 6362 0 ESAT-6 13,166 6118 85 PET-CT: Positron Emission Tomography/Computed Tomography; Neg .: negative; Pos .: positive; NA : not available; IGRA : interferon--release assay; SEB : staphylococcal enterotoxin B; PPD : purified protein derivative; HBHA : heparin-binding-hemagglutinin; ESAT-6 : early-secreted-antigen target-6; IGRA positivity limits: Pos control > 2000 pg/ml - PPD > 200 pg/ml - HBHA > 50 pg/ml โ€“ ESAT-6 > 50 pg/ml
4.105469
0.975098
sec[2]/p[1]
en
0.999997
32498706
https://doi.org/10.1186/s12882-020-01875-w
[ "mediastinal", "igra", "control", "several", "fever", "myalgia", "blood", "tomography", "esat", "hbha" ]
[ { "code": "CB22.Z", "title": "Disease of mediastinum, unspecified" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "CB22.Y", "title": "Other specified diseases of mediastinum, not elsewhere classified" }, { "code": "2F91.Y&XA7WA2", "title": "Neoplasms of unknown behaviour of mediastinum" }, { "code": "CB22.0", "title": "Fibrosing mediastinitis" }, { "code": "6C01.Z", "title": "Encopresis, unspecified" }, { "code": "6C00.Z", "title": "Enuresis, unspecified" }, { "code": "MF50.2Z", "title": "Urinary incontinence, unspecified" }, { "code": "5A14", "title": "Diabetes mellitus, type unspecified" }, { "code": "6C0Z", "title": "Elimination disorders, unspecified" } ]
=== ICD-11 CODES FOUND === [CB22.Z] Disease of mediastinum, unspecified Also known as: Disease of mediastinum, unspecified | Diseases of mediastinum, not elsewhere classified | disease of mediastinum | disorder of mediastinum | mediastinal disease [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [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 [CB22.0] Fibrosing mediastinitis Definition: Fibrosing mediastinitis, also known as sclerosing mediastinitis or mediastinal fibrosis, is a disorder characterised by an excessive fibrotic reaction in the mediastinum. It can result in compromise of airways, great vessels, and other mediastinal structures, with morbidity directly related to the location and extent of fibrosis. The commonest cause is histoplasmosis, of which it is a rare late complication, but it may also occur in association with other infections and with systemic autoimmune Also known as: Fibrosing mediastinitis | mediastinal fibrosis | idiopathic mediastinal fibrosis | Histoplasmosis-related fibrosing mediastinitis | Histoplasmosis-related mediastinal fibrosis mediastinitis [6C01.Z] Encopresis, unspecified Also known as: Encopresis, unspecified | Encopresis | Problems of bowel control | encopresis of nonorganic origin | faecal incontinence of nonorganic origin [6C00.Z] Enuresis, unspecified Also known as: Enuresis, unspecified | Enuresis | Functional enuresis | Problems of bladder control | enuresis NOS [MF50.2Z] Urinary incontinence, unspecified Also known as: Urinary incontinence, unspecified | Urinary incontinence | urinary incontinence, NOS | bladder incontinence NOS | absence of bladder continence [5A14] Diabetes mellitus, type unspecified Also known as: Diabetes mellitus, type unspecified | diabetes NOS | DM - [diabetes mellitus] NOS | severe diabetes mellitus | sudden-onset diabetes mellitus Excludes: Idiopathic Type 1 diabetes mellitus | Type 2 diabetes mellitus | Diabetes mellitus, other specified type [6C0Z] Elimination disorders, unspecified Also known as: Elimination disorders, unspecified | Problems of bowel or bladder control === GRAPH WALKS === --- Walk 1 --- [CB22.Z] Disease of mediastinum, unspecified --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora... --CHILD--> [CB22.Z] Disease of mediastinum, unspecified --- Walk 2 --- [CB22.Z] Disease of mediastinum, unspecified --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora... --CHILD--> [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified --- Walk 3 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with... --CHILD--> [?] Bronchopleural tuberculosis --- Walk 4 --- [CA44] Pyothorax Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ... --PARENT--> [?] Lung infections Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source.... --CHILD--> [CA42] Acute bronchitis Def: An acute disease of the bronchi, commonly caused by an infection with a bacterial or viral source. This disease is characterised by inflammation of the bronchi. This disease presents with cough, wheez... --- Walk 5 --- [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora... --CHILD--> [CB22.Z] Disease of mediastinum, unspecified --- Walk 6 --- [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora... --CHILD--> [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified
[ "[CB22.Z] Disease of mediastinum, unspecified\n --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified\n Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora...\n --CHILD--> [CB22.Z] Disease of mediastinum, unspecified", "[CB22.Z] Disease of mediastinum, unspecified\n --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified\n Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora...\n --CHILD--> [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --CHILD--> [?] Bronchopleural tuberculosis", "[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --PARENT--> [?] Lung infections\n Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....\n --CHILD--> [CA42] Acute bronchitis\n Def: An acute disease of the bronchi, commonly caused by an infection with a bacterial or viral source. This disease is characterised by inflammation of the bronchi. This disease presents with cough, wheez...", "[CB22.Y] Other specified diseases of mediastinum, not elsewhere classified\n --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified\n Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora...\n --CHILD--> [CB22.Z] Disease of mediastinum, unspecified", "[CB22.Y] Other specified diseases of mediastinum, not elsewhere classified\n --PARENT--> [CB22] Diseases of mediastinum, not elsewhere classified\n Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora...\n --CHILD--> [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified" ]
CB22.Z
Disease of mediastinum, unspecified
[ { "from_icd11": "CB22.Z", "icd10_code": "J9859", "icd10_title": "Other diseases of mediastinum, not elsewhere classified" }, { "from_icd11": "CB22.Z", "icd10_code": "J9851", "icd10_title": "Mediastinitis" }, { "from_icd11": "CB22.Z", "icd10_code": "J985", "icd10_title": "Diseases of mediastinum, not elsewhere classified" }, { "from_icd11": "CA44", "icd10_code": "J869", "icd10_title": "Pyothorax without fistula" }, { "from_icd11": "CA44", "icd10_code": "J860", "icd10_title": "Pyothorax with fistula" }, { "from_icd11": "CA44", "icd10_code": "J85-J86", "icd10_title": "" }, { "from_icd11": "CA44", "icd10_code": "J86", "icd10_title": "Pyothorax" }, { "from_icd11": "6C01.Z", "icd10_code": "F981", "icd10_title": "Encopresis not due to a substance or known physiological condition" }, { "from_icd11": "6C00.Z", "icd10_code": "F980", "icd10_title": "Enuresis not due to a substance or known physiological condition" }, { "from_icd11": "MF50.2Z", "icd10_code": "N39498", "icd10_title": "Other specified urinary incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3941", "icd10_title": "Urge incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3946", "icd10_title": "Mixed incontinence" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3945", "icd10_title": "Continuous leakage" }, { "from_icd11": "MF50.2Z", "icd10_code": "N3944", "icd10_title": "Nocturnal enuresis" }, { "from_icd11": "MF50.2Z", "icd10_code": "N39490", "icd10_title": "Overflow incontinence" } ]
J9859
Other diseases of mediastinum, not elsewhere classified
A 36-year-old woman with height of 160 cm and weight of 62 kg was admitted to the hospital because of a 4-year history of uterine fibroids and 1-month history of frequent urination. Multiple uterine fibroids and incomplete uterine mediastinum were found on ultrasound examination. Routine blood examination findings, liver and kidney function, electrolyte levels, and coagulation function were in the normal range preoperatively. On the third day of admission, hysteroscopic mediastinotomy combined with myomectomy was performed under general anesthesia. During the operation, 7500 mL 1.5% glycine infusion solution was used, the uterine distention pressure was 100 mm Hg, and the difference in uterine distention liquid was 1500 mL. After the operation, the patient experienced sudden cardiac arrest; cardiopulmonary resuscitation (CPR) comprising chest cardiac compression, epinephrine, furosemide, and 25% mannitol, was applied immediately; 200 J electric defibrillation was performed 3 times. Blood gas analysis revealed the following: pH, 7.026; Na + , 110.7 mmol/L; K + , 4.90 mmol/L; base excess, โˆ’11 mmol/L; and lactic acid, 18 mmol/L. Twenty-six minutes after CPR was commenced, the patient's spontaneous heartbeat recovered. Electrocardiogram monitoring revealed a heart rate of 100 beats/min, the blood pressure was 95/58 mm Hg (epinephrine 0.4 ฮผg/kg/min, norepinephrine 1.0 ฮผg/kg/min), and the peripheral oxygen saturation was 73%. Physical examination found a bilateral pupil diameter of 5 mm and lack of a direct light reflex, a large number of blister sounds on double lung auscultation, pink foamy liquid in the tracheal cannula, terminal cyanosis of the lips and extremities, facial swelling, and a Glasgow coma score of E1VTM1. Blood gas analysis after initial resuscitation revealed pH 7.296, PO 2 42.7 mm Hg, PCO 2 51.1 mm Hg, base excess โˆ’15 mmol/L, and Na + 118.1 mmol/L. The left ventricular ejection fraction was 62.62% on echocardiography . Furosemide 200 mg, 5% bicarbonate injection 375 mL, and 3% sodium chloride injection 100 mL were prescribed. The parameters of the ventilator were adjusted to an oxygen concentration of 100%, respiratory rate of 20 beats/min, positive end-expiratory pressure of 10 cmH 2 O, and an inspiratory time of 1.0 second. Oxygenation did not improve and pulmonary ultrasound revealed a significant number of B lines . The indication for acute VV ECMO was confirmed by the ECMO team. We installed the VV ECMO equipment (centrifugal pump, Maquet Rotaflow RF 32; Maquet Cardiopulmonary AG, Hirrlingen, Germany) at the bedside. A 17-French ECMO catheter (Duraflo, Edwards Lifesciences; Irvine, CA) was inserted via the right internal jugular vein, between the superior vena cava and right atrium; a 19-French catheter was inserted into the femoral vein and advanced under B-mode ultrasound guidance. Both catheters were then connected to their respective ECMO sheaths. The ECMO was set to a flow rate of 4.0 L/min, with a pump speed of 3000 r/min, return pressure of 120 mm Hg, and access pressure of โˆ’40 mm Hg. No anticoagulation was selected within 24 hours because of the bloody fluid in the catheter and heparin-coated lung. After 4 hours of ECMO, the blood pressure was maintained at 100/65 mm Hg. Epinephrine was gradually stopped, and norepinephrine was gradually reduced to 0.4 ฮผg/kg/min. The patient was transferred to the intensive care unit (ICU). Subsequent examination revealed radial artery blood gas pH, 7.30; PO 2 , 62 mm Hg; PCO 2 , 32 mm Hg; lactic acid, 15 mmol/L; base excess, โˆ’8.5 mmol/L; Na + , 130 mmol/L; creatinine, 235 ฮผmol/L (normal value <80 ฮผmol/L); free hemoglobin, 84 mg/L (normal value; 0โ€“40 mg/L); prothrombin time, 23 seconds; and activated partial thromboplastin time (APTT), 120 seconds. The oxygen concentration of the ventilator was adjusted to 40%, lung recruitment strategy, and head hypothermia brain protection, blood transfusion, infection prevention, diuresis, and maintaining the stability of the internal environment were treated. After 12 hours of ECMO, the patient could open their eyes in response to calls and partially obeyed the doctor's commands. After 24 hours of ECMO, heparin was used for anticoagulation, and the APTT was maintained at 55 to 60 seconds. Concomitantly, norepinephrine was gradually reduced and stopped, serum sodium (137 ฮผmol/L) returned to the normal range. On the 5th day of VV ECMO, a small amount of exudation was seen on chest X-ray, and the heart rate, blood pressure, and peripheral oxygen saturation did not change after 2 hours of oxygen deprivation; blood gas analysis revealed pH, 7.36; PO 2 , 86 mm Hg; and PCO 2 , 38.2 mm Hg. The patient was weaned from VV ECMO safely. Thrombi in the right internal jugular vein and the left lower limb intermuscular vein were detected using bedside ultrasonography. Low molecular weight heparin was used to anticoagulate for . On the 7th day of admission to the ICU, the patient was weaned from the ventilator after a spontaneous breathing test. At the same time, computed tomography (CT) revealed a small subarachnoid hemorrhage, a small hematoma in the right renal capsule, and multiple rib fractures ; the anticoagulant drug was changed to rivaroxaban 20 mg once per day. After 18 days in the ICU, the patient was transferred back to the Obstetrics and Gynecology Department for further treatment. One month later, ultrasound examination revealed that the lower extremity venous thrombosis had disappeared, the right internal jugular vein was partially recanalized, and the head CT revealed no abnormality. After 45 days, the patient was discharged and followed up for 6 months.
3.931641
0.976563
sec[1]/p[0]
en
0.999997
33847671
https://doi.org/10.1097/MD.0000000000025519
[ "ecmo", "blood", "mmol", "pressure", "uterine", "oxygen", "vein", "hours", "ultrasound", "time" ]
[ { "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": "GB42.1", "title": "Albuminuria, Grade A3" }, { "code": "GB42.0", "title": "Albuminuria, Grade A2" }, { "code": "MA18.0Y", "title": "Other specified elevated blood glucose level" } ]
=== 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 [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 === 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 --PARENT--> [PK81] Certain medical procedures associated with injury or harm in therapeutic use --CHILD--> [PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use --- 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 --CHILD--> [QC48.0] Personal history of long-term use of anticoagulants --- Walk 5 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Diseases of the immune system --- Walk 6 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics
[ "[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 --PARENT--> [PK81] Certain medical procedures associated with injury or harm in therapeutic use\n --CHILD--> [PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use", "[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 --CHILD--> [QC48.0] Personal history of long-term use of anticoagulants", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics" ]
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
A 50-year-old man with no significant comorbidities and a smoking history of over 50 pack-years presented with 3 months progressive fatigue, muscles weakness and diffuse joint pain (especially in both hips and shoulders) associated with heliotrope rash , photosensitivity with purplish sunburn reaction over dรฉcolletรฉ and anterior chest and papules overlying Interphalangeal joints of the hands (Gottronโ€™s papules) . Laboratory evaluation showed normocytic anemia, transaminitis and a creatine phosphokinase (CPK) level of 3500 units/L (normal 26โ€“192 UI/L). Electromyography and muscle biopsy supported the preliminary diagnosis of inflammatory myopathy. Screening for specific antibodies of myositis were positive for anti-transcription intermediary factor 1 gamma (anti-TIF1-ฮณ) corroborating the diagnosis of DM. The patient underwent whole-body computed tomography (CT) with IV contrast that was negative for neoplastic diseases. He received IV high-dose corticosteroids with no response. A 3-month second-line therapy course of IVIG at a dose of 2.0 g per kilogram of body weight were administrated leading to a prompt reduction of both CPK level and DM clinical manifestations. Prednisone was tapered over 8 weeks. About six months later the diagnosis of DM, the patient suddenly presented gross hematuria with severe anemia, hypotension and suprapubic pain, all coinciding with a mild exacerbation of cutaneous and muscular manifestation of DM as heliotrope rash and muscles weakness and pain requiring an increase of daily prednisone. An abdominal CT with IV contrast showed irregular bladder wall thickening with foci of urothelial hyperenhancement and a vascularized mass along posterior wall, several enlarged pelvic lymph nodes, two suspected liver metastases in the right lobe and also a bone metastasis in left ischiopubic ramus. Bladder biopsy taken during cystoscopy demonstrated urothelial carcinoma. Cancer staging was completed with brain and thoracic CT, showing negative results, and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) that confirmed locoregional nodal, bone and liver metastasis. Due to intractable hematuria, the patient underwent palliative radical cystectomy, lymphadenectomy and Bricker-type cutaneous ureteral ileostomy, with diagnosis of sarcomatoid urothelial carcinoma infiltrating the entire bladder wall and local lymph nodes (stage pT4N2). One month after surgery, he was started on first-line chemotherapy with cisplatin and gemcitabine with concomitant administration of pegfilgrastim and dexamethasone during each cycle. We knew that our patient would be candidate to receive avelumab as maintenance therapy or pembrolizumab as second-line treatment subsequently chemotherapy; therefore, after multidisciplinary discussion involving rheumatologist and medical oncologist as well the patient itself, we decided to administrate another 3-month course IVIG preceding ICI initiation to reduce the risk of DM exacerbation as well as steroid sparing agent to avoid any potential loss of efficacy. In the course of chemotherapy DM symptoms and laboratory tests (CPK and inflammatory markers) gradually improved also due to IVIG administration and daily prednisone was gradually tapered to < 10 mg. A whole-body CT scan performed after four cycles revealed metastatic progression in bone (right ischiopubic ramus and iliac wing) and lungs with round sharply nodules of varying size throughout the pulmonary fields. Due to disease progression, the patient started pembrolizumab continuing with the administration of IVIG to prevent DM exacerbation. During immunotherapy the patient was closely monitored to assess the onset of irAEs: physical examination, kidney, liver and pancreatic function tests together with thyroid and pituitary gland function tests and CPK were performed before each ICI administration, while echocardiogram was done every 3 cycles. Pembrolizumab was well tolerated: the patient was totally asymptomatic and did not report any irAEs as well as any exacerbation of myopathy symptoms and skin manifestation related to DM. The first CT scan performed after the fourth cycle showed stable disease; on the assumption of good tolerance and efficacy, the patient continued pembrolizumab and concomitant IVIG administration. Unfortunately, six months after starting immunotherapy the patient re-experienced heliotrope rash around eyes and on both cheeks and erythema over chest and upper back, followed by muscle weakness of the extremities and myalgia without oculomotor involvement; serum CPK restarted growing. DM exacerbation required higher dose of steroids; at the same time, pembrolizumab was discontinued and a whole-body CT scan was performed showing cancer progression in liver. Therefore, the patient started treatment with enfortumab vedotin (EV) continuing with concomitant administration of high-dose corticosteroids and IVIG due to DM exacerbation. Two days after EV first administration, he experienced a severe worsening of skin manifestation involving all the extremities, extreme muscle weakness, difficulties in walking and swallowing. Supportive therapy with fluids, parenteral nutrition and intravenous higher dose of steroids were administrated achieving a gradually improvement of clinical condition within four weeks. A whole-body CT scan showed further disease progression with new bone lesions in the T12-L2 vertebral bodies, lymph node metastasis in the mediastinal and abdominal fields and major metastatic dissemination in lungs. The patient received fourth line therapy with weekly paclitaxel but he passed away two months after starting chemotherapy.
3.992188
0.978027
sec[1]/p[0]
en
0.999998
40165953
https://doi.org/10.3389/fimmu.2025.1558964
[ "administration", "ivig", "exacerbation", "body", "pembrolizumab", "over", "weakness", "whole", "line", "liver" ]
[ { "code": "PL14.0", "title": "Non-administration of necessary drug" }, { "code": "3B51", "title": "Acquired fibrinolytic defects" }, { "code": "PL13.50", "title": "Incorrect route of drug or medicament, as mode of injury" }, { "code": "PL13.52", "title": "Incorrect timing of drug or medicament, as mode of injury" }, { "code": "QA01.Z", "title": "Examination or encounter for administrative purposes, unspecified" }, { "code": "CA22.0", "title": "Chronic obstructive pulmonary disease with acute exacerbation, unspecified" }, { "code": "EK5Y", "title": "Other specified skin disorders provoked by external factors" }, { "code": "CA23.30", "title": "Unspecified asthma with exacerbation" }, { "code": "CA25.Z", "title": "Cystic fibrosis, unspecified" }, { "code": "BD42.1", "title": "Secondary Raynaud phenomenon" } ]
=== ICD-11 CODES FOUND === [PL14.0] Non-administration of necessary drug Also known as: Non-administration of necessary drug | Nonadministration of necessary drug, medicament or biological substance Excludes: Underdosing, as mode of injury or harm [3B51] Acquired fibrinolytic defects Definition: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in the fibrinolysis system leading to coagulation of the blood. This disease may present with thrombosis. Also known as: Acquired fibrinolytic defects | Drug-induced fibrinolytic disorder | medicament-induced fibrinolytic disorder | Fibrinolytic disorder due to administration of tissue-type plasminogen activator | Fibrinolytic disorder due to administration of tPA - [ tissue-type plasminogen activator] [PL13.50] Incorrect route of drug or medicament, as mode of injury Also known as: Incorrect route of drug or medicament, as mode of injury | wrong route of administration of drug | route error | administration error involving route of drug | medication error involving route of drug Excludes: Overdose of substance, as mode of injury or harm [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 [QA01.Z] Examination or encounter for administrative purposes, unspecified Also known as: Examination or encounter for administrative purposes, unspecified | Examination or encounter for administrative purposes [CA22.0] Chronic obstructive pulmonary disease with acute exacerbation, unspecified Definition: An acute unspecified exacerbation of COPD is an acute event characterised by a worsening of the patientโ€™s respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medication. Exacerbations of COPD can be precipitated by several factors. The diagnosis of an exacerbation relies exclusively on the clinical presentation of the patient complaining of an acute change of symptoms (baseline dyspnoea, cough, and/or sputum production) that is beyond normal day-to-day varia Also known as: Chronic obstructive pulmonary disease with acute exacerbation, unspecified | exacerbation COPD NOS | acute exacerbation COPD | AECOPD โ€“ [acute exacerbation of chronic obstructive pulmonary disease] | Chronic obstructive pulmonary disease with acute exacerbation, unspecified, very severe airflow limitation [EK5Y] Other specified skin disorders provoked by external factors Also known as: Other specified skin disorders provoked by external factors | Dermatoses provoked by physical or environmental factors | Piezogenic pedal papules | Occupational callosities | Interdigital pilonidal sinus [CA23.30] Unspecified asthma with exacerbation Definition: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute sudden worsening. Also known as: Unspecified asthma with exacerbation | Unspecified asthma with acute exacerbation [CA25.Z] Cystic fibrosis, unspecified Also known as: Cystic fibrosis, unspecified | Cystic fibrosis | mucoviscidosis | CF - [cystic fibrosis] | cystic fibrosis nos [BD42.1] Secondary Raynaud phenomenon Also known as: Secondary Raynaud phenomenon | Raynaud syndrome | Raynaud phenomenon due to nonorgan specific systemic autoimmune disorder | Raynaud phenomenon secondary to non organ specific systemic autoimmune disorder | Raynaud phenomenon due to other specified disorder === GRAPH WALKS === --- Walk 1 --- [PL14.0] Non-administration of necessary drug --EXCLUDES--> [?] Underdosing, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 2 --- [PL14.0] Non-administration of necessary drug --EXCLUDES--> [?] Underdosing, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 3 --- [3B51] Acquired fibrinolytic defects Def: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in th... --PARENT--> [?] Fibrinolytic defects Def: A disease caused by determinants arising during the antenatal period, after birth or genetically inherited factors, affecting the fibrinolysis system which prevents blood clots from growing and becomi... --CHILD--> [3B51] Acquired fibrinolytic defects Def: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in th... --- Walk 4 --- [3B51] Acquired fibrinolytic defects Def: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in th... --PARENT--> [?] Fibrinolytic defects Def: A disease caused by determinants arising during the antenatal period, after birth or genetically inherited factors, affecting the fibrinolysis system which prevents blood clots from growing and becomi... --CHILD--> [3B50] Inherited fibrinolytic defects Def: A disease caused by genetically inherited mutations affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in the ... --- Walk 5 --- [PL13.50] Incorrect route of drug or medicament, as mode of injury --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm Def: Incorrect dose - too high... --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 6 --- [PL13.50] Incorrect route 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
[ "[PL14.0] Non-administration of necessary drug\n --EXCLUDES--> [?] Underdosing, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PL14.0] Non-administration of necessary drug\n --EXCLUDES--> [?] Underdosing, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[3B51] Acquired fibrinolytic defects\n Def: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in th...\n --PARENT--> [?] Fibrinolytic defects\n Def: A disease caused by determinants arising during the antenatal period, after birth or genetically inherited factors, affecting the fibrinolysis system which prevents blood clots from growing and becomi...\n --CHILD--> [3B51] Acquired fibrinolytic defects\n Def: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in th...", "[3B51] Acquired fibrinolytic defects\n Def: A disease caused by determinants arising after birth, affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in th...\n --PARENT--> [?] Fibrinolytic defects\n Def: A disease caused by determinants arising during the antenatal period, after birth or genetically inherited factors, affecting the fibrinolysis system which prevents blood clots from growing and becomi...\n --CHILD--> [3B50] Inherited fibrinolytic defects\n Def: A disease caused by genetically inherited mutations affecting the fibrinolysis system which prevents blood clots from growing and becoming problematic. This disease is characterised by defects in the ...", "[PL13.50] Incorrect route 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 --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[PL13.50] Incorrect route 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" ]
PL14.0
Non-administration of necessary drug
[ { "from_icd11": "PL14.0", "icd10_code": "Y636", "icd10_title": "Underdosing and nonadministration of necessary drug, medicament or biological substance" }, { "from_icd11": "3B51", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "QA01.Z", "icd10_code": "Z0289", "icd10_title": "Encounter for other administrative examinations" }, { "from_icd11": "QA01.Z", "icd10_code": "Z0281", "icd10_title": "Encounter for paternity testing" }, { "from_icd11": "QA01.Z", "icd10_code": "Z0283", "icd10_title": "Encounter for blood-alcohol and blood-drug test" }, { "from_icd11": "QA01.Z", "icd10_code": "Z765", "icd10_title": "Malingerer [conscious simulation]" }, { "from_icd11": "QA01.Z", "icd10_code": "Z02", "icd10_title": "Encounter for administrative examination" }, { "from_icd11": "QA01.Z", "icd10_code": "Z028", "icd10_title": "Encounter for other administrative examinations" }, { "from_icd11": "QA01.Z", "icd10_code": "Z029", "icd10_title": "Encounter for administrative examinations, unspecified" }, { "from_icd11": "QA01.Z", "icd10_code": "Z76", "icd10_title": "Persons encountering health services in other circumstances" }, { "from_icd11": "CA22.0", "icd10_code": "J441", "icd10_title": "Chronic obstructive pulmonary disease with (acute) exacerbation" }, { "from_icd11": "EK5Y", "icd10_code": "L259", "icd10_title": "Unspecified contact dermatitis, unspecified cause" }, { "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" } ]
Y636
Underdosing and nonadministration of necessary drug, medicament or biological substance
A 67 years old male, a non-smoker, with history of ischaemic heart disease, status postโ€”coronary artery bypass graft, and bronchiectasis was diagnosed to have angioimmunoblastic T-cell lymphoma (AIBTCL), stage III B at King Faisal Specialist Hospital and Research Centre (KFSH&RC) in Riyadh in late December 2004. He presented with: fever, skin rash, generalized external lymphadenopathy and splenomegaly. The blood counts, blood film and bone marrow biopsy were all normal. The renal and hepatic profiles as well as the immunoglobulin levels were within normal limits. Serological tests for CMV, Epstein-Barr virus (EBV), hepatitis C virus and HIV were negative. Computed tomography (CT) scans of chest, abdomen and pelvis showed numerous small lymph nodes in mediastinal, mesenteric and retroperitoneal areas in addition to splenomegaly with focal splenic lesions. Skin biopsy showed atypical lymphohistiocytic changes. A right axillary lymph node biopsy revealed diffuse infiltration with: immunoblasts, lymphocytes, polymorphs, plasma cells, histiocytes and eosinophils with considerable proliferation of small blood vessels. The immunohistochemical stains showed positive: CD1A, CD3, CD4, CD7, CD8, CD15, CD20, CD21, CD30, CD45, CD68 and S100. The gene rearrangement studies revealed a monoclonal T-cell population. The AIBTCL was treated with: prednisone, mycophenolate mofetil and subcutaneous alemtuzumab: 30 mg/month for 4 months. Thereafter the patient developed: CMV infection treated with IV ganciclovir and pulmonary embolism treated with IV heparin then oral warfarin. On 29/10/06, the patient was readmitted with two week history of: fever, cough productive of yellowish sputum and mild dyspnea. He denied any associated chest or abdominal pain, headache or bleeding from any site. Physical examination revealed an unwell elderly male who was in mild respiratory distress. The temperature was 38.7 ยฐC, blood pressure (BP): 112/68 mmHg, pulse rate: 92/minute, respiratory rate: 20/minute and oxygen saturation was 93% on room air. There was pallor but no cyanosis, leg oedema, jaundice or external lymphadenopathy. The inspiratory volume was decreased and coarse crackles were heard over mid and lower lung fields bilaterally. There was no abdominal distension, tenderness or palpable organomegaly. Cardiovascular and neurological examinations did not reveal any abnormality. Full blood count (FBC) showed: WBC: 1.83 ร— 10 9 /L, Hb: 109 g/L and PLT: 315 ร— 10 9 /L. Differential cell count (DCC) showed neutrophils of 1.1 and lymphocytes of 0.3. Renal and hepatic profiles were all within normal limits. Blood, urine, stool cultures and CMV antigen test were all negative. Chest radiography showed bronchiectatic changes involving both lower lobes and bilateral nodular infiltration consistent with severe pneumonia. The patient was commenced on IV tazobactam-piperacillin: 4.5 grams thrice daily and gentamicin 2 mg/kg IV twice daily in addition to oxygen via mask at 2โ€“4 Liter/minute and IV fluids at rate of 50โ€“80 cc/hour. Initially the patient had partial response then he started to have higher pyrexia and respiratory distress. On 6/11/2006, the patient was experiencing high grade fever and rigors and his BP dropped to 85/45 mmHg. Septic screens were repeated and the IV antibiotics were replaced by IV meropenem 1 gram thrice daily and IV vancomycin 1 gram twice daily. Later on, BP improved and fever started to subside. A repeat CT scan of the chest showed: bronchiectatic cavities involving the lower lobes of both lungs, bilateral nodular infiltration, areas of segmental consolidation and bilateral pleural thickening . Echocardiogram showed no vegetations, pericardial effusions or valvular defects and brain CT scan showed no evidence of space occupying lesions. Bronchoscopy was performed and BAL fluid showed scattered lipid laden macrophages and gram positive rods identified later on as Nocardia asteroides ( N. asteroides ). Special stains for fungi were positive and the fungus was identified as Aspergillus niger ( A. niger ). BAL fluid was negative for acid fast bacilli, pneumocystis carinii, viral cytopathy and malignant cells. Meanwhile, the previously taken sputum cultures grew branching gram positive rods identified as N. asteroides . However, sputum cultures were negative for acid fast bacilli, candida and aspergillus. Aspergillus galactomannan test was positive. Consequently, the following management modifications were made: vancomycin was stopped and meropenem was continued, IV liposomal amphotericin-B (amBisome) 5 mg/kg/day was commenced in addition to oral trimethoprim-sulphamethoxazole (TMP/SMZ) 960 mg thrice daily as well as IV amikacin 15 mg/kg/day. Later on, the patient started to improve clinically and radiologically and oxygen requirements decreased gradually. One week later, the patient sustained his hemodynamic stability and his clinical improvement so IV meropenem was discontinued. On 20/11/2006, IV amikacin was stopped and IV amBisome was replaced by oral voriconazole. Two days later; the patient was totally asymptomatic and his physical examination showed few basal crackles with good air entry bilaterally. FBC showed WBC: 2.25 ร— 10 9 /L with neutrophils of 1.4, Hb: 94 g/L and PLT: 147 ร— 10 9 /L. Renal and hepatic profiles were normal. He was discharged on: voriconazole 200 mg orally twice daily and TMP/SMZ 960 mg orally thrice daily for 6 weeks in addition to warfarin, omeprazole, prophylactic valganciclovir as well as ventolin and atrovent inhalers. Thereafter, the patient had regular follow up at the hematology outpatient clinic and he remained clinically stable.
4.015625
0.979004
sec[1]/p[0]
en
0.999996
24179349
N/A
[ "daily", "blood", "fever", "chest", "addition", "thrice", "gram", "cell", "biopsy", "renal" ]
[ { "code": "QF21", "title": "Difficulty or need for assistance with general life tasks or life management" }, { "code": "8A83", "title": "Other primary headache disorder" }, { "code": "QB42", "title": "Dependence on renal dialysis" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" }, { "code": "MG26", "title": "Fever of other or unknown origin" }, { "code": "1D81.Z", "title": "Infectious mononucleosis, unspecified" } ]
=== ICD-11 CODES FOUND === [QF21] Difficulty or need for assistance with general life tasks or life management Also known as: Difficulty or need for assistance with general life tasks or life management | difficulty with carrying out tasks and daily routine | life management problem | difficulty with life management tasks | Difficulty with dealing with change such as relocation Includes: difficulty with carrying out tasks and daily routine [8A83] Other primary headache disorder Definition: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attributed to direct physical but innocuous stimuli; epicranial headaches; and other miscellaneous primary headache disorders. Also known as: Other primary headache disorder | Primary cough headache | Primary exercise headache | Primary headache associated with sexual activity | Preorgasmic headache [QB42] Dependence on renal dialysis Also known as: Dependence on renal dialysis | renal dialysis status | presence of arteriovenous shunt for dialysis | dependence on haemodialysis | Dependence on renal dialysis, acute haemodialysis Includes: renal dialysis status Excludes: dialysis preparation, treatment or session [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 [MG26] Fever of other or unknown origin Definition: An abnormal elevation of body temperature of unknown origin, often as a result of a pathologic process. Also known as: Fever of other or unknown origin | febrile | febris | fever | feverish Excludes: fever of unknown origin in newborn | Malignant hyperthermia due to anaesthesia [1D81.Z] Infectious mononucleosis, unspecified Also known as: Infectious mononucleosis, unspecified | Infectious mononucleosis | Glandular fever | Gammaherpesviral mononucleosis | kissing disease === GRAPH WALKS === --- Walk 1 --- [QF21] Difficulty or need for assistance with general life tasks or life management --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management --- Walk 2 --- [QF21] Difficulty or need for assistance with general life tasks or life management --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management --- Walk 3 --- [8A83] Other primary headache disorder Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri... --PARENT--> [?] Headache disorders --CHILD--> [8A82] Trigeminal autonomic cephalalgias Def: A group of related primary headache disorders essentially characterised by unilateral headache and trigeminal autonomic activation. In most but not all of these disorders, the headache is short-lastin... --- Walk 4 --- [8A83] Other primary headache disorder Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri... --PARENT--> [?] Headache disorders --CHILD--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --- Walk 5 --- [QB42] Dependence on renal dialysis --EXCLUDES--> [?] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --EXCLUDES--> [?] Dependence on renal dialysis --- Walk 6 --- [QB42] Dependence on renal dialysis --EXCLUDES--> [?] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --CHILD--> [?] Care involving extracorporeal dialysis
[ "[QF21] Difficulty or need for assistance with general life tasks or life management\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[QF21] Difficulty or need for assistance with general life tasks or life management\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[8A83] Other primary headache disorder\n Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri...\n --PARENT--> [?] Headache disorders\n --CHILD--> [8A82] Trigeminal autonomic cephalalgias\n Def: A group of related primary headache disorders essentially characterised by unilateral headache and trigeminal autonomic activation. In most but not all of these disorders, the headache is short-lastin...", "[8A83] Other primary headache disorder\n Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri...\n --PARENT--> [?] Headache disorders\n --CHILD--> [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...", "[QB42] Dependence on renal dialysis\n --EXCLUDES--> [?] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --EXCLUDES--> [?] Dependence on renal dialysis", "[QB42] Dependence on renal dialysis\n --EXCLUDES--> [?] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --CHILD--> [?] Care involving extracorporeal dialysis" ]
QF21
Difficulty or need for assistance with general life tasks or life management
[ { "from_icd11": "QF21", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "QF21", "icd10_code": "Z600", "icd10_title": "Problems of adjustment to life-cycle transitions" }, { "from_icd11": "8A83", "icd10_code": "G44209", "icd10_title": "Tension-type headache, unspecified, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G44221", "icd10_title": "Chronic tension-type headache, intractable" }, { "from_icd11": "8A83", "icd10_code": "G44229", "icd10_title": "Chronic tension-type headache, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G44201", "icd10_title": "Tension-type headache, unspecified, intractable" }, { "from_icd11": "8A83", "icd10_code": "G44219", "icd10_title": "Episodic tension-type headache, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G442", "icd10_title": "Tension-type headache" }, { "from_icd11": "QB42", "icd10_code": "Z992", "icd10_title": "Dependence on renal dialysis" }, { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" } ]
Z742
Need for assistance at home and no other household member able to render care
A 74-year-old Japanese woman, suffering from nonproductive cough for one month, referred to our hospital (a 500-bed city teaching hospital, serving about 560,000 people in southwest Tokyo, Japan) on April 14, 2010, due to having fever for one week. The patient had been medically treated with a calcium blocker and alendronate sodium hydrate because of hypertension and osteoporosis for three years. At the time of the visit for cough, although the patient had neither sputum nor wheezing, there was evidence of only slight infiltration at the lower right lung on the chest X-ray. The patient was almost in the normal range for the ratio of forced expiratory volume in one second (FEV1: 1.42 L) to forced vital capacity (FVC: 1.88 L): the lung function test result was 75.5%, and only normal flora were detected in a provocation sputum culture. She was prescribed a cough medicine and an antibacterial agent (garenoxacin [GRNX], 400 mg/day for five days) with diagnosis of bronchitis; although her cough and other clinical symptoms had reduced for several days, they subsequently returned to their original levels. She referred to our hospital again on May 18 (one month after the first consultation). On the reconsultation day, the patientโ€™s body temperature was 37ยฐC and her unproductive cough was worsened. There was no evidence of swollen lymph nodes, eczema or other abnormalities. The patientโ€™s white blood cell (WBC) count was 11000/ยตL, the percentages of neutrophils and eosinophils were 69.3% and 2.7%, respectively, and C-reactive protein (CRP) concentration was 1.25 mg/dL ( Table 1 ). No other abnormalities were observed in the blood examination. However, a chest CT showed evidence of thickened bronchial walls and mucus plugging, causing a โ€œtree-in-budโ€ pattern on the right lower lobe . At that time, we considered the patient temporarily diagnosed with a bronchial hypersensitivity, such as ABPA, that the imaging findings suggested. However, her unproductive cough remained dry, and no significant bacteria or fungus was detected in cultures of provocation sputum and gastric juice. In addition, both Aspergillus antigen and IgE antibody were negative, and a T-SPOT.TB test was also negative. The patient was treated with cough medicine, an inhaler (budesonid/formoterol), and a leukotriene antagonist after a short-term GRNX prescription (400 mg/day for five days). Although there was no episode of fever, the patientโ€™s unproductive cough was maintained, and the CT findings continued to change from thickened bronchial walls to increased clubbing bronchiectasis and mucoid impaction . Treatment with a macrolide (clarithromycin [CAM], 400 mg/day) was then added, after the patientโ€™s unproductive cough became productive in September 30. Meanwhile, there were no eosinophils in the provocation sputum, and no significant bacteria or fungi were detected in the accompanying cultures. These findings suggested that the patient was suffering from neither bronchial asthma nor ABPA. Her clinical symptoms maintained with scant improvement, and a high fever of 39ยฐC and right chest pain appeared under productive cough and sputum on November 18. The patient was admitted to our hospital for pneumonopleuritis at that time with a respiratory rate of 20 breaths/min, blood pressure of 142/88 mmHg, regular pulse of 96 beats/min, and an oxygen saturation of 95% on room air. The patientโ€™s WBC count was 22500/ยตL, the neutrophils and eosinophils percentages were 82.0% and 0.0%, respectively, and CRP was at 26.29 mg/dL. Since a strong inflammatory response was observed, we considered that the patient had bacteremia. The results of other blood examinations were also in the normal ranges, including the transaminases, except for lactate dehydrogenase (LDH), which was slightly elevated (243 U/L) ( Table 1 ). Both pneumococcal and legionella urine antigen rapid tests were also negative, and no pathogenic organism was detected, although hemoculture, sputum culture, and urinary culture were performed along with antibacterial agent (cefpirome sulfate [CPR], 4 g/day, drip infusion) preinitiation treatment. Four days later, after treatment with CPR, the patientโ€™s fever abated, although a part of her productive cough continued, and WBC and CRP results improved to 12700/ยตL and 8.78 mg/dL, respectively. On November 25, we considered that FBSC should be performed, as the clubbing bronchiectasis and pulmonary atelectasis at the right lower lung had not improvements . FBSC findings of rubor and swelling of the bronchial mucosa at the distal intermediate bronchus were observed. When the purulent sputum was absorbed carefully, a granuloma-like structure was observed, surrounding a white foreign body at the right B9 bronchus , and a roughly 8 ร— 5 ร— 2 mm 3 white foreign body was then extracted from that location . As a result of a pathology search, this white foreign body was identified as a vegetable core , along with a bronchus necrotic tissue. In the culture of the bronchial lavage, no significant bacteria were detected, except for scant alpha streptococcus . After extraction of the foreign body, the productive cough and sputum, as well as the clinical symptoms and blood examination results improved dramatically, and the pulmonary atelectasis also improved . The patient left our hospital on November 30. The cough had disappeared completely during the 18-month period following discharge. As for the chest CT findings at May 8, 2012 (almost 18 months after the TFB extraction), the peripheral portion of the clubbing bronchiectasis observed in the right lower lung had improved, although the central portion remained .
3.958984
0.979492
sec[1]/p[0]
en
0.999998
25031859
https://doi.org/10.5812/ircmj.18199
[ "cough", "sputum", "that", "although", "bronchial", "body", "blood", "fever", "lung", "chest" ]
[ { "code": "MD12", "title": "Cough" }, { "code": "1C12.Z", "title": "Whooping cough, unspecified" }, { "code": "CA20.10", "title": "Simple chronic bronchitis" }, { "code": "1C12.Y", "title": "Other specified whooping cough" }, { "code": "MD22", "title": "Haemoptysis" }, { "code": "MD10", "title": "Abnormal sputum" }, { "code": "MD40.Y", "title": "Other specified clinical findings in specimens from respiratory organs and thorax" }, { "code": "MD40.51", "title": "Positive sputum culture" }, { "code": "1B10.0", "title": "Respiratory tuberculosis, confirmed" }, { "code": "8A80.Z", "title": "Migraine, unspecified" } ]
=== ICD-11 CODES FOUND === [MD12] Cough Definition: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom of most respiratory disorders and may be indicative of trivial to very serious airway or lung pathology. Also known as: Cough | complaining of cough | coughing | finding of cough | observation of cough Excludes: cough with haemorrhage [1C12.Z] Whooping cough, unspecified Also known as: Whooping cough, unspecified | Whooping cough | bordetella infection | bordetellosis | pertussis [CA20.10] Simple chronic bronchitis Also known as: Simple chronic bronchitis | chronic catarrhal bronchitis | Smokers bronchitis | smokers cough [1C12.Y] Other specified whooping cough Also known as: Other specified whooping cough | Whooping cough due to other Bordetella species | Whooping cough due to Bordetella bronchiseptica | whooping cough due to b. bronchiseptica [MD22] Haemoptysis Definition: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries. Also known as: Haemoptysis | blood streaked sputum | coughing up blood | Blood-stained sputum | Cough with haemorrhage Includes: Blood-stained sputum | Cough with haemorrhage [MD10] Abnormal sputum Definition: This category includes the abnormalities of quantity, colour and odor in sputum which may suggest an aetiology. Patients with chronic bronchitis typically expectorate small quantities of mucoid yellow material. A foul or fetid odor should suggest infection from anaerobic organisms, usually in cases of lung abscess. Occasionally, greatly excessive amounts of sputum or "bronchorrhoea" is associated with bronchioloalveolar carcinoma. Also known as: Abnormal sputum | abnormal sputum examination | Abnormal amount of sputum | excess secretion of sputum | excessive sputum Excludes: blood-stained sputum [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 [MD40.51] Positive sputum culture Also known as: Positive sputum culture [1B10.0] Respiratory tuberculosis, confirmed Definition: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough, and sputum production that may be haemorrhagic. Transmission is commonly by inhalation of infected respiratory secretions. Confirmation is by identification of Mycobacterium tuberculosis in clinical samples. Also known as: Respiratory tuberculosis, confirmed | respiratory tuberculosis, with bacteriological or histological confirmation | tuberculosis of chest, with bacteriological or histological confirmation | Tuberculosis of lung, confirmed by sputum microscopy with or without culture | pulmonary tuberculosis confirmed by sputum microscopy with or without culture [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine === GRAPH WALKS === --- Walk 1 --- [MD12] Cough Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ... --EXCLUDES--> [?] Haemoptysis Def: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries.... --PARENT--> [?] Haemorrhage from respiratory passages Def: Haemorrhage from respiratory passages is the bleeding from upper respiratory tract or lower respiratory tract. The major passages and structures of the upper respiratory tract include the nose or nost... --- Walk 2 --- [MD12] Cough Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ... --PARENT--> [?] Symptoms or signs involving the respiratory system --CHILD--> [MD11] Abnormalities of breathing Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing.... --- Walk 3 --- [1C12.Z] Whooping cough, unspecified --PARENT--> [1C12] Whooping cough Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v... --CHILD--> [1C12.1] Whooping cough due to Bordetella parapertussis Def: A disease of the upper respiratory tract, caused by an infection of the gram-negative bacteria Bordetella parapertussis. This disease typically presents with a mild clinical presentation of paroxysmal... --- Walk 4 --- [1C12.Z] Whooping cough, unspecified --PARENT--> [1C12] Whooping cough Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v... --CHILD--> [1C12.0] Whooping cough due to Bordetella pertussis Def: A disease of the upper respiratory tract, caused by an infection of the gram-negative bacteria Bordetella pertussis. This disease typically presents with paroxysmal cough, inspiratory whoop, and faint... --- Walk 5 --- [CA20.10] Simple chronic bronchitis --PARENT--> [CA20.1] Chronic bronchitis --EXCLUDES--> [?] Certain specified chronic obstructive pulmonary disease --- Walk 6 --- [CA20.10] Simple chronic bronchitis --PARENT--> [CA20.1] Chronic bronchitis --CHILD--> [CA20.12] Mixed simple and mucopurulent chronic bronchitis
[ "[MD12] Cough\n Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ...\n --EXCLUDES--> [?] Haemoptysis\n Def: Expectoration or spitting of blood originating from any part of the respiratory tract, usually from haemorrhage in the lung parenchyma and the bronchial arteries....\n --PARENT--> [?] Haemorrhage from respiratory passages\n Def: Haemorrhage from respiratory passages is the bleeding from upper respiratory tract or lower respiratory tract. The major passages and structures of the upper respiratory tract include the nose or nost...", "[MD12] Cough\n Def: Cough is an important natural defensive mechanism and protective reflex for clearing the upper and lower airways of excessive secretions such as mucus and inhaled particles. Cough is a common symptom ...\n --PARENT--> [?] Symptoms or signs involving the respiratory system\n --CHILD--> [MD11] Abnormalities of breathing\n Def: Abnormalities of breathing includes dyspnoea, stridor, wheezing, periodic breathing, hyperventilation, mouth breathing, hiccough, sneezing, and other abnormalities of breathing....", "[1C12.Z] Whooping cough, unspecified\n --PARENT--> [1C12] Whooping cough\n Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v...\n --CHILD--> [1C12.1] Whooping cough due to Bordetella parapertussis\n Def: A disease of the upper respiratory tract, caused by an infection of the gram-negative bacteria Bordetella parapertussis. This disease typically presents with a mild clinical presentation of paroxysmal...", "[1C12.Z] Whooping cough, unspecified\n --PARENT--> [1C12] Whooping cough\n Def: A disease of the upper respiratory tract, caused by an infection with the gram-negative bacteria Bordetella. This disease typically presents with paroxysmal cough, inspiratory whoop, and fainting or v...\n --CHILD--> [1C12.0] Whooping cough due to Bordetella pertussis\n Def: A disease of the upper respiratory tract, caused by an infection of the gram-negative bacteria Bordetella pertussis. This disease typically presents with paroxysmal cough, inspiratory whoop, and faint...", "[CA20.10] Simple chronic bronchitis\n --PARENT--> [CA20.1] Chronic bronchitis\n --EXCLUDES--> [?] Certain specified chronic obstructive pulmonary disease", "[CA20.10] Simple chronic bronchitis\n --PARENT--> [CA20.1] Chronic bronchitis\n --CHILD--> [CA20.12] Mixed simple and mucopurulent chronic bronchitis" ]
MD12
Cough
[ { "from_icd11": "MD12", "icd10_code": "R05", "icd10_title": "Cough" }, { "from_icd11": "1C12.Z", "icd10_code": "A3790", "icd10_title": "Whooping cough, unspecified species without pneumonia" }, { "from_icd11": "1C12.Z", "icd10_code": "A3791", "icd10_title": "Whooping cough, unspecified species with pneumonia" }, { "from_icd11": "1C12.Z", "icd10_code": "A30-A49", "icd10_title": "" }, { "from_icd11": "1C12.Z", "icd10_code": "A37", "icd10_title": "Whooping cough" }, { "from_icd11": "1C12.Z", "icd10_code": "A378", "icd10_title": "Whooping cough due to other Bordetella species" }, { "from_icd11": "1C12.Z", "icd10_code": "A379", "icd10_title": "Whooping cough, unspecified species" }, { "from_icd11": "CA20.10", "icd10_code": "J410", "icd10_title": "Simple chronic bronchitis" }, { "from_icd11": "MD22", "icd10_code": "R042", "icd10_title": "Hemoptysis" }, { "from_icd11": "MD10", "icd10_code": "R093", "icd10_title": "Abnormal sputum" }, { "from_icd11": "1B10.0", "icd10_code": "A159", "icd10_title": "Respiratory tuberculosis unspecified" }, { "from_icd11": "1B10.0", "icd10_code": "A150", "icd10_title": "Tuberculosis of lung" }, { "from_icd11": "1B10.0", "icd10_code": "A157", "icd10_title": "Primary respiratory tuberculosis" }, { "from_icd11": "1B10.0", "icd10_code": "A154", "icd10_title": "Tuberculosis of intrathoracic lymph nodes" }, { "from_icd11": "1B10.0", "icd10_code": "A156", "icd10_title": "Tuberculous pleurisy" } ]
R05
Cough
In August 2009, a 79-year-old woman, 3 gravida 3 para, was admitted to the Gynaecologic Oncology Unit of the Catholic University of Campobasso, complaining of vulvar burning. Her family history did not reveal malignancies in first-degree relatives, and her past medical history was unremarkable. At gynaecological examination vagina, cervix and uterus appeared normal, whereas an ulcerated area (maximum diameter = 7 cm) involving the clitoris and both the right and left majus and minus labium was documented. Inguinal lymphadenopathies (maximum diameter = 1.5 cm) were bilaterally palpable. Biopsy of the lesion documented a well differentiated vulvar squamous cell carcinoma, and staging work-up, including chest X-rays, and abdominal CT scan, did not show any sign of distant sites of disease. Radical vulvectomy plus bilateral inguinal lymphadenectomy and vulvar reconstruction using the medial thigh VY advancement flap was performed. At histology, frank squamous maturation was particularly represented on tumor surface, whereas a gradient of dedifferentiation was observed toward deeper portions of tumor in which spindle shaped cells were more evident . Both patterns were more or less represented in primary tumor , as well as in lymph node metastases. Panel D and E also showed immunohistochemical analysis of high molecular weight cytokeratin (Monoclonal Mouse Anti-Human Cytokeratin High Molecular Weight, clone 34ฮฒE12, DAKO, Carpinteria, CA, USA) and vimentin (DAKO, Carpinteria, CA, USA) performed using a labeled streptavidin biotin peroxidase method (Visualization of the reaction was performed with the DAKO LSAB 2 kit peroxidase). Both squamous cell carcinoma and sarcomatoid components showed reactivity for high molecular weight cytokeratins, especially in the better differentiated areas ; vimentin highlighted the dense stromal reaction, whereas tumor cell resulted consistently negative . Staining for HHF-35 (DAKO, Carpinteria, CA, USA) and S-100 (DAKO, Carpinteria, CA, USA) was also documented in areas with sarcomatoid features (data not shown). Considering the morphological features showing the presence of two easily identifiable epithelial and sarcomatoid components, the apparent transition from carcinomatous to sarcomatoid areas, as well as the results of the immunohistochemical analysis revealing reactivity of giant nucleated cells for cytokeratin with negative staining for vimentin, the case was finally defined as vulvar squamous cell carcinoma with sarcomatoid features (VSCS). Overall lymph node metastases were documented in 5 of 47 inguinal lymph nodes and final staging was pT2N2M0 according to TNM classification . Surgical margins of resection appeared uninvolved. Given the occurrence of bilateral groin wound dehiscence requiring approximately 3 months of intensive wound care for complete resolution, the original treatment plan including chemotherapy plus radiation had to be shifted to systemic treatment: considering the paucity of data about medical treatment of this neoplasia, a regimen including platinum agents as well as anthracyclines was chosen given the widely recognized activity of these two classes of drugs in epithelial and sarcomatous neoplasia, respectively . Considering also age and clinical conditions, the patient was triaged to the less toxic combination of carboplatin (AUC 5) and pegylated liposomal doxorubicin (30 mg/m 2 ) q21. After completion of 6 cycles of primary treatment, the patient started the routinary follow-up program, and only 1 month after the last cycle gynaecological examination revealed the presence of a fixed nodule in the left majus labium (maximum diameter = 2.5 cm). Complete surgical excision of the suspected area was carried out and final histology documented the same phenotypic features of the primary tumor with squamous cell differentiation as the largely dominating component . One month later, PET-computed tomography showed abnormal uptake of the radiotracer in the right lung hilar, mediastinal, and right obturatory lymph nodes. The patient was triaged to receive salvage chemotherapy with paclitaxel (135 mg/m 2 ) q21 and consolidation by involved field stereotactic radiotherapy. Chest/abdominal CT scan was performed after 4 cycles of chemotherapy documenting a partial response to treatment with the disappearance of the right obturatory lymphadenopathies and a significant reduction of the mediastinal (5 mm vs 10 mm as maximum diameter), and right hilar (12 mm vs 19 mm as maximum diameter) lymphadenopathies. Thereafter, extracranial stereotactic radiotherapy was planned by the Precise-Plan treatment planning system. Patient was immobilized using the Stereotactic Body-Frame (Elekta) and a class solution with 4 non-coplanar fixed beams based on the tetrad configuration was used to treat pre-chemotherapy nodal targets. Five consecutive daily fractions were delivered to mediastinal and right hilar nodes up to a total dose of 45 Gy/9 Gy fraction and to right obturatory lymphadenopaties up to 40 Gy/8 Gy fraction. Treatment was very well tolerated and obtained a radiological complete response. Two months later, in January 2011, the patients was admitted to our Institution complaining of severe asthenia and moderate dyspnoea. Total body CT scan documented multiple bilateral pulmunary metastases (maximum diameter = 2 cm), enlarged right iliac lymph nodes (maximum diameter = 2 cm), a focal liver lesion (maximum diameter = 2 cm), and an ulcerated perineal area infiltrating the urethra (maximum diameter = 5 cm). The patient died after 1 month due to acute respiratory failure, after 18 months from initial diagnosis.
4.261719
0.928711
sec[1]/p[0]
en
0.999998
21961623
https://doi.org/10.1186/1746-1596-6-95
[ "maximum", "diameter", "documented", "well", "squamous", "cell", "tumor", "lymph", "dako", "sarcomatoid" ]
[ { "code": "9B75.1&XS5S", "title": "Non-traumatic macular hole, stage 2, full thickness macular hole maximum 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": "LB70.0Y", "title": "Other specified craniosynostosis" }, { "code": "PL14.7", "title": "Problem associated with clinical documentation" }, { "code": "QA87", "title": "Problem with clinical documentation without injury or harm" }, { "code": "QA50", "title": "Embolisation without injury or harm" }, { "code": "QA89", "title": "Incorrect diagnosis without injury or harm" }, { "code": "QA63", "title": "Obstruction of device without injury or harm" }, { "code": "EB30", "title": "Eosinophilic cellulitis" } ]
=== ICD-11 CODES FOUND === [LB70.0Y] Other specified craniosynostosis Also known as: Other specified craniosynostosis | Monosutural craniosynostosis | Scaphocephaly | Dolichocephaly | dolichocephalia [PL14.7] Problem associated with clinical documentation Definition: Clinical documentation error or omission led to injury of patient Also known as: Problem associated with clinical documentation [QA87] Problem with clinical documentation without injury or harm Definition: Documentation on wrong patient; incomplete documentation; incorrect documentation identified as inconsistent with other source, but without documented injury or harm to the patient. Also known as: Problem with clinical documentation without injury or harm | documentation on wrong patient without documented injury or harm | incomplete documentation without documented injury or harm | incorrect documentation identified as inconsistent with other source without documented injury or harm Excludes: Problem associated with clinical documentation [QA50] Embolisation without injury or harm Definition: An embolisation without documented injury or harm occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there. Also known as: Embolisation without injury or harm | Embolic phenomenon without documented injury or harm | Air embolism without documented injury or harm | Injection of air without injury or harm Excludes: Embolisation, as mode of injury or harm [QA89] Incorrect diagnosis without injury or harm Definition: Diagnosis changed after further study and as a result, treatment was incorrect; misdiagnosis; conflicting diagnoses Also known as: Incorrect diagnosis without injury or harm | conflicting diagnoses without documented injury or harm | misdiagnosis without documented injury or harm Excludes: Incorrect diagnosis [QA63] Obstruction of device without injury or harm Definition: A device that has become obstructed or blocked but without any documented injury or harm. Also known as: Obstruction of device without injury or harm | Blockage of device without documented injury or harm | Blocked tube causing obstruction without documented injury or harm | Occlusion of device without documented injury or harm | Thrombosis of device without documented injury or harm Excludes: Obstruction of device, as mode of injury or harm [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 โ€˜flameโ€™ 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 === 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--> [LB70.0Z] Craniosynostosis, unspecified --- Walk 3 --- [PL14.7] Problem associated with clinical documentation Def: Clinical documentation error or omission led to injury of patient... --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft --- Walk 4 --- [PL14.7] Problem associated with clinical documentation Def: Clinical documentation error or omission led to injury of patient... --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --PARENT--> [?] Causes of healthcare related harm or injury
[ "[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--> [LB70.0Z] Craniosynostosis, unspecified", "[PL14.7] Problem associated with clinical documentation\n Def: Clinical documentation error or omission led to injury of patient...\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft", "[PL14.7] Problem associated with clinical documentation\n Def: Clinical documentation error or omission led to injury of patient...\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --PARENT--> [?] Causes of healthcare related harm or injury" ]
9B75.1&XS5S
Non-traumatic macular hole, stage 2, full thickness macular hole maximum diameter
[ { "from_icd11": "QA87", "icd10_code": "XXI", "icd10_title": "" }, { "from_icd11": "EB30", "icd10_code": "L983", "icd10_title": "Eosinophilic cellulitis [Wells]" } ]
XXI
A 79-year-old man with a mild headache underwent an MRI, revealing a left tentorial DAVF (TDAVF) , confirmed by cerebral angiography. The TDAVF was supplied by the left tentorial, left middle meningeal, and left posterior auricular arteries, forming a shunt pouch in the left petrotentorial area. Venous drainage showed arterialisation of the left petrosal vein, creating a varix that drained into the right transverse sinus confluence. It was classified as Cognard type IV and Borden type III, indicating cerebellar cortical venous regurgitation . The patient opted for an endovascular approach over craniotomy. We planned TAE and determined that the left tentorial artery was the best access route due to the inaccessibility and tortuosity of the middle meningeal and posterior auricular arteries near the shunt . Despite stenosis at the origin of the meningeal hypophyseal trunk (MHT), the left tentorial artery provided close shunt access . Under general anesthesia, TAE was performed using the Onyx liquid embolic system via a transfemoral artery approach. A 9-French introducer was placed in the right femoral artery, followed by systemic heparinisation . A 9-French Optimo EPD guiding catheter (Tokai Medical Products, Aichi, Japan) was inserted into the right internal carotid artery (ICA), with a TACTICS PLUS intermediate catheter (Technocrat, Aichi, Japan) advanced into the cavernous segment of the ICA for stenotic passage support. The DeFrictor Nano catheter (Medico's Hirata, Osaka, Japan) and CHIKAI X 010 micro guidewire (Asahi Intecc, Aichi, Japan) navigated through the stenotic lesion to reach near the shunt . Onyx (0.5 mL) was injected under continuous fluoroscopy. Initially, the Onyx distribution within the shunt was optimal. However, leakage proximal to the microcatheter tip suggested a potential obstruction . The microcatheter was withdrawn to prevent worsening. The initial embolization resulted in incomplete occlusion, necessitating a second procedure for complete closure. If the initial attempt fails, a different vessel is typically chosen for follow-up embolization. However, in this case, alternative vessels were too tortuous to access. The partial reopening of the Onyx-embolism feeder, caused by the inadequacy of the initial procedure, exposed the shunt's access route. This suggested the possibility of successful re-embolization . We opted for a repeat embolization through the tentorial artery for total occlusion. We navigated closer to the shunt in the second embolization, staying more proximal than in the initial procedure . NBCA (0.1 mL) was injected, ensuring glue penetration at the fistula . Final left ICA angiography confirmed complete occlusion of the left tentorial DAVF . Follow-up MRI confirmed the disappearance of the DAVF . The patient was discharged without complications and lived his daily life, like before, at the 3-month follow-up visit. Fig. 1 The shunt point of DAVF is indicated (asterisk). (A,B) Magnetic resonance imaging (MRI) reveals a left tentorial DAVF. (C,D) Digital subtraction angiography (DSA) of the left common carotid artery showing that the tentorial DAVF (asterisk) is fed from the left tentorial, left middle meningeal, and left posterior auricular arteries. A shunt pouch is formed in the left petrotentorial location. Drainage occurs via arterialization of the left petrosal vein, forms a varix, and drains into the confluence of the right transverse sinus. (E,F) DSA of the left external carotid artery showing that the middle meningeal artery (MMA) and posterior auricular artery (PAA) are tortuous and inaccessible near the shunt point of DAVF (asterisk). (G,H) DSA of the left internal carotid artery showing that the tentorial artery is a relatively straight and well-dilated vessel to the DAVF (asterisk), but the origin of the meningohypophyseal trunk (MHT) is highly stenotic. Fig 1: Fig. 2 First embolization using Onyx: yellow line indicates the position of the microcatheter. (A) DSA of the left internal carotid artery showing that the origin of MHT is narrowed to 0.25 mm. The DeFrictor Nano tip diameter is 0.43 mm, and the length of the thin part is 6 cm, which is thicker than the diameter of the origin of MHT. (B) The TACTICS PLUS (green arrow) is positioned immediately adjacent to the origin of the MHT to obtain backup support when passing through the stenotic lesion. (C) The DeFrictor Nano catheter easily passes through the stenotic lesion and reaches near the DAVF (asterisk). Fig 2: Fig. 3 Operative images of transarterial embolization (TAE) for left tentorial dural arteriovenous fistula (TDAVF). (A,B) First embolization using Onyx: yellow line indicates the position of the microcatheter. Defrictor Nano catheter easily passes the stenotic lesion and reaches near the shunt. (C) X-ray film showing the Onyx casting. (D,E) Incomplete embolization because of the obstruction in the DeFrictor Nano. Residual DAVF is visualized (asterisk). Second embolization using n-butyl-2-cyanoacrylate (NBCA): blue line indicates the position of the microcatheter. Reapproach via the same feeder as the first embolization. We are forced to inject from the more proximal site because the area near the shunt is already filled with Onyx. Defrictor Nano reaches near the already-filled Onyx cast. (F) Superselective angiogram via a DeFrictor Nano showing that NBCA filling with the residual shunt. No significant distal dispersal or proximal regurgitation of NBCA is observed. Fig 3: Fig. 4 (A,B) Postoperative DSA of the left ICA showing that the DAVF has disappeared. (C,D) The disappearance of the DAVF is confirmed on follow-up MRI. Fig 4:
4.0625
0.96582
sec[1]/p[0]
en
0.999996
39263518
https://doi.org/10.1016/j.radcr.2024.07.138
[ "shunt", "artery", "davf", "tentorial", "embolization", "onyx", "that", "near", "defrictor", "nano" ]
[ { "code": "PL12.3", "title": "Obstruction of device, as mode of injury or harm" }, { "code": "PK91.2Y", "title": "Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "LA90.21", "title": "Congenital portosystemic shunt" }, { "code": "NE83.1", "title": "Infection arising from device, implant or graft, not elsewhere classified" }, { "code": "BE14.B", "title": "Postprocedural disorder following cardiovascular conduit or shunt procedure" }, { "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 === [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 [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 [LA90.21] Congenital portosystemic shunt Also known as: Congenital portosystemic shunt | anomalous pulmonary venous drainage to hepatic veins | anomaly of portal vein connection | portal vein deformity | portal vein anomaly [NE83.1] Infection arising from device, implant or graft, not elsewhere classified Also known as: Infection arising from device, implant or graft, not elsewhere classified | Infection or inflammatory reaction due to other cardiac and vascular devices, implants and grafts NOS | Infection or inflammation of artificial heart NOS | Infection or inflammation of vascular balloon implant or device NOS | Infection or inflammatory reaction of heart valve prosthesis NOS [BE14.B] Postprocedural disorder following cardiovascular conduit or shunt procedure Also known as: Postprocedural disorder following cardiovascular conduit or shunt procedure | Superior cavopulmonary anastomosis related disorder | Formation of pulmonary arteriovenous fistulas or malformations due to superior cavopulmonary anastomosis | Failed Fontan type circulation | Acquired narrowing of constructed cardiac intraventricular tunnel [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 --- [PL12.3] Obstruction of device, as mode of injury or harm Def: Obstruction associated with prosthetic devices, grafts or implants... --EXCLUDES--> [?] Obstruction of device without injury or harm Def: A device that has become obstructed or blocked but without any documented injury or harm.... --EXCLUDES--> [?] Obstruction of device, as mode of injury or harm Def: Obstruction associated with prosthetic devices, grafts or implants... --- Walk 2 --- [PL12.3] Obstruction of device, as mode of injury or harm Def: Obstruction associated with prosthetic devices, grafts or implants... --PARENT--> [PL12] Mode of injury or harm associated with a surgical or other medical device, implant or graft --CHILD--> [PL12.1] Functional device failure, as mode of injury or harm --- Walk 3 --- [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident... --EXCLUDES--> [?] Cardiovascular devices associated with injury or harm, left ventricular assist devices --- Walk 4 --- [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident... --CHILD--> [PK91.22] Cardiovascular devices associated with injury or harm, mechanical or bioprosthetic valves --- Walk 5 --- [LA90.21] Congenital portosystemic shunt --PARENT--> [LA90.2] Peripheral venous malformations --CHILD--> [LA90.20] Vein of Galen aneurysm Def: Vein of Galen aneurysmal malformation (VGAM) is a congenital vascular malformation characterised by dilation of the embryonic precursor of the vein of Galen. It is a sporadic lesion that occurs during... --- Walk 6 --- [LA90.21] Congenital portosystemic shunt --PARENT--> [LA90.2] Peripheral venous malformations --RELATED_TO--> [?] Developmental venous malformations involving the skin Def: Certain genetically-determined syndromes presenting with venous anomalies in the skin...
[ "[PL12.3] Obstruction of device, as mode of injury or harm\n Def: Obstruction associated with prosthetic devices, grafts or implants...\n --EXCLUDES--> [?] Obstruction of device without injury or harm\n Def: A device that has become obstructed or blocked but without any documented injury or harm....\n --EXCLUDES--> [?] Obstruction of device, as mode of injury or harm\n Def: Obstruction associated with prosthetic devices, grafts or implants...", "[PL12.3] Obstruction of device, as mode of injury or harm\n Def: Obstruction associated with prosthetic devices, grafts or implants...\n --PARENT--> [PL12] Mode of injury or harm associated with a surgical or other medical device, implant or graft\n --CHILD--> [PL12.1] Functional device failure, as mode of injury or harm", "[PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident...\n --EXCLUDES--> [?] Cardiovascular devices associated with injury or harm, left ventricular assist devices", "[PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --PARENT--> [PK91.2] Cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n Def: A cardiovascular prosthetic or other implant, or cardiovascular material or an accessory device was associated with an adverse incident...\n --CHILD--> [PK91.22] Cardiovascular devices associated with injury or harm, mechanical or bioprosthetic valves", "[LA90.21] Congenital portosystemic shunt\n --PARENT--> [LA90.2] Peripheral venous malformations\n --CHILD--> [LA90.20] Vein of Galen aneurysm\n Def: Vein of Galen aneurysmal malformation (VGAM) is a congenital vascular malformation characterised by dilation of the embryonic precursor of the vein of Galen. It is a sporadic lesion that occurs during...", "[LA90.21] Congenital portosystemic shunt\n --PARENT--> [LA90.2] Peripheral venous malformations\n --RELATED_TO--> [?] Developmental venous malformations involving the skin\n Def: Certain genetically-determined syndromes presenting with venous anomalies in the skin..." ]
PL12.3
Obstruction of device, as mode of injury or harm
[ { "from_icd11": "LA90.21", "icd10_code": "Q265", "icd10_title": "Anomalous portal venous connection" }, { "from_icd11": "NE83.1", "icd10_code": "T8359XA", "icd10_title": "" }, { "from_icd11": "NE83.1", "icd10_code": "T8453XD", "icd10_title": "Infection and inflammatory reaction due to internal right knee prosthesis, subsequent encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T826XXA", "icd10_title": "Infection and inflammatory reaction due to cardiac valve prosthesis, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T84622A", "icd10_title": "Infection and inflammatory reaction due to internal fixation device of right tibia, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T8463XA", "icd10_title": "Infection and inflammatory reaction due to internal fixation device of spine, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T84620A", "icd10_title": "Infection and inflammatory reaction due to internal fixation device of right femur, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T85733A", "icd10_title": "Infection and inflammatory reaction due to implanted electronic neurostimulator of spinal cord, electrode (lead), initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T8351XA", "icd10_title": "" }, { "from_icd11": "NE83.1", "icd10_code": "T8454XD", "icd10_title": "Infection and inflammatory reaction due to internal left knee prosthesis, subsequent encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T836XXA", "icd10_title": "" }, { "from_icd11": "NE83.1", "icd10_code": "T84623A", "icd10_title": "Infection and inflammatory reaction due to internal fixation device of left tibia, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T8459XA", "icd10_title": "Infection and inflammatory reaction due to other internal joint prosthesis, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T84621A", "icd10_title": "Infection and inflammatory reaction due to internal fixation device of left femur, initial encounter" }, { "from_icd11": "NE83.1", "icd10_code": "T83593A", "icd10_title": "Infection and inflammatory reaction due to other urinary stents, initial encounter" } ]
Q265
Anomalous portal venous connection
Diagnosed as secondary syphilis, amoxycillin 1500 mg per day and probenecid 1000 mg per day were orally administered for 2 weeks. Subsequently, rash, inguinal lymph nodes and serological markers were improved , however, the lung mass remained unchanged in size . TBB confirmed the pulmonary involvement of syphilis by PCR techniques (tpp47-, and polA-PCR) , whereas malignancy and other possible infections such as bacteria and fungi were negative (Table 2 ). Five months after the first visit, right basal segmentectomy was performed to exclude other comorbid diseases, especially malignancy. The remained lung mass was an abscess and histological analysis showed the granuloma formation by epithelioid histiocytes and Langhans giant cells with necrosis . The comprehensive PCR tests for multi-microbes were performed in the resected lung specimens, and no microbes were significantly positive (Table 2 ). Subsequently, penicillin G 2.4 million units per day was intravenously administered for 2 weeks, and the pulmonary involvement has resolved without relapse after 8 months follow-up. Fig. 3 Clinical course of the treatment. The induction of the oral antibiotics caused fever, headache and exacerbation of erythematous papular rash on the next day, which was considered as Jarisch-Herxheimer reaction. Treatment for 2 weeks improved the rash and serological data. However, the lung mass had not changed in size. Surgical resection was followed, and then, additional intravenous antibiotics for 2 weeks was administered. Abbreviation; rapid plasma reagin test: RPR; Treponema pallidum hemagglutination test: TPHA Fig. 4 Electrophoresis of the amplified products from the lung mass with polymerase chain reaction (PCR) techniques. BAL was performed with 20 mL saline. The two types of gene fragments of Treponema pallidum (tpp47 and polA) acquired from bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) was amplified by PCR techniques. Both gene fragments were positive in samples from TBB, but not BAL Table 2 Microbiological analysis in specimens obtained by bronchofiberscopy and surgery 1. Bronchofiberscopy PCR tests for Treponema pallidum Bronchoalveolar lavage Undetected TBB Detected (tpp47-PCR and polA-PCR) Culture tests for bacteria and mycobacteria Bronchoalveolar lavage Undetected Lavage of forceps in TBB Undetected 2. Surgery Real-time PCR tests for Treponema pallidum Undetected Culture test for bacteria in pus inside the abscess Undetected Real-time PCR tests for multi-microbes Number Bacteria name Quantity 1 Staphylococcus aureus Undetected 2 Bacillus anthracis Undetected 3 Listeria monocytogenes Undetected 4 Streptococcus pyogenes Undetected 5 Streptococcus agalactiae Undetected 6 Streptococcus mutans Undetected 7 Streptococcus sobrinus Undetected 8 Streptococcus sanguinis Undetected 9 Streptococcus oralis Undetected 10 Streptococcus salivaris Undetected 11 Streptococcus pneumoniae Undetected 12 Enterococcus faecalis Undetected 13 Enterococcus faecium Undetected 14 Clostridium tetani Undetected 15 Clostridium difficile Undetected 16 Peptostreptococcus anaerobius Undetected 17 Actinomyces Undetected 18 Corynebacterium diphtheriae Undetected 19 Mycobacterium tuberculosis Undetected 20 Mycobacterium laprae Undetected 21 Mycobacterium chelonae Undetected 22 Mycobacterium kansasii Undetected 23 Mycobacterium avium complex Undetected 24 Nocardia asteroids Undetected 25 Bacteroides fragills Undetected 26 Elizabethkingia meningosepticum Undetected 27 Campylobacter jejuni Undetected 28 Helicobacter cinaedi Undetected 29 Helicobacter pylori Undetected 30 Rickettsia prowazekii Undetected 31 Rickettsia japonica Undetected 32 Orientia tsutsugamushi Undetected 33 Bartonella henselae Undetected 34 Brucella Undetected 35 Bordetella pertussis Undetected 36 Burkhoderia mallei Undetected 37 Burkhoderia cepacian Undetected 38 Neisseria gonorrhoeae Undetected 39 Neisseria meningitidis Undetected 40 Francisella tularensis Undetected 41 Legionella pneumophilia Undetected 42 Moraxella catarrhalis Undetected 43 Pseudomonas aeruginosa Undetected 44 Acinetobacter baumannii Undetected 45 Aeromonas hydrophia Undetected 46 Vibrio cholerae Undetected 47 Vibrio parahaemolyticus Undetected 48 Vibrio vulnificus Undetected 49 Haemophilus influenzae Undetected 50 Escherichia coli Undetected 51 Salmonella enterica Undetected 52 Shigella Undetected 53 Klebsiella pneumonia Undetected 54 Yersinia psttis Undetected 55 Yersinia enterocolitica Undetected 56 Citrobacter freundii Undetected 57 Proteus mirabilis Undetected 58 Morganella morganii Undetected 59 Providencia Undetected 60 Mycoplasma pneumoniae Undetected 61 Fusobacterium nucleatum Undetected 62 Leptospira interrogans Undetected 63 Chlamydia psittaci Undetected 64 Chlamydia trachomatis Undetected 65 Chlamydia pneumoniae Undetected 66 Aspergillus fumigatus Undetected 67 Aspergillus nigar Undetected 68 Aspergillus flavus Undetected 69 Cryptococcus Undetected 70 Histoplasma Undetected 71 Trichosporon Undetected 72 Mucor Undetected 73 Coccidioides Undetected 74 Propionibacterium acnes Detected (not significant) 75 Stenotrophomonas maltophilia Detected (not significant) 76 Candida albicans Detected (not significant) Abbreviations : TBB Transbronchial biopsy, PCR Polymerase chain reaction Fig. 5 Gross and microscopic pathology of lung specimens obtained by surgery a Gross pathology showed pus inside the lung abscess (arrow), b Microscopic pathology showed granuloma formation by epithelioid histiocytes and Langhans giant cells (arrow), in addition to necrosis (arrow-head). Original Magnification X100. Hematoxylin and eosin (HE) staining
4.207031
0.790039
sec[1]/p[2]
en
0.999998
31288744
https://doi.org/10.1186/s12879-019-4236-4
[ "undetected", "streptococcus", "lung", "mycobacterium", "bacteria", "treponema", "pallidum", "lavage", "rash", "techniques" ]
[ { "code": "1B5Z", "title": "Staphylococcal or streptococcal diseases, unspecified" }, { "code": "1B5Y", "title": "Other specified staphylococcal or streptococcal diseases" }, { "code": "1B5Y/BB20.0&XN3NM", "title": "Acute streptococcal pericarditis" }, { "code": "1B7Y", "title": "Other specified pyogenic bacterial infection of skin or subcutaneous tissue" }, { "code": "1B53", "title": "Meningitis due to Streptococcus" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" } ]
=== ICD-11 CODES FOUND === [1B5Z] Staphylococcal or streptococcal diseases, unspecified Also known as: Staphylococcal or streptococcal diseases, unspecified | Staphylococcal infection of unspecified site | staphylococcal infection NOS | Sepsis due to staphylococcus with septic shock | Sepsis due to Staphylococcus aureus infection with mention of septic shock [1B5Y] Other specified staphylococcal or streptococcal diseases Also known as: Other specified staphylococcal or streptococcal diseases | Skin infection classified elsewhere due to Panton-Valentine leucocidin producing Staphylococcus aureus | Skin infection classified elsewhere due to PVL producing Staphylococcus aureus | Acute streptococcal pericarditis | streptococcal pericarditis [1B7Y] Other specified pyogenic bacterial infection of skin or subcutaneous tissue Also known as: Other specified pyogenic bacterial infection of skin or subcutaneous tissue | Miscellaneous pyogenic bacterial infections of the skin | Cutaneous botryomycosis | Pyoderma vegetans | Chancriform pyoderma [1B53] Meningitis due to Streptococcus Definition: A disease of the meninges, caused by an infection with the gram-positive bacteria genus Streptococcus. This disease commonly presents with nausea, vomiting, photophobia, and confusion. Transmission is through haematogenous spread to the meninges after inhalation of infected respiratory secretions. Confirmation is by identification of Streptococcus in the cerebrospinal fluid. Also known as: Meningitis due to Streptococcus | Streptococcal meningitis | acute streptococcal meningitis | Meningitis due to Streptococcus pneumoniae | pneumococcal meningitis Includes: Streptococcal meningitis [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung === GRAPH WALKS === --- Walk 1 --- [1B5Z] Staphylococcal or streptococcal diseases, unspecified --PARENT--> [?] Certain staphylococcal or streptococcal diseases --RELATED_TO--> [?] Toxic shock syndrome --- Walk 2 --- [1B5Z] Staphylococcal or streptococcal diseases, unspecified --PARENT--> [?] Certain staphylococcal or streptococcal diseases --CHILD--> [1B51] Streptococcal pharyngitis Def: A disease of the pharynx, caused by an infection with the gram-positive bacteria Streptococcus pyogenes. This disease is characterised by fever, sore throat, tonsillar exudates, or large cervical lymp... --- Walk 3 --- [1B5Y] Other specified staphylococcal or streptococcal diseases --PARENT--> [?] Certain staphylococcal or streptococcal diseases --CHILD--> [1B51] Streptococcal pharyngitis Def: A disease of the pharynx, caused by an infection with the gram-positive bacteria Streptococcus pyogenes. This disease is characterised by fever, sore throat, tonsillar exudates, or large cervical lymp... --- Walk 4 --- [1B5Y] Other specified staphylococcal or streptococcal diseases --PARENT--> [?] Certain staphylococcal or streptococcal diseases --RELATED_TO--> [?] Toxic shock syndrome --- Walk 5 --- [1B7Y] Other specified pyogenic bacterial infection of skin or subcutaneous tissue --PARENT--> [?] Pyogenic bacterial infections of the skin or subcutaneous tissues --CHILD--> [1B70] Bacterial cellulitis, erysipelas or lymphangitis Def: Diffuse, spreading infections of skin and soft tissues by a range of bacterial organisms, most commonly beta-haemolytic streptococci and Staphylococcus aureus. The clinical presentation is dependent n... --- Walk 6 --- [1B7Y] Other specified pyogenic bacterial infection of skin or subcutaneous tissue --PARENT--> [?] Pyogenic bacterial infections of the skin or subcutaneous tissues --RELATED_TO--> [?] Acute bacterial paronychia Def: Acute bacterial paronychia is an acute infection, usually by Staphylococcus aureus, of the paronychial tissues of a digit. It may result from local injury, e.g. a thorn prick in a lateral nail groove,...
[ "[1B5Z] Staphylococcal or streptococcal diseases, unspecified\n --PARENT--> [?] Certain staphylococcal or streptococcal diseases\n --RELATED_TO--> [?] Toxic shock syndrome", "[1B5Z] Staphylococcal or streptococcal diseases, unspecified\n --PARENT--> [?] Certain staphylococcal or streptococcal diseases\n --CHILD--> [1B51] Streptococcal pharyngitis\n Def: A disease of the pharynx, caused by an infection with the gram-positive bacteria Streptococcus pyogenes. This disease is characterised by fever, sore throat, tonsillar exudates, or large cervical lymp...", "[1B5Y] Other specified staphylococcal or streptococcal diseases\n --PARENT--> [?] Certain staphylococcal or streptococcal diseases\n --CHILD--> [1B51] Streptococcal pharyngitis\n Def: A disease of the pharynx, caused by an infection with the gram-positive bacteria Streptococcus pyogenes. This disease is characterised by fever, sore throat, tonsillar exudates, or large cervical lymp...", "[1B5Y] Other specified staphylococcal or streptococcal diseases\n --PARENT--> [?] Certain staphylococcal or streptococcal diseases\n --RELATED_TO--> [?] Toxic shock syndrome", "[1B7Y] Other specified pyogenic bacterial infection of skin or subcutaneous tissue\n --PARENT--> [?] Pyogenic bacterial infections of the skin or subcutaneous tissues\n --CHILD--> [1B70] Bacterial cellulitis, erysipelas or lymphangitis\n Def: Diffuse, spreading infections of skin and soft tissues by a range of bacterial organisms, most commonly beta-haemolytic streptococci and Staphylococcus aureus. The clinical presentation is dependent n...", "[1B7Y] Other specified pyogenic bacterial infection of skin or subcutaneous tissue\n --PARENT--> [?] Pyogenic bacterial infections of the skin or subcutaneous tissues\n --RELATED_TO--> [?] Acute bacterial paronychia\n Def: Acute bacterial paronychia is an acute infection, usually by Staphylococcus aureus, of the paronychial tissues of a digit. It may result from local injury, e.g. a thorn prick in a lateral nail groove,..." ]
1B5Z
Staphylococcal or streptococcal diseases, unspecified
[ { "from_icd11": "1B5Z", "icd10_code": "B9561", "icd10_title": "Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere" }, { "from_icd11": "1B5Z", "icd10_code": "B956", "icd10_title": "Staphylococcus aureus as the cause of diseases classified elsewhere" }, { "from_icd11": "1B53", "icd10_code": "G002", "icd10_title": "Streptococcal meningitis" }, { "from_icd11": "1B53", "icd10_code": "G001", "icd10_title": "Pneumococcal meningitis" }, { "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": "" } ]
B9561
Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere
On general physical examination he had a body temperature of 36.7 ยฐC and a heart rate of 84 beats per minute in a normal condition and 121 beats per minute in a cardiopalmus condition. His respiratory rate was 16 breaths per minute. He had a blood pressure of 110/72 mm Hg and an oxygen saturation of 98% on room air. His cardiac examination was normal; there were no murmurs or extracardiac sounds on auscultation. His complete physical examination including a neurological examination was unremarkable. Laboratory tests revealed: normal markers of myocardial injury, for example MB isoenzyme of creatine kinase (CK-MB), high-sensitive troponin I (hsTnI), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST); a positive enterovirus (EVs) -ribonucleic acid (RNA); and negative coxsackievirus B (CoxB)3 -immunoglobulin M (IgM), CoxB5-IgM, and cytomegalovirus ยฉ-IgM in the virologic examination. The antinuclear antibody (ANA) spectrum showed a positive anti-double-stranded deoxyribonucleic acid (dsDNA) antibody, and the titer of anti-ANA was within a normal range. Other ANAs were negative. The inflammatory indicators of C-reactive protein (CRP), antistreptolysin O (ASO), and erythrocyte sedimentation rate (ESR) were within the normal ranges. Routine laboratory tests for liver, renal, electrolytes, and blood glucose were normal. His low-density lipoprotein (LDL) cholesterol was mildly elevated (3.4 mmol/L) in the serum lipid profile and the other lipids were within normal range (Table 1 ). His blood, urine, and stool routine tests were all normal (data not shown). The ECG was reexamined and showed paroxysmal sinus tachycardia and Q waves in I-III, avF, and V4 to V6 leads . A subsequent coronary-computed tomography angiography (CTA) check showed normal coronary artery and no coronary stenosis . Both left ventricle contrast echocardiography and cardiac magnetic resonance (CMR) demonstrated that apical congenital LVA coexisted with prominent LV trabeculation . We re-evaluated his medical history carefully and comprehensively and found no family history of heart diseases or genetic diseases. Table 1 Laboratory data of the patient Parameters Results Reference values Myocardial enzyme spectrum CK-MB (ng/ml) 0.5 <6.6 hsTnI (pg/ml) 2.1 <262 LDH (U/L) 135 109โ€“245 AST (U/L) 16 8โ€“40 Virologic test CoxB3-IgM Negative Negative CoxB5-IgM Negative Negative EVs-RNA Positive Negative C-IgM Negative Negative ANA spectrum Anti-ANA <1:100 <1:100 SM Negative Negative Anti-dsDNA Positive Negative ACA (RU/ml) 5.0 <12 CENPB Negative Negative nRNP Negative Negative SSA Negative Negative SSB Negative Negative SCL-70 Negative Negative JO-1 Negative Negative RA-54 Negative Negative DM-53 Negative Negative Dโ€™E Negative Negative Inflammatory indicators CRP (mg/L) <3.28 <8 ASO (IU/ml) <55.3 <200 ESR (mm/h) 2 <15 T-BIL (ฮผmol/L) 12 5.1โ€“19 D-BIL (ฮผmol/L) 6.6 1.7โ€“6.8 ALT (U/L) 15 5โ€“40 ALP (U/L) 63 40โ€“150 GGT (U/L) 21 11โ€“50 A/G 1.9 1.5โ€“2.5 LDL cholesterol (mmol/L) 3.4 2.7โ€“3.1 Total cholesterol (mmol/L) 5.14 <5.2 HDL cholesterol (mmol/L) 1.38 1.16โ€“1.42 Triglycerides (mmol/L) 0.88 <1.7 Fasting glucose (mmol/L) 4.61 3.9โ€“6.1 HbA1C (%) 4.7 4.5โ€“6.2 BUN (mmol/L) 3.9 2.9โ€“8.2 Creatinine (ฮผmol/L) 73.5 44โ€“133 URIC (ฮผmol/L) 408 208โ€“428 CK (U/L) 116 38โ€“174 LDH (U/L) 135 109โ€“245 Na (mmol/L) 141 136โ€“145 K (mmol/L) 4.0 3.5โ€“5.2 Cl (mmol/L) 106 96โ€“106 Ca (mmol/L) 2.32 2.03โ€“2.54 CO 2 -CP (mmol/L) 24 22โ€“28 P (mmol/L) 1.2 0.96โ€“1.62 Mg (mmol/L) 0.75 0.70โ€“1.10 ACA anticardiolipin antibody, A/G albumin/globulin, ALP alkaline phosphatase, ALT alanine transaminase, ANA antinuclear antibody, Anti-dsDNA anti-double-stranded DNA antibody, ASO antistreptolysin O, AST aspartate aminotransferase, BUN blood urea nitrogen, C cytomegalovirus, Ca calcium, CENPB centromere protein B, CK creatine kinase, CK-MB, MB isoenzyme of creatine kinase, Cl Chlorine, CO 2 -CP carbon dioxide combining power, CoxB coxsackievirus B, EVs enterovirus, C cytomegalovirus, CRP C-reactive protein, D-BIL direct bilirubin, Dโ€™E anti-Dโ€™E polypeptide, DM dermatomyositis, ESR erythrocyte sedimentation rate, EVs enterovirus, GGT ฮณ-glutamyl transpeptidase, HbA1c glycosylated hemoglobin, HDL high-density lipoprotein, hsTnI high-sensitive troponin I, IgM Immunoglobulin M, Jo-1 anti-histidyl-transfer RNA synthetase K potassium, LDH lactate dehydrogenase, LDL low-density lipoprotein, Mg magnesium, Na sodium, nRNP nuclear ribonucleoprotein, P phosphorus, RA rheumatoid arthritis, RNA ribonucleic acid, SCL systemic sclerosis or scleroderma, SM Smith antibody, SSA Sjรถgrenโ€™s syndrome A, SSB Sjรถgrenโ€™s syndrome B, T-BIL total bilirubin, URIC uric acid Fig. 1 Electrocardiogram and computed tomography angiography at diagnosis. Panel a Twelve-lead electrocardiogram showing sinus tachycardia (121 beats per minute) and Q waves in I to III, avF, and V4 to V6 leads ( arrow ). Panel b Computed tomography angiography showing normal coronary artery and no coronary stenosis Fig. 2 Contrast echocardiography and cardiac magnetic resonance at diagnosis. Panel a , b Contrast echocardiography. a Apical short-axis view of left ventricle showing prominent left ventricular trabeculae and deep intertrabecular recesses ( arrowheads ). b Transapical view of the left ventricular apex showing an aneurysm-like out-pouching structure with a wide connection to the left ventricle ( arrow ). Panel c , d Magnetic resonance imaging. c Left ventricle short-axis view showing prominent left ventricular trabeculae and deep intertrabecular recesses ( arrowheads ). d Left ventricular outflow tract view showing an apical protrusion with a wide connection to the left ventricle ( arrow )
4.132813
0.947754
sec[1]/p[1]
en
0.999996
28821295
https://doi.org/10.1186/s13256-017-1405-1
[ "mmol", "anti", "antibody", "coronary", "ventricle", "minute", "blood", "acid", "cholesterol", "panel" ]
[ { "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": "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" } ]
=== 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 [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 === 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 โ€œat riskโ€ 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 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 โ€œat riskโ€ pat... --CHILD--> [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ 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 โ€œat riskโ€ pat... --CHILD--> [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --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... --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Postprocedural hypoinsulinaemia Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus....
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ 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...", "[GB42.1] 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 โ€œat riskโ€ 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 โ€œat riskโ€ 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 โ€œat riskโ€ pat...\n --CHILD--> [GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --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...", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Postprocedural hypoinsulinaemia\n Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus...." ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "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" } ]
O26841
The patient is a girl who developed acute severe colitis at 2 years of age. She is the first child of non-consanguineous Caucasian parents and the only significant family history was left-sided ulcerative colitis (UC) of benign course diagnosed in her mother at 32 years . The child had no history of recurrent or opportunistic infections and diagnostic tests for cowโ€™s milk protein allergy and celiac disease were negative. Endoscopic examination showed severe pancolitis with edematous and fragile mucosa and multiple erosions and pangastritis of mild intensity. In contrast, esophagus, duodenum, jejunum, and terminal ileum were macroscopically normal and there were no peri-anal or extra-intestinal manifestations. Histology showed chronic active colitis with crypt architectural distortion, destructive cryptitis, and crypt abscesses and immunohistochemistry revealed an important lymphocytic infiltrate containing CD4 + but almost no CD8 + cells . Ileal biopsies at diagnosis showed a mixed inflammatory infiltrate and cryptitis that, in contrast to the colonic inflammation, resolved during immunosuppressive treatment. At diagnosis and before the start of immunosuppression, leukocyte count and absolute number of T, NK, and B lymphocytes in peripheral blood were within normal range. 23 Serum concentrations of immunoglobulins were also normal. As the disease was refractory to standard immunosuppressive-, immunomodulatory-, and biological therapy, subtotal colectomy with temporary ileostomy was performed one year after initial diagnosis, followed 12 months later by proctectomy and ileoanal pouch anastomosis. Subtotal colectomy resulted in drastic clinical improvement without further need for immunosuppressive therapy . After surgery and without immunosuppression, despite normal absolute number of lymphocytes, the patient displayed a high CD4:CD8 ratio in peripheral blood when compared to age-matched VEO-IBD patients , a published age-matched reference population, 23 adult and infant healthy controls, and adolescent PIBD with active disease (inflammation) or disease in remission . The patientโ€™s clinical course and time points at sample collection are depicted in Fig. 1a and Table 1 . Fig. 1 A 374 kb duplication on 10p15.1 including the IL2RA locus leads to intrinsically increased CD25 and enhanced IL-2 signaling in CD4 + T cells. a Timeline depicting the patientโ€™s clinical course and time points of sample collection (denoted as visits S0-S4). PUCAI, pediatric ulcerative colitis activity index. b H&E staining on paraffin-embedded colonic tissue at the time of diagnosis (left, time point S0) and immunohistochemical detection of CD4 and CD8 in paraffin-embedded resected colonic tissue (right, time point S2). c Flow cytometric analysis of CD4:CD8 ratio in peripheral blood of the patient, her parents (time points S3 and S4), and VEO-IBD patients ( n = 9). Median (5th to 95th percentiles) for the 2โ€“5 year age category is 1.6 (0.9โ€“2.9). 23 d Localization of the patientโ€™s duplication on chromosome 10. e โ€“ g Flow cytometric analysis of CD3, CD4, CD38, CD62L, CD45RA, CCR7, CD25, and/or Foxp3 expression was performed on peripheral blood from the patient, her parents (time points S3 and S4) and healthy adult controls (HC, n = 4โ€“6). e CD25 expression (MFI) on total CD4 + T cells (left) and on effector memory (CD45RA neg CCR7 neg ), central memory (CD45RA neg CCR7 + ) and naive (CD45RA + CCR7 + ) CD4 + T cells in the patient (right). f CD25 expression on regulatory Foxp3 + CD4 + T cells and Foxp3 neg CD4 + T cells. g Frequency of pSTAT5-positive cells among control primary T cells transduced with retrovirus particles carrying full-length IL2RA or an empty vector upon stimulation with increasing concentrations of IL-2 (0.2 to 100IU/mL) . h PBMCs of the patient, PIBD patients with active intestinal inflammation ( n = 3), and PIBD patients in remission ( n = 3) were stimulated with IL-2 (100 IU/mL) for 15 min followed by quantification of STAT5 phosphorylation (pY694) in CD4 + cells by flow cytometry (visit S3). n.s., not significant, * p < 0.05, ** p < 0.01, *** p < 0.001 using one-way ANOVA followed by the Bonferroniโ€™s Multiple Comparison Test. Table 1 Time points of sample collection. Visit Sample collection (peripheral blood and intestinal tissue) Treatment CRP (mg/L) Calprotectin (ฮผg/g) PUCAI February 2015 S0 Presentation with severe acute colitis. Diagnostic endoscopy with biopsies in small intestine and colon. No treatment 19 2861 ฮผg/g 55 August 2015 S1 Persistent disease activity using infliximab 10 mg/kg every 4 weeks and azathioprine 25 mg/day. Received blood sample. Infliximab 5 mg/kg/day per 4 weeks, Azathioprine 1dd30 mg, Allopurinol 1dd50 mg, Cholecalciferol 1dd800IE, Omeprazol 1dd10 mg, Cotrimoxazol 1dd30mg <3 ND 45 December 2016 S2 Subtotal colectomy with ileostoma. Received blood sample and intestinal tissue of patient. Infliximab 5 mg/kg/day per 4 weeks , Azathioprine 1dd30 mg, Allopurinol 1dd50 mg, Cholecalciferol 1dd800IE, Omeprazol 1dd10 mg, Vancomycin 2dd250 mg, Gentamicin 2dd50 mg 209 ND 55 January 2017 S3 Closure of double-barreled ileostomy, one month protectomy and ileoanal pouch anastomosis. No symptoms of intestinal disease. Received blood samples of patient and parents. No immunosuppressive treatment. No recent antibiotic use. ND ND 0 August 2017 S4 Regular visit at outpatient clinic. No symptoms of intestinal disease. Received blood samples of patient and parents. No immunosuppressive treatment. No recent antibiotic use. ND ND 0 CRP C-reactive protein, PUCAI pediatric ulcerative colitis activity index, dd daily dosis, ND not determined.
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https://doi.org/10.1038/s41385-021-00423-5
[ "cells", "blood", "time", "colitis", "intestinal", "sample", "parents", "immunosuppressive", "points", "patients" ]
[ { "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": "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 === [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 [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 --- [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 --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 --EXCLUDES--> [?] Sialidosis --CHILD--> [?] Sialidosis type 2 Def: Sialidosis is a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinoses. Two types of sialidosis have been defined, type 2 (also referred to as the infantile, dysmor... --- Walk 4 --- [5C56.20] Mucolipidosis --RELATED_TO--> [?] Wolman disease Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir... --PARENT--> [?] 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--> [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --- Walk 6 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da...
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --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 --EXCLUDES--> [?] Sialidosis\n --CHILD--> [?] Sialidosis type 2\n Def: Sialidosis is a lysosomal storage disease belonging to the group of oligosaccharidoses or glycoproteinoses. Two types of sialidosis have been defined, type 2 (also referred to as the infantile, dysmor...", "[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] 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--> [3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Other sickle-cell disorders with retinopathy\n Def: This is an autosomal recessive genetic blood disorder with overdominance, characterised by red blood cells that assume an abnormal, rigid, sickle shape. This diagnosis is due to persistent or acute da..." ]
MF9Y
Other specified clinical findings on examination of urine, without diagnosis
[ { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" }, { "from_icd11": "3A61.Z", "icd10_code": "D609", "icd10_title": "Acquired pure red cell aplasia, unspecified" }, { "from_icd11": "3A61.Z", "icd10_code": "D608", "icd10_title": "Other acquired pure red cell aplasias" }, { "from_icd11": "3A61.Z", "icd10_code": "D60", "icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]" }, { "from_icd11": "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" } ]
D571
Sickle-cell disease without crisis
We performed thoracoscopic left lower lobectomy in a lung cancer patient with AP. The number of case reports on this variation has been increasing in recent years, owing to the wider use of 3D-CECT angiography ( Table 1 ). Pulmonary vascular variation is reported in 16.4 % of patients, of whom 47.8 % exist in the left lung . An abnormal pulmonary vessel branch can potentially induce unexpected vessel injury, with life-threatening bleeding or accidental extra-lung resection. Careful surgery is required to dissect the branch that enters the preserved lobe. This is especially emphasized in video-assisted thoracoscopic lung resection, in which it is difficult to obtain a comprehensive picture of vessel anatomy. Preoperative 3D-CECT angiography reconstruction is helpful for identifying vessel anomalies and preventing such accidents. Hence, it is desirable to confirm vascular branching patterns routinely using this noninvasive investigation before anatomical lung resection, enabling surgeons to perform lung surgery more safely with fewer complications . In patients with mediastinal branches of the pulmonary artery on the left side, vascular treatment should be managed by considering the possibility that the branches may enter either the lingular or basal segments . Fig. 1 Preoperative chest computed tomography (CT) and FDG-PET/CT images. (a) CT, axial section image; (b) CT, coronal section image: primary lung adenocarcinoma in the left lower lobe S 9 a, 18 ร— 12 ร— 16 mm (red arrow); (c) CT, sagittal section image showing a poorly developed interlobar fissure of the left lung. (d) FDG-PET/CT: FDG uptake into the cancer is significant (SUVmax: 7.44) (red arrow). Fig. 1 Fig. 2 3D-CECT angiography images. (a) Combination 3D image of the pulmonary vessels and bronchial tree: green dotted line: A 4+5 , blue dotted line: aberrant mediastinal basal artery A 8 a +9 . Green mass: S 9 a lung cancer. (b) 3D image of the bronchial tree; the left bronchial tree is depicted with a blue dotted line. (c) Combination 3D image of the pulmonary artery and bronchial tree: green dotted line: A 4+5 , blue dotted line: aberrant mediastinal basal artery A 8 a +9 . By utilizing a combination of 3D images of the accompanying pulmonary artery and bronchial tree, accurate identification of AP, A 8 a +9 , becomes easier. (d) 3D image of the pulmonary artery: green dotted line: independent A 4+5 ; blue dotted line: independent AP, A 8 a+ 9 . Fig. 2 Fig. 3 Operative findings. (a) The aberrant mediastinal basal artery (AP), A 8 a + A 9 (red arrow) enters the lower lobe from the anteromedial aspect. (b) The division of aberrant A 8a+9 . (c) Creation of the interlobar fissure (yellow arrow) and stump of A 8a+9 (red arrow). Fig. 3 Table 1 Reported cases of mediastinal basal pulmonary artery (AP). Table 1 Patient Source Variant AP branches Age Sex Surgery Surgical indication Preoperative diagnosis Interlobar fissure size dominance of AP Type of A4 + 5 Type of AP 1 1985 Banba A 9 + 10 55 M OC-LUL Lung cancer + Poor Mediastinal Independent 2 1994 Iwabuchi A 5 + 8 68 M OC-LLL Lung cancer โˆ’ Poor Combination Common-trunk 3 1996 Sano A 9 + 10 70 M OC-LLL Lung cancer + Interlobar Independent 4 2009 Moriyama A 8 + 9 75 M VATS-LUL Lung cancer โˆ’ Interlobar Independent 5 2010 Kataoka A 5 + 8 + 9 + 10 67 M VATS-LUL Lung cancer โˆ’ + Mediastinal Common-trunk 6 2011 Sueda A 8 58 M OC-LLL Lung cancer + Interlobar Independent 7 2012 Shibano A 8 56 M OC-LUL Lung cancer โˆ’ Mediastinal Independent 8 2012 Kaneda A 9 78 F VATS-LLL Lung cancer โˆ’ Mediastinal Independent 9 2012 Kozu A 5 + 8b 84 M OC-LUL Lung cancer + Combination Common-trunk 10 2012 Matsumoto A 5 + 8 + 9b 78 M VATS-LLL Lung cancer + + Combination Common-trunk 11 2014 Kato A 5b + 8b 79 F OC-LUL Lung cancer โˆ’ Poor Combination Common-trunk 12 2014 Yajima A 4 + 5 + 9 + 10 74 M VATS-LUL Lung cancer + + Combination Common-trunk 13 2014 Kim A 10 52 M No surgery (Bacterial pneumonia) Interlobar Independent 14 2015 Kawai A 8b + 9b + 10 69 F VATS-LLL Lung cancer + Mediastinal Independent 15 2015 Hong A 3 + 4 + 7 + 8 + 9 29 M No surgery (None) Unknown Common-trunk 16 2015 Hong A 3 + 5 + 7 + 8 + 9 66 M No surgery (Lung cancer) + Unknown Common-trunk 17 2015 Hong A 7 + 8 72 M No surgery (Tuberculosis) Unknown Independent 18 2015 Hong A 4 + 5 + 7 + 10 64 M No surgery (Colon cancer) + Mediastinal Common-trunk 19 2016 Sonoda A 4 + 5 + 8 + 9 + 10 73 M VATS-LUL Lung cancer + Mediastinal Common-trunk 20 2016 Nagata A 5 + 8 + 10 Unknown Unknown OC-LUL Lung cancer + Mediastinal Common-trunk 21 2017 Sugiura A 4 + 5 + 8 70 M OC-LUL Lung cancer + Mediastinal Common-trunk 22 2018 Mochinaga A 8b + 9b + 10b 60 M VATS-S8 + 9 SEG Lung cancer + Interlobar Independent 23 2018 Yatsuyanagi A 9 + 10 65 M VATS-LUL Lung cancer + Mediastinal Independent 24 2018 Nakano A 4 + 5 + 8 + 9 + 10 66 F OC-LUL, S6 SEG Lung cancer + + Mediastinal Common-trunk 25 2018 Mizukami A 8 76 F VATS-LUL Lung cancer โˆ’ Mediastinal Independent 26 2019 Uchida A 5 + 8 + 9b 65 M VATS-LUL Lung cancer โˆ’ Poor Combination Common-trunk 27 2020 Iijima A 4 + 5 + 8 + 9 68 M VATS-LUL Meta. lung cancer + Poor + Mediastinal Common-trunk 28 2022 Diong A 5 + 9 71 M VATS-LUL Lung cancer + Combination Common-trunk 29 2022 Liu A 8 48 F VATS-LUL Lung cancer + Interlobar Independent 30 2023 Agasthian A 8 69 M VATS-LUL Lung cancer โˆ’ Poor Combination Independent 31 2023 Present A 8a + 9 69 F VATS-LLL Lung cancer + Poor Mediastinal Independent OC: open chest, VATS: video-assisted thoracoscopic surgery, LUL: left upper lobectomy, LLL: left lower lobectomy, SEG: segmentectomy, meta: metastatic, AP: Arteria Praebronchialis.
4.171875
0.500977
sec[2]/p[0]
en
0.999997
38394937
https://doi.org/10.1016/j.ijscr.2024.109394
[ "lung", "cancer", "mediastinal", "independent", "vats", "common", "trunk", "combination", "interlobar", "pulmonary" ]
[ { "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": "2D4Z", "title": "Unspecified malignant neoplasms of unspecified sites" }, { "code": "2C0Z", "title": "Malignant neoplasms of intestine, unspecified" }, { "code": "2B5Z", "title": "Malignant mesenchymal neoplasm of unspecified type" }, { "code": "2E2Z", "title": "Malignant neoplasm metastasis, unspecified" }, { "code": "2D42", "title": "Malignant neoplasms of ill-defined sites" } ]
=== ICD-11 CODES FOUND === [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 [2D4Z] Unspecified malignant neoplasms of unspecified sites Also known as: Unspecified malignant neoplasms of unspecified sites | malignancy of unspecified site | malignancy unspecified primary site | malignant growth of unspecified site | malignant mass of unspecified site [2C0Z] Malignant neoplasms of intestine, unspecified Also known as: Malignant neoplasms of intestine, unspecified | cancer of intestine | malignant neoplasm of intestine NOS | malignant tumour of intestine NOS | intestinal cancer NOS [2B5Z] Malignant mesenchymal neoplasm of unspecified type Also known as: Malignant mesenchymal neoplasm of unspecified type | calvarium cancer | ethmoid bone cancer | facial bone cancer | frontal bone cancer [2E2Z] Malignant neoplasm metastasis, unspecified Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases [2D42] Malignant neoplasms of ill-defined sites Definition: Malignant neoplasms of ill defined sites is used for cases where the documentation refers to a site that includes multiple organ systems and tissue types that should be coded separately. Also known as: Malignant neoplasms of ill-defined sites | Malignant neoplasm of ill-defined site of head, face or neck | Malignant neoplasm of nose NOS | Primary malignant neoplasm of cheek | malignant neoplasm of cheek NOS === GRAPH WALKS === --- Walk 1 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --PARENT--> [12] Diseases of the respiratory system --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] 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 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.1] 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 ... --RELATED_TO--> [?] Congenital pneumonia Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi.... --- 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 ... --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....
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --PARENT--> [12] Diseases of the respiratory system", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] 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...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.1] 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 --RELATED_TO--> [?] Congenital pneumonia\n Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi....", "[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...." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
A 60 year old male smoker with a history of arterial hypertension and myocardial infarction developed typical COVID-19 symptoms in April 2021โ€”cough, exertional dyspnoea, chest tightness, and fever. Developing prior to the widespread availability of antiCOVID-19 vaccines, he was unvaccinated. Four days after the onset of symptoms, he was admitted to the Pulmonary Department of the University Hospital Brno due to the worsening dyspnoea. He tested positive for SARS-CoV-2. The exact viral variant was not identified. The predominant variant in the Czech population was B.1.1.7 (Alpha) at that time. His initial chest X-ray revealed diffuse lung infiltrates, especially in the right upper-middle quadrant. Despite receiving standard treatment with remdesivir for five days, corticosteroids (methylprednisolone 80 mg intravenously per day), and a prophylactic dose of low-molecular-weight heparin (LMWH), his dyspnoea worsened. Hence, supplemental oxygen and antibiotics (i.e., clarithromycin 500 mg IV BID and ceftriaxone 2 g IV BID for 5 days) were administered. Due to the progressively increasing levels of D-Dimers in laboratory tests, CT angiography was performed, showing typical findings consistent with COVID-19 pneumonia of diffuse lung parenchyma involvement without any signs of pulmonary embolism . The patientโ€™s oxygen was gradually increased to achieve a peripheral blood saturation of >90%. On day 11, the patient was transferred to the ICU after his saturation dropped to 50โ€“60% despite an oxygen flow via face mask of approximately 15 litres per minute. High-flow oxygen therapy (HFOT) with awake prone positioning was commenced, and corticosteroids were switched from methylprednisolone 80 mg to dexamethasone 6 mg IV per day. Despite ten days of corticosteroid administration, the patientโ€™s clinical condition began to deteriorate significantly, and his hypoxaemia worsened. On day 12, he was intubated and placed on invasive ventilation with aggressive parameters (positive end-expiratory pressure: 12 cm H 2 O; fraction of oxygen: 80%). Bronchoalveolar lavage (BAL) was performed with the PCR testing showing more than 2 million copies of SARS-CoV-2 per millilitre (a significant number); no fungal DNA was detected at this time. As the patient became anuric, daily dialysis treatment commenced on day 13. Ventilator-associated pneumonia (VAP) caused by Klebsiella pneumoniae producing extended-spectrum beta-lactamase (ESBL) was confirmed by BAL fluid cultivation, and meropenem 2 g per day in continuous infusion was started. Serum levels of cardiac markers were elevated (troponin T: 67 ng/L; NT pro Brain Natriuretic Peptide (NTproBNP): 3892 ng/L), indicating advancing myocardial injury. Norepinephrine infusion was needed to achieve adequate blood pressure. The capillary refill time was prolonged over 2 s, consistent with circulatory dysfunction. A day later, the patient developed atrial fibrillation and hemodynamic instability with doses of norepinephrine up to 0.5 ยตg/kg/min. On day 16, a tracheostomy was performed, while the ventilation remained fully controlled with a P/F (PaO 2 /inspiration fraction of O 2 ) index below 150. Two days later, the progression of circulatory dysfunction became apparent, accompanied by an elevation of inflammatory markers. Follow-up BAL was performed, empirical vancomycin was added on day 19, and doses were adjusted respecting dialysis procedures. Abdominal ultrasound revealed no clear site of a new infection. Blood cultures were negative, and BAL showed more than 3 million copies of SARS-CoV-2 and 1200 copies of Cryptococcus neoformans per millilitre/BAL. Serum panfungal antigen ((1,3)-ฮฒ-glucan D) and serum cryptococcal antigen (i.e., glucuronoxylomannan) levels were negative. Over the next four days, organ dysfunction slightly improved; therefore, the patient was slowly weaned-off sedation, and the mode of ventilation was switched to pressure support. On day 21, vancomycin was switched to linezolid 600 mg IV BID. On day 22, a follow-up BAL was performed. PCR showed borderline positivity for Cryptococcus neoformans (300 copies per millilitre), and serum positivity for cryptococcal antigen was detected. Combined antifungal therapy with liposomal amphotericin B (Abelcet) 500 mg IV per day and fluconazole 800 mg IV per day was commenced. Blood cultures were negative for bacteria and fungi. Cerebrospinal fluid analysis, including PCR, ruled out CNS dissemination. On day 24, the patientโ€™s circulatory instability progressed rapidly with no response to vasopressors and inotropes, which led to a subsequent cardiac arrest followed by unsuccessful cardiopulmonary resuscitation (CPR). Multiorgan dysfunction caused by COVID-19 infection and cryptococcal pneumonia was stated as the primary cause of death from a clinicianโ€™s perspective. The most significant feature during the histopathological examination was the severe diffuse alveolar damage (DAD) , specifically its exudative/proliferative stage, due to the prolonged period of COVID-19 pneumonia. In addition, a considerable number of dispersed intra-alveolar microorganisms, with a thick mucus capsule, were found in the lung parenchyma . These microorganisms (variably sized: approximately 7โ€“20 ฮผm) stained with both Alcian blue and Giemsa . There was only a very subtle inflammatory reaction in the surrounding tissue, mostly lymphocytic. A post-mortem lung smear was microbiologically tested and returned positive for Cryptococcus neoformans . Thus, we consider secondary lung cryptococcosis as proven. Respiratory failure as a result of DAD was the immediate cause of death of the patient.
3.943359
0.977051
sec[0]/p[0]
en
0.999996
PMC9406651
https://doi.org/10.3390/diagnostics12081944
[ "lung", "oxygen", "covid", "pneumonia", "blood", "copies", "serum", "dysfunction", "dyspnoea", "sars" ]
[ { "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": "MD11.1", "title": "Asphyxia" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "3A51.7", "title": "High affinity haemoglobin" }, { "code": "NF05", "title": "Asphyxiation" }, { "code": "PB08", "title": "Unintentional threat to breathing from low oxygen environment" } ]
=== 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 [MD11.1] Asphyxia Definition: Asphyxia is a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system. More generally the term indicates all the conditions generating impaired or impeded breathing. Also known as: Asphyxia | pathological asphyxia | decreased oxygen supply | oxygen deficiency | positional asphyxia Excludes: asphyxia due to foreign body in respiratory tract | asphyxia due to carbon monoxide | asphyxia due to traumatic [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [3A51.7] High affinity haemoglobin Definition: A disease caused by determinants arising after birth, in the antenatal period or by genetically inherited factors leading to high oxygen affinity haemoglobin. This disease is characterised by abnormalities in the globin chains that alter the affinity of the haemoglobin molecule for oxygen, affecting the normal loading of oxygen in the lungs and delivery of oxygen to the tissues. Also known as: High affinity haemoglobin | Haemoglobins with abnormal oxygen affinity [NF05] Asphyxiation Also known as: Asphyxiation | suffocation NOS | traumatic asphyxia | positional asphyxiation | asphyxia (ligature) Excludes: Respiratory distress of newborn | Adult acute respiratory distress syndrome | asphyxia from carbon monoxide [PB08] Unintentional threat to breathing from low oxygen environment Also known as: Unintentional threat to breathing from low oxygen environment | confined to or trapped in a low-oxygen environment | Accidental mechanical suffocation in refrigerator | Diving with insufficient air supply | Accidentally shut in other airtight space === GRAPH WALKS === --- Walk 1 --- [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 2 --- [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 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--> [LA75.1] 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 ... --CHILD--> [CA40.1] Viral pneumonia Def: A disease of the pulmonary system, caused by an infection with a viral source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhalation... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cellโ€“mediated immunity such as those receiving corticosteroids, antiโ€“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--> [?] Airway obstruction in the neonate due to airway abnormality", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...", "[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--> [LA75.1] 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 --CHILD--> [CA40.1] Viral pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a viral source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhalation...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cellโ€“mediated immunity such as those receiving corticosteroids, antiโ€“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
Her blood pressure and heart rate during echocardiographic examination were 140/80 mm Hg and 116 bpm, respectively. Her echocardiogram revealed concentric hypertrophy of the left ventricle with septal dimensions of 17 mm at diastole and 22 mm at systole, posterior wall dimension of 16 mm at diastole and 20 mm at systole , estimated left ventricular mass index of 152 g/m 2 body surface area, and a visually assessed ejection fraction of 70% ( Video 1 ). The basal septum measured 24 mm in systole . The apical four-chamber view showed a sigmoid-shaped septum with apical hypokinesia and compensatory hyperkinesia of basal segments ( Video 2 ). Color Doppler evaluation at mitral valve showed moderate mitral regurgitation occupying 50% of the left atrium and vena contracta of 5 mm , and continuous-wave Doppler evaluation showed a mid-late systolic jet of mitral regurgitation with a peak velocity of 6.1 m/sec . There was systolic anterior motion of anterior mitral leaflet , and color Doppler evaluation showed turbulence at the LVOT with a peak velocity of 3.28 m/sec and peak gradient of 43 mm Hg by continuous-wave Doppler evaluation. The aortoseptal angle was 102ยฐ . Aortic, pulmonary, and tricuspid valve evaluations were normal. Longitudinal strain analysis by speckle-tracking showed postsystolic shortening in the mid and apical segments of the left ventricle with significantly reduced longitudinal strain in the apex (โ€“6%) and relatively preserved strain in the basal septum , with a bull's-eye plot corroborating the same . The patient was started on intravenous metoprolol 2.5 mg (single bolus dose) and an oral regimen of metoprolol tartrate 50 mg twice daily, after which the heart rate was reduced to 64 bpm. The patient underwent fibrinolysis with streptokinase (1.5 million units), and 8 hours after fibrinolysis she underwent pharmacoinvasive angioplasty of the left anterior descending artery with two sirolimus eluting stents of sizes 2.75 ร— 28 mm and 2.5 ร— 23 mm. The septal perforator originating from the left anterior descending artery supplying the basal anteroseptum had no flow-limiting lesion that might explain the compensatory hypercontractility of the basal septum ( Video 4 ). Catheter pullback from left ventricular outflow to aorta did not reveal any subaortic or aortic gradients. After initiating beta-blockers (metoprolol tartrate 50 mg twice daily) and revascularization of the left anterior descending artery, the heart rate was reduced to 64 bpm and the intensity of the murmurs decreased substantially. Echocardiographic evaluation after revascularization revealed reduction of gradient at the LVOT from 43 mm Hg to 5 mm Hg and resolution of systolic anterior motion of the anterior mitral leaflet , favoring a possibility of acquired dynamic LVOT obstruction due to acute STEMI. Figure 2 (A) Two-dimensional transthoracic echocardiogram (TTE) parasternal long-axis view in diastole showing dimensions of the interventricular septum (17 mm, yellow arrows ), ventricular cavity (35 mm, red arrows ), posterior wall (16 mm, white arrows ), and basal septum (20 mm, blue arrows ). (B) Two-dimensional TTE of parasternal long-axis view in systole showing the dimensions of the interventricular septum (22 mm), ventricular cavity (21 mm), posterior wall (20 mm), and basal septum (24 mm). Figure 3 (A) Two-dimensional TTE apical four-chamber view with color Doppler evaluation. The mitral regurgitation in mid-late systole was demonstrated to be moderate grade with a regurgitant jet area of 50% and a vena contracta of 5.0 mm (B) Two-dimensional TTE with continuous-wave Doppler across the mitral valve showing a mid-late systolic mitral regurgitation ( teal lines ) and a peak velocity of 6.1 mm Hg. Figure 4 (A) Two-dimensional TTE parasternal long-axis view in systole showing systolic anterior motion of the mitral leaflet ( yellow arrow ) approximating with the basal septum. (B) Two-dimensional TTE apical 5-chamber view in systole with continuous-wave Doppler across the LVOT showing a late systolic jet with a peak gradient of 43 mm Hg. (C) Two-dimensional TTE parasternal long-axis view in systole showing resolution of systolic anterior motion of the mitral leaflet ( white arrow ) after initiating beta-blockers and revascularization. (D) Two-dimensional TTE apical 5-chamber view with continuous-wave Doppler across the LVOT showing a reduction of the peak gradient to 5 mm Hg after initiating beta-blockers and revascularization. Figure 5 (A) Two-dimensional TTE apical four-chamber view showing systolic anterior motion of mitral leaflet ( yellow arrow ) proximate to the basal septum. (B) Two-dimensional TTE apical four-chamber view showing resolution of systolic anterior motion of mitral leaflet ( red arrow ) after revascularization. (C) Two-dimensional TTE apical five-chamber view with color Doppler evaluation showing turbulence at the LVOT due to dynamic outflow tract obstruction. (D) Two-dimensional TTE apical five-chamber view with color Doppler evaluation at LVOT showing resolution of turbulence at LVOT following revascularization. Figure 6 Two-dimensional TTE parasternal long-axis view showing an aortoseptal angle of 102ยฐ measured using an online protractor. Figure 7 (A) Global left ventricular longitudinal strain: quad format display showing postsystolic contraction of the mid and apical segments of the left ventricle with significantly reduced strain in the apex (โ€“6%). (B) Bull's-eye plot showing significantly reduced strain in the apical segments and relatively preserved strain in the basal segments, with a global average longitudinal strain of โ€“13%.
4.136719
0.960449
sec[1]/p[1]
en
0.999996
PMC9050574
https://doi.org/10.1016/j.case.2021.12.006
[ "view", "dimensional", "apical", "mitral", "basal", "septum", "doppler", "systolic", "systole", "chamber" ]
[ { "code": "BC46&XA7XU8", "title": "Apical thrombosis" }, { "code": "DA09.71", "title": "Chronic apical periodontitis" }, { "code": "BC43.5", "title": "Stress-induced cardiomyopathy" }, { "code": "DA09.8", "title": "Radicular cyst" }, { "code": "DA09.62", "title": "Periapical abscess without sinus" }, { "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" } ]
=== ICD-11 CODES FOUND === [DA09.71] Chronic apical periodontitis Definition: A periapical inflammation characterised by dental granuloma formation. Also known as: Chronic apical periodontitis | Apical periodontitis NOS | apex periodontitis | periapical infection NOS | Apical or periapical granuloma [BC43.5] Stress-induced cardiomyopathy Definition: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocardial infarction, but with non-specific electrocardiographic ST elevation and T wave changes, and minimal myocardial enzymatic release, in the absence of coronary stenosis. Also known as: Stress-induced cardiomyopathy | Takotsubo cardiomyopathy | stress cardiomyopathy | broken heart syndrome | apical ballooning syndrome Includes: Takotsubo cardiomyopathy [DA09.8] Radicular cyst Definition: The radicular cyst is defined as an area of chronic inflammation exhibiting a closed central cavity surrounded by an epithelial lining. Also known as: Radicular cyst | apical cyst | apical radicular cyst | periradicular cyst | radiculodental cyst Excludes: lateral periodontal cyst [DA09.62] Periapical abscess without sinus Also known as: Periapical abscess without sinus | apical abscess | apical tooth abscess | suppurative apical periodontitis | apex abscess [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 === GRAPH WALKS === --- Walk 1 --- [DA09.71] Chronic apical periodontitis Def: A periapical inflammation characterised by dental granuloma formation.... --PARENT--> [DA09.7] Periapical periodontitis --CHILD--> [DA09.71] Chronic apical periodontitis Def: A periapical inflammation characterised by dental granuloma formation.... --- Walk 2 --- [DA09.71] Chronic apical periodontitis Def: A periapical inflammation characterised by dental granuloma formation.... --PARENT--> [DA09.7] Periapical periodontitis --CHILD--> [DA09.71] Chronic apical periodontitis Def: A periapical inflammation characterised by dental granuloma formation.... --- Walk 3 --- [BC43.5] Stress-induced cardiomyopathy Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard... --PARENT--> [BC43] Cardiomyopathy Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea... --EXCLUDES--> [?] Myocarditis Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an... --- Walk 4 --- [BC43.5] Stress-induced cardiomyopathy Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard... --PARENT--> [BC43] Cardiomyopathy Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea... --EXCLUDES--> [?] Myocarditis Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an... --- Walk 5 --- [DA09.8] Radicular cyst Def: The radicular cyst is defined as an area of chronic inflammation exhibiting a closed central cavity surrounded by an epithelial lining.... --EXCLUDES--> [?] Developmental odontogenic cysts Def: Cysts derived from odontogenic (tooth forming) tissue, usually containing fluid or semisolid material, which develop during various stages of odontogenesis.... --CHILD--> [?] Dental lamina keratocyst --- Walk 6 --- [DA09.8] Radicular cyst Def: The radicular cyst is defined as an area of chronic inflammation exhibiting a closed central cavity surrounded by an epithelial lining.... --EXCLUDES--> [?] Developmental odontogenic cysts Def: Cysts derived from odontogenic (tooth forming) tissue, usually containing fluid or semisolid material, which develop during various stages of odontogenesis.... --PARENT--> [?] Cysts of oral or facial-neck region Def: Cysts of oral or facial-neck region, having a distinct epithelial lining and division compared to the nearby tissue, which may contain air, fluids, or semi-solid material....
[ "[DA09.71] Chronic apical periodontitis\n Def: A periapical inflammation characterised by dental granuloma formation....\n --PARENT--> [DA09.7] Periapical periodontitis\n --CHILD--> [DA09.71] Chronic apical periodontitis\n Def: A periapical inflammation characterised by dental granuloma formation....", "[DA09.71] Chronic apical periodontitis\n Def: A periapical inflammation characterised by dental granuloma formation....\n --PARENT--> [DA09.7] Periapical periodontitis\n --CHILD--> [DA09.71] Chronic apical periodontitis\n Def: A periapical inflammation characterised by dental granuloma formation....", "[BC43.5] Stress-induced cardiomyopathy\n Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard...\n --PARENT--> [BC43] Cardiomyopathy\n Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea...\n --EXCLUDES--> [?] Myocarditis\n Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...", "[BC43.5] Stress-induced cardiomyopathy\n Def: Stress-induced or Takotsubo cardiomyopathy is a disease of the myocardium characterised by episodes of acute onset, reversible left ventricular apical wall motion abnormalities mimicking acute myocard...\n --PARENT--> [BC43] Cardiomyopathy\n Def: These are myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disea...\n --EXCLUDES--> [?] Myocarditis\n Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...", "[DA09.8] Radicular cyst\n Def: The radicular cyst is defined as an area of chronic inflammation exhibiting a closed central cavity surrounded by an epithelial lining....\n --EXCLUDES--> [?] Developmental odontogenic cysts\n Def: Cysts derived from odontogenic (tooth forming) tissue, usually containing fluid or semisolid material, which develop during various stages of odontogenesis....\n --CHILD--> [?] Dental lamina keratocyst", "[DA09.8] Radicular cyst\n Def: The radicular cyst is defined as an area of chronic inflammation exhibiting a closed central cavity surrounded by an epithelial lining....\n --EXCLUDES--> [?] Developmental odontogenic cysts\n Def: Cysts derived from odontogenic (tooth forming) tissue, usually containing fluid or semisolid material, which develop during various stages of odontogenesis....\n --PARENT--> [?] Cysts of oral or facial-neck region\n Def: Cysts of oral or facial-neck region, having a distinct epithelial lining and division compared to the nearby tissue, which may contain air, fluids, or semi-solid material...." ]
BC46&XA7XU8
Apical thrombosis
[ { "from_icd11": "DA09.71", "icd10_code": "K045", "icd10_title": "Chronic apical periodontitis" }, { "from_icd11": "DA09.8", "icd10_code": "K048", "icd10_title": "Radicular cyst" }, { "from_icd11": "DA09.62", "icd10_code": "K047", "icd10_title": "Periapical abscess without sinus" }, { "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" } ]
K045
Chronic apical periodontitis
An 81-year-old woman had a total hip arthroplasty for osteoarthritis of the hip joint at a different hospital. Her coagulation tests showed almost normal values. Activated partial thromboplastin time (APTT) was 37.7 sec, and prothrombin time international normalized ratio (PTINR) was 1.20. The implant was inserted using a posterolateral approach. The operation lasted 97 minutes, and the total bleeding during the operation was 520 grams. The patient experienced no problems with the surgery before leaving the operating room. In her hospital room at 3 hours postoperative, however, the outflow from the drain was 1290 grams, her blood pressure decreased, and she had disseminated intravascular coagulation (DIC). She was given a blood transfusion and was treated for DIC. After a few days, she recovered from the DIC, but she developed an infection on the prosthesis. Based on culture tests, she was diagnosed as having a pseudomonas infection. At this point, she was transferred to our hospital for treatment of the infection. In our hospital, we noted that her surgical wound appeared red and swollen. Her blood tests showed C-reactive protein at 7.5 mg/dL and a white blood cell count at 9.8 10 3 / ฮผ . Her coagulation tests did not show abnormal values with an activated partial thromboplastin time (APTT) at 31.2 sec and a prothrombin time international normalized ratio (PTINR) at 1.19. Since the infection continued and the risk of massive bleeding was low, we decided to remove the prosthesis to reduce the infection. At 41 days after the initial operation, a second operation was performed using a posterolateral approach . The operation lasted 145 minutes and the total bleeding during the operation was 1000 grams. She received a blood transfusion of 2 units RCC-LR. When leaving the operating room, her blood pressure was 125 over 60 mmHg, her heart rate was 132 per minute, and she was conscious. Thirty minutes after arriving at her hospital room, she suddenly had low blood pressure. Her systolic blood pressure was 50 mmHg, the amount of lost blood in the drain bag was 400 grams, and blood oozed from the surgical wound through the bandage. In her hospital room, she received a blood transfusion of 2 units RCC-LR and 2 units fresh frozen plasma. At postoperative three hours, blood still oozed heavily from her surgical wound. Her systolic blood pressure was 70 mmHg and her heart rate was 150 per minutes. Her blood tests indicated that hemoglobin was 4.0 g/dL. In the function blood coagulation tests, APTT was 122 sec, PTINR was 2.77, and FDP was 228 ฮผ g/mL. Thus, she had disseminated intravascular coagulation (DIC) again. Because she had lost consciousness, we intubated her and used a mechanical ventilator. The next day, her hemoglobin was 9.2 g/dL and her blood platelet count was 8.9 10 4 / ฮผ . In the function blood coagulation tests, APTT was 45.8 sec, PTINR was 1.85, and FDP was 284.1 ฮผ g/mL. Her blood systolic pressure was 80 mmHg and her heart rate was 140 per minute. Since her condition did not improve, we gave her transfusions every day to stabilize her condition. However, we were not able to determine the cause of the bleeding based on her blood tests or on image diagnosis. At 44 days after the second operation, she resumed eating a normal diet since her general condition was improved. But the bleeding continued and the surgical wound was dehiscence and infected. By this time, she had received a total of 28 blood transfusions of RCC-LR, 8 units of fresh frozen plasma, and 20 units of platelet concentrate since the second operation. Unfortunately, we had not diagnosed the cause of the bleeding at this time. Because the surgical wound was dehiscence and the infection remained, we needed to perform a third operation on her. At 53 days after the second operation, we consulted a hematologist. He determined the cause of the bleeding as due to a decrease in coagulation factor XIII(13) and diagnosed her as having acquired coagulation factor XIII(13) deficiency. Her coagulation factor XIII(13) activity was 48% (normal value 70~140%). The treatment of acquired coagulation factor XIII(13) deficiency is replenishment of coagulation factor XIII(13) using fresh frozen plasma or a blood product. At day 65 after the second operation, we made plans for a third operation for irrigation and insertion of a cemented spacer mixed with antibiotics. As a countermeasure to the bleeding due to coagulation factor XIII(13) deficiency, we planned to give the blood product coagulation factor XIII(13) for five days after the surgery. At day 65 after the second operation, the third operation was performed using a posterolateral approach. The operation lasted 145 minutes, and the total bleeding during the operation was 470 grams. She had a blood transfusion of 4 units RCC-LR. When leaving the operation room, her blood pressure was 167 over 76 mmHg and her heart rate was 92 per minute. She was fully conscious. The amount of lost blood in the drain bag was 100 grams, and blood did not ooze from the wound through the bandage in the first 24 hours. Since the bleeding from the surgical wound was slight, we did not need to give an additional blood transfusion. Subsequently, she did not have low blood pressure and did not have signs of disseminated intravascular coagulation. In the third operation, no diastasis was noted in the surgical wound, and infection was absent. Her general condition stabilized, and she was transferred to the previous hospital for the next revision surgery. Unfortunately, a malignant tumor had developed in the pancreas and the planned surgery was cancelled.
3.830078
0.981445
sec[1]/sec[0]/p[0]
en
0.999998
23533879
https://doi.org/10.1155/2013/473014
[ "blood", "coagulation", "bleeding", "pressure", "wound", "infection", "factor", "xiii", "time", "grams" ]
[ { "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": "3B4Z", "title": "Coagulation defects, unspecified" }, { "code": "3B21.Z", "title": "Haemorrhagic disorder due to unspecified circulating anticoagulants or coagulation factors" }, { "code": "3B6Z", "title": "Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified" }, { "code": "MA18.3", "title": "Abnormal coagulation profile" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" } ]
=== 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 [3B4Z] Coagulation defects, unspecified Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality [3B21.Z] Haemorrhagic disorder due to unspecified circulating anticoagulants or coagulation factors Also known as: Haemorrhagic disorder due to unspecified circulating anticoagulants or coagulation factors | Haemorrhagic disorder due to circulating anticoagulants or coagulation factors inhibitors | acquired coagulation factor inhibitor disorder | acquired inhibitor of coagulation | antithrombinaemia [3B6Z] Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified Also known as: Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified | Haemorrhagic condition, unspecified | unspecified hemorrhagic conditions | haemorrhagic disease NOS | haemorrhage diathesis [MA18.3] Abnormal coagulation profile Also known as: Abnormal coagulation profile | raised INR - [international normalized ratio] | subtherapeutic INR | supratherapeutic INR [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Diseases of the immune system --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.4Z] 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--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] 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--> [MA12.2] 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 2-year-old intact female miniature Pinscher weighing 1.7 kg with a body condition score of 2 out of 5 was presented for acute vomiting, lethargy for 2 days, and large petechial skin lesions on the hip region including the tail. The dog was primarily diagnosed with acute pancreatitis based on clinical signs, strong positive cPLI test and abdominal ultrasound. The treatment was initiated mainly with fluid therapy (0.9% normal saline) and fresh frozen plasma (10 ml/kg) concurrently with other supportive treatment, including analgesics (Tramadol, 3 mg/kg, IV), antiemetics (Maropitant, 1 mg/kg, SQ), and H2-blockers (Ranitidine, 2 mg/kg, IV). While the clinical signs associated with acute pancreatitis had been improved in 3โ€“5 days, lesion of petechial appeared on the left hip region 7 days after the presentation, with a fast progression into a necrotic tissue along the left side hip. The concurrent cutaneous manifestation of systemic DIC was recognized according to diagnostic references by the acute pancreatitis diagnosis and laboratory results showing a low platelet count, prolonged blood clotting time, and increased fibrin degradation products such as D-dimer (Table 1 ). The skin lesions were diagnosed as small petechiea that appeared on the left stifle on the first day of presentation, with fast progression to necrotic tissue along the left side of hip within the 3 days. Initial treatments included debridement and warm saline washes with systemic cephalexin twice per day (Cephalexin; Ildong Pharm Co., Ltd. Seoul, South Korea) to protect against secondary infection. The lesions had not improved 5 days after the acute pancreatitis signs had improved . Allogeneic PRP was added to the conventional treatments to promote skin healing and regeneration on day 5 because autologous PRP was impossible due to the patientโ€™s low body mass (<2 kg, toy breed). The basic protocol to prepare the PRP was based on the Weibrich and Kleis method . The PRP applied in this case was allogeneic PRP, instead of autologous PRP, in which the PRP blood source was from a donor dog (5-year-old intact healthy female beagle). Except for this difference, the other procedures for preparing the PRP were similar to those of the Weibrich and Kleis method, in which the donorโ€™s blood (8 mL) was drawn into a citrate tube and centrifuged for 10 minutes at 629 ร— g to separate the blood into two basic components according to density (PRP in the top layer and red blood cells and white blood cells in the bottom layer). The PRP was carefully removed with a pipette and mixed with 200 ฮผL of the lower layer, which contained large but more recently synthesized platelets. The mixture was centrifuged at 1,233 ร— g for 14 minutes to separate the platelet pellet in the supernatant layer. Centrifugation was repeated until the PRP mixture was obtained, including 0.6โ€“0.7 mL of supernatant and a mean platelet concentration of 1.0โ€“1.2 ร— 10 platelets/ฮผL. The PRP was mixed with an equal volume of sterile saline solution and 10% calcium chloride. The topical PRP gel (0.1 mL) was applied to the hip lesion, supplemented with erythropoietin (Epokine, Pharma CJ Cheiljedang, Icheon-si, Republic of Korea) and granulocyte colony-stimulating factor (Leukokine, Pharma CJ Cheiljedang, Icheon-si, Republic of Korea) for active hematopoiesis while continuing debridement and saline cleansing. Two days after applying the PRP, the inflammatory exudate decreased, and granulation tissue began to grow . The lesions improved in color and mild regression in size was observed 5 days after applying the PRP . The defect regressed significantly, almost by half in diameter, 13 days after applying the topical PRP . Four weeks after the first presentation and 3 weeks after the first PRP application, the wound had significantly regenerated with healthy granulation tissue and was almost completely healed with epithelialization . The skin lesions had almost completely regenerated 25 days after the allogeneic PRP application, which was 30 days after the first presentation of the skin lesion. A marked reduction in swelling, lack of crusts and erosion, and hair regrowth were observed . This case trial has been carried out under the ethical guidelines of Chonbuk University IACUC. Table 1 Specific hematology, serum chemistry, and coagulation profile data of a dog with disseminated intravascular coagulation associated with pancreatitis Hematology Value Reference interval WBC 19.41 6 ~ 12 (10x9/L) WBC-Lymph(#) 1.1 1 ~ 3.6 (10x9/L) WBC-Lymph(%) 5.8 0 ~ 100 (%) WBC-Mono(#) 0.6 0 ~ 0.5 (10x9/L) WBC-Mono(%) 3.2 0 ~ 100 (%) WBC-Gran(#) 17.7 3 ~ 10 (10x9/L) WBC-Gran(%) 91 0 ~ 100 (%) WBC-Eos(%) 1.1 ~ (%) RBC 6.89 5.5 ~ 8.5 (10x12/L) Hemoglobin[Hb] 15.69 15 ~ 20 (g/dL) Hematocrit[Hct] 48.13 37 ~ 54 (%) MCV 70 60 ~ 77 (fL) MCH 22.77 17 ~ 23 (pg) MCHC 32.61 31 ~ 36 (g/dL) RDW-CV 14.43 14 ~ 17 (%) Platelet 66 200 ~ 460 (10x9/L) MPV 8.37 6.7 ~ 11.1 (fL) Serum chemistry Value Reference interval Albumin 2.2 2.2 ~ 3.9 (g/dL) ALKP 159 23 ~ 212 (U/L) ALT 61 10 ~ 100 (U/L) Amylase 2500 500 ~ 1500 (U/L) BUN 50 7 ~ 27 (mg/dL) Calcium[Ca++] 8.4 7.9 ~ 12 (mg/dL) Cholesterol-Total 200 110 ~ 320 (mg/dL) Creatinine 0.4 0.5 ~ 1.8 (mg/dL) Glucose 83 77 ~ 125 (mg/dL) Phosphorus-Inorganic 3.4 2.5 ~ 6.8 (mg/dL) Bilirubin-Total 1 0 ~ 0.9 (mg/dL) Protein-Total 6.1 5.2 ~ 8.2 (g/dL) Coagulation panel Value Reference interval Whole blood APTT 99 60 ~ 93 (sec) Whole blood PT 15.5 11 ~ 14 (sec) D-dimer 0.7 0.1 ~ 0.5 (mg/dL) Figure 1 Clinical improvement of lesions on (a) Day0, (b) Day2, (c) Day5, (d) Day13, (e) Day21 and (f) Day28 after topical PRP application.
4.242188
0.87793
sec[1]/p[0]
en
0.999996
25763181
https://doi.org/10.1186/s13620-015-0032-7
[ "blood", "lesions", "skin", "pancreatitis", "saline", "improved", "tissue", "platelet", "which", "layer" ]
[ { "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": "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 === [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 [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 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Diseases of the immune system --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] 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... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --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--> [?] Diseases of the immune system", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] 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 --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --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
In the ICU, a central venous catheter was inserted into the right jugular vein and a catheter for pulse contour analysis and continuous hemodynamic measurement was placed into the left femoral artery. The patient received colloids, crystalloids and a continuous infusion of glucose 10% under concurrent laboratory control of glucose, arterial blood gases, lactate and electrolytes every 4 hours. Two units of platelets were transfused. Quinine (QuinimaxR) was administered intravenously, starting with a bolus injection followed by continuous infusion over 24 hours under regular control of quinine blood levels. Additionally doxycycline was given orally. The first hemodynamic measurement revealed a central venous pressure (CVP) of 11 mmHg, cardiac output of 6.0 l/min and a systemic vascular resistance (SVR) of 729 dynes*s/cm2. CVP was measured every 4 hours. During the first 14 hours in the ICU, the overall fluid administration was 4.7 l and diuresis was 3.6 l, resulting in positive fluid balance of 1.1 liter. The heart rate decreased to 120 beats/min and the systolic blood pressure (SBP) increased to 100 mmHg with a mean arterial blood pressure (MAP) of 70 mmHg. The next day, the parasite load of 25.5% on admission increased to 36.7%. A second venous catheter was inserted into the right femoral vein and a red cell exchange with a cell seperator (Cobe Spectra, Gambro BCT, Munich, Germany) was initiated. A 1.5 fold blood volume red cell exchange was performed with 20 units of packed red blood cells. The procedure was well tolerated and no bleeding occurred. The parasite load dropped to 16%. The following day the hemodynamic status of the patient destabilized with a drop of SBP to 80 mmHg and of the MAP to 45 mmHg, respectively. The heart rate increased to 180 beats/min and the CVP was 3 mmHg. The respiratory rate was 25/min under supplementation of 10 l O2 given via venturi face mask. Laboratory data showed a peak lactate level of 21.4 mmol/l, a base excess of -16.4 mmol/l and a pH of 7.24. The patient showed severe agitation. A mechanical ventilation was immediately initiated under analgesia and sedation with propofol and sufentanil. The patient was breathing spontaneously by means of pressure support of 15 to 20 mmHg and a positive endexspiratory pressure of 5 mmHg. The shock was treated with fluid resuscitation according to the concept of early goal directed therapy. During the next 6 hours, administration of 2 liters of cristalloids and 1 liter of colloids was required to increase the CVP. Increase of MAP over 65 mmHg and a sufficient central oxygen venous saturation could only be reached by means of dobutamine and norepinephrine. After hemodynamic stabilization, CVP was around 12 mmHg. Lactate levels fell gradually to 5.5 mmol/l and the pH normalized. The net fluid balance was 5.3 l. Because of the high parasite load of 16%, a second red blood cell exchange via cell separation was undertaken with 13 units of packed red blood cells. The parasite load decreased to 2% the next day. The patient remained hemodynamically stable during the procedure with no need for increased doses of catecholamines. A CT scan of the brain showed no signs of bleeding, ischemia or edema. Due to increased myoglobin levels and the subsequently developed renal failure, renal replacement therapy was initiated via continuous venovenous hemodiafiltration (CVVHDF). Although the thrombocyte count remained low, administration of heparin was initiated at 200 i.u. per hour in order to prevent clotting of the dialysis machine and provide prophylaxis against deep vein thrombosis. As a consequence of the shock, the patient developed a severe hepatic dysfunction with a massive increase of liver enzymes and bilirubin and a decrease of albumin to one third of normal levels. Furthermore, the patient developed rhabdomyolysis. With a positive fluid balance of almost 4 liters the fourth day, the patient remained hemodynamically stable. Thereafter dobutamine could be stopped and norepinephrine slightly reduced. With a CVP between 9 and 13 the patient developed no pulmonary edema and all respiratory parameters remained stable. On the fifth day C-reactive protein (CRP) and leucocyte count increased, but temperature remained stable between 38 and 39ยฐC. Cultures from blood, respiratory secretions and urine were performed and the patient was given antimicrobial treatment with a fixed preparation of combined piperacillin and tazobactam. All cultures remained negative. During the following days norepinephrine was further decreased based under hemodynamic status and was finally discontinued on the seventh day. Based on CVP measurements, the net fluid balance was negative from day 5 on until discharge from the ICU. Mechanical ventilation was discontinued on day 7, and continuous dialysis was replaced by intermittent dialysis. The extremely high scores (Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment) on the day of the shock improved gradually. Hepatic dysfunction and rhabdomyolysis dissolved, but the patient remained in renal failure. Thrombocytes and leucocytes returned to normal values. After extubation the patient's confusion improved slowly. At discharge from the ICU on day 12, there was sufficient orientation in time and person, but not in situation. The patient remained hospitalized for a further period of three weeks. During this time he regained full orientation. At the time of discharge creatine level was 286 ฮผmol/l, renal function had been resumed and thus there was no need for further dialysis.
3.898438
0.968262
sec[1]/p[1]
en
0.999997
20181174
https://doi.org/10.1186/1757-1626-2-6644
[ "mmhg", "blood", "remained", "fluid", "continuous", "hemodynamic", "hours", "pressure", "cell", "venous" ]
[ { "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": "LA13.0", "title": "Congenital anomalies of the vitreous" }, { "code": "2A02.Z", "title": "Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "5C70.0", "title": "Dehydration" }, { "code": "5C78", "title": "Fluid overload" } ]
=== 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 [LA13.0] Congenital anomalies of the vitreous Also known as: Congenital anomalies of the vitreous | Congenital vitreous cysts | Congenital malformation of vitreous humour, not otherwise specified | congenital malformation of vitreous humour | Congenital vitreous opacity [2A02.Z] Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified Also known as: Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified | Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system | Neoplasm of uncertain or unknown behaviour of spinal cord | Epidural cancer NOS [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 === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --CHILD--> [?] Diseases of spleen --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.41] 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--> [MF50.40] Macroscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Diseases of spleen", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] 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--> [MF50.40] Macroscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
In August 2018, an elderly male patient underwent a chest CT scan during a routine check-up, which revealed a 24ร—25mm lesion in the lower lobe of the left lung. Clinical presentation includes occasional cough that can resolve on its own, without taking any cough suppressant medication. No coughing up phlegm, no significant chest pain, no chest tightness or shortness of breath, no fever or sweating, no abdominal pain, no diarrhea or constipation. Previously in good health. Denies a history of lung diseases such as tuberculosis or pneumonia. Denies a history of infectious diseases such as hepatitis or enteritis. No history of trauma, surgery, or blood transfusion. No history of food or drug allergies. 33-year smoking history, consuming 20 cigarettes per day. Occasional alcohol consumption.Vital signs are stable. Specifically: H 175cm, W 66kg, HR 82/min, BP 126/75mmHg.Laboratory tests: WBC 5.35ร—10 9 /L (4-10ร—10 9 /L), RBC 4.24ร—10 12 /L (4-5.5ร—10 12 /L), Hb 135g/L(120-160g/L), PLT 125ร—10 9 /L (100-300ร—10 9 /L), CEA 71.5ng/mlโ†‘ (<3.4ng/ml), CA24-2 89U/mlโ†‘ (<15U/ml), other tumor markers are within normal range. Enlarged left hilar and mediastinal lymph nodes were also observed, indicating possible metastasis. To determine the nature of the lesion, a CT-guided biopsy of the left lower lobe lesion was performed, and the pathological examination confirmed poorly differentiated adenocarcinoma. The 10-gene panel testing for lung cancer (EGFR, ALK, ROS1, BRAF, KRAS, NRAS, HER2, PIK3CA, RET, MET) showed negative results, and the PD-L1 expression was positive at a rate of 20%. Additional imaging studies were conducted, and no evidence of metastatic lesions was found. The patient was clinically staged as cT1N3M0 IIIB. A multidisciplinary consultation involving thoracic surgery, radiology, pathology, medical oncology, radiation oncology, and respiratory medicine was conducted, and the recommendation was to proceed with concurrent chemoradiotherapy followed by maintenance therapy. From September 2018 to March 2019, the patient underwent 8 cycles of PP regimen chemotherapy (Pemetrexed 500mg/m 2 IV day 1, Nedaplatin 120mg/m 2 IV day 1, every 3 weeks) in combination with anti-angiogenic therapy (Endostatin 30mg/day from day 1 to 7, every 3 weeks). During the 3rd to 4th cycle of treatment, concurrent chemoradiotherapy was administered. The specific radiotherapy plan involved 6MV-X rays, delivering a dose of 66Gy to 95% of the planning target volume (PTV) over 33 fractions for a duration of 6 to 7 weeks. The treatment toxicity was manageable. After completion of the chemoradiotherapy, the treatment response was evaluated according to the RECIST v1.1 criteria, which indicated a Partial Remission (PR). At that time in China, PD-1 inhibitors had not yet obtained indications for maintenance therapy in stage IIIB non-small cell lung cancer. Results from the Beyond study, focusing on the Chinese population, demonstrated that during the maintenance phase of non-small cell lung cancer treatment, the combination of pemetrexed with anti-angiogenic therapy improved Overall Response Rate (ORR) and Time to Progression (TTP). Therefore, subsequently, pemetrexed in combination with endostatin was administered as maintenance therapy (Pemetrexed 500mg/m 2 IV day 1, Endostatin 30mg/day from day 1 to 7, every 3 weeks).In May 2021, a follow-up chest CT revealed an increased size of the residual lesion in the left lung accompanied by carcinomatous lymphangitis, and the treatment response was evaluated as Progressive Disease (PD), suggesting possible resistance. From June 2021 to December 2021, the patient received a second-line treatment regimen (Camrelizumab <PD-1 inhibitor> 200mg IV day 1, Bevacizumab 500mg IV day 1, every 3 weeks) for a total of 8 cycles. The treatment response assessment after the 2nd and 4th cycles indicated Partial Remission (PR), while the assessment after the 6th and 8th cycles showed Stable Disease (SD).In January 2022, a follow-up examination revealed a nodular lesion in the right liver . Ultrasound-guided biopsy was performed, and the pathological result indicated hepatic cavernous hemangioma. Following the biopsy, there was an occurrence of intraperitoneal bleeding, resulting in the drainage of 3500ml of hemorrhagic ascites. Cell pathology examination did not reveal malignant tumor cells, and the patientโ€™s condition improved after receiving symptomatic treatment for hemostasis. Considering the change in the patientโ€™s condition, a multidisciplinary consultation was conducted again, and it was speculated that the occurrence of hepatic cavernous hemangioma could not be ruled out as an adverse drug reaction to Camrelizumab, with the possibility that Bevacizumab might exacerbate the risk of bleeding. Based on the patientโ€™s condition and the consultation results, after a two-month period of recuperation, the patient commenced a new treatment regimen in April 2022, which involved switching the immune checkpoint inhibitor and continuing with Bevacizumab. The immune checkpoint inhibitor was changed from Camrelizumab to Tislelizumab(200mg ivd d1, q3w), while Bevacizumab treatment remained the same. Regular follow-up examinations every two months indicated sustained stable disease in the primary lesion, and the hepatic cavernous hemangioma disappeared . These results suggest a close association between the occurrence of hepatic cavernous hemangioma and Camrelizumab, and that there is a risk of intraperitoneal bleeding with the combination of anti-angiogenic therapy. However, the bleeding risk was reversible after discontinuation of the medication.
3.951172
0.973145
sec[1]/sec[0]/p[0]
en
0.999998
PMC10435320
https://doi.org/10.3389/fonc.2023.1221309
[ "lesion", "lung", "that", "every", "chest", "maintenance", "cycles", "pemetrexed", "combination", "response" ]
[ { "code": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "LA75.1", "title": "Agenesis of lung" }, { "code": "CA40.Z", "title": "Pneumonia, organism unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "NB32.3Y", "title": "Other injury of lung" } ]
=== ICD-11 CODES FOUND === [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 [CB40.Y] Other specified diseases of the respiratory system Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum [LA75.1] Agenesis of lung Definition: This refers to the absence or rudimentary residua of an undeveloped lung. Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism [CA40.Z] Pneumonia, organism unspecified Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [NB32.3Y] Other injury of lung Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Osteoarthritis Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art... --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Osteoarthritis Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art... --- Walk 3 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 4 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders --- Walk 5 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.0] Skin lesion of uncertain nature Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made.... --- Walk 6 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --CHILD--> [ME60.2] Ulcer of skin of uncertain nature Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made....
[ "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.0] Skin lesion of uncertain nature\n Def: This denotes the presence of a skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.2] Ulcer of skin of uncertain nature\n Def: This denotes the presence of a skin ulcer but uncertainty as to its nature. No inference as to whether the ulcer might be of serious significance (e.g. suspected skin cancer) is made...." ]
FA5Z
Arthropathies, unspecified
[ { "from_icd11": "FA5Z", "icd10_code": "M00-M25", "icd10_title": "" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "ME60.Z", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "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": "" } ]
M00-M25
A 28-year-old, unvaccinated, African American female with a past medical history of asthma, tobacco abuse, and a BMI of 46 initially presented to the emergency department in September 2021 with a complaint of fever, cough, and shortness of breath for two days. Her initial COVID-19 test was negative, and her symptoms were attributed to asthma which was treated with albuterol. Of note, her last documented asthma exacerbation was one month prior to her current presentation. She continued to have a fever with a peak of 104ยฐF along with myalgias and arthralgias which prompted her to return to the ED the following day. Her SpO 2 was 98%, and chest X-ray showed signs of lobar pneumonia . She was empirically treated as an outpatient with amoxicillin-clavulanic acid. Her symptoms worsened despite treatment, so she returned to the ED two days later with an additional complaint of dark urine and bilateral lower extremity muscle weakness. She was found to have SpO 2 of 93% with desaturation to 80% when walking, which required treatment with supplemental oxygen at 2 L/min via nasal cannula. Urinalysis revealed gross hematuria, 2-4 red blood cells per high-power field, 100 mg/dL protein, >8.0 mg/dL urobilinogen, and 0-2 hyaline casts; urine hemoglobin and urine myoglobin were not part of the urinalysis test. She was retested for COVID-19 which came back positive, but other viral testing was not performed to rule out alternate viral etiologies. She did meet sepsis criteria at that time for possible superimposed bacterial pneumonia (fever, elevated leukocyte count, tachycardia, elevated respiratory rate, and elevated lactic acid > 2.0), thus necessitating hospital admission. She was empirically treated with a course of levofloxacin and ceftriaxone for pneumonia while respiratory and blood culture results were pending; however, both culture results came back negative a few days later. Antibiotics were discontinued after receiving the negative culture results, and she was started on corticosteroids to address acute respiratory distress. Chest CT on day 1 of hospitalization revealed consolidation in the right middle and right lower lobes, but it was negative for pulmonary embolism . CT pulmonary angiogram on day 2 revealed worsening consolidation and pulmonary infiltrates that had become bilateral, and ground-glass type opacities predominant in the central lungs concerning for COVID-19 pneumonia . Meanwhile, her ALT and AST levels increased exponentially over the duration of 12 hours since admission, with a peak on day 5 . Her CK level was also elevated at > 40,000 U/L during the first six days of hospitalization . The following liver enzymes were within normal limits: ALP (75 U/L) and gamma-glutamyltransferase (GGT) (45 U/L). Total bilirubin (1.6 mg/dL) and international normalized ratio (INR) (0.95) were also within the normal range. Urine culture was negative and repeat testing four days later remained negative. A comprehensive metabolic panel showed creatinine levels between 1.08 and 1.32 mg/dL and glomerular filtration rate (GFR) between 48 and 59 mL/min/1.73 m 2 corresponding with the timeframe of the transaminitis. Blood ethanol and acetaminophen levels were within normal limits. Urine Legionella antigen, urine drug screen, and hepatitis panel were negative. Her liver ultrasound revealed a normal biliary tract without evidence of fibrosis. Gastroenterology was consulted, and transaminitis was attributed secondary to rhabdomyolysis likely associated with COVID-19. It was suggested that transaminitis would improve once CK level normalized, so conservative management of rhabdomyolysis with intravenous fluids was advised. She was initially unable to receive remdesivir treatment for COVID-19 due to transaminitis, and an IL-6 inhibitor was contraindicated given her underlying sepsis. She did receive corticosteroids and supplemental oxygen for the treatment of COVID-19. After day 8, her CK, ALT, and AST levels started to decrease, but her respiratory status continued to deteriorate despite previous treatment with corticosteroids. Her supplemental oxygen requirement steadily increased from 2 L/min on admission to 30 L/min via high-flow nasal cannula the following week and up to 60 L/min two weeks after admission. She was retested for COVID-19 on day 16 which came back positive. Her respiratory and blood cultures were repeated at the same time, and they remained negative. Given her negative respiratory and blood cultures, her worsening respiratory status was attributed to COVID-19. She was started on remdesivir treatment after resolution of rhabdomyolysis and transaminitis; this was the only available option during her hospitalization in September 2021 given the supply shortages at that time. Maximal medical therapy was reached without improvement of her respiratory status, and she eventually required intubation and mechanical ventilation on day 20. She received propofol, cisatracurium, and epoprostenol while being mechanically ventilated, and she required upwards of 15 cm H2O of positive end-expiratory pressure (PEEP). Attempted ventilator weaning trials were unsuccessful as she rapidly desaturated each time. She developed tongue ulceration after prolonged intubation on day 44, followed by sepsis. CT angiogram of the chest on day 57 revealed diffuse pulmonary fibrosis with associated ground-glass attenuation, bilateral centrilobular consolidations, and traction bronchiectasis . These findings were attributed to the sequelae of severe COVID-19 pneumonia. Her family decided to switch to comfort care, and the patient passed away on day 59.
3.941406
0.979492
sec[1]/p[0]
en
0.999997
PMC9547668
https://doi.org/10.7759/cureus.28950
[ "covid", "respiratory", "urine", "which", "pneumonia", "blood", "transaminitis", "attributed", "that", "time" ]
[ { "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": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "CB41.2Z", "title": "Respiratory failure, unspecified" }, { "code": "CB40.Y", "title": "Other specified diseases of the respiratory system" }, { "code": "MD11.Y", "title": "Other specified abnormalities of breathing" } ]
=== 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 [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [CB41.2Z] Respiratory failure, unspecified Also known as: Respiratory failure, unspecified | Respiratory failure, unspecified as acute or chronic | respiration failure | respiratory failure NOS | respiration failed [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 [MD11.Y] Other specified abnormalities of breathing Also known as: Other specified abnormalities of breathing | Bradypnoea | Choking sensation | Hypoventilation | hypoventilation syndrome NOS === 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--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to... --EXCLUDES--> [?] COVID-19, virus 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 --PARENT--> [25] Codes for special purposes --- 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... --CHILD--> [RA01.1] COVID-19, virus not identified --EXCLUDES--> [?] COVID-19, virus identified --- Walk 6 --- [RA01] COVID-19 Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description... --CHILD--> [RA01.0] COVID-19, virus identified --EXCLUDES--> [?] Coronavirus infection, unspecified site
[ "[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] 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--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...\n --EXCLUDES--> [?] COVID-19, virus 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 --PARENT--> [25] Codes for special purposes", "[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 --CHILD--> [RA01.1] COVID-19, virus not identified\n --EXCLUDES--> [?] COVID-19, virus identified", "[RA01] COVID-19\n Def: As definition may evolve, the URL for the Global surveillance document will be added as the short description...\n --CHILD--> [RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site" ]
RA01.0
COVID-19, virus identified
[ { "from_icd11": "QA08.5", "icd10_code": "Z1159", "icd10_title": "Encounter for screening for other viral diseases" }, { "from_icd11": "QA08.5", "icd10_code": "Z1151", "icd10_title": "Encounter for screening for human papillomavirus (HPV)" }, { "from_icd11": "QA08.5", "icd10_code": "Z115", "icd10_title": "Encounter for screening for other viral diseases" }, { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "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" }, { "from_icd11": "CB41", "icd10_code": "J96", "icd10_title": "Respiratory failure, not elsewhere classified" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9691", "icd10_title": "Respiratory failure, unspecified with hypoxia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9690", "icd10_title": "Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9692", "icd10_title": "Respiratory failure, unspecified with hypercapnia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J9621", "icd10_title": "Acute and chronic respiratory failure with hypoxia" }, { "from_icd11": "CB41.2Z", "icd10_code": "J969", "icd10_title": "Respiratory failure, unspecified" } ]
Z1159
Encounter for screening for other viral diseases
A 57-year-old woman was admitted to the Clinic of Gastroenterohepatology with a two-month history of general weakness, malaise, abdominal fullness, increased abdominal gear, nausea, vomiting, and peripheral edema . No fever was noted before admission. She had a distended and dull abdomen without peritoneal signs and her bowel sounds were normal. There were no enlarged and palpable lymph nodes. The patient did not have significant previous medical history. Eight years ago she underwent hysterectomy with bilateral oophorectomy due to uterine myoma.Two years ago the patient had a total colonoscopy in another medical institution, but no remarkable abnormalities were found. One year ago she had a total body technetium scan which detected few accumulations in the cervical spine interpreted as lesions of degenerative origin. The peripheral blood count was initially unremarkable (hemoglobin 134 g/L, hematocrit 41%, red blood cells count 4.5 ร— 10 12 /L, white blood cells count 9.8 ร— 10 9 /L, and platelet count 197 ร— 10 9 /L). During the stay the leukocyte count raised up to 16.7 ร— 10 9 /L with granulocytic predominance. The peripheral blood smear showed no immature cells (80.4% neutrophils, 8.5% lymphocytes, 10.7% monocytes, 0.1% eosinophils, and 0.3% basophils). The routine laboratory tests showed no specific abnormalities, except for the remarkable LDH values of 3194 U/L (normal value: 213โ€“423 U/L) and uric acid of 1068 ฮผ mol/L (normal value: 150โ€“450 ฮผ mol/L). The total plasma protein level was 58 g/L, albumin level 35 g/L, globulin level 23 g/L, and CRP level 37 mg/L. Renal and liver functional tests, bilirubin, and electrolytes were normal. The serological screening for B and C hepatitis (HBsAg and anti-HCV) was negative. The abdominal ultrasound showed large amount of ascites without findings of liver cirrhosis or portal hypertension . The CT scan revealed diffusely thickened, nodular, and irregular peritoneum mainly affecting the upper parts of the abdomen and the anterior abdominal wall, findings which are initially consistent with peritoneal carcinomatosis. The CT scan did not indicate any tumor formation, bowel affection, or abdominal lymph node enlargement. The diagnostic paracentesis yielded chylous fluid. The LDH level in the peritoneal fluid was extremely elevated reaching values of 32585 U/L and the LDH ascites/serum ratio was 0.05. The protein level was ranging from 28 to 39 g/L, albumin level from 13 to 26 g/L, globulin level from 7 to 13 g/L, glucose level 0.2 mmol/L, cholesterol level 2 mmol/L, and triglycerides level 1.5 mmol/L. Serum-ascites albumin gradient ranged from 14 to 16 g/L. The tumor markers were also analyzed. The serum carbohydrate antigen 125 (CA 125) level was 597.9 U/mL (normal value <35.0 U/mL) and the ascites CA 125 level was elevated up to 4221 U/mL. The levels of carcinoembryonic antigen (CEA), CA 19โ€“9 and CA 72โ€“4 were within the normal range. The adenosine deaminase (ADA) level in ascites ranged from 67.5 U/L to 122.9 U/L and ADA ascites/serum ratio ranged from 3 to 5.91. Lysozyme level ranged from 11.2 mg/L to 20.7 mg/L. The chest radiography and thoracic ultrasound revealed small unilateral pleural effusion . The pleural fluid was hemorrhagic and the biochemical analysis showed LDH level of 175.8 U/L (LDH pleural fluid/serum ratio 0.05), total protein of 24.2 g/L, albumin 15.5 g/L, glucose 0.3 mmol/L, CRP 19.8 mg/L, triglycerides 0.4 mmol/L, and cholesterol level of 1.5 mmol/L. The ADA and lysozyme values in the pleural fluid were 43.4 U/L and 9.0 U/L, respectively, with pleural fluid/serum ratio of 1.95 for ADA and 0.76 for lysozyme. The tumor markers in the pleural fluid were not elevated. Because of the elevated ADA in ascites, we performed additional investigations (acid-fast staining, the Lowenstein-Jensen culture test of ascitic fluid, and the Mantoux test) in order to exclude peritoneal tuberculosis, but all these findings were negative. The gastroscopy showed few small mucosal elevations with central depression. The cytology from the peritoneal and pleural fluid did not detect any malignant cells (cytology class I) with massive coagulation necrosis, granulocytes, and macrophages in the ascitic fluid. The diagnostic laparoscopy performed by a gastroenterologist discovered only thickened peritoneum, but the histological analysis of the peritoneal biopsies did not reveal the nature of the findings. Afterwards a surgical laparoscopy was performed which also confirmed diffuse peritoneal thickening and nodular omental infiltration. During the diagnostic process the patient became febrile up to 38.5ยฐC and she developed progressive cardiorespiratory deterioration which led to multiorgan failure and lethal outcome within twenty-two days of admission despite all symptomatic and supportive measures. The definitive diagnosis was established postmortem with the histological report from the peritoneal biopsies taken during the surgical laparoscopy four days before the lethal outcome. The preliminary histological report unexpectedly showed presence of neoplastic lymphoid cells diffusely infiltrating the fibrous and fat tissue with โ€œstarry skyโ€ phenomenon, findings which are consistent with aggressive type of B-cell NHL . Afterwards, immunohistochemical study was performed and showed CD 20+ expression with proliferative fraction higher than 80% in favor of DLBCL. The patient's family did not allow us to perform an autopsy; hence we were not able to discover any other potential lymphomatous involvement affecting other organs and tissues and to determine the disease extension and stage.
4.078125
0.975098
sec[1]/p[0]
en
0.999996
24711934
https://doi.org/10.1155/2014/723473
[ "fluid", "peritoneal", "ascites", "pleural", "serum", "mmol", "abdominal", "which", "count", "cells" ]
[ { "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": "DC5Z", "title": "Diseases of peritoneum, unspecified" }, { "code": "DC50.Z", "title": "Peritonitis, unspecified" }, { "code": "NB91.Y&XA0KZ0", "title": "Peritoneal laceration" }, { "code": "2F94", "title": "Neoplasms of unknown behaviour of peritoneum" }, { "code": "DC51.Y", "title": "Other specified disorders of peritoneum or retroperitoneum" } ]
=== 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 [DC5Z] Diseases of peritoneum, unspecified Also known as: Diseases of peritoneum, unspecified | peritoneal disease [DC50.Z] Peritonitis, unspecified Also known as: Peritonitis, unspecified | Peritonitis | peritoneum inflammation | peritonitis of undetermined cause | peritonitis of unspecified cause [2F94] Neoplasms of unknown behaviour of peritoneum Also known as: Neoplasms of unknown behaviour of peritoneum | peritoneum tumour NOS [DC51.Y] Other specified disorders of peritoneum or retroperitoneum Also known as: Other specified disorders of peritoneum or retroperitoneum | Abdominal granuloma | Peritoneal granuloma | Epiploic appendagitis | Male frozen pelvis === GRAPH WALKS === --- Walk 1 --- [FA36.Z] Effusion of joint, unspecified --PARENT--> [FA36] Effusion of joint Def: Increased intra-articular fluid secondary to trauma and/or other acquired conditions not detailed in other codes.... --CHILD--> [FA36.Y] Other specified effusion of joint --- 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.... --PARENT--> [?] Certain specified joint disorders or deformities of limbs --- Walk 3 --- [5C70.0] Dehydration Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water... --PARENT--> [5C70] Volume depletion --EXCLUDES--> [?] Hypovolaemic shock --- Walk 4 --- [5C70.0] Dehydration Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water... --PARENT--> [5C70] Volume depletion --CHILD--> [5C70.1] Hypovolaemia Def: This is a state of decreased blood volume; more specifically, decrease in volume of blood plasma. It is thus the intravascular component of volume contraction (or loss of blood volume due to things su... --- Walk 5 --- [5C78] Fluid overload Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart... --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance --CHILD--> [5C70] Volume depletion --- Walk 6 --- [5C78] Fluid overload Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart... --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance --CHILD--> [5C72] Hypo-osmolality or hyponatraemia Def: Serum sodium concentrations of less than 135 mEq/L; decreased 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 --CHILD--> [FA36.Y] Other specified effusion of joint", "[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", "[5C70.0] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...\n --PARENT--> [5C70] Volume depletion\n --EXCLUDES--> [?] Hypovolaemic shock", "[5C70.0] Dehydration\n Def: Dehydration occurs when there is an insufficient amount or excessive loss of water in the body. This can be caused by vomiting, diarrhoea, fever, use of diuretics, profuse sweating, or decreased water...\n --PARENT--> [5C70] Volume depletion\n --CHILD--> [5C70.1] Hypovolaemia\n Def: This is a state of decreased blood volume; more specifically, decrease in volume of blood plasma. It is thus the intravascular component of volume contraction (or loss of blood volume due to things su...", "[5C78] Fluid overload\n Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C70] Volume depletion", "[5C78] Fluid overload\n Def: This is the condition where there is too much fluid in the blood. The opposite condition is hypovolemia, which is too little fluid volume in the blood. Fluid volume excess in the intravascular compart...\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C72] Hypo-osmolality or hyponatraemia\n Def: Serum sodium concentrations of less than 135 mEq/L; decreased 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
A 74-year-old woman was admitted to our hospital with a complaint of slowly progressive anorexia and fatigue. Five years prior to admission, she was admitted to our hospital with fever, multiple pulmonary nodules and renal failure. She was diagnosed with granulomatosis with polyangiitis (GPA) based on bronchoscopy findings of necrotizing granulomatous vasculitis and elevated serum MPO-ANCA. Her multiple pulmonary nodules and proteinuria disappeared following induction remission therapy with prednisolone (PSL) and 4 doses of weekly rituximab (500 mg/body). The dose of PSL was gradually reduced while checking the disease activity. Azathioprine was started as maintenance therapy during the course of the disease, but was discontinued because of thrombocytopenia. Finally, the patient was maintained on 3 mg/day of PSL without worsening disease activity. A persistent fever occurred 3 months prior to admission, and blood tests showed elevated C-reactive protein (CRP) and MPO-ANCA. Infection was ruled out and the patient was considered to be having a flare of GPA. PSL was increased to 30 mg/d and avacopan was initiated at 60 mg/d, resulting in a resolution of her fever. The CRP also became negative and so the MPO-ANCA titer was decreased. Two weeks prior to admission PSL was gradually reduced to 9 mg/day. A week before admission, she experienced fatigue and anorexia. She visited our hospital as her symptoms gradually worsened. No abnormalities were found on physical examination of her abdomen. Laboratory data showed no renal impairment and MPO-ANCA titers were lower compared to 2 weeks prior. In contrast, severe hepatic abnormalities were observed: aspartate aminotransferase (AST) 233 U/L, alanine aminotransferase (ALT) 670 U/L, lactate dehydrogenase (LDH) 302 U/L, total bilirubin (T-Bil) 4.0 mg/dL, alkaline phosphatase (ALP) 285 U/L and ฮณ-glutamyl transpeptidase (ฮณ-GTP) 595 U/L. CRP was only slightly elevated at 0.94 mg/dL. Albumin (Alb) was maintained at 3.7 g/dL. There was no anemia, thrombocytopenia, or coagulation abnormality. There was no alcohol consumption, new medications, or supplements, except avacopan, within 2 years. Whole body enhanced computed tomography (CT) showed no pulmonary nodules, no periportal edema, no thickening of the gallbladder wall, or any biliary obstruction. Abdominal ultrasound and magnetic resonance cholangiopancreatography also showed that the gallbladder and bile ducts were intact. Further blood test results were as follows: hepatitis A IgM negative, hepatitis B surface antigen negative, IgM antibody to hepatitis B core antigen negative, hepatitis C antibody negative, Epsteinโ€“Barr virus (EBV) viral capsid antigen (VCA) immunoglobulin-G (IgG) positive, EBV VCA-IgM negative, EBV nuclear antigen positive, cytomegalovirus (CMV) IgG positive, CMV IgM negative, antinuclear antibody negative, antiliver kidney microsome-1 antibody negative, antismooth muscle antibody negative and antimitochondrial M2 antibody negative. These results suggested that liver injury due to viral infection, autoimmune hepatitis and primary biliary cholangitis (PBC) was unlikely. The possibility of liver damage due to GPA was considered unlikely as CRP elevation was mild, MPO-ANCA titer tended to improve and renal damage and pulmonary nodules did not worsen. Therefore, DILI was highly suspected. Excepting avacopan, she was taking PSL, azilsartan, bisoprolol, sulfamethoxazole-trimethoprim (ST), edoxaban, esomeprazole and ramelteon at the time of admission and for more than 2 years. The patientโ€™s Revised Electronic Causality Assessment Method score was 11, and in the definite/highly likely group; therefore, the possibility of DILI secondary to avacopan was high. We discontinued avacopan from the time of admission and monitored hepatobiliary enzymes. Despite the discontinuation of avacopan, hepatobiliary enzymes gradually increased to AST 681 U/L, ALT 890 U/L, T-Bil 11.4 mg/dL, ALP 499 U/L, and ฮณ-GTP 702 U/L by day 8. PT was in the normal range, but Alb dropped to 2.5 g/dL. We increased PSL to 40 mg/d for DILI. After the PSL dose was increased, hepatobiliary enzymes showed a temporary tendency to improve, but worsened again, with AST 937 U/L, ALT 1557 U/L, T-Bil 28.8 mg/dL, ALP 1282 U/L, and ฮณ-GTP 2087 U/L on day 15. As DILI worsened during glucocorticoid administration, we added UDCA. After initiating UDCA, the liver injury improved to AST 308 U/L, ALT 999 U/L, T-Bil 21.8 mg/dL, ALP 876 U/L, and ฮณ-GTP 1626 U/L on day 19. Although T-bil and ALP steadily improved thereafter, a re-elevation of liver enzymes was conducted on day 24, with AST 420 U/L and ALT 1028U/L. As CRP was not elevated and CMV antigemia was negative, hepatotoxicity associated with infection was considered negative. Because she had DILI refractory to treatment, acute liver failure resulted and MMF 1000 mg/d was commenced on day 24. After MMF initiation, liver injury gradually improved, improving liver enzymes to AST 81 U/L, ALT 372 U/L, T-Bil 5.6 mg/dL, ALP 395 U/L, and ฮณ-GTP 925 U/L by day 31. Alb also improved to 3.0 g/dL. We therefore reduced the PSL dose to 30 mg/day. PSL was subsequently reduced again and she was discharged on day 45 without recurrence of liver injury. Further PSL reduction was performed on an outpatient basis, and the liver injury did not recur . The Birmingham Vasculitis Activity Score was 0, CRP was negative, and MPO-ANCA was improving, so we considered that there was no GPA relapse. There was concern about liver damage due to cytomegalovirus antigenemia, therefore the patient was followed several times, but remained negative.
4.039063
0.974609
sec[1]/p[0]
en
0.999996
40228281
https://doi.org/10.1097/MD.0000000000042121
[ "liver", "anca", "avacopan", "antibody", "gradually", "hepatitis", "injury", "dili", "enzymes", "pulmonary" ]
[ { "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": "4A44.AZ", "title": "Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified" }, { "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" } ]
=== 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 [4A44.AZ] Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified Also known as: Antineutrophil cytoplasmic antibody-associated vasculitis, unspecified | Antineutrophil cytoplasmic antibody-associated vasculitis | ANCA - [Antineutrophil cytoplasmic antibodies] associated vasculitis | ANCA [Antineutrophil cytoplasmic antibodies] positive vasculitis [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 === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Metabolic or transporter liver disease --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Structural developmental anomalies of liver --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --RELATED_TO--> [?] Hepatic sarcoidosis Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in multiple organs, of the liver.... --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --CHILD--> [DB97.1] Hepatic berylliosis --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --RELATED_TO--> [?] Cirrhotic cardiomyopathy Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation... --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --EXCLUDES--> [?] Hepatic vein thrombosis Def: Venous thrombosis within the hepatic vein....
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Metabolic or transporter liver disease", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Structural developmental anomalies of liver", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --RELATED_TO--> [?] Hepatic sarcoidosis\n Def: This is a syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in multiple organs, of the liver....", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.1] Hepatic berylliosis", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Cirrhotic cardiomyopathy\n Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation...", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Hepatic vein thrombosis\n Def: Venous thrombosis within the hepatic vein...." ]
DB9Z
Diseases of liver, unspecified
[ { "from_icd11": "DB9Z", "icd10_code": "K7681", "icd10_title": "Hepatopulmonary syndrome" }, { "from_icd11": "DB9Z", "icd10_code": "K7689", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K769", "icd10_title": "Liver disease, unspecified" }, { "from_icd11": "DB9Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "DB9Z", "icd10_code": "K762", "icd10_title": "Central hemorrhagic necrosis of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K70-K77", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K778", "icd10_title": "" }, { "from_icd11": "DB9Z", "icd10_code": "K72", "icd10_title": "Hepatic failure, not elsewhere classified" }, { "from_icd11": "DB9Z", "icd10_code": "K76", "icd10_title": "Other diseases of liver" }, { "from_icd11": "DB9Z", "icd10_code": "K768", "icd10_title": "Other specified diseases of liver" }, { "from_icd11": "DB97.Z", "icd10_code": "K7581", "icd10_title": "Nonalcoholic steatohepatitis (NASH)" }, { "from_icd11": "DB97.Z", "icd10_code": "K7589", "icd10_title": "Other specified inflammatory liver diseases" }, { "from_icd11": "DB97.Z", "icd10_code": "K759", "icd10_title": "Inflammatory liver disease, unspecified" }, { "from_icd11": "DB97.Z", "icd10_code": "K752", "icd10_title": "Nonspecific reactive hepatitis" }, { "from_icd11": "DB97.Z", "icd10_code": "K75", "icd10_title": "Other inflammatory liver diseases" } ]
K7681
Hepatopulmonary syndrome
A 32-year-old woman was diagnosed with acute tonsillitis by her family doctor. Microbiological examination was not performed at that time. Amoxicillin/clavulanic acid 875/125 mg twice daily for 5 days was prescribed empirically. The symptoms of tonsillitis resolved within five-day treatment, however, four days after completing the course of antibiotic therapy, sore throat, more prominent on the left side, reappeared. Two days later the patient presented to the Emergency Department with a two-day history of worsening sore throat, painful swallowing and fever. The patient was previously well, with no history of chronic diseases, recurrent tonsillitis or previous peritonsillar abscess. Seven months previously she gave birth to her second child and was still breastfeeding the baby. She denied smoking. On physical examination her temperature was 38ยฐC, pulse rate: 80 beats/min, respiratory rate: 22 breaths/min and blood pressure: 120/80 mm Hg. Examination of the oral cavity and oropharynx showed enlarged and inflamed left tonsil as well as congested and bulging soft palate on the left side with contralateral displacement of the uvula. Both tonsils were covered with whitish exudate. No dental caries was noted. There was also bilateral, moderately tender submandibular lymphadenopathy. The remainder of physical examination was unremarkable. Blood tests results are shown in Table 1 . Separate swabs were obtained from the surfaces of both tonsils. Next, under local anesthesia, diagnostic needle aspiration of left tonsil was performed by otolaryngologist, during which scanty amount of pus was obtained. This initial procedure was followed by incision and drainage. Tonsil swabs and abscess aspirate were sent to laboratory for microbiological examination. The patient refused hospitalization at the Otolaryngology Department, thus was discharged home on a 10-day course of cefuroxime (500 mg twice daily) and metronidazole (500 mg 3 times daily) with recommendation to discontinue breastfeeding for the duration of the antibiotic therapy and to present at follow-up visit to Otolaryngology Clinic after completing antibiotic therapy. The symptoms of peritonsillar abscess as well as fever were subsiding steadily during treatment, however on the last day of antibiotic therapy, swelling and pain of the left ankle appeared, thus the patient presented to her family doctor. Upon presentation she was afebrile and had marked oedema and pain of her left ankle. Her heart rate was 72 beats/min, she did not have an appreciable cardiac murmur. Her chest was clear to auscultation. Antibiotic therapy with cefuroxime (500 mg once daily) for next 5 days was prescribed, as well as pain relief medication with paracetamol. After completing antibiotic therapy the patient presented at follow-up visit to Otolaryngology Clinic. She was afebrile, with normal vital signs. Examination of oropharynx showed resolution of both, congestion and oedema of left tonsil and soft palate. There was no exudate on the tonsils. Cultures of throat swabs and abscess aspirate collected 2 weeks before revealed the presence of Streptococcus pyogenes in all three materials. According to the patient report, left ankle swelling with which she presented to her family doctor, resolved within 4 days. Upon presentation the patient only had moderate pain in the joint. She was consulted by rheumatologist. Her heart rate was 70 beats/min. She did not have a regurgitant murmur. Her chest was clear to auscultation. Antistreptolysin O (ASO) titer was evaluated and proved to be 412 IU/ml (normal 0โ€“200 IU/ml). The level of C-reactive protein was 13,0 mg/L. Control throat swabs were collected for culture, which revealed normal oropharynx flora. The patient was recommended to continue pain relief medication with paracetamol and present at follow-up visit to Rheumatology Clinic after 2 weeks. Her only complaint was persisting slight pain in left ankle joint. The results of physical examination were analogous to those observed at previous follow-up. ASO titer was 503 IU/ml. Control throat swabs were collected and culture yielded normal flora. The patient was recommended to present at follow-up visit at Rheumatology Clinic after 2 months. At that time, she was well. Ankle pain, according to the patient report, disappeared shortly after last visit. The results of physical examination were analogous to those observed previously. ASO titer was 396 IU/ml. Six months after the presentation at Emergency Department, the patient was well, with ASO titer reaching 262 IU/ml. Table 1 summarizes the chronology of clinical findings and blood tests results. Table 1 Summary of clinical findings and blood tests over time Timeline Clinical findings Blood tests results Day 1: presentation to the family doctor Acute tonsillitis Not performed Day 11: presentation to the Emergency Department Left side peritonsillar abscess Leukocytosis: 15 270/mm 3 Granulocytes: 79.7% Lymphocytes: 15.9% Monocytes: 2.8% Hemoglobin: 13.0 g/dl Hematocrit: 38.9% Platelet count: 329 000/mm 3 CRP: 131.0 mg/L (normal <5.0 mg/L) Day 20: 2nd presentation to the family doctor Left ankle arthritis Not performed Day 25: follow-up visit to the Otolaryngology Department and the rheumatologist consultation Left ankle arthralgia ASO: 412 IU/ml (normal 0โ€“200 IU/ml) CRP: 13.0 mg/L Day 40: 1st follow up to the rheumatologist Left ankle arthralgia ASO: 503 IU/ml Day 100: 2nd follow up to the rheumatologist Healthy ASO: 396 IU/ml Day 180: 3rd follow up to the rheumatologist Healthy ASO: 262 IU/ml CRP: C-reactive protein; ASO: antistreptolysin titer.
3.759766
0.982422
sec[1]/p[0]
en
0.999996
25885601
https://doi.org/10.1186/s12879-015-0780-8
[ "ankle", "pain", "antibiotic", "well", "visit", "family", "doctor", "throat", "department", "abscess" ]
[ { "code": "QF00", "title": "Acquired absence of limb" }, { "code": "ND14.7Z", "title": "Strain or sprain of ankle, unspecified" }, { "code": "MG29.00", "title": "Ankle oedema" }, { "code": "ND11.0", "title": "Abrasion of ankle" }, { "code": "ND11.40", "title": "Splinter in ankle" }, { "code": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" } ]
=== ICD-11 CODES FOUND === [QF00] Acquired absence of limb Also known as: Acquired absence of limb | post traumatic loss of limb | postoperative loss of limb | bilateral amputee | amputee Includes: postoperative loss of limb | post traumatic loss of limb Excludes: Other acquired deformities of limbs | Congenital absence of thigh or lower leg with foot present | Congenital absence of both lower leg and foot [ND14.7Z] Strain or sprain of ankle, unspecified Also known as: Strain or sprain of ankle, unspecified | Strain or sprain of ankle | twisted ankle NOS | Strain of ankle [MG29.00] Ankle oedema Also known as: Ankle oedema | ankle swelling [ND11.0] Abrasion of ankle Also known as: Abrasion of ankle [ND11.40] Splinter in ankle Also known as: Splinter in ankle [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain === GRAPH WALKS === --- Walk 1 --- [QF00] Acquired absence of limb --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip.... --PARENT--> [?] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --- Walk 2 --- [QF00] Acquired absence of limb --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip.... --PARENT--> [?] Reduction defects of lower limb Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb.... --- Walk 3 --- [ND14.7Z] Strain or sprain of ankle, unspecified --PARENT--> [ND14.7] Strain or sprain of ankle --CHILD--> [ND14.71] Strain or sprain of deltoid ligament --- Walk 4 --- [ND14.7Z] Strain or sprain of ankle, unspecified --PARENT--> [ND14.7] Strain or sprain of ankle --EXCLUDES--> [?] Injury of Achilles tendon --- Walk 5 --- [MG29.00] Ankle oedema --PARENT--> [MG29.0] Localised oedema --RELATED_TO--> [?] Swollen tongue --- Walk 6 --- [MG29.00] Ankle oedema --PARENT--> [MG29.0] Localised oedema --RELATED_TO--> [?] Swollen tongue
[ "[QF00] Acquired absence of limb\n --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present\n Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip....\n --PARENT--> [?] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....", "[QF00] Acquired absence of limb\n --EXCLUDES--> [?] Congenital absence of thigh or lower leg with foot present\n Def: Any condition caused by the failure of the thigh and lower leg to develop during the antenatal period. These conditions are characterised by direct connection of the foot to the hip....\n --PARENT--> [?] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....", "[ND14.7Z] Strain or sprain of ankle, unspecified\n --PARENT--> [ND14.7] Strain or sprain of ankle\n --CHILD--> [ND14.71] Strain or sprain of deltoid ligament", "[ND14.7Z] Strain or sprain of ankle, unspecified\n --PARENT--> [ND14.7] Strain or sprain of ankle\n --EXCLUDES--> [?] Injury of Achilles tendon", "[MG29.00] Ankle oedema\n --PARENT--> [MG29.0] Localised oedema\n --RELATED_TO--> [?] Swollen tongue", "[MG29.00] Ankle oedema\n --PARENT--> [MG29.0] Localised oedema\n --RELATED_TO--> [?] Swollen tongue" ]
QF00
Acquired absence of limb
[ { "from_icd11": "QF00", "icd10_code": "Z89412", "icd10_title": "Acquired absence of left great toe" }, { "from_icd11": "QF00", "icd10_code": "Z89611", "icd10_title": "Acquired absence of right leg above knee" }, { "from_icd11": "QF00", "icd10_code": "Z89421", "icd10_title": "Acquired absence of other right toe(s)" }, { "from_icd11": "QF00", "icd10_code": "Z89431", "icd10_title": "Acquired absence of right foot" }, { "from_icd11": "QF00", "icd10_code": "Z89522", "icd10_title": "Acquired absence of left knee" }, { "from_icd11": "QF00", "icd10_code": "Z89411", "icd10_title": "Acquired absence of right great toe" }, { "from_icd11": "QF00", "icd10_code": "Z89511", "icd10_title": "Acquired absence of right leg below knee" }, { "from_icd11": "QF00", "icd10_code": "Z89429", "icd10_title": "Acquired absence of other toe(s), unspecified side" }, { "from_icd11": "QF00", "icd10_code": "Z89422", "icd10_title": "Acquired absence of other left toe(s)" }, { "from_icd11": "QF00", "icd10_code": "Z89211", "icd10_title": "Acquired absence of right upper limb below elbow" }, { "from_icd11": "QF00", "icd10_code": "Z89612", "icd10_title": "Acquired absence of left leg above knee" }, { "from_icd11": "QF00", "icd10_code": "Z89512", "icd10_title": "Acquired absence of left leg below knee" }, { "from_icd11": "QF00", "icd10_code": "Z89432", "icd10_title": "Acquired absence of left foot" }, { "from_icd11": "QF00", "icd10_code": "Z89021", "icd10_title": "Acquired absence of right finger(s)" }, { "from_icd11": "QF00", "icd10_code": "Z89419", "icd10_title": "Acquired absence of unspecified great toe" } ]
Z89412
Acquired absence of left great toe
We report a case of a 52-year old woman, 1 year after menopause, 3 months after SARS-CoV-2 infection, and 12 days after COVID-19 vaccination (BioNTech; Pfizer โ€“ Comirnaty). She presented with fever up to 38 ยฐC, neck pain at palpation, and muscle and joint pains. The symptoms were accompanied by urticarial skin lesions on the trunk and limbs Based on her laboratory test results (CRP, ESR, and blood cell count), thyroid ultrasound scans, and fine needle aspiration (FNA) biopsy findings, the patient was diagnosed with subacute thyroiditis (SAT) and received therapy with prednisolone 40 mg daily, with immediate clinical improvement. Unfortunately, every attempt to withdraw the glucocorticoid therapy 6 weeks later resulted in recurrent SAT and urticaria, confirmed by FNA biopsy and histopathologic examination, respectively Urticaria recurred when the prednisolone dose was reduced (down to 10 mg daily) and fever with neck pain was observed with further steroid dose reduction (down do 5 mg of prednisone daily). In total, the patient suffered from five SAT recurrences. It is of interest to note that thyroid hormone levels remained unchanged in all SAT episodes and thyroid antibodies were negative. During further follow-up, consecutive attempts to withdraw glucocorticoid therapy manifested with five relapses, confirmed by laboratory test results, ultrasound scans, and FNA biopsy findings. Genetic analysis revealed the presence of three alleles associated with a high risk of SAT development, specifically, HLA-B*35:01, HLA-C*04:01, and HLA-DRB1*01:01, which suggests high genetic susceptibility to SAT. However, the allele profile was not typical of a high risk of recurrent SAT. The presence of HLA-B*35:01, HLA-DQA1*02:01, and HLA-DQB1:05:02 alleles in our patient identify her as having increased susceptibility to chronic urticaria. The presence of HLA-B*35:01 and HLA-C*04:01 identifies increased genetic susceptibility to ASIA syndrome following SARS-CoV-2 vaccination Due to the multiple recurring episodes of SAT and based on the results of genetic and cytological examinations, the patient was found to be suitable for total thyroidectomy, which, in fact, is not the recommended treatment for SAT. The surgery was performed with no complications and the patientโ€™s thyrometabolic status was subsequently normal with continued L-thyroxine replacement therapy at a dose of 88 mcg. The thyroid resection resulted in relief of neck pain, but fever, muscle pain, and urticaria recurred when glucocorticoid therapy was withdrawn. The prednisone dose reduction down to 5 mg daily caused the recurrence of urticaria, and with further prednisone dose reduction down to 2 mg daily, recurrence of fever was observed . Interestingly, it was already during the treatment of recurrent episodes of SAT that FSH and LH decreased and hyperprolactinemia occurred, with pituitary MRI scans showing the features of transient pituitary edema , accompanied by headache. Within 4 months of cabergoline and corticosteroid treatment, the edema was resorbed, prolactin levels returned to normal, and FSH and LH levels returned to postmenopausal values , while the complaints of headache have subsided. The main criteria that led us to the diagnosis of hypophysistis were increased prolactin levels and recurrent headache. Elevated prolactin levels have been described in 30% of hypophisitis patients and have been reported in lymphocytic hypophystitis in men and non-pregnant women, most likely as a result of compression of the pituitary stalk . Headache is the most common symptom of hypophysitis, affecting 60% of hypophysitis patients. In hypophysitis, the gland is generally symmetrically enlarged, with administration of gadolinium homogeneously enhancing the gland. Furthermore, in hypophysitis, the pituitary displays a relatively low signal on T-1 and a relatively high signal on T-2 weighted images. In contrast, in adenomas, gadolinium enhances the gland more focally. Finally, we did not detect any lesions typical of sarcoidosis, histiocytosis, Wegenerโ€™s granulomatosis, or IgG4-related hypophysitis. Fig. 1 Disease pattern: post COVID-19 status in March 2021. Patient vaccinated against COVID-19 (BioNTech; Pfizerโ€”Comirnaty) in April 2021. 2 weeks after the vaccination, skin lesions in the form of urticaria appeared, and after another week the first episode of subacute thyroiditis occurred Fig. 2 Urticarial lesions on the skin of the trunk and extremities Fig. 3 Fine-needle aspiration biopsy of the thyroid gland, HE Subacute thyroiditis lesion with prominent multinucleated giant cell type around a foreign body Fig. 4 Skin biopsy from the right lower leg. HE. Changes consistent with urticaria: dilated blood vessels, features of edema in the dermis, perivascularly and between collagen fibers scattered acidophilic granulocytes and lymphoid cells Fig. 5 Genetic test result Fig. 6 Diagram showing how the carrying of particular haplotypes in our patient could have affected the disease picture Fig. 7 Diagram showing the effect of thyroidectomy. In the postoperative period, urticaria occurred after the prednisone dose was reduced to 5 mg (versus 10 mg in the preoperative period), and general symptoms occurred with further dose reduction to 2.5 mg (versus 5 mg in the preoperative period) Fig. 8 Graph showing the concentrations of the inflammatory markers (CRP and ESR) in the preoperative and postoperative periods Fig. 9 Transient pituitary oedema most likely in the course of the underlying disease Fig. 10 Graph showing the concentrations of gonadotropins, oestradiol and prolactin
4.164063
0.969238
sec[7]/p[1]
en
0.999996
38775985
https://doi.org/10.1007/s42000-024-00567-6
[ "urticaria", "thyroid", "biopsy", "daily", "genetic", "pituitary", "hypophysitis", "fever", "pain", "skin" ]
[ { "code": "EB05", "title": "Urticaria of unspecified type" }, { "code": "EB00.0", "title": "Acute urticaria" }, { "code": "EB00.1", "title": "Chronic urticaria" }, { "code": "EB01.Z", "title": "Inducible urticaria or angioedema, unspecified" }, { "code": "EB01.3", "title": "Contact urticaria" }, { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" } ]
=== ICD-11 CODES FOUND === [EB05] Urticaria of unspecified type Also known as: Urticaria of unspecified type | Nettle rash | Hives | wheal | Urticaria NOS Includes: Hives | Nettle rash [EB00.0] Acute urticaria Definition: Spontaneous urticaria lasting less than six weeks Also known as: Acute urticaria | Acute spontaneous urticaria | Acute ordinary urticaria | Acute urticaria due to IgE-mediated allergy | Allergic urticaria [EB00.1] Chronic urticaria Definition: Spontaneous urticaria lasting six weeks or more. Also known as: Chronic urticaria | Chronic spontaneous urticaria | Chronic ordinary urticaria | Chronic autoimmune urticaria | Chronic urticaria due to underlying infection or infestation Includes: Chronic spontaneous urticaria | Chronic ordinary urticaria | Chronic autoimmune urticaria [EB01.Z] Inducible urticaria or angioedema, unspecified Also known as: Inducible urticaria or angioedema, unspecified | Inducible urticaria or angioedema | physical urticaria or angioedema | inducible urticaria NOS | angioedema NOS [EB01.3] Contact urticaria Definition: Urticaria resulting from skin or mucosal contact with a substance or substances capable of inducing wealing either by immunological or by non-immunological means. Also known as: Contact urticaria | Non-allergic contact urticaria | Occupational non-allergic contact urticaria | Urticaria due to plants [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid === GRAPH WALKS === --- Walk 1 --- [EB05] Urticaria of unspecified type --PARENT--> [?] Urticaria, angioedema or other urticarial disorders Def: A heterogeneous group of disorders characterised by dermal and/or subcutaneous and submucosal oedema. The most common underlying mechanism is release of histamine from mast cells with consequent capil... --EXCLUDES--> [?] Papular urticaria Def: A reaction pattern to insect bites with the formation of multiple itchy, urticated papules or papulovesicles.... --- Walk 2 --- [EB05] Urticaria of unspecified type --PARENT--> [?] Urticaria, angioedema or other urticarial disorders Def: A heterogeneous group of disorders characterised by dermal and/or subcutaneous and submucosal oedema. The most common underlying mechanism is release of histamine from mast cells with consequent capil... --CHILD--> [EB00] Spontaneous urticaria Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both.... --- Walk 3 --- [EB00.0] Acute urticaria Def: Spontaneous urticaria lasting less than six weeks... --PARENT--> [EB00] Spontaneous urticaria Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both.... --CHILD--> [EB00.1] Chronic urticaria Def: Spontaneous urticaria lasting six weeks or more.... --- Walk 4 --- [EB00.0] Acute urticaria Def: Spontaneous urticaria lasting less than six weeks... --PARENT--> [EB00] Spontaneous urticaria Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both.... --CHILD--> [EB00.Z] Spontaneous urticaria, unspecified --- Walk 5 --- [EB00.1] Chronic urticaria Def: Spontaneous urticaria lasting six weeks or more.... --PARENT--> [EB00] Spontaneous urticaria Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both.... --CHILD--> [EB00.1] Chronic urticaria Def: Spontaneous urticaria lasting six weeks or more.... --- Walk 6 --- [EB00.1] Chronic urticaria Def: Spontaneous urticaria lasting six weeks or more.... --PARENT--> [EB00] Spontaneous urticaria Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both.... --CHILD--> [EB00.Z] Spontaneous urticaria, unspecified
[ "[EB05] Urticaria of unspecified type\n --PARENT--> [?] Urticaria, angioedema or other urticarial disorders\n Def: A heterogeneous group of disorders characterised by dermal and/or subcutaneous and submucosal oedema. The most common underlying mechanism is release of histamine from mast cells with consequent capil...\n --EXCLUDES--> [?] Papular urticaria\n Def: A reaction pattern to insect bites with the formation of multiple itchy, urticated papules or papulovesicles....", "[EB05] Urticaria of unspecified type\n --PARENT--> [?] Urticaria, angioedema or other urticarial disorders\n Def: A heterogeneous group of disorders characterised by dermal and/or subcutaneous and submucosal oedema. The most common underlying mechanism is release of histamine from mast cells with consequent capil...\n --CHILD--> [EB00] Spontaneous urticaria\n Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both....", "[EB00.0] Acute urticaria\n Def: Spontaneous urticaria lasting less than six weeks...\n --PARENT--> [EB00] Spontaneous urticaria\n Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both....\n --CHILD--> [EB00.1] Chronic urticaria\n Def: Spontaneous urticaria lasting six weeks or more....", "[EB00.0] Acute urticaria\n Def: Spontaneous urticaria lasting less than six weeks...\n --PARENT--> [EB00] Spontaneous urticaria\n Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both....\n --CHILD--> [EB00.Z] Spontaneous urticaria, unspecified", "[EB00.1] Chronic urticaria\n Def: Spontaneous urticaria lasting six weeks or more....\n --PARENT--> [EB00] Spontaneous urticaria\n Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both....\n --CHILD--> [EB00.1] Chronic urticaria\n Def: Spontaneous urticaria lasting six weeks or more....", "[EB00.1] Chronic urticaria\n Def: Spontaneous urticaria lasting six weeks or more....\n --PARENT--> [EB00] Spontaneous urticaria\n Def: Spontaneous urticaria is a disease characterised by the daily or almost daily eruption of spontaneous weals, angioedema or both....\n --CHILD--> [EB00.Z] Spontaneous urticaria, unspecified" ]
EB05
Urticaria of unspecified type
[ { "from_icd11": "EB05", "icd10_code": "L509", "icd10_title": "Urticaria, unspecified" }, { "from_icd11": "EB00.0", "icd10_code": "L500", "icd10_title": "Allergic urticaria" }, { "from_icd11": "EB00.0", "icd10_code": "L272", "icd10_title": "Dermatitis due to ingested food" }, { "from_icd11": "EB00.1", "icd10_code": "L501", "icd10_title": "Idiopathic urticaria" }, { "from_icd11": "EB01.3", "icd10_code": "L506", "icd10_title": "Contact urticaria" }, { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" } ]
L509
Urticaria, unspecified
Four days after the second infusion, the patient experienced an asymptomatic but sustainable mild rise in serum creatine phosphokinase. From the evening of the seventh day to the morning of the eighth day, ST-segment elevation was observed in the cardiac monitor despite the absence of any complaint. Hence 12-lead electrocardiography (ECG) was performed, and ST-segment elevation was seen in all leads . Laboratory analysis revealed a high level of inflammatory reaction and elevation of myocardial biomarkers (creatine kinase MB-isozyme, 23, 488 U/L; troponin-I, 100,680 pg/mL; NT-proBNP, 15,964 pg/mL), and the patient was immediately referred to cardiovascular internal medicine. Echocardiography showed an akinetic apex, a hypokinetic septum, and an ejection fraction of 50% (baseline 2 months previously was 72%). Emergency cardiac catheterization excluded relevant coronary disease, and left ventriculography showed that the left ventricular apex was nearly akinetic and the remaining left ventricle was hyperkinetic . The differential diagnoses at this point included Takotsubo cardiomyopathy triggered by viral infection and myocarditis due to autoimmunological causes. To monitor for hemodynamic failure, the patient was admitted to the coronary care unit. Twelve hours after admission to the care unit, he complained of chest tightness and shortness of breath. His hemodynamics rapidly worsened due to cardiogenic shock, and echocardiography revealed widespread cardiac akinesis except for the back wall. To maintain and improve cardiorespiratory function, dopamine, dobutamine, and noradrenaline were infused, an intra-aortic balloon pump was inserted, and adaptive servo ventilation therapy was initiated. The clinical oncology unit was consulted, and they noted that the clinical presentation was suggestive of myocarditis as an irAE. Momentarily, right heart catheterization was performed and myocardial biopsy was also performed for histological analysis. Thereafter, a 3-day methylprednisolone mini-pulse (500 mg/day) therapy was administered followed by prednisolone administration at 1 mg/kg. Nevertheless, the patientโ€™s condition worsened, and he was admitted to the intensive care unit for percutaneous cardiopulmonary support. Although he experienced notable arrhythmia such as ventricular fibrillation, his hemodynamics gradually improved with troponin I decrease, and he returned to the general ward after treatment in the high care unit for 18 days . Serological analysis of paired serum samples for cardiotropic viruses was negative. The myocardial biopsy sample taken during the acute phase demonstrated marked lymphocytic infiltration with a predominance of CD4-positive cells . Additionally, on the 32nd day after starting steroid treatment, myocardial repeat biopsy revealed an admixture of CD4+ and CD8+ T cells and many histiocytes/macrophages within the myocardial inflammation suggested chronic smoldering myocarditis . Because of the persisting inflammation, the patient was placed under long-term prednisone therapy (15 mg/day). Cardiac MRI showed that the left ventricular wall was extensively fibrotic, and myocardial scintigraphy revealed that the ejection fraction had dropped to 20% . The tumor reduction tendency of immunotherapy continued in both the remaining primary lesion and multiple lung metastases . Since the patientโ€™s performance status remained limited due to the chronic heart failure and many of these tumor responses were sustained over months, we decided to observe and not to reintroduce immunotherapy. Figure 8 shows a summary of his clinical course. Fig. 3 Electrocardiography findings ( a ) and ventriculogram during diastole ( b-1 ) and systole ( b-2 ) from immune checkpoint inhibitors-associated myocarditis. Twelve-lead electrocardiogram showing segment elevation in all leads ( a ). While the left ventricular apex in these two images appears nearly akinetic, the remaining left ventricle seems hyperkinetic ( b ) Fig. 4 Details of the second cycle of ipilimumab/nivolumab combination therapy including myocarditis as immune-related adverse events management Fig. 5 Photomicrographs of the endomyocardial biopsy sample before and after treatment. Hematoxylinโ€“eosin staining and immunohistochemical staining of sections of the interventricular septum demonstrating staining with anti-CD3, anti-CD4, anti-CD8, anti-CD68, and anti-CD20 antibodies. All images are displayed at 20ร— the original magnification. Histologic findings show lymphocytic infiltration in the myocardium comprising CD3 positive T lymphocytes, many of which were positive for CD4 compared with CD8, abundance of CD68-positive macrophage infiltrate, and only rare B lymphocytes before treatment ( a ). Despite intense treatment, the remaining prominent inflammatory infiltrate consisted of CD3+, CD4+, and CD8+ T cells, and CD68+ macrophages, suggesting smoldering myocarditis ( b ) Fig. 6 Cardiac magnetic resonance imaging (MRI) and myocardial scintigraphy in the chronic phase. Late gadolinium enhancement in the short axis ( a ) and two-chamber ( b ) views show diffuse fibrosis of the left ventricular wall especially in the inferior and anterior wall (yellow arrows). Decreased viability may be commonly observed on the anterior wall and septum of the left ventricular myocardium from the middle to the apex (red arrows) ( c ) Fig. 7 Therapeutic effect on the primary lesion and lung metastasis under immunotherapy Fig. 8 Summary of the clinical course of the present case. RCC renal cell carcinoma, Ipi ipilimumab, Nivo nivolumab, irAEs immune-related adverse events
4.054688
0.970215
sec[1]/p[2]
en
0.999996
34649593
https://doi.org/10.1186/s13256-021-03097-6
[ "myocardial", "ventricular", "myocarditis", "cardiac", "unit", "wall", "anti", "elevation", "apex", "that" ]
[ { "code": "BD1Z", "title": "Heart failure, unspecified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "BA52.Z", "title": "Coronary atherosclerosis, unspecified site" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "BA6Z", "title": "Ischaemic heart diseases, unspecified" }, { "code": "LA89.Z", "title": "Functionally univentricular heart, unspecified" }, { "code": "BC45", "title": "Cardiomegaly" }, { "code": "BC46&XA7XU8", "title": "Ventricular thrombosis" }, { "code": "BD1Z&XT5R", "title": "Acute heart failure" }, { "code": "BC42.Z", "title": "Myocarditis, unspecified" } ]
=== ICD-11 CODES FOUND === [BD1Z] Heart failure, unspecified Also known as: Heart failure, unspecified | myocardial failure | cardiac decompensation | cardiac failure | cardiac failure NOS [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [BA52.Z] Coronary atherosclerosis, unspecified site Also known as: Coronary atherosclerosis, unspecified site | Coronary atherosclerosis | cardiac sclerosis | coronary artery atherosclerosis | coronary artery sclerosis [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 [BA6Z] Ischaemic heart diseases, unspecified Also known as: Ischaemic heart diseases, unspecified | Ischaemic heart disease NOS | cardiac ischaemia, NOS | IHD - [ischaemic heart disease], NOS | cardiac ischemia [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 [BC42.Z] Myocarditis, unspecified Also known as: Myocarditis, unspecified | Myocarditis | Inflammatory cardiomyopathy | acute myocarditis NEC | acute myocarditis NOS === GRAPH WALKS === --- Walk 1 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --CHILD--> [BD12] High output syndromes Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure.... --- Walk 2 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --EXCLUDES--> [?] Complications following abortion, ectopic or molar pregnancy Def: Any complication affecting pregnant females, caused by or subsequent to abortion, ectopic, and molar pregnancy.... --- Walk 3 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --CHILD--> [BA41.0] Acute ST elevation myocardial infarction Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:... --- Walk 4 --- [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--> [?] Subsequent myocardial infarction Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction... --- Walk 5 --- [BA52.Z] Coronary atherosclerosis, unspecified site --PARENT--> [BA52] Coronary atherosclerosis Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i... --PARENT--> [?] Chronic ischaemic heart disease Def: Chronic heart disease is seen due to the atherosclerosis of coronary arteries. It is characterised by angina pectoris and unstable angina.... --- Walk 6 --- [BA52.Z] Coronary atherosclerosis, unspecified site --PARENT--> [BA52] Coronary atherosclerosis Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i... --CHILD--> [BA52.0] Coronary atherosclerosis of native coronary artery Def: Atherosclerotic lesions, or atherosclerotic plaques of native coronary artery....
[ "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --CHILD--> [BD12] High output syndromes\n Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure....", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --EXCLUDES--> [?] Complications following abortion, ectopic or molar pregnancy\n Def: Any complication affecting pregnant females, caused by or subsequent to abortion, ectopic, and molar pregnancy....", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.0] Acute ST elevation myocardial infarction\n Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:...", "[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--> [?] Subsequent myocardial infarction\n Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction...", "[BA52.Z] Coronary atherosclerosis, unspecified site\n --PARENT--> [BA52] Coronary atherosclerosis\n Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i...\n --PARENT--> [?] Chronic ischaemic heart disease\n Def: Chronic heart disease is seen due to the atherosclerosis of coronary arteries. It is characterised by angina pectoris and unstable angina....", "[BA52.Z] Coronary atherosclerosis, unspecified site\n --PARENT--> [BA52] Coronary atherosclerosis\n Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i...\n --CHILD--> [BA52.0] Coronary atherosclerosis of native coronary artery\n Def: Atherosclerotic lesions, or atherosclerotic plaques of native coronary artery...." ]
BD1Z
Heart failure, unspecified
[ { "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" }, { "from_icd11": "BD1Z", "icd10_code": "I5042", "icd10_title": "Chronic combined systolic (congestive) and diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5043", "icd10_title": "Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5041", "icd10_title": "Acute combined systolic (congestive) and diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I50812", "icd10_title": "Chronic right heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I50811", "icd10_title": "Acute right heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5082", "icd10_title": "Biventricular heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I50810", "icd10_title": "Right heart failure, unspecified" }, { "from_icd11": "BD1Z", "icd10_code": "I5040", "icd10_title": "Unspecified combined systolic (congestive) and diastolic (congestive) heart failure" } ]
I5023
Acute on chronic systolic (congestive) heart failure
A 29-year-old man with Marfan syndrome was referred for assessment of a huge mediastinal fluid collection associated with an aortic prosthetic graft. At age 20 years, he had undergone Bentall procedure with a short-cut composite graft (Carbomedics Inc., Austin, TX) for acute aortic dissection type A. Eight years later, he had a successive replacement of ascending aorta and the entire aortic arch with a 24-mm Dacron graft (Gelweave, Vascutek Ltd, Renfrewshire, Scotland), again for acute aortic dissection involving the remaining aorta Surgery was performed under moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion. The repair was accomplished by ligation of the left subclavian artery and extranatomic reconstruction with an aorto-subclavian bypass by placing an 8-mm vascular Dacron graft. The patient was extubated at the first postoperative day (POD), and subsequently was transferred to the ward. Intra- and peri-operative antibiotic prophylaxis consisted by ciprofloxacin and daptomycin as the patient had known drug allergies to penicillin and cephalosporin antibiotics. The patient was discharged home on POD 12. He was well and fit until ten months later. At that moment he presented to his local hospital with hyperexia (39.5ยฐC), sweats, and chills. Routine laboratory investigations revealed a leukocytosis of 19 ร— 10 9 cells/L. The patient was started on intravenous rifampin and daptomycin. Multi-slice computed tomographic (CT) aortography of his chest demonstrated evidence of a huge fluid collection surrounding both the ascending and aortic arch prosthetic grafts. Transthoracic echocardiography and subsequent transesophageal echocardiography confirmed the above findings. No prosthetic valve malfunction or valvular vegetation was found and the blood cultures were negative. Five days after his initial presentation, the patient was transferred to our institution for further care. The patient was afebrile and hemodynamically stable. Upon patientโ€™s physical examination no surgical site infection was present. Chest roentgenogram revealed a soft infiltration of the left lower lobe. Repeat CT angiography was performed the next day to definitively evaluate the integrity of anastomotic sites. There was no evidence of anastomotic leak or false aneurysm formation. The collection had a diameter of 15 cm with a density not exceeding 20 Hounsfield Units strongly suggestive of prosthetic graft infection . The patient underwent subsequently fine-needle aspiration of purulent fluid under CT guidance which confirmed the clinical diagnosis of prosthetic graft infection that needed to be treated. Two hours after the intervention, the patient was brought to the operating room and the median sternotomy incision was reopened. Surgical exploration of the mediastinum demonstrated a considerable amount of purulent fluid with which the ascending/arch prosthetic graft was flooded. Suction of turbid effusion was followed by moderate debridement of necrotic, infected tissues around the prosthetic graft. Suture lines were intact but exposed within the contaminated field. The aortic root, however, was entirely covered with healthy autogenous tissue and thus not exposed to pus. In the initial step, the mediastinal cavity, especially around the graft, was thoroughly irrigated and washed initially with 3 liters of diluted, 1% iodine solution, and then with 1 liter of saline solution containing 1 g vancomycin. Thereafter, sponges soaked with undiluted, 10% iodine solution were packed around the contaminated graft as well as in the surrounding operative field. The patient was returned to intensive care unit (ICU) with the chest left open but covered by aseptic drape. The same procedure of irrigation and packing of the mediastinum was repeated every 8 hours for a 48 hour period in the ICU, while the patient was maintained intubated and sedated. The patient was brought back to the operating room for the second operative step 48 hours later. The omentum was harvested via a short upper abdominal midline incision, separately from the previous sternotomy wound, and transferred as a vascularized pedicle into the mediastinal cavity in order to wrap around the ascending and arch prosthetic graft and anastomotic sites with omentum completely . The chest was closed in layers without placement of chest tubes or irrigation catheters. The patient had no operative complications, completed four weeks of intravenous colistin, teicoplanin, and metronidazole therapy, and was thereafter discharged home in good condition on a regimen of orally administered moxifloxacin. Cultures of serial blood samples as well as specimens obtained both directly from the infection site under CT guidance and intraoperatively from the perigraft pus collection were negative throughout the course of treatment. The patient remains well without evidence of infectious sequela 18 months after the operation . Figure 1 Multi-slice computed tomography (CT) of the chest. Preoperative CT shows a huge mediastinal fluid collection surrounding both A) the ascending, and B) aortic arch prosthetic grafts having a diameter of 15 cm with a low density (12-18 Hounsfield Units). Postoperative CT shows omental wrapping with normal density (65-80 Hounsfield Units) around the C) the ascending, and D) aortic arch prosthetic grafts without evidence of fluid collection or infectious sequela 18 months after the operation. Figure 2 Intraoperative photograph. A pedicle of omentum is brought up into chest to fill the mediastinal cavity and to surround the exposed prosthetic graft.
3.894531
0.979004
sec[1]/p[0]
en
0.999996
24741478
https://doi.org/10.1186/2193-1801-3-172
[ "graft", "prosthetic", "aortic", "chest", "fluid", "collection", "ascending", "arch", "mediastinal", "around" ]
[ { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" }, { "code": "EL53", "title": "Skin graft failure" }, { "code": "EL54", "title": "Composite graft failure" }, { "code": "PK99.2", "title": "Orthopaedic devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "PK95.2Y", "title": "Other specified neurological devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" }, { "code": "BC01", "title": "Prosthetic valve disease" }, { "code": "BC01/BB9Z", "title": "Pulmonary prosthetic valve disease" }, { "code": "BC01/BB6Z", "title": "Mitral prosthetic valve disease" }, { "code": "BC01/BB8Z", "title": "Tricuspid prosthetic valve disease" }, { "code": "BC01/BB7Z", "title": "Aortic prosthetic valve disease" } ]
=== ICD-11 CODES FOUND === [NE84] Failure or rejection of transplanted organs or tissues Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection [EL53] Skin graft failure Definition: Failure of skin graft tissue to engraft as intended Also known as: Skin graft failure | Split skin graft failure | Full thickness skin graft failure [EL54] Composite graft failure Definition: Failure of composite graft tissue (e.g. skin and cartilage) to engraft as intended Also known as: Composite graft failure [PK99.2] Orthopaedic devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Definition: Orthopaedic related prosthetic and other implants, materials and accessory devices were involved in an adverse related incident Also known as: Orthopaedic devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Surgical operation with implant of artificial internal orthopaedic device associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Orthopaedic devices associated with injury or harm, limb prosthesis | Orthopaedic devices associated with injury or harm, joint prosthesis | Mechanical complication of internal joint prosthesis Excludes: Wear of articular bearing surface of joint prosthesis | Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK95.2Y] Other specified neurological devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified neurological devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Mechanical complication of nerve graft [BC01] Prosthetic valve disease Also known as: Prosthetic valve disease | homograft prosthetic valve disease | mechanical prosthetic valve disease | allograft prosthetic valve disease | biological prosthetic valve disease === GRAPH WALKS === --- Walk 1 --- [NE84] Failure or rejection of transplanted organs or tissues --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --EXCLUDES--> [?] Attention to artificial openings --- Walk 2 --- [NE84] Failure or rejection of transplanted organs or tissues --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified --CHILD--> [NE81] Injury or harm arising from a procedure, not elsewhere classified Def: Any complication attributable to a medical, surgical or other clinical procedure which cannot be more precisely coded elsewhere in the classification.... --- Walk 3 --- [EL53] Skin graft failure Def: Failure of skin graft tissue to engraft as intended... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --CHILD--> [EL51] Cutaneous flap necrosis Def: Necrosis of surgical skin flap... --- Walk 4 --- [EL53] Skin graft failure Def: Failure of skin graft tissue to engraft as intended... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --CHILD--> [EL51] Cutaneous flap necrosis Def: Necrosis of surgical skin flap... --- Walk 5 --- [EL54] Composite graft failure Def: Failure of composite graft tissue (e.g. skin and cartilage) to engraft as intended... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --CHILD--> [EL51] Cutaneous flap necrosis Def: Necrosis of surgical skin flap... --- Walk 6 --- [EL54] Composite graft failure Def: Failure of composite graft tissue (e.g. skin and cartilage) to engraft as intended... --PARENT--> [?] Postprocedural disorders of the skin Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions.... --CHILD--> [EL50] Unsatisfactory surgical scar of skin Def: A surgical skin scar with a poor functional or cosmetic outcome....
[ "[NE84] Failure or rejection of transplanted organs or tissues\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --EXCLUDES--> [?] Attention to artificial openings", "[NE84] Failure or rejection of transplanted organs or tissues\n --PARENT--> [?] Injury or harm arising from surgical or medical care, not elsewhere classified\n --CHILD--> [NE81] Injury or harm arising from a procedure, not elsewhere classified\n Def: Any complication attributable to a medical, surgical or other clinical procedure which cannot be more precisely coded elsewhere in the classification....", "[EL53] Skin graft failure\n Def: Failure of skin graft tissue to engraft as intended...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --CHILD--> [EL51] Cutaneous flap necrosis\n Def: Necrosis of surgical skin flap...", "[EL53] Skin graft failure\n Def: Failure of skin graft tissue to engraft as intended...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --CHILD--> [EL51] Cutaneous flap necrosis\n Def: Necrosis of surgical skin flap...", "[EL54] Composite graft failure\n Def: Failure of composite graft tissue (e.g. skin and cartilage) to engraft as intended...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --CHILD--> [EL51] Cutaneous flap necrosis\n Def: Necrosis of surgical skin flap...", "[EL54] Composite graft failure\n Def: Failure of composite graft tissue (e.g. skin and cartilage) to engraft as intended...\n --PARENT--> [?] Postprocedural disorders of the skin\n Def: This group of disorders incorporates drug eruptions, other cutaneous side effects of medication and adverse reactions to medical and surgical interventions....\n --CHILD--> [EL50] Unsatisfactory surgical scar of skin\n Def: A surgical skin scar with a poor functional or cosmetic outcome...." ]
NE84
Failure or rejection of transplanted organs or tissues
[ { "from_icd11": "NE84", "icd10_code": "T865", "icd10_title": "Complications of stem cell transplant" }, { "from_icd11": "NE84", "icd10_code": "T8649", "icd10_title": "Other complications of liver transplant" }, { "from_icd11": "NE84", "icd10_code": "T86891", "icd10_title": "Other transplanted tissue failure" }, { "from_icd11": "NE84", "icd10_code": "T86890", "icd10_title": "Other transplanted tissue rejection" }, { "from_icd11": "NE84", "icd10_code": "T86822", "icd10_title": "Skin graft (allograft) (autograft) infection" }, { "from_icd11": "NE84", "icd10_code": "T86828", "icd10_title": "Other complications of skin graft (allograft) (autograft)" }, { "from_icd11": "NE84", "icd10_code": "T8641", "icd10_title": "Liver transplant rejection" }, { "from_icd11": "NE84", "icd10_code": "T8642", "icd10_title": "Liver transplant failure" }, { "from_icd11": "NE84", "icd10_code": "T8613", "icd10_title": "Kidney transplant infection" }, { "from_icd11": "NE84", "icd10_code": "T8643", "icd10_title": "Liver transplant infection" }, { "from_icd11": "NE84", "icd10_code": "T86898", "icd10_title": "Other complications of other transplanted tissue" }, { "from_icd11": "NE84", "icd10_code": "T86821", "icd10_title": "Skin graft (allograft) (autograft) failure" }, { "from_icd11": "NE84", "icd10_code": "T8621", "icd10_title": "Heart transplant rejection" }, { "from_icd11": "NE84", "icd10_code": "T8622", "icd10_title": "Heart transplant failure" }, { "from_icd11": "NE84", "icd10_code": "T86892", "icd10_title": "Other transplanted tissue infection" } ]
T865
Complications of stem cell transplant
This clinical case describes an extremely rare JV causing gastrointestinal obstruction. Volvulus occurs most commonly in the large bowel than in the small bowel and stomach . SBV is a rare condition among adults where the bowel loops coiled around the axis of its own mesentery. A twist of small bowel loops greater than 180ยฐ around its mesenteric vascular pedicle results in acute mechanical gastrointestinal obstruction and in vascular inflow and outflow compromise, leading to bowel ischemia and necrosis, bowel perforation and peritonitis . SBV can be classified as primary and secondary subtypes according to the cause. Primary SBV occurs without underlying anatomical abnormalities or predisposing factors and it is observed mainly in children and young adults; it is more common in Africa and Asia continent. Many mechanisms of primary SBV have been suggested including a strong anterior abdominal muscle tone, high peristaltic tone of the bowel, a bulky higher fiber meal in the small bowel after a prolonged period of fasting, longer mesenteric length and shortness of the mesenteric root allowing abnormal mobility of a small bowel segment . Secondary SBV is usually found between the age of 40 and 90 years , it is more common in Western countries and makes up 78% to 90% of SBV . Secondary SBV is mainly due to postoperative adhesions, fibrous band, Meckel's diverticulum, congenital malrotation of the gut, tumours, mesenteric lymph nodes, parasitic infestations, internal hernias, lipomas, pregnancy, endometriosis, hematomas, aneurysms, tuberculosis, intestinal duplication, jejunal diverticulum, small bowel diverticula, paraduodenal hernia. , , . This is the first case of a JV secondary to a inguinal hernia reported in the literature: we suppose that the presence of jejunal loops within the inguinal hernia sac have induced forceful bowel peristalsis resulting in JV. Diagnosis of SBV is difficult due to its rarity and nonspecific clinical presentation. A high index of suspicion is required and an early diagnosis is essential to avoid mesenteric ischemia and bowel necrosis. SBV may present either acutely (89%) due to acute vascular insufficiency or peritonitis, or else with vague symptoms and signs (abdominal pain, nausea, vomiting, abdominal distension, a decrease in flatus production) that are common to others causes of gastrointestinal obstruction , , . In our case report the patient presented symptoms and signs of gastrointestinal obstruction without peritoneal signs. No laboratory findings of SBV are specific as in our case. Preoperative diagnostic workup of SBV includes plain abdominal radiography, ultrasonography (US), Color Doppler US and abdominal CECT . Plain abdominal radiography has low accuracy in diagnosing SBV, it can demonstrate nonspecifically signs of intestinal obstruction (air-fluid levels, dilated bowel loops), ischemia or necrosis (thumbprinting, pneumatosis intestinalis, portal vein gas). US is operator dependent and can show the twisting of small bowel around its mesentery . Color Doppler US can demonstrate the encircling of the small bowel loops and the superior mesenteric vein around the superior mesenteric artery, which is termed the โ€œwhirlpool signโ€, with a sensitivity, specificity and positive predictive value of 92%, 100% and 100% respectively . Abdominal CECT represents the investigation of choice with a sensitivity of 60%โ€“100% and a specificity of 90%โ€“95% : it can demonstrate โ€œwhirl signโ€, โ€œspoke wheel signโ€, โ€œbeak signโ€, โ€œbarber pole signsโ€, signs of small bowel obstruction (dilatation of closed or air-filled bowel loops) and ischemia (thickening or presence of air in the bowel wall, portal vein gas, free peritoneal fluid); however none of these findings is pathognomonic of SBV . M. Lepage-Saucier et al. observed on abdominal CECT three signs of SBV which are multiple transition points, transition points located โ‰ค7 cm from the spine in the anteroposterior plane and the whirl sign: the presence of any one of these signs confirms SBV with a sensitivity of 94%, the presence of all signs confirms SBV with100% specificity . In our case report abdominal radiography showed gastric dilatation with suspected pneumoperitoneum and intestinal loops in the right inguinal sac, abdominal CT scan revealed massive gastroduodenal dilatation with pneumoperitoneum and small bowel loops in the right inguinal sac and diagnosis of JV was made intraoperatively. The management of SBV is strictly surgical, conservative management is not indicated because the twisted intestinal loops carry an high risk of gangrene and peritonitis. Emergency surgery is the correct treatment to be undertaken with the aim of untwisting the SBV and re-establishing the intestinal blood flow. If small bowel is necrotic, resection and primary intestinal anastomosis or stoma are necessary . The incidence of gangrenous bowel requiring resection has been reported as 15โ€“50% . Although it is clear that secondary SBV causes must be corrected during surgery, there is a continuing controversy regarding the surgical management of primary SBV: some authors considered the simple devolvulation as the most appropriate operation, others recommend additional intestinal fixation or even suggest resection to avoid recurrence (up to 30% of cases) . In our case report only devolvulation of JV and a right prosthetic inguinal hernia repair were performed. Delay in diagnosis and surgery increases morbidity and mortality rates. Mortality rates range between 9% and 35% , but with gangrenous bowel mortality rates as high as 20โ€“100% have been reported , .
4.265625
0.921875
sec[2]/p[0]
en
0.999996
35149283
https://doi.org/10.1016/j.ijscr.2022.106757
[ "bowel", "small", "abdominal", "loops", "mesenteric", "intestinal", "obstruction", "inguinal", "gastrointestinal", "around" ]
[ { "code": "DB30.Z", "title": "Obstruction of large intestine, unspecified" }, { "code": "DA96.04", "title": "Short bowel syndrome" }, { "code": "DD3Z", "title": "Ischaemic vascular disorders of intestine, unspecified" }, { "code": "DD30.Z", "title": "Acute vascular disorders of intestine, unspecified" }, { "code": "DA93.0", "title": "Paralytic ileus" }, { "code": "MF54.2", "title": "Small kidney" }, { "code": "DA9Z", "title": "Diseases of small intestine, unspecified" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "KA20.0Z", "title": "Small for gestational age, unspecified" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" } ]
=== ICD-11 CODES FOUND === [DB30.Z] Obstruction of large intestine, unspecified Also known as: Obstruction of large intestine, unspecified | Obstruction of large intestine | bowel obstruction | large bowel obstruction | abdominal colon obstruction [DA96.04] Short bowel syndrome Definition: Having less than 200 cm of residual small bowel with or without colon in an adult and for children (< 18 yrs), less than 25% of the normal length of intestine for their respective age. Also known as: Short bowel syndrome | Secondary short bowel syndrome | short gut syndrome | short bowel NOS | SBS - [short bowel syndrome] Excludes: Congenital short bowel [DD3Z] Ischaemic vascular disorders of intestine, unspecified Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS [DD30.Z] Acute vascular disorders of intestine, unspecified Also known as: Acute vascular disorders of intestine, unspecified | Acute vascular disorders of intestine | acute intestinal ischemia NOS | acute intestinal ischemic syndrome | acute ischaemic bowel disease [DA93.0] Paralytic ileus Definition: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need to be complete, but the intestinal muscles must be so inactive that it leads to a functional blockage of the intestine. Also known as: Paralytic ileus | adynamic ileus | Paralytic ileus of bowel | ileus NOS | paralysis of bowel Excludes: Obstructive ileus of small intestine due to impaction | Gallstone ileus of small intestine [MF54.2] Small kidney Definition: A condition characterised by a kidney smaller in size and weight than the average (less than 11 centimetres long, 5-7.5 centimetres wide, 2.5 centimetres thick, and weighing less than 120 grams). Also known as: Small kidney | Small kidney, unilateral | unilateral small kidney | Small kidney, bilateral [DA9Z] Diseases of small intestine, unspecified Also known as: Diseases of small intestine, unspecified [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 [KA20.0Z] Small for gestational age, unspecified Also known as: Small for gestational age, unspecified | Small for gestational age | Small-for-dates | small fetus or newborn for gestational age | dysmaturity [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 --- [DB30.Z] Obstruction of large intestine, unspecified --PARENT--> [DB30] Obstruction of large intestine Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ... --EXCLUDES--> [?] Paralytic ileus of large intestine Def: Paralytic ileus of large intestine is a decreased motor activity of colon due to non-mechanical causes. The intestinal paralysis need not be complete, but it must be sufficient to prohibit the passage... --- Walk 2 --- [DB30.Z] Obstruction of large intestine, unspecified --PARENT--> [DB30] Obstruction of large intestine Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ... --CHILD--> [DB30.1] Volvulus of large intestine Def: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vess... --- Walk 3 --- [DA96.04] Short bowel syndrome Def: Having less than 200 cm of residual small bowel with or without colon in an adult and for children (< 18 yrs), less than 25% of the normal length of intestine for their respective age.... --EXCLUDES--> [?] Congenital short bowel Def: Short bowel syndrome is a condition in which nutrients are not properly absorbed due to a congenital defect where a large part of the small intestine is missing.... --PARENT--> [?] Structural developmental anomalies of small intestine Def: Congenital gross anatomical structural defect of small intestine that results from interference with the normal growth and differentiation of the fetus, which may be inherited genetically, acquired du... --- Walk 4 --- [DA96.04] Short bowel syndrome Def: Having less than 200 cm of residual small bowel with or without colon in an adult and for children (< 18 yrs), less than 25% of the normal length of intestine for their respective age.... --PARENT--> [DA96.0] Intestinal malabsorption Def: Intestinal malabsorption (syndrome) occurs due to pathological interference with the normal physiological sequence of digestion (intraluminal process), absorption (mucosal process), and transport (pos... --CHILD--> [DA96.00] Bacterial overgrowth syndrome Def: Bacterial overgrowth syndrome is a term that describes clinical manifestations that occur when poor movement of intestinal contents allows certain normal intestinal bacteria to grow excessively, causi... --- Walk 5 --- [DD3Z] Ischaemic vascular disorders of intestine, unspecified --PARENT--> [?] Ischaemic vascular disorders of intestine Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand... --CHILD--> [DD3Y] Other specified ischaemic vascular disorders of intestine --- Walk 6 --- [DD3Z] Ischaemic vascular disorders of intestine, unspecified --PARENT--> [?] Ischaemic vascular disorders of intestine Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand... --CHILD--> [DD31] Chronic vascular disorders of intestine
[ "[DB30.Z] Obstruction of large intestine, unspecified\n --PARENT--> [DB30] Obstruction of large intestine\n Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...\n --EXCLUDES--> [?] Paralytic ileus of large intestine\n Def: Paralytic ileus of large intestine is a decreased motor activity of colon due to non-mechanical causes. The intestinal paralysis need not be complete, but it must be sufficient to prohibit the passage...", "[DB30.Z] Obstruction of large intestine, unspecified\n --PARENT--> [DB30] Obstruction of large intestine\n Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...\n --CHILD--> [DB30.1] Volvulus of large intestine\n Def: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vess...", "[DA96.04] Short bowel syndrome\n Def: Having less than 200 cm of residual small bowel with or without colon in an adult and for children (< 18 yrs), less than 25% of the normal length of intestine for their respective age....\n --EXCLUDES--> [?] Congenital short bowel\n Def: Short bowel syndrome is a condition in which nutrients are not properly absorbed due to a congenital defect where a large part of the small intestine is missing....\n --PARENT--> [?] Structural developmental anomalies of small intestine\n Def: Congenital gross anatomical structural defect of small intestine that results from interference with the normal growth and differentiation of the fetus, which may be inherited genetically, acquired du...", "[DA96.04] Short bowel syndrome\n Def: Having less than 200 cm of residual small bowel with or without colon in an adult and for children (< 18 yrs), less than 25% of the normal length of intestine for their respective age....\n --PARENT--> [DA96.0] Intestinal malabsorption\n Def: Intestinal malabsorption (syndrome) occurs due to pathological interference with the normal physiological sequence of digestion (intraluminal process), absorption (mucosal process), and transport (pos...\n --CHILD--> [DA96.00] Bacterial overgrowth syndrome\n Def: Bacterial overgrowth syndrome is a term that describes clinical manifestations that occur when poor movement of intestinal contents allows certain normal intestinal bacteria to grow excessively, causi...", "[DD3Z] Ischaemic vascular disorders of intestine, unspecified\n --PARENT--> [?] Ischaemic vascular disorders of intestine\n Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand...\n --CHILD--> [DD3Y] Other specified ischaemic vascular disorders of intestine", "[DD3Z] Ischaemic vascular disorders of intestine, unspecified\n --PARENT--> [?] Ischaemic vascular disorders of intestine\n Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand...\n --CHILD--> [DD31] Chronic vascular disorders of intestine" ]
DB30.Z
Obstruction of large intestine, unspecified
[ { "from_icd11": "DB30.Z", "icd10_code": "K5660", "icd10_title": "Unspecified intestinal obstruction" }, { "from_icd11": "DB30.Z", "icd10_code": "K56600", "icd10_title": "Partial intestinal obstruction, unspecified as to cause" }, { "from_icd11": "DB30.Z", "icd10_code": "K5669", "icd10_title": "Other intestinal obstruction" }, { "from_icd11": "DB30.Z", "icd10_code": "K56609", "icd10_title": "Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction" }, { "from_icd11": "DB30.Z", "icd10_code": "K56699", "icd10_title": "Other intestinal obstruction unspecified as to partial versus complete obstruction" }, { "from_icd11": "DB30.Z", "icd10_code": "K56690", "icd10_title": "Other partial intestinal obstruction" }, { "from_icd11": "DB30.Z", "icd10_code": "K56691", "icd10_title": "Other complete intestinal obstruction" }, { "from_icd11": "DB30.Z", "icd10_code": "K56601", "icd10_title": "Complete intestinal obstruction, unspecified as to cause" }, { "from_icd11": "DB30.Z", "icd10_code": "K567", "icd10_title": "Ileus, unspecified" }, { "from_icd11": "DB30.Z", "icd10_code": "K624", "icd10_title": "Stenosis of anus and rectum" }, { "from_icd11": "DB30.Z", "icd10_code": "K55-K64", "icd10_title": "" }, { "from_icd11": "DB30.Z", "icd10_code": "K56", "icd10_title": "Paralytic ileus and intestinal obstruction without hernia" }, { "from_icd11": "DB30.Z", "icd10_code": "K566", "icd10_title": "Other and unspecified intestinal obstruction" }, { "from_icd11": "DD3Z", "icd10_code": "K559", "icd10_title": "Vascular disorder of intestine, unspecified" }, { "from_icd11": "DD3Z", "icd10_code": "K558", "icd10_title": "Other vascular disorders of intestine" } ]
K5660
Unspecified intestinal obstruction
A 64-year-old previously healthy man visited our hospital with arthralgia and morning stiffness in July 2005. Physical examination revealed no dry eye, dry mouth, erythematous nodules or other autoimmune-mediated manifestations. His blood test results were unremarkable; his white blood cell (WBC), red blood cell, and platelet counts were normal, and C-reactive protein (CRP) was negative. Serological examination indicated positivity for anti-nuclear antibody (ANA) (1:80, speckled pattern), and negativity for anti-double strand DNA antibody, rheumatoid factor, anti-RNP antibody, and anti-SS-A antibody. Bilateral hand X-rays showed mild swelling and destruction of the metacarpo-phalangeal (MP) and proximal-inter-phalangeal (PIP) joints. He was diagnosed to have RA. He had unsatisfactory response to anti-non steroid inflammatory drugs (NSAIDS). We therefore administered prednisolone (PSL; 5 mg/day) and bucillamine (200 mg/day), but discontinued the bucillamine after 4 months due to skin rash and eye lid edema. His regular blood tests revealed worsening anemia and thrombocytopenia, and he was admitted to our hospital for further examination. Blood examination revealed mild leukocytosis (9,600/cu mm) with increase of blasts (43%), anemia (Hg 7.9 g/100 mL) and thrombocytopenia (3.1 ร— 10 4 /cu mm). Blood biochemical examination disclosed slight elevation of the serum levels of lactate dehydrogenase (LDH: 304 IU/mL). Bone marrow (BM) examination revealed an increase of myeloid blasts (23.1%) with dysplasia in three myeloid cell lineages , and a diagnosis of AML-MLD was made based on World Health Organization (WHO) criteria . The immunophenotype of blasts was CD7, 13, 33, 34, and HLA-DR positive, and an abnormal karyotype, i(7)(p10), was detected in 7 of 20 cells examined. After receiving two courses of low-dose Ara-C (30 mg continuous intravenous drip injection (d.i.v.) for 14 days), the patient achieved partial remission, and additional chemotherapy consisting of two courses of CAG (Ara-C 30 mg/day continuous d.i.v. for 14 days, aclarubicin 10 mg/day on days 1โ€“3, and G-CSF 250 mcg d.i.v. on days 1โ€“14) led to complete remission (CR). During the chemotherapy, RA manifestations such as arthralgia and morning stiffness were not observed. After achieving CR, he remained well for several weeks as an outpatient, but high fever and dyspnea suddenly appeared in January 2007. He was admitted again, and antibiotics and anti-fungal drugs were administered with no improvement. His blood test indicated pancytopenia (WBC: 1,700/cu mm; Hb: 12.4 g/100 mL; platelets: 5.1 ร— 10 4 /cu mm), liver dysfunction (aspartate aminotransferase (AST): 100 IU/L; alanine aminotransferase (ALT): 78 IU/L), and elevated LDH (525 IU/L). His WBC showed relative neutropenia, and monocytosis without blast cell increase. His CRP was high (4.0 mg/100 mL), and his ferritin level was extremely elevated (46,802 ng/mL). Antibodies directed against cytomegalovirus (CMV), human T-cell lymphotropic virus type 1 (HTLV-1) and human immunodeficiency virus (HIV) I/II were negative. The EBV serology of this patient revealed an existing infectious pattern, i.e., anti-Epstein-Barr virus-viral capsid antigen (VCA) IgM <10, anti-VCA IgG X9.5, and anti-Epstein-Barr virus nuclear antigen (EBNA) X6. The aPTT and PT were prolonged (54% and 53 seconds, respectively), and FDP (52 pg/100 mL) was elevated, suggesting DIC state. Chest X-ray indicated mild cardiomegaly with massive pleural effusion, and whole body computer tomography showed other abnormalities, such as ascites, axillary and para aorta lymphadenopathies and splenomegaly (not shown). The level of soluble interleukin-2 receptor in serum was extremely elevated (35,800 IU/L). A thoracentesis was done to evaluate the etiology. Cytology study indicated no malignancy and culture revealed no bacterial/fungal/tubercular infection. Therefore, hydrocortisone was given to relieve the symptoms. The clinical course was shown in Figure 2 . A BM examination showed residual blast cells, but small lymphocytes were increased, expressing the CD3+CD4-CD8-CD19-CD20-CD56-MPO-phenotype, and EBER was also detected . Based on these facts, EBV-mediated T-LPD was diagnosed. PSL (60 mg/day) was started. Although fever, pleural effusion and liver dysfunction showed a partial response to this medication, the skin rash and LDH elevation progressed . A skin biopsy was performed and revealed T-cell infiltration in the dermal lesion, with phenotype similar to that seen in BM tissue . This suggested persistent T-LPD. Thus high dose steroid pulse therapy (methylprednisolone 1 g/day for 2 days) and cyclophosphamide (750 mg d.i.v. for a day) were administered. However, patient's condition worsened rapidly. Three weeks after the diagnosis of T-LPD, the patient died of multiple organ failure with pneumonia and sepsis. An autopsy revealed the presence of leukemic cell infiltration into multiple organs: the BM, liver, spleen, lymph nodes (LNs), pancreas, and adrenal glands . In addition, EBER was negative in all these organs except the LNs. Both myeloid blasts and EBER-positive small T-lymphocytes were detected in the LNs . The lung tissue did not show infiltration of AML cells or EBV-infected T cells; however, gram-negative bacteria, aspergillus and mucor infection were detected. Moreover, massive alveolar bleeding and congestion were also documented. The finger joints were slightly deformed, and the membranes of these joints showed mild synovial and lymphoid proliferation. These findings were compatible with the pathological findings of RA joints.
4.105469
0.972656
sec[1]/p[0]
en
0.999998
19566938
https://doi.org/10.1186/1756-8722-2-27
[ "anti", "blood", "cell", "antibody", "joints", "blasts", "cells", "virus", "these", "skin" ]
[ { "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": "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 [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 [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.... --CHILD--> [JA86.0] Maternal care for red cell antibodies Def: Maternal care for rhesus or other isoimmunization... --- Walk 2 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --EXCLUDES--> [?] Labour or delivery complicated by fetal distress --- Walk 3 --- [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --CHILD--> [MB23.2] Avoidance behaviour Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.... --- Walk 4 --- [MB23.1] Antisocial behaviour Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --CHILD--> [MB23.2] Avoidance behaviour Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.... --- Walk 5 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood.... --- Walk 6 --- [3B4Z] Coagulation defects, unspecified --PARENT--> [?] Coagulation defects --CHILD--> [?] Congenital or constitutional haemorrhagic condition Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo...
[ "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.0] Maternal care for red cell antibodies\n Def: Maternal care for rhesus or other isoimmunization...", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....", "[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.2] Avoidance behaviour\n Def: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual....", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Haemorrhagic diseases due to acquired coagulation factor defects\n Def: Any disease caused by determinants arising after birth. These diseases are characterised by abnormal coagulation of the blood....", "[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [?] Congenital or constitutional haemorrhagic condition\n Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo..." ]
JA86.Y
Maternal care for other specified fetal problems
[ { "from_icd11": "JA86.Y", "icd10_code": "O26841 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26843 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O26849 ", "icd10_title": "" }, { "from_icd11": "JA86.Y", "icd10_code": "O3680X0 ", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D688", "icd10_title": "Other specified coagulation defects" }, { "from_icd11": "3B4Z", "icd10_code": "D689", "icd10_title": "Coagulation defect, unspecified" }, { "from_icd11": "3B4Z", "icd10_code": "D699", "icd10_title": "Hemorrhagic condition, unspecified" }, { "from_icd11": "3B4Z", "icd10_code": "D698", "icd10_title": "Other specified hemorrhagic conditions" }, { "from_icd11": "3B4Z", "icd10_code": "D65-D69", "icd10_title": "" }, { "from_icd11": "3B4Z", "icd10_code": "D69", "icd10_title": "Purpura and other hemorrhagic conditions" }, { "from_icd11": "4A45.Z", "icd10_code": "D6861", "icd10_title": "Antiphospholipid syndrome" }, { "from_icd11": "4A45.Z", "icd10_code": "D6869", "icd10_title": "Other thrombophilia" }, { "from_icd11": "4A45.Z", "icd10_code": "D6862", "icd10_title": "Lupus anticoagulant syndrome" }, { "from_icd11": "4A45.Z", "icd10_code": "D686", "icd10_title": "Other thrombophilia" }, { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" } ]
O26841
A 55 years-old male suffering from long lasting chronic non erosive seronegative arthritis without health impairments was diagnosed with ET in 1994 and began treatment with aspirin and hydroxyurea (HU). The disease remained stable for 22 years until June 2016 when he presented with severe abdominal pain, fever and anorexia. Physical examination was significant for pallor and palpable hepatomegaly and splenomegaly of new-onset. Abdominal computed tomography (CT) revealed portal, superior mesenteric and splenic vein thrombosis, massive splenomegaly with splenic infarct of 13 cm, multiple renal and hepatic infarcts, and floating thrombus of the abdominal aorta. A complete blood count showed anemia (hemoglobin level 8.8 g/dl), thrombocytosis , and leukocytosis (white blood cell count 20,390 ร— 10 9 /L) with neutrophilia and presence of circulating myelocytes, metamyelocytes, and blasts (2%, 3%, and 1%, respectively). Work-up for the patientโ€™s hypercoagulability revealed no alterations and blood biochemistries revealed abnormal liver function tests (grade 4 according Common Terminology Criteria for Adverse Events) and altered indices of inflammation. Molecular testing resulted positive for type 1 CALR mutation (variant allele frequency, VAF 58%) in absence of other mutations (including ASXL1, TET2, TP53, BCOR, RUNX1, NRAS, KRAS, SRSF2, DNMT3A, SF3B1, U2AF1, IDH1/2). Histologic examination showed a hypercellular bone marrow with increased granulopoiesis and megakaryocitopoiesis and increase in reticulin fibrosis (MF grade 2, according to EUMNET consensus). Atypical megakaryocytes formed loose clusters. Revision of bone marrow biopsy at diagnosis confirmed the diagnosis of ET and the second biopsy was referred to a post-ET myelofibrosis, categorized as intermediate-2 risk (MYSEC-PM). The patient was managed with warfarin and ruxolitinib (15 mg BID), experiencing a progressive improvement of spleen size, liver impairment, and constitutional symptoms. After 6 months, a CT scan confirmed the resolution of aortic thrombosis, hepatic ischemic area, and half-reduction of the splenic ischemic area. However, the patient reported episodes of melena and hematemesis and several endoscopic ligations for varices were performed. On September 2018, another abdomen CT showed no recanalization of SVT. On March 2019, he presented with two-week history of worsening fatigue, weight loss and petechiae. Investigations revealed pancytopenia (total white cell count 3.37 ร— 10 9 /L, hemoglobin 8.5 g/dl, platelet count 10 ร— 10 9 /L), elevated lactate dehydrogenase, and no evidence of coagulopathy. The peripheral blood (PB) smear showed 12% blasts with cytoplasmic granules. Flow cytometry analysis of peripheral blood revealed a population of blast cells according for 30% of total cellularity. Conventional cytogenetic and fluorescence in situ (FISH) revealed the presence of t(15;17) (q24;q21) /46, idem, del(9)(q21q32) in 20% of metaphases of analyzed cells . Molecular studies were positive for PML/RARฮฑ and showed the persistence of CALR mutation type 1 (VAF 53%) in absence of other. Bone marrow biopsy exhibited diffuse sheets of immature myeloid cells and granulated promyelocytes with MPO+, CD15-, CD117-, CD34-, CD687PGM1-, and fibrosis grade 2, confirming the leukemic evolution. Bone marrow and peripheral blood examination, flow cytometry immunophenotyping, conventional cytogenetic and FISH yielded to the diagnosis of acute promyelocytic leukemia (APL). Immunohistochemistry was performed on serial bone marrow sections from 1994 to 2019 with a commercial antibody for immunodetection of all CALR mutations in ET and PMF (Anti-CALRmut, CAL2, Dianova Int.): megakaryocytes were positive in all specimens with promyelocytes and immature myeloid precursors staining positive in APL specimen . The patient was immediately started on all-trans retinoic acid (ATRA)/ arsenic trioxide (ATO) therapy for clinically intermediate-risk APL, according to Sanz. The patient tolerated well the ATO/ATRA regimen, with achievement of molecular complete response (CR) after consolidation. Moreover, at last control on December 2019, the BM showed reversion to the chronic phase MPN with grade 2 fibrosis. Platelets were increased, the CALR mutation persisted (VAF 44%), and SVT was stable. Therefore, he started again warfarin and HU. The patients remained APL-free for 9 months, but, unfortunately, died of COVID-19 pneumonia on February 2020. Fig. 1 Evolution of bone marrow histology from 1994 to 2019. In 1994, MPN in chronic phase with ET morphology: normocellular bone marrow with enlarged megakaryocytes with hyperlobulated nuclei (A), reactive for CALR immunostaining (B). In 2016, progression to fibrotic phase as post-ET Myelofibrosis: hypercellular bone marrow with dense clusters of atypical megakaryocytes (C), reactive for CARL immunostaining (D). In 2019, APL-blast crisis with hypergranulated promyelocytes (E), staining positive for CALR together with a megakaryocyte (F) . Fig. 1 Fig. 2 Conventional cytogenetic (A) and fluorescence in situ (B) at time of leukemic evolution. (A) G-banded karyotype revealed a reciprocal translocation between the long arms of chromosomes 15 and 17 at 15q22 and 17q21 [t(15;17)] in 20% of metaphases analyzed. An additional cytogenetic abnormality in chromosome 9 was found [del(9)(q21q32)]. (B) Interphase FISH demonstrated a fusion signal pattern of chromosome 15 and 17 in the patient. The PML gene in the chromosome 15 is labelled red, the RARฮฑ gene in the chromosome 17 is labelled green and the PML-RARฮฑ is labelled yellow. Fig. 2
4.101563
0.976563
sec[1]/p[0]
en
0.999997
34040959
https://doi.org/10.1016/j.lrr.2021.100243
[ "bone", "marrow", "blood", "calr", "count", "grade", "according", "megakaryocytes", "cytogenetic", "chromosome" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "3A70.Z", "title": "Aplastic anaemia, unspecified" }, { "code": "3C0Y", "title": "Other specified diseases of the blood or blood-forming organs" }, { "code": "3A70.12", "title": "Idiopathic aplastic anaemia" }, { "code": "NE84", "title": "Failure or rejection of transplanted organs or tissues" } ]
=== ICD-11 CODES FOUND === [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [3A70.Z] Aplastic anaemia, unspecified Also known as: Aplastic anaemia, unspecified | Aplastic anaemia | erythroid aplasia | AA - [aplastic anaemia] | haematopoietic aplasia [3C0Y] Other specified diseases of the blood or blood-forming organs Also known as: Other specified diseases of the blood or blood-forming organs | Congenital anomaly blood or lymph other | Blood dyscrasia | blood dyscrasia NOS | Bone marrow hyperplasia [3A70.12] Idiopathic aplastic anaemia Also known as: Idiopathic aplastic anaemia | Idiopathic bone marrow failure | idiopathic aplastic anaemia NOS [NE84] Failure or rejection of transplanted organs or tissues Also known as: Failure or rejection of transplanted organs or tissues | organ transplant rejection | transplant failure | transplant rejection | Bone-marrow transplant rejection === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --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 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes Def: !markdown In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre... --- Walk 3 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --PARENT--> [?] Osteopathies or chondropathies --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Inflammatory conditions of jaws --- Walk 5 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopoikilosis --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopenia
[ "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --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...", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --PARENT--> [?] Osteopathies or chondropathies", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Inflammatory conditions of jaws", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopoikilosis", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopenia" ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
A 90-year-old Hispanic woman presented with a 2-week history of symptomatic anemia and comprehensive purpuric lesions that extended from the left arm towards the lateral aspect of the thorax and a large hematoma on the left thigh. She had a past medical history of multiple falls, Alzheimerโ€™s dementia, hypothyroidism, stage 3 chronic kidney disease and an uncorrected compression lumbar fracture (L3). Her surgical history was positive for a total abdominal hysterectomy, cholecystectomy, bilateral wrist surgery, left shoulder surgery and right knee surgery. Apart from maintenance pharmacological therapies, the only recent medication change was Duloxetine 60 mg OD, starting 4 days prior. Laboratory work-up was remarkable for a Hemoglobin level of 7.3 g/dL (Normal = 12.0, 16.0), a hematocrit percentage of 21.9% (Normal = 36.0โ€“48.0%) and a PTT value of 70.9 > 200 s (Normal = 23.5, 30.3 s) . Patient was admitted with the initial diagnosis of acute symptomatic anemia and GI consult was brought on board to determine potential sources of bleeding with Hematology/Oncology consult also being requested to explore alternative hematological diagnoses not considered initially. Management of the present condition was oriented towards conservation of hemostasis, administering PRBC, FFP and cryoprecipitate transfusions during acute exacerbations of anemia until a more definitive diagnosis was drawn upon. On day 10 of admission, Hematology/Oncology service determined the tentative diagnosis of Chronic DIC, due to the increased D-dimer of 4.89 (Normal = 0.00, 0.59) and an elevated FDP of 5.59 (Normal = 0.00, 0.59), and was given a total of 50 g of aminocaproic acid IV and started on Methylprednisolone 80 mg IV q8 h. Stool Occult Blood test was negative, subtracting diagnostic importance that suggests a lower gastrointestinal bleed. Urinalysis demonstrated no hematuria, which attenuated the relevance of the urinary tract as a source of the blood loss. Abdominopelvic CT scan without contrast demonstrated a poorly defined hypodense neoplastic process in the liver that measures approximately 4.5 cm; however due to persistently low hemoglobin levels, a liver biopsy was not attempted. Cardiac telemetry showed normal sinus rhythm; however, the latter did not offer diagnostic value. Anteriorโ€“Posterior Chest X-Ray did not contribute to the diagnosis. Left extremity Venous Doppler showed normal flow of the major vessels, withdrawing some diagnostic support from the left thigh hematoma as a local cause for the symptomatic anemia and ruling out deep venous thromboses. MRI of the right hip without contrast elucidated right gluteal and left thigh intramuscular hematomas, adding empirical evidence towards a chronic bleeding disorder related to the immune system. Physical examination supported the previous conclusions, showing extensive hematoma of the right shoulder and left thigh . Due to the lack of clinical improvement, despite aggressive hemostatic measures (30 units of PRBCโ€™s, 19 units of FFP and 10 units of cryoprecipitate were expended during inpatient stay), Hematology/Oncology consultation suggested the differential diagnosis of multiple myeloma versus Acquired Hemophilia A. Serum Protein Electrophoresis, Factor VIII activity assay and a Factor VIII inhibition profile was ordered to determine which of these conditions was prevalent on the patient. There was a faint IgG monoclonal band on electrophoresis, but not sufficient to diagnose a monoclonal gammopathy. The factor VIII activity assay showed less than 11% of activity, adding weight to the diagnosis of Acquired Hemophilia. The latter was further supported by a positive factor VIII inhibitory screen and the presence of Bethesda Units (BU) with a value of 76 (factor VIII-IgG complexes). Upon confirmation of the chief diagnosis, recombinant porcine factor VIII (rpFVIII) in conjunction with Methylprednisolone 500 mg IV and Cyclophosphamide 500 mg IV was given to the patient (12,000 units q6 h. IV 4ร— doses) which demonstrated remarkable improvement in Factor VIII activity (final measure read at 335% above baseline values). This is, in part, due to the overwhelming of the present autoantibodies with exogenous factor VIII with tandem immune suppression, which eventually decreased the acquired immune response to this clotting protein. As a follow-up to rule out underlying autoimmune disorders, titers for ANA, dsDNA, SS-A, SS-B, RNP, Scl-70, Smith, Ribosomal P, TPO, C3, C4 and RF autoantibodies were ordered and found to be negative for their respective conditions. Upon relative normalization of adjusted laboratory values in concert with the chronic ailments that the patient possesses, the latter was discharged with home care planning and subsequent hematology/oncology consult to follow up on the remission of the acquired autoimmune condition. The inpatient treatment strategies and acute management were in accordance with the wishes of family member in prolonging a stable health status for the patient, insofar no attempts were made to resuscitate the patient if the latter were to enter cardiopulmonary arrest. Fig. 1 PTT (Dade) levels during inpatient stay. Description: PTT (Dade) Levels of the Patient during Hospital Stay demonstrate the effect of conservative hemostatic management of the patient vs. recombinant porcine factor VIII administration Fig. 2 Extensive hematoma formation of the right shoulder with inclusion of the right upper arm Fig. 3 Hematoma of the Left thigh, highlighting the appearance of spontaneous subcutaneous hemorrhagic instances that is specific for AHA
3.96875
0.979492
sec[1]/p[0]
en
0.999995
28870236
https://doi.org/10.1186/s13104-017-2767-6
[ "factor", "viii", "that", "hematoma", "thigh", "anemia", "hematology", "oncology", "which", "latter" ]
[ { "code": "3B14.0", "title": "Hereditary deficiency of factor I" }, { "code": "3B14.Z", "title": "Other inherited coagulation factor deficiency with bleeding tendency, unspecified" }, { "code": "3B14.1", "title": "Hereditary factor X deficiency" }, { "code": "3B11.Z", "title": "Hereditary factor IX deficiency, unspecified" }, { "code": "PB6Z", "title": "Unspecified unintentional cause of morbidity or mortality" }, { "code": "3B10.Z", "title": "Hereditary factor VIII deficiency, unspecified" }, { "code": "3B10.0", "title": "Haemophilia A" }, { "code": "3B10.Y", "title": "Other specified hereditary factor VIII deficiency" }, { "code": "3B12", "title": "Von Willebrand disease" }, { "code": "8A80.Z", "title": "Migraine, unspecified" } ]
=== 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 [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified Also known as: Other inherited coagulation factor deficiency with bleeding tendency, unspecified | Other inherited coagulation factor deficiency with bleeding tendency | Hereditary factor V deficiency | Proaccelerin deficiency | Owren disease [3B14.1] Hereditary factor X deficiency Definition: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms. Also known as: Hereditary factor X deficiency | Congenital Stuart factor deficiency | Stuart-Prower factor deficiency | Deficiency of factor X | congenital factor x deficiency [3B11.Z] Hereditary factor IX deficiency, unspecified Also known as: Hereditary factor IX deficiency, unspecified | Hereditary factor IX deficiency | factor 9 deficiency | factor IX deficiency | hereditary factor IX deficiency disease [PB6Z] Unspecified unintentional cause of morbidity or mortality Also known as: Unspecified unintentional cause of morbidity or mortality | Exposure to unspecified factor | Exposure to unspecified factor causing fracture | Exposure to unspecified factor causing other and unspecified injury | accidental cause NOS [3B10.Z] Hereditary factor VIII deficiency, unspecified Also known as: Hereditary factor VIII deficiency, unspecified | Hereditary factor VIII deficiency | Factor VIII deficiency NOS | functional factor VIII deficiency | Deficiency factor VIII with functional defect [3B10.0] Haemophilia A Definition: Haemophilia A is the most common form of haemophilia characterised by spontaneous or prolonged haemorrhages due to factor VIII deficiency. Depending on the extent of the factor VIII deficiency, it can be severe (biological activity of factor VIII below 1%), moderately severe (activity of factor VIII between 1% and 5%), or mild (activity of factor VIII between 5 and 40%). Also known as: Haemophilia A | AHG - [antihaemophilic globulin] deficiency | AHG - [antihaemophilic globulin] deficiency disease | congenital factor VIII disorder | sex-linked factor VIII deficiency Includes: Severe haemophilia A | Moderately severe haemophilia A | Mild haemophilia A Excludes: factor VIII deficiency with vascular defect [3B10.Y] Other specified hereditary factor VIII deficiency Also known as: Other specified hereditary factor VIII deficiency [3B12] Von Willebrand disease Definition: A disease caused by inherited genetic mutations. This disease is characterised by quantitative, structural or function abnormalities of von Willebrand factor leading to abnormalities in coagulation of the blood. This disease may present with prolonged bleeding, easy bruising or bleeding gums. Confirmation is by identification of mutation through genetic testing. Also known as: Von Willebrand disease | Factor VIII deficiency with vascular defect | Vascular haemophilia | Willebrand Jurgen thrombopathy | pseudohaemophilia Includes: Factor VIII deficiency with vascular defect | Vascular haemophilia | Angiohaemophilia Excludes: factor VIII deficiency with functional defect | factor VIII deficiency NOS | Acquired von Willebrand disease or syndrome [8A80.Z] Migraine, unspecified Also known as: Migraine, unspecified | Migraine === 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... --CHILD--> [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.... --- 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 --- [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified --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--> [3B14.0] 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.... --- Walk 4 --- [3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified --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--> [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --- Walk 5 --- [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --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 6 --- [3B14.1] Hereditary factor X deficiency Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms.... --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--> [3B14.0] 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....
[ "[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--> [3B14.0] 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....", "[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...", "[3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified\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--> [3B14.0] 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....", "[3B14.Z] Other inherited coagulation factor deficiency with bleeding tendency, unspecified\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--> [3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....", "[3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....\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...", "[3B14.1] Hereditary factor X deficiency\n Def: Congenital factor X deficiency is an inherited bleeding disorder with a decreased antigen and/or activity of factor X (FX) and characterised by mild to severe bleeding symptoms....\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--> [3B14.0] 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...." ]
3B14.0
Hereditary deficiency of factor I
[ { "from_icd11": "3B14.0", "icd10_code": "D682", "icd10_title": "Hereditary deficiency of other clotting factors" }, { "from_icd11": "3B11.Z", "icd10_code": "D67", "icd10_title": "Hereditary factor IX deficiency" }, { "from_icd11": "PB6Z", "icd10_code": "W312XXA", "icd10_title": "Contact with powered woodworking and forming machines, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W311XXA", "icd10_title": "Contact with metalworking machines, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3189XA", "icd10_title": "Contact with other specified machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W319XXS", "icd10_title": "Contact with unspecified machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W3182XA", "icd10_title": "Contact with other commercial machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3182XS", "icd10_title": "Contact with other commercial machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W3089XA", "icd10_title": "Contact with other specified agricultural machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W309XXS", "icd10_title": "Contact with unspecified agricultural machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W3089XS", "icd10_title": "Contact with other specified agricultural machinery, sequela" }, { "from_icd11": "PB6Z", "icd10_code": "W310XXA", "icd10_title": "Contact with mining and earth-drilling machinery, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3183XA", "icd10_title": "Contact with special construction vehicle in stationary use, initial encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W3183XD", "icd10_title": "Contact with special construction vehicle in stationary use, subsequent encounter" }, { "from_icd11": "PB6Z", "icd10_code": "W319XXA", "icd10_title": "Contact with unspecified machinery, initial encounter" } ]
D682
Hereditary deficiency of other clotting factors
This patient is a 35-year-old female with both her husband and herself Tibetans. She claimed no intermarriage and no medical history. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Pregnancy history showed G2P0 + 1 with spontaneous conception this time. She was diagnosed with hypothyroidism during the first trimester and was treated with 25 ยตg levothyroxine tablets which are taken orally every day. The color Doppler ultrasound examined in the first trimester showed no abnormalities, and patient claimed no history of exposure to toxic substances or radioactive substances. Non-Invasive Prenatal Testing (NIPT) results for the fetus indicated low risk. Furthermore, after several inquiries about medical history, the patient claimed no history of prior-conception diabetes. However, considering her overweight, she took an oral glucose tolerance test at 18 weeks of gestation and her fasting blood glucose was monitored to be normal with an 2-hour postprandial blood glucose exceeding 8.5 mmol/l which is less than 11.0 mmol/l. Therefore, the patient should be diagnosed as gestational diabetes mellitus rather than pregestational diabetes mellitus which at least requires one factor of the 2-hour postprandial blood glucose exceeding 11.0 mmol/l. At 24 weeks of pregnancy, she took a fetal 3D color Doppler ultrasound examination at a primary hospital and the results showed possible suspicions of omphalocele, rotarian placenta, single umbilical artery and fetal ventricular septal defect. Thus, she was referred to our hospital and received a targeted color Doppler ultrasound. There is no sign of bladder display , the insertion position of the abdominal wall of the umbilical cord is low, an isoechoic protrusion with a size of 1.82 cm ร— 1.58 cm is seen below the umbilical cord, the pubic symphysis is widened by about 2 cm, only two blood vessels are seen in the umbilical cord, the fetal heart ventricular septal defect is 2 mm and the depth of amniotic fluid is 8.2 cm. She then accepted amniocentesis for fetal chromosomal microarray analysis at 25 + 4 weeks of pregnancy, which showed no abnormal fetal karyotype. She was 28 weeks pregnant when she received this result. Then, she consulted with pediatric surgeons and physicians from pediatric cardiovascular department in our hospital respectively and both departments informed her to continue pregnancy and seek treatment immediately after the infantโ€™s birth. Afterwards, she failed to go through regular obstetric examinations and was admitted to the hospital for elective cesarean section at 38 + 3 weeks of pregnancy. The physiological gender of the fetus is male according to fetal chromosomal microarray analysis, yet the ultrasound examination cannot accurately display the exact external reproductive organs. Furthermore, the physiological gender of the fetus is highly related to the prognosis considering that maleโ€™s reproductive systemโ€™s reconstruction surgery would be much more complicated and costly than that of femaleโ€™s, which may place undue burdens upon patientโ€™s financial situations and future life quality. In addition, a detailed explanation was given to the patient and her spouse on the necessity of conducting an MRI examination. The patient fully understood and consented the MRI examination which contained a comprehensive evaluation of the fetus, especially the external genitalia . The results showed that the axial view of T2WI indicated bladder exstrophy, and there was no high signal of bladder in the abdominal cavity; sagittal view showed the high signal of low insertion of the umbilical cord; the external genitalia were unclear; both sagittal and axial T2WI showed discontinuous abdominal wall and local protruding mixed signal shadows; sagittal T1WI and T2WI showed normal positions of the rectum and conus medullaris; no obvious abnormalities in the shape and size of both kidneys; and no dilation of bilateral ureters. No abnormality was found in other tissues and organs. We arranged a multidisciplinary team (MDT) discussion for her including a genetic counselor, ultrasound physician, radiologist, pediatric urologist and obstetrician. It was clearly explained to her and her husband that the fetus was diagnosed with bladder exstrophy accompanied by abnormal external genitalia, and the physiological gender of the fetus is male. Further examinations were necessary after birth, and multiple surgical treatments were required. The surgery was complicated and difficult, and the prognosis was uncertain. Also, there may be risks of urinary tract obstruction and infection during childhood, uncontrollable urination, large scars on the abdominal wall and inability to urinate spontaneously which may affect future sexual activities and quality of life at high costs. The patient and her family eventually decided to induce fetal demise. This patient underwent amniocentesis and injection of ethacridine for induced labor. Two days later, a male dead infant was delivered . The macroscopic appearance of the infant showed an abdominal wall defect of about 2 ร— 3 cm below the insertion point of the umbilical cord. Posterior mucosa eversion, about 4 ร— 4 ร— 3 cm in size, discontinuous symphysis pubis with proximate space of 2 cm, extremely short penis, flat scrotum, testicles are palpated in it, and there are only two blood vessels in the umbilical cord. On the third day after delivery, the patient was discharged without any discomfort. The patient and their family expressed satisfaction with the treatment plan.
3.818359
0.984863
sec[1]/p[0]
en
0.999995
PMC10854176
https://doi.org/10.1186/s12884-024-06318-0
[ "which", "fetal", "umbilical", "fetus", "cord", "this", "pregnancy", "ultrasound", "blood", "abdominal" ]
[ { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "LD9Z", "title": "Developmental anomalies, unspecified" }, { "code": "KB20.Z", "title": "Intrauterine hypoxia, unspecified" }, { "code": "3A50.4", "title": "Hereditary persistence of fetal haemoglobin" }, { "code": "KB42", "title": "Persistent pulmonary hypertension of the newborn" }, { "code": "LD2Z", "title": "Multiple developmental anomalies or syndromes, unspecified" }, { "code": "LB03.Y", "title": "Other specified structural developmental anomalies of umbilical cord" } ]
=== ICD-11 CODES FOUND === [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [LD9Z] Developmental anomalies, unspecified Also known as: Developmental anomalies, unspecified | congenital malformations, deformations and chromosomal abnormalities | congenital malformation NOS | developmental abnormality NOS | fetal abnormality NOS [KB20.Z] Intrauterine hypoxia, unspecified Also known as: Intrauterine hypoxia, unspecified | Intrauterine hypoxia | fetal distress | fetal distress syndrome | intrauterine distress [3A50.4] Hereditary persistence of fetal haemoglobin Definition: Hereditary persistence of fetal haemoglobin (HPFH) associated with beta-thalassaemia is a haemoglobinopathy characterised by high haemoglobin (Hb)F levels and an increased number of fetal-Hb-containing cells. The association of HPFH with beta-thalassaemia mitigates the clinical manifestations which vary from a normal state to beta-thalassaemia intermedia. Also known as: Hereditary persistence of fetal haemoglobin | HPFH - [Hereditary persistence of fetal haemoglobin] | fetal haemoglobin | persistence of fetal haemoglobin | persistent haemoglobin F [KB42] Persistent pulmonary hypertension of the newborn Definition: Persistent pulmonary hypertension of the newborn is a cardiopulmonary disorder characterised by systemic arterial hypoxemia secondary to pulmonary hypertension and extrapulmonary right-to-left shunting across the foramen ovale and ductus arteriosus. Also known as: Persistent pulmonary hypertension of the newborn | persistent fetal circulation syndrome | fetal circulation | PFC - [persistent fetal circulation] syndrome | PPHN - [Persistent pulmonary hypertension of the newborn] [LD2Z] Multiple developmental anomalies or syndromes, unspecified Also known as: Multiple developmental anomalies or syndromes, unspecified | multiple congenital birth defects NOS | multiple congenital birth deformities NOS | multiple fetal abnormalities NOS | severe birth deformities NOS [LB03.Y] Other specified structural developmental anomalies of umbilical cord Also known as: Other specified structural developmental anomalies of umbilical cord | Umbilical cord calcifications | Omphalomesenteric duct remnants or cysts | Vitelline duct remnants and cysts | Persistent omphalomesenteric duct === GRAPH WALKS === --- Walk 1 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --CHILD--> [BD50.4Z] Abdominal aortic aneurysm, without mention of perforation or rupture --- Walk 2 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --PARENT--> [BD50] Aortic aneurysm or dissection Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ... --- Walk 3 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.1] Poikiloderma vasculare atrophicans Def: Poikiloderma vasculare atrophicans is a cutaneous reaction pattern characterised by mottled hyper- and hypomelanosis, telangiectasia and progressive dermal and epidermal atrophy. It may manifest as a ... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 4 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.1] Poikiloderma vasculare atrophicans Def: Poikiloderma vasculare atrophicans is a cutaneous reaction pattern characterised by mottled hyper- and hypomelanosis, telangiectasia and progressive dermal and epidermal atrophy. It may manifest as a ... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 5 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --EXCLUDES--> [?] Sudden infant death syndrome Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance... --- Walk 6 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --CHILD--> [MH12.Y] Other specified sudden death, cause unknown
[ "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --CHILD--> [BD50.4Z] Abdominal aortic aneurysm, without mention of perforation or rupture", "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --PARENT--> [BD50] Aortic aneurysm or dissection\n Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.1] Poikiloderma vasculare atrophicans\n Def: Poikiloderma vasculare atrophicans is a cutaneous reaction pattern characterised by mottled hyper- and hypomelanosis, telangiectasia and progressive dermal and epidermal atrophy. It may manifest as a ...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.1] Poikiloderma vasculare atrophicans\n Def: Poikiloderma vasculare atrophicans is a cutaneous reaction pattern characterised by mottled hyper- and hypomelanosis, telangiectasia and progressive dermal and epidermal atrophy. It may manifest as a ...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --EXCLUDES--> [?] Sudden infant death syndrome\n Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance...", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --CHILD--> [MH12.Y] Other specified sudden death, cause unknown" ]
BD50.41
Abdominal aortic aneurysm with rupture
[ { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" }, { "from_icd11": "EK91", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MH12.1", "icd10_code": "R961", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q898", "icd10_title": "Other specified congenital malformations" }, { "from_icd11": "LD9Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "LD9Z", "icd10_code": "Q89", "icd10_title": "Other congenital malformations, not elsewhere classified" }, { "from_icd11": "LD9Z", "icd10_code": "XVII", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q10-Q18", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q38-Q45", "icd10_title": "" }, { "from_icd11": "LD9Z", "icd10_code": "Q80-Q89", "icd10_title": "" }, { "from_icd11": "KB20.Z", "icd10_code": "P20", "icd10_title": "" }, { "from_icd11": "KB20.Z", "icd10_code": "P209", "icd10_title": "" }, { "from_icd11": "3A50.4", "icd10_code": "D564", "icd10_title": "Hereditary persistence of fetal hemoglobin [HPFH]" }, { "from_icd11": "KB42", "icd10_code": "P293", "icd10_title": "Persistent fetal circulation" }, { "from_icd11": "LD2Z", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" } ]
I713
Abdominal aortic aneurysm, ruptured
A 38-year-old pregnant woman, at 15 weeks of gestation, was referred to the High-Risk Pregnancy Clinic, Mother and Child Department, University Hospital Federico II, in Naples, Italy. She was in her sixth pregnancy, reporting two previous stillbirths and three previous pregnancies, all complicated by fetal growth restriction. Of note, the last miscarriage occurred along with pleuropericarditis. Since then, she remained asymptomatic and had no limitations to exercise tolerance. She did not report any chronic disease and her personal and family history were negative for thromboembolic events. According to local protocols, a cardiologic examination was requested. Cardiac and lung examinations, as well as the electrocardiogram, showed no significant findings. The patient was apyretic, cuff-blood pressure was 110/60 mmHg, heart rate was 80 beats per minute, and oxygen saturation was 97% in room air. Transthoracic echocardiography revealed a large mobile mass with irregular borders, attached to the sub-valvular apparatus of the tricuspid anterior leaflet, presenting heterogeneous echogenicity and associated with mild valve regurgitation . Its dimensions, measured by multiplanar 3D echocardiography were 2 cm ร— 1.5 cm. Considering her clinical history, three main differential diagnoses were examined for the intramyocardial mass: a tumor such as papillary fibroelastoma or myxoma, infectious endocarditis, nonbacterial thrombotic endocarditis (NTBE), and thrombus. Urgent cardiac magnetic resonance (CMR) with gadolinium contrast examination was then required. Cardiovascular magnetic resonance (CMR) was performed using a 1.5 Tesla whole-body scanner (Philips Achieva; Phillips Healthcare, The Netherlands). Left and right ventricular volumes and function were within normal ranges. Cine SSFP images confirmed the presence of a large, highly mobile mass with irregular borders in the right ventricle in-flow, probably attached to the tricuspid valve chordae . This mass appeared to have a low signal intensity, compared to the myocardium, in both STIR T2-weighted and FSE T1-weighted images ; however, due to the irregular shape, a contrast agent was administrated to exclude malignancy, and the mass showed no contrast uptake . Therefore, CMR findings were in keeping with a diagnosis of a large right-ventricular thrombus. The patient was admitted to the Cardiac Intensive Care Unit of University Hospital Federico II, and since the diagnosis of intracardiac thrombus was consistent, anti-coagulant therapy with low-molecular-weight heparin (LMWH) and acetylsalicylic acid 100 mg, one tablet a day, was started. Although MRI specificity for suspected thrombus is reported to be as high as 99โ€“100% , blood culture was carried out to exclude infectious endocarditis. Laboratory tests yielded the following: normal complete blood count, normal electrolytes, and normal creatinine. Partial thromboplastin time was prolonged at 63.6 s and C reactive protein was high at 26.10 mg/L (normal range: 0โ€“5.0 mg/l). Taking into account the occurrence of intracardiac thrombus, the patientโ€™s previous history of pleuropericarditis, pregnancy morbidity, and altered laboratory values, a thrombophilic screening was required to rule out antiphospholipid syndrome (APS). Anticardiolipin antibody IgG and anti-b2 glycoprotein-1 IgG tested positive and they were respectively 63 U/mL (cut off value < 20 U/mL) and 200 U/mL (cut off value < 20 U/mL), while lupus anticoagulant was negative, thus the patient received a diagnosis of primary antiphospholipid syndrome, pending confirmation of the laboratory results at 12 weeks. Despite adequate anticoagulant therapy for three weeks, guided by the anti-factor Xa assays for dose adjustment, transthoracic three-dimensional echocardiography showed the persistence of the vegetation attached to the tricuspid valve, without changes in its size. Therefore, a cardiac surgery consultancy was requested. Considering the high risk of thrombo-embolic and mass detachment , with subsequent massive pulmonary embolism, an early, lifesaving surgical thrombectomy was recommended. After multidisciplinary counseling with obstetricians, cardiologists, anesthesiologists, and cardiac surgeons, the patient decided to refuse the termination of pregnancy and undergo cardiac surgery while pregnant. The thrombolytic approach was discarded because of the potential inefficacy of this treatment, as reported in a clinical case series concerning giant right atrial thrombi . The surgical procedure regarding right intracardiac thrombus removal has been previously described in detail . After the surgery, a transabdominal ultrasound evaluation confirmed the presence of a viable fetus with a normal heart rate and a normally inserted placenta. The mass was sent for histological examination and was first addressed as a thrombus. Due to the peculiarity of the patientโ€™s history and the unusual location and size of the mass, we asked the pathologists to review the histological slides providing a second opinion; after this second revision, the presence of nonbacterial thrombotic endocarditis (i.e., Libmanโ€“Sacks endocarditis) was stated . After two days in the ICU and 7 days in the cardiology department, the patient was discharged with the following home therapy: acetylsalicylic acid 100 mg/die, enoxaparin 6000 UI/die, and hydroxychloroquine sulfate (200 mg every 12 h). Transthoracic echocardiograms performed monthly after discharge revealed preserved bi-ventricular function with complete competence of the tricuspid valve and the absence of additional masses.
4.066406
0.973633
sec[1]/p[0]
en
0.999996
36233742
https://doi.org/10.3390/jcm11195875
[ "thrombus", "cardiac", "endocarditis", "pregnancy", "three", "tricuspid", "valve", "blood", "transthoracic", "echocardiography" ]
[ { "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" }, { "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": "BC43.3", "title": "Endocardial fibroelastosis" } ]
=== ICD-11 CODES FOUND === [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 [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 [BC43.3] Endocardial fibroelastosis Definition: Endocardial fibroelastosis is the formation of a marked fibro-elastic thickening of the subendocardium in one or both cardiac ventricles. A disorder of fetuses and infants, secondary causes include congenital left-sided obstructive cardiac lesions, metabolic disorders, autoimmune disease (anti-Ro/anti-La antibodies), and transplacental viral infection such as mumps. Primary endocardial fibroelastosis has been linked to recessive and x-linked inheritance, such as with Barth syndrome. Also known as: Endocardial fibroelastosis | elastomyofibrosis | endomyocardial fibroelastosis | EFE - [endocardial fibroelastosis] | primary endocardial fibroelastosis === GRAPH WALKS === --- Walk 1 --- [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 2 --- [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... --- Walk 3 --- [PL12.3] Obstruction of device, as mode of injury or harm Def: Obstruction associated with prosthetic devices, grafts or implants... --PARENT--> [PL12] Mode of injury or harm associated with a surgical or other medical device, implant or graft --CHILD--> [PL12.0] Structural device failure, as mode of injury or harm Def: Harm arising due to mechanical or material device failure not related to the installation of the device.... --- Walk 4 --- [PL12.3] Obstruction of device, as mode of injury or harm Def: Obstruction associated with prosthetic devices, grafts or implants... --EXCLUDES--> [?] Obstruction of device without injury or harm Def: A device that has become obstructed or blocked but without any documented injury or harm.... --PARENT--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm --- Walk 5 --- [BD5Y] Other specified diseases of arteries or arterioles --PARENT--> [?] Diseases of arteries or arterioles --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --- Walk 6 --- [BD5Y] Other specified diseases of arteries or arterioles --PARENT--> [?] Diseases of arteries or arterioles --EXCLUDES--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart....
[ "[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...", "[PL12.3] Obstruction of device, as mode of injury or harm\n Def: Obstruction associated with prosthetic devices, grafts or implants...\n --PARENT--> [PL12] Mode of injury or harm associated with a surgical or other medical device, implant or graft\n --CHILD--> [PL12.0] Structural device failure, as mode of injury or harm\n Def: Harm arising due to mechanical or material device failure not related to the installation of the device....", "[PL12.3] Obstruction of device, as mode of injury or harm\n Def: Obstruction associated with prosthetic devices, grafts or implants...\n --EXCLUDES--> [?] Obstruction of device without injury or harm\n Def: A device that has become obstructed or blocked but without any documented injury or harm....\n --PARENT--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm", "[BD5Y] Other specified diseases of arteries or arterioles\n --PARENT--> [?] Diseases of arteries or arterioles\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...", "[BD5Y] Other specified diseases of arteries or arterioles\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart...." ]
BA41.Z
Acute myocardial infarction, unspecified
[ { "from_icd11": "BA41.Z", "icd10_code": "I21A1", "icd10_title": "Myocardial infarction type 2" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A9", "icd10_title": "Other myocardial infarction type" }, { "from_icd11": "BA41.Z", "icd10_code": "I2109", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2119", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2111", "icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2102", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2129", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I2121", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2101", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I214", "icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I213", "icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site" }, { "from_icd11": "BA41.Z", "icd10_code": "I219", "icd10_title": "Acute myocardial infarction, unspecified" }, { "from_icd11": "BA41.Z", "icd10_code": "I21", "icd10_title": "Acute myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I212", "icd10_title": "ST elevation (STEMI) myocardial infarction of other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I210", "icd10_title": "ST elevation (STEMI) myocardial infarction of anterior wall" } ]
I21A1
Myocardial infarction type 2
A 78-year-old man with a medical history of hypertension, hypercholesterolemia, aneurysm of the ascending aorta, and chronic inflammatory pleurisy presented headaches and visual disturbances (left homonymous hemianopia). Brain magnetic resonance imaging (MRI) revealed an occipital extra-axial lesion with surrounding edema . Three weeks later, the patient underwent a total resection, which revealed a malignant meningioma with Ki-67 proliferative index of 40% . Next-generation sequencing (NGS) detected no specific mutation. Immunohistochemical analysis found high expression of pankeratin AE1/AE3, vimentin, INI-1 (clone MRQ-27), and focal expression of epithelial membrane antigen. P53, cytokeratin 7, and cytokeratin 20 were negative. All melanocytic makers (HBM45, SOX10, Melan A) were negative. Moreover, there was no expression of STAT-6 , bcl-2 , and a nonspecific granular cytoplasmic staining of CD99 . Postoperative brain MRI showed hemorrhagic remodeling without any evidence of a residual tumor . According to the actual data of the literature, postoperative surgical bed irradiation with total dose of 68 Gy (34 daily fractions of 2 Gy) was performed. At the end of RT, the patient was in a good health condition without neurologic symptoms. One week after the end of RT, he underwent a total resection of a right shoulder cutaneous lesion. Histopathological analysis revealed a superficial spreading melanoma. Four months after the end of RT, the patient presented dizziness and left arm weakness. A brain MRI revealed a local recurrence and six new brain lesions . In order to distinguish melanoma brain metastases between meningioma brain metastases, the occipital lesion was biopsied. Pathological analysis confirmed WHO grade III meningioma with Ki-67 proliferative index (MIB-1) of 80%. Immunohistochemical analysis revealed a focal expression of progesterone receptor without any expression of melanocytic markers (SOX10, HMB45, Melan A). Thus, a hypothesis of melanoma brain metastases was excluded. Positron emission tomography with radiolabeled [18F]-fluoro-2-deoxy-D-glucose coupled to a CT-scan ( 18 FDG PET/CT) showed six hypermetabolic cerebral and cerebellar lesions , a focal intense uptake lesion of the fundus , and a sigmoidal nodule. The results of the brain MRI, 18 FDG PET/CT, and the pathological examination of the brain lesion suggested that the patients developed several distant brain metastases of a malignant meningioma. No specific treatment was initiated. Five weeks after the cerebral biopsy, the patient presented a digestive hemorrhage. Gastroscopy showed many duodenal micro-ulcerations; no biopsy was made. He had a second digestive hemorrhage 5 days later, which required hemostatic surgery. Pathological examination of a gastro-intestinal tract specimen revealed a malignant lesion, which had the same morphological and immunohistochemical features of the right occipital lesion . Again, there was also no specific mutation on NGS. Radiation therapy of the whole brain was performed (30 Gy in 10 fractions of 3 Gy). One month after the end of RT, despite the lack of guidelines, a systemic treatment with bevacizumab (10 mg/kg intravenous every 2 weeks) was administrated. Only one injection was made. The patient died suddenly on the 15th of June. The main hypothesis of the cause of death was a cardiac arrest secondary to a pulmonary embolism. An autopsy was not proposed to the family to understand the cause of death that is why the post-mortem examination was not performed to determine the real cause of death. Fig. 1 MRI-enhanced axial and coronal T1-weighted imagings. a An extra-axial lesion in the right occipital lobe with a mass effect of the posterior horn of the right ventricle. b Gross total resection of the right occipital meningioma. c Distant brain metastases of malignant meningioma Fig. 2 Histological features of intracranial and intestinal samples. a Resection of the right occipital lesion: pseudosarcomateous proliferation of atypical fusiform cells with focal progesterone receptors and EMA (not shown) expression consistent with a malignant meningioma, WHO grade III. b Resection of one of the new occipital lesion showing the same proliferation with focal expression of progesterone receptors. Melanomaโ€™s markers, such as SOX10 or HMB45 and Melan A (not shown) were not expressed. c Intestinal resection showing a morphologically similar proliferation involving the mucosa and the sub-mucosa. Immunohistochemical phenotype was similar too with focal expression of progesterone receptors and negativity of melanocytic markers (SOX10, HMB45, and Melan A). Fig. 3 Histological features of intracranial and intestinal samples. a Resection of the right occipital lesion: pseudosarcomateous proliferation of atypical fusiform cells with focal progesterone receptors and EMA (not shown) expression consistent with a malignant meningioma, WHO grade III. b Resection of one of the new occipital lesion showing the same proliferation with focal expression of progesterone receptors. Melanomaโ€™s markers, such as SOX10 or HMB45 and Melan A (not shown), were not expressed. c Intestinal resection showing a morphologically similar proliferation involving the mucosa and the sub-mucosa. Immunohistochemical phenotype was similar too with focal expression of progesterone receptors and negativity of melanocytic markers (SOX10, HMB45, and Melan A) Fig. 4 18 FDG TEP TDM. a , b , c , d Hypermetabolic cerebral and cerebellar lesions related to secondary lesion of malignant meningioma. e , f Hypermetabolic lesion at the fundus
4.078125
0.973633
sec[1]/p[0]
en
0.999996
30992070
https://doi.org/10.1186/s12957-019-1596-6
[ "lesion", "brain", "expression", "occipital", "resection", "meningioma", "malignant", "progesterone", "melan", "proliferation" ]
[ { "code": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "8E7Y", "title": "Other specified diseases of the nervous system" }, { "code": "LA05.Z", "title": "Cerebral structural developmental anomalies, unspecified" }, { "code": "1D00.Z", "title": "Infectious encephalitis, unspecified" }, { "code": "LA00.0Z", "title": "Anencephaly, unspecified" }, { "code": "NA07.3Y", "title": "Other specified diffuse brain injury" } ]
=== ICD-11 CODES FOUND === [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [8E7Y] Other specified diseases of the nervous system Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis [LA05.Z] Cerebral structural developmental anomalies, unspecified Also known as: Cerebral structural developmental anomalies, unspecified | Cerebral structural developmental anomalies | Malformations of brain | brain abnormality NOS | brain deformity NOS [1D00.Z] Infectious encephalitis, unspecified Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation [LA00.0Z] Anencephaly, unspecified Also known as: Anencephaly, unspecified | Anencephaly | anencephalic monster | anencephalus | brain absence [NA07.3Y] Other specified diffuse brain injury Also known as: Other specified diffuse brain injury | Brain contusion | Cerebral contusion NOS | Diffuse cortex contusion | diffuse cortical contusion === GRAPH WALKS === --- Walk 1 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Infection related arthropathies Def: A disease of the joints, caused by an infection with a bacterial, viral, fungal, or parasitic source. Distinction is made between the following types of etiological relationship. a) direct infection ... --- Walk 2 --- [FA5Z] Arthropathies, unspecified --PARENT--> [?] Arthropathies --CHILD--> [?] Inflammatory arthropathies --- Walk 3 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Monogenic autoinflammatory syndromes Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies.... --- Walk 4 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --CHILD--> [?] Arthropathies --- Walk 5 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --PARENT--> [?] Symptoms or signs involving the skin Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis.... --- Walk 6 --- [ME60.Z] Skin lesion of unspecified nature --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not... --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....
[ "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Infection related arthropathies\n Def: A disease of the joints, caused by an infection with a bacterial, viral, fungal, or parasitic source.\n\nDistinction is made between the following types of etiological relationship.\na) direct infection ...", "[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Inflammatory arthropathies", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Monogenic autoinflammatory syndromes\n Def: Monogenic hereditary autoinflammatory diseases characterised by apparently unprovoked generalised inflammation in the absence of infection or high titre autoantibodies....", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --CHILD--> [?] Arthropathies", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....", "[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --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...." ]
FA5Z
Arthropathies, unspecified
[ { "from_icd11": "FA5Z", "icd10_code": "M00-M25", "icd10_title": "" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "ME60.Z", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "LA05.Z", "icd10_code": "Q048", "icd10_title": "Other specified congenital malformations of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q043", "icd10_title": "Other reduction deformities of brain" }, { "from_icd11": "LA05.Z", "icd10_code": "Q049", "icd10_title": "Congenital malformation of brain, unspecified" }, { "from_icd11": "LA05.Z", "icd10_code": "Q04", "icd10_title": "Other congenital malformations of brain" }, { "from_icd11": "1D00.Z", "icd10_code": "G0490", "icd10_title": "Encephalitis and encephalomyelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0491", "icd10_title": "Myelitis, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0430", "icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified" }, { "from_icd11": "1D00.Z", "icd10_code": "G0431", "icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0439", "icd10_title": "Other acute necrotizing hemorrhagic encephalopathy" }, { "from_icd11": "1D00.Z", "icd10_code": "G0481", "icd10_title": "Other encephalitis and encephalomyelitis" } ]
M00-M25
The clinical history of our patient is summarized in Figure 1 . He first came to our observation at the age of 57 yr for a large non-functioning intra/suprasellar mass (maximal diameter 37 mm), revealed by bitemporal hemianopsia, and invasive into the left cavernous sinus; basal pituitary function was normal, including normal prolactinemia. He underwent transsphenoidal (TS) surgery in November 2012 (Neuromed, IRCCS, Pozzilli, Italy). A diagnosis of โ€œnull cellโ€ PitNET was made based on negative immunostaining for all pituitary hormones, with no mitosis but a focally high Ki67 (10%) and a low p53 expression (5%). In June 2013, the surgical resection was completed transcranially, with similar pathological findings. Visual defects normalized and a small remnant was left in the left cavernous sinus (<10 mm). One year later, he received stereotactic radiotherapy (STR, 50.4 Gy) on the left cavernous due to initial regrowth (adjacent intrasellar and intra-cavernous nodules, 13 and 14 mm respectively), with a good response and shrinkage to a unique, small paracavernous lesion (11 mm) in 2015. However, infrasellar regrowth occurred in 2017, first presenting as nasal pseudopolyps, and leading to TS re-operation in March 2018. The pathological diagnosis was consistent with the aggressive clinical behavior (1 mitosis/10 HPF, Ki67 20%, p53 10%) and two small pre-pontine nodules revealed metastatic progression. Further immunohistochemical characterization of the tumor indicated a Pit1 lineage since first surgery. The patient started TMZ with a standard schedule for 5 cycles, together with complementary STR on the primary site and pre-pontine nodules, with an initial response. Then, additional, small, and asymptomatic brain metastases were detected at MRI, and TMZ was shifted to a metronomic schedule. In July 2020, a spinal lesion was also detected (C7-D1). In addition, the primary tumor was rapidly regrowing in the sella (maximal diameter 24 mm) and extended laterally and again inferiorly to the sphenoid sinus and nasal cavities, causing nasal obstruction, and anteriorly to the right retrobulbar optic area, causing homolateral visual loss. For such reasons, complementary STR was given to the frontal and temporal areas, emerging brain metastasis, and the C7-D1 spinal lesion, during metronomic TMZ treatment . Metabolic re-evaluation by 18FDG PET-CT confirmed disease progression with a sellar/suprasellar, nasal, and spinal uptake, whereas the small, irradiated brain metastases were negative and showed necrotic changes at MRI. Searching for alternative therapeutic options, a high expression of PDL1 was found by immunohistochemistry (95%) suggesting immunotherapy targeting the PD1/PDL1 pathway. The pathological and molecular characterization of the tumor at last surgery is shown in Figure 2 (see legend for details). In the meantime, further asymptomatic spinal dissemination was noticed and nasal obstruction worsened, causing progressive respiratory distress. TMZ was therefore withdrawn and in March 2021 the patient started Pembro as an off-label treatment, according to a standard schedule (200 mg i.v every 21 days), upon approval by the Ethic Committee of Sapienza University of Rome (NETs unit). The patient reported an improvement in nasal obstruction, breathing, and vision since the 2nd cycle of treatment. Nasal and respiratory symptoms had resolved, and visual autonomy had recovered, when, after 4 cycles of treatment, significant tumor shrinkage was confirmed by MRI (>20% of the sellar/parasellar mass, 50% of the pre-pontine and spinal metastases), accompanied by a reduction in SUV max (8.5 vs. 16.5) of the primary tumor and main spinal metastasis (1.7 vs. 6.8) at 18FDG PET-CT. Further evaluation was obtained after four additional cycles of Pembro, showing a remarkable radiological and metabolic response, with: (i) a further shrinkage of the primary tumor (>70%); (ii) the disappearance of most brain and spinal metastases, with a necrotic aspect of small residual lesions, and the absence of new metastatic sites; (iii) a further decrease in SUV values of the primary tumor and the major spinal lesion (to 2.9 and 0, respectively). The radiological and metabolic response to treatment is illustrated in Figure 3 and Figure 4 . Moderate cutaneous and renal toxicities (G1โ€“G2) occurred, including a maculo-papular skin rash since the first cycles, a transient mild hypereosinophilia, and an acute increase in creatinine up to 2.4 mg/dL with fatigue and increased blood pressure at cycle 8, suggesting auto-immune nephritis. These were successfully managed by low-dose systemic steroid therapy, except for the acute nephritis which required transient drug withdrawal at cycle 9 with a normalization of renal function. Pembro was therefore re-introduced and is still in use as a maintenance therapy, with a clinical and neuroradiological stabilization of the disease confirmed at last follow-up . Albeit remarkable and nearly complete, the response was classified as partial due to the persistence of minimal metabolic activity and imaging of uncertain significance at the primary site. From an endocrinological point of view, the patient developed progressive hypopituitarism since 2013 and was already on replacement therapy (cortisone acetate, L-thyroxine, and transdermal testosterone) when immunotherapy was started. The treatment was then maintained with transient increases in adrenal replacement therapy as required and a modest increase in L-thyroxine due to worsening central hypothyroidism in the absence of anti-thyroid antibodies.
4.082031
0.973145
sec[1]/p[0]
en
0.999997
PMC9454884
https://doi.org/10.3390/cancers14174093
[ "spinal", "nasal", "tumor", "small", "response", "cavernous", "lesion", "since", "cycles", "brain" ]
[ { "code": "FB1Z", "title": "Conditions associated with the spine, unspecified" }, { "code": "FA7Z", "title": "Structural disorders of spine, unspecified" }, { "code": "FA9Z", "title": "Inflammation of spine, unspecified" }, { "code": "LB73.2Z", "title": "Structural developmental anomalies of spine, unspecified" }, { "code": "FA82", "title": "Spinal stenosis" }, { "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 === [FB1Z] Conditions associated with the spine, unspecified Also known as: Conditions associated with the spine, unspecified | dorsopathies | disorder of spine | spinal disorder [FA7Z] Structural disorders of spine, unspecified Also known as: Structural disorders of spine, unspecified | spinal disease [FA9Z] Inflammation of spine, unspecified Also known as: Inflammation of spine, unspecified | spinal inflammation | discitis, unspecified [LB73.2Z] Structural developmental anomalies of spine, unspecified Also known as: Structural developmental anomalies of spine, unspecified | Structural developmental anomalies of spine | Malformations of spine | maldevelopment of spine [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 [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 --- [FB1Z] Conditions associated with the spine, unspecified --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.... --RELATED_TO--> [?] Spinal pain Def: This is a condition characterised by pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.... --- Walk 2 --- [FB1Z] Conditions associated with the spine, unspecified --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.... --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --- Walk 3 --- [FA7Z] Structural disorders of spine, unspecified --PARENT--> [?] Structural disorders of spine --CHILD--> [FA70] Spinal deformities --- Walk 4 --- [FA7Z] Structural disorders of spine, unspecified --PARENT--> [?] Structural disorders of 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.... --- Walk 5 --- [FA9Z] Inflammation of spine, unspecified --PARENT--> [?] Inflammation of spine --CHILD--> [FA91] Infection of intervertebral disc Def: A condition of the intervertebral discs, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, stiffness of the ne... --- Walk 6 --- [FA9Z] Inflammation of spine, unspecified --PARENT--> [?] Inflammation of spine --CHILD--> [FA90] 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...
[ "[FB1Z] Conditions associated with the spine, unspecified\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 --RELATED_TO--> [?] Spinal pain\n Def: This is a condition characterised by pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine....", "[FB1Z] Conditions associated with the spine, unspecified\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 --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....", "[FA7Z] Structural disorders of spine, unspecified\n --PARENT--> [?] Structural disorders of spine\n --CHILD--> [FA70] Spinal deformities", "[FA7Z] Structural disorders of spine, unspecified\n --PARENT--> [?] Structural disorders of 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....", "[FA9Z] Inflammation of spine, unspecified\n --PARENT--> [?] Inflammation of spine\n --CHILD--> [FA91] Infection of intervertebral disc\n Def: A condition of the intervertebral discs, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, stiffness of the ne...", "[FA9Z] Inflammation of spine, unspecified\n --PARENT--> [?] Inflammation of spine\n --CHILD--> [FA90] 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..." ]
FB1Z
Conditions associated with the spine, unspecified
[ { "from_icd11": "FB1Z", "icd10_code": "M435X2", "icd10_title": "Other recurrent vertebral dislocation, cervical region" }, { "from_icd11": "FB1Z", "icd10_code": "M438X4", "icd10_title": "Other specified deforming dorsopathies, thoracic region" }, { "from_icd11": "FB1Z", "icd10_code": "M4324", "icd10_title": "Fusion of spine, thoracic region" }, { "from_icd11": "FB1Z", "icd10_code": "M4325", "icd10_title": "Fusion of spine, thoracolumbar region" }, { "from_icd11": "FB1Z", "icd10_code": "M438X6", "icd10_title": "Other specified deforming dorsopathies, lumbar region" }, { "from_icd11": "FB1Z", "icd10_code": "M4320", "icd10_title": "Fusion of spine, site unspecified" }, { "from_icd11": "FB1Z", "icd10_code": "M438X7", "icd10_title": "Other specified deforming dorsopathies, lumbosacral region" }, { "from_icd11": "FB1Z", "icd10_code": "M438X5", "icd10_title": "Other specified deforming dorsopathies, thoracolumbar region" }, { "from_icd11": "FB1Z", "icd10_code": "M4326", "icd10_title": "Fusion of spine, lumbar region" }, { "from_icd11": "FB1Z", "icd10_code": "M438X2", "icd10_title": "Other specified deforming dorsopathies, cervical region" }, { "from_icd11": "FB1Z", "icd10_code": "M4327", "icd10_title": "Fusion of spine, lumbosacral region" }, { "from_icd11": "FB1Z", "icd10_code": "M4322", "icd10_title": "Fusion of spine, cervical region" }, { "from_icd11": "FB1Z", "icd10_code": "M4321", "icd10_title": "Fusion of spine, occipito-atlanto-axial region" }, { "from_icd11": "FB1Z", "icd10_code": "M438X9", "icd10_title": "Other specified deforming dorsopathies, site unspecified" }, { "from_icd11": "FB1Z", "icd10_code": "M4328", "icd10_title": "Fusion of spine, sacral and sacrococcygeal region" } ]
M435X2
Other recurrent vertebral dislocation, cervical region
The hematology report of the patient, dated June 22, 2020, gave the following information: Complete blood count (white blood cell count 6.54 ร— \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$10^3$$\end{document} 10 3 /ฮผl; neutrophil percent \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$68.5\%$$\end{document} 68.5 % ; lymphocyte percent \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$20.8\%$$\end{document} 20.8 % ; monocyte percent* \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$9.1\%$$\end{document} 9.1 % ; eosinophil percent* \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.8\%$$\end{document} 0.8 % ; basophil percent \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.2\%$$\end{document} 0.2 % ; neutrophil number 4.48 ร— \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$10^3$$\end{document} 10 3 /ฮผl; lymphocyte number 1.36 ร— \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$10^3$$\end{document} 10 3 /ฮผl; monocyte number 0.6 ร— \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$10^3$$\end{document} 10 3 /ฮผl; red blood cell count 5.34 ร— \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$10^3$$\end{document} 10 3 /ฮผl; hemoglobin concentration* 11.4g/dl; hematocrit* \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$34.6\%$$\end{document} 34.6 % ; mean corpuscular volume* 64.8fL; mean corpuscular hemoglobin* 21.3pg; mean corpuscular hemoglobin concentration 32.9g/dl; red cell distribution width* \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$17.9\%$$\end{document} 17.9 % ; platelet count* 50x \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$10^3$$\end{document} 10 3 /ฮผl; mean platelet volume 10.3fl; procalcitonin* \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.051\%$$\end{document} 0.051 % ; platelet distribution width* \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$14\%$$\end{document} 14 % โ€”Remarks: hypochromia, microcytosis). Erythrocyte sedimentation rate* 22 mm first hour. The biochemistry report dated June 22, 2020, gave the following information: Glycosylated hemoglobin (HbA1c)* (high-performance liquid chromatography on D10 analyzer) \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$9.2\%$$\end{document} 9.2 % โ€” Remarks: Average blood glucose concentration is around 210โ€“220 mg/dl. Renal profile (blood urine nitrogenโ€”kinetic ultraviolet test* 30.4 mg/dl; creatinineโ€”kinetic color test* 1.83 mg/dl; uric acidโ€”enzyme color test* 10.68 mg/dl; sodium* 132 mEq/l; potassium* 5.31mEq/l; calciumโ€”color test 9.4 mg/dl; inorganic phosphorusโ€”UV test 3.0 mg/dlโ€”Remarks: deranged kidney function, electrolyte imbalance). The ultrasound (whole abdomen) report, dated June 23, 2020, mentioned: Grade II hepatic steatosis, hepatosplenomegaly, umbilical hernia.
3.837891
0.662109
sec[2]/sec[0]/sec[6]/p[1]
en
0.999996
33627186
https://doi.org/10.1186/s13256-020-02624-1
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[ { "code": "PL14.7", "title": "Problem associated with clinical documentation" }, { "code": "QA87", "title": "Problem with clinical documentation without injury or harm" }, { "code": "QA50", "title": "Embolisation without injury or harm" }, { "code": "QA89", "title": "Incorrect diagnosis without injury or harm" }, { "code": "QA63", "title": "Obstruction of device without injury or harm" } ]
=== ICD-11 CODES FOUND === [PL14.7] Problem associated with clinical documentation Definition: Clinical documentation error or omission led to injury of patient Also known as: Problem associated with clinical documentation [QA87] Problem with clinical documentation without injury or harm Definition: Documentation on wrong patient; incomplete documentation; incorrect documentation identified as inconsistent with other source, but without documented injury or harm to the patient. Also known as: Problem with clinical documentation without injury or harm | documentation on wrong patient without documented injury or harm | incomplete documentation without documented injury or harm | incorrect documentation identified as inconsistent with other source without documented injury or harm Excludes: Problem associated with clinical documentation [QA50] Embolisation without injury or harm Definition: An embolisation without documented injury or harm occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there. Also known as: Embolisation without injury or harm | Embolic phenomenon without documented injury or harm | Air embolism without documented injury or harm | Injection of air without injury or harm Excludes: Embolisation, as mode of injury or harm [QA89] Incorrect diagnosis without injury or harm Definition: Diagnosis changed after further study and as a result, treatment was incorrect; misdiagnosis; conflicting diagnoses Also known as: Incorrect diagnosis without injury or harm | conflicting diagnoses without documented injury or harm | misdiagnosis without documented injury or harm Excludes: Incorrect diagnosis [QA63] Obstruction of device without injury or harm Definition: A device that has become obstructed or blocked but without any documented injury or harm. Also known as: Obstruction of device without injury or harm | Blockage of device without documented injury or harm | Blocked tube causing obstruction without documented injury or harm | Occlusion of device without documented injury or harm | Thrombosis of device without documented injury or harm Excludes: Obstruction of device, as mode of injury or harm === GRAPH WALKS === --- Walk 1 --- [PL14.7] Problem associated with clinical documentation Def: Clinical documentation error or omission led to injury of patient... --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft --- Walk 2 --- [PL14.7] Problem associated with clinical documentation Def: Clinical documentation error or omission led to injury of patient... --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes --CHILD--> [PL14.1] Non provision of necessary procedure --- Walk 3 --- [QA87] Problem with clinical documentation without injury or harm Def: Documentation on wrong patient; incomplete documentation; incorrect documentation identified as inconsistent with other source, but without documented injury or harm to the patient.... --PARENT--> [?] Circumstances associated with other aspects of care influencing the episode of care without injury or harm --CHILD--> [QA81] Non-provision of necessary procedure without injury or harm Def: Medically ordered procedure not performed in the episode of care (interrupted, cancelled).... --- Walk 4 --- [QA87] Problem with clinical documentation without injury or harm Def: Documentation on wrong patient; incomplete documentation; incorrect documentation identified as inconsistent with other source, but without documented injury or harm to the patient.... --EXCLUDES--> [?] Problem associated with clinical documentation Def: Clinical documentation error or omission led to injury of patient... --PARENT--> [?] Mode of injury or harm associated with other health care related causes --- Walk 5 --- [QA50] 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.... --EXCLUDES--> [?] Embolisation, as mode of injury or harm Def: An embolisation occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there.... --EXCLUDES--> [?] 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 6 --- [QA50] 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.... --PARENT--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm --CHILD--> [QA50] 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....
[ "[PL14.7] Problem associated with clinical documentation\n Def: Clinical documentation error or omission led to injury of patient...\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft", "[PL14.7] Problem associated with clinical documentation\n Def: Clinical documentation error or omission led to injury of patient...\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --CHILD--> [PL14.1] Non provision of necessary procedure", "[QA87] Problem with clinical documentation without injury or harm\n Def: Documentation on wrong patient; incomplete documentation; incorrect documentation identified as inconsistent with other source, but without documented injury or harm to the patient....\n --PARENT--> [?] Circumstances associated with other aspects of care influencing the episode of care without injury or harm\n --CHILD--> [QA81] Non-provision of necessary procedure without injury or harm\n Def: Medically ordered procedure not performed in the episode of care (interrupted, cancelled)....", "[QA87] Problem with clinical documentation without injury or harm\n Def: Documentation on wrong patient; incomplete documentation; incorrect documentation identified as inconsistent with other source, but without documented injury or harm to the patient....\n --EXCLUDES--> [?] Problem associated with clinical documentation\n Def: Clinical documentation error or omission led to injury of patient...\n --PARENT--> [?] Mode of injury or harm associated with other health care related causes", "[QA50] 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....\n --EXCLUDES--> [?] Embolisation, as mode of injury or harm\n Def: An embolisation occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there....\n --EXCLUDES--> [?] 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....", "[QA50] 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....\n --PARENT--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm\n --CHILD--> [QA50] 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...." ]
PL14.7
Problem associated with clinical documentation
[ { "from_icd11": "QA87", "icd10_code": "XXI", "icd10_title": "" } ]
XXI
After discharge from hospital, the patient took maintenance therapy for a year. She began to engage in private teaching, but after a period of work overload, her sleep was disturbed and she became irritable and anxious. The dose of trifluoperazine was increased to 20 mg per day. She began to notice tremors, 'problems with the tongue [and] jaw' and felt stiffness of muscles. In November 2007, she was transferred to risperidone therapy at a dose of 4 mg per day in the psychoneurological dispensary. She continued to experience extrapyramidal symptoms, so she stopped taking the drug on her own. She did not receive the maintenance therapy for two years. During this period, she met a man and got pregnant. According to her mother, during pregnancy, 'she started indulging in illusions again' and was sure that the child's father was actually her professor, but her behaviour was not disturbed and she was calm. She gave birth to a daughter in 2009, out of wedlock. After the birth, she did not maintain a relationship with the child's father, saying 'he just vanished, who cares'; she did not worry, she 'was up in the clouds' and took care of the child under the supervision of her mother. A few months after birth, she began to express ideas of reference towards her mother, blamed her that 'her husband left her, she was jealous of me, she was in love with him and broke our relationship', became angry, irritable and decided to find her professor, 'because this child had to be his'. She stopped taking care of the child, did not feed her and according to the patient's mother 'the child did not bother my daughter in any way'. When the patient's mother wanted to take the child into her care, the patient showed aggression, saying 'you're a witch, you want to kill my child'. She became suspicious, checked the food again because she thought that 'her mother might have poisoned her', listened to sounds coming from the street at the window, drew the curtains, closed the windows in the room and sat in silence for a long time 'so as not to give herself away'. She reported that 'they show me on the Internet, they know what shampoo I use' and turned off lights in the apartment. She began to think that she was being 'shot on camera'. In September 2009, she was admitted to a psychiatric hospital involuntarily. During the transportation, she resisted, cursed and shouted 'you are all in collusion, I did not give birth to the Messiah, you want to kill me'. Upon admission, she developed hallucinatory-delusional symptoms. In hospital, she received risperidone at a dose of 2 mg per day. During the therapy, her condition stabilized and hallucinatory-delusional symptoms were resolved. Thought disorders, negative symptoms and increasing apathy and abulia symptoms came to the forefront in clinical assessment. In the ward, she kept to herself, did not communicate with other patients and did not make plans for the future. After discharge, she was assigned to disability group II for a year. Her mental state was stable on the maintenance therapy for several years, but negative symptoms and personality changes came to the forefront in clinical assessment, and autism symptom were growing. She was engaged in raising her daughter together with her mother, and the relationship in the family was satisfactory. In 2011, she stopped taking medication, became wary and anxious, relations with her neighbours and her mother worsened, she stopped taking her child to kindergarten, was afraid to go out and expressed delusional ideas of persecution and exposure. She began to leave the house at night, returning in the morning with no explanation and stopped cleaning her room. In her diary, she addressed 'God, the angels' and 'the people who have been following her for many years'. She wrote about 'information leaks, loss of energy and devil worship'. She began to believe that 'her mother is in cahoots with the devil worshippers'. She reported that there was an invasion of her life, that someone 'is constantly filming her on camera, laughing at her', asked to 'turn off the broadcast of me' and that 'these are experiments on me'. The patient was involuntarily admitted to a psychiatric hospital. Upon admission, she developed hallucinatory-delusional symptoms, was agitated and screamed 'Freemasons, stop trying to force powerful thoughts on me'. She tried to escape, saying 'I must jump from a roof and die'. In the ward, she was tense, negatively predisposed, anxious, suspicious, psychomotor agitation persisted and periodically increased, she was impulsive, spiteful and her speech was in monologue. She revealed pronounced disorders ofthinking, expressed affective delusional ideas of reference, persecution, significant influence and gave a delusional interpretation of what was happening, considering hospitalization to be the result of 'collusion of doctors with my mother", reporting that her mother'spoils my energy, wants to replace my aura with hers' and accusing her of 'practising black magic'. At first, she received therapy with haloperidol at a dose of up to 10 mg per day, but noted pronounced extrapyramidal symptoms and was transferred to therapy with quetiapine at a dose of 600 mg per day. Her state showed some improvement, but a week after starting quetiapine, she again began to express delusional ideas. She was transferred to risperidone at a dose of up to 9 mg per day and trihexyphenidyl at a dose of 4 mg per day. On this therapy, her state improved, her behaviour was ordered, delusional symptoms stopped and extrapyramidal symptoms were reduced.
3.076172
0.980957
sec[0]/sec[3]/p[3]
en
0.999998
PMC11240131
https://doi.org/10.17650/2712-7672-2020-1-2-53-62
[ "mother", "that", "delusional", "became", "taking", "birth", "ideas", "maintenance", "anxious", "transferred" ]
[ { "code": "QA48.1", "title": "Care or examination of lactating mother" }, { "code": "KB60.1", "title": "Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent" }, { "code": "1C1D.0", "title": "Primary yaws" }, { "code": "KD35", "title": "Neonatal withdrawal syndrome from maternal use of drugs of addiction" }, { "code": "KB60.0", "title": "Syndrome of infant of mother with gestational diabetes" }, { "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 === [QA48.1] Care or examination of lactating mother Also known as: Care or examination of lactating mother | care of lactating mother | examination of lactating mother | supervision of lactation | supervision of breastfeeding Excludes: Certain specified disorders of breast or lactation associated with childbirth [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent Definition: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birth injuries, congenital anomalies, hypoglycaemia, respiratory distress, caudal regression syndrome and hypertrophic cardiomyopathy. Also known as: Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent | infant of a diabetic mother syndrome | maternal diabetes syndrome | syndrome of infant of diabetic mother | infant of diabetic mother [1C1D.0] Primary yaws Definition: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developing into a large non-tender ulcerating nodule, often resembling a raspberry (hence the name โ€˜framboesiaโ€™). The primary lesion is most commonly located on the legs and ankles may also be found on the buttocks, arms, hands, and face. It usually heals after 3โ€“6 months and is still present at the onset o Also known as: Primary yaws | Chancre of yaws | Primary framboesia | initial lesions of yaws | mother yaw Includes: Chancre of yaws | Primary framboesia [KD35] Neonatal withdrawal syndrome from maternal use of drugs of addiction Definition: Intrauterine exposure to addictive drugs can lead to neonatal withdrawal symptoms. Withdrawal symptoms are usually neurological, preventing normal autonomic function. The clinical presentation of drug withdrawal is variable and dependent on several factors, such as, the type and dose of drug used and rate of metabolism and excretion of the mother and infant. Also known as: Neonatal withdrawal syndrome from maternal use of drugs of addiction | Drug withdrawal syndrome in infant of dependent mother | Neonatal abstinence syndrome | drug withdrawal syndrome in newborn | neonatal drug withdrawal syndrome Includes: Drug withdrawal syndrome in infant of dependent mother | Neonatal abstinence syndrome Excludes: Fetus or newborn affected by maternal anaesthesia or analgesia in pregnancy, labour or delivery [KB60.0] Syndrome of infant of mother with gestational diabetes Definition: 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 effects include macrosomia, intrauterine growth restriction, birth injuries, congenital anomalies, hypoglycaemia, respiratory distress, and hypertrophic cardiomyopathy. Also known as: Syndrome of infant of mother with gestational diabetes | infant of mother with gestational diabetes | IGDM - [infant of gestational diabetic mother] | Fetus or newborn with hypoglycaemia affected by maternal gestational diabetes | Fetus or newborn affected by maternal gestational diabetes [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 --- [QA48.1] Care or examination of lactating mother --PARENT--> [QA48] Postpartum care or examination --CHILD--> [QA48.2] Routine postpartum follow-up --- Walk 2 --- [QA48.1] Care or examination of lactating mother --EXCLUDES--> [?] Certain specified disorders of breast or lactation associated with childbirth --CHILD--> [?] Retracted nipple associated with childbirth Def: A condition characterised as the abnormal inversion of a nipple that does not return to normal position even when stimulated that has occurred in association with childbirth.... --- Walk 3 --- [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt... --PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ... --PARENT--> [?] Transitory endocrine or metabolic disorders specific to fetus or newborn Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with changes in hormone production or utilization (endocrine system) or when abnormal chemical... --- Walk 4 --- [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt... --PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ... --CHILD--> [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt... --- Walk 5 --- [1C1D.0] Primary yaws Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developi... --PARENT--> [1C1D] Yaws Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con... --CHILD--> [1C1D.0] Primary yaws Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developi... --- Walk 6 --- [1C1D.0] Primary yaws Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developi... --PARENT--> [1C1D] Yaws Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con... --CHILD--> [1C1D.1] Secondary yaws Def: Secondary yaws results from lymphatic and haematogenous spread of Treponema pallidum subsp. pertenue spirochaetes from the initial inoculation site and appears from a few weeks to 2 years after the pr...
[ "[QA48.1] Care or examination of lactating mother\n --PARENT--> [QA48] Postpartum care or examination\n --CHILD--> [QA48.2] Routine postpartum follow-up", "[QA48.1] Care or examination of lactating mother\n --EXCLUDES--> [?] Certain specified disorders of breast or lactation associated with childbirth\n --CHILD--> [?] Retracted nipple associated with childbirth\n Def: A condition characterised as the abnormal inversion of a nipple that does not return to normal position even when stimulated that has occurred in association with childbirth....", "[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...\n --PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn\n Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ...\n --PARENT--> [?] Transitory endocrine or metabolic disorders specific to fetus or newborn\n Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with changes in hormone production or utilization (endocrine system) or when abnormal chemical...", "[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...\n --PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn\n Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ...\n --CHILD--> [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...", "[1C1D.0] Primary yaws\n Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developi...\n --PARENT--> [1C1D] Yaws\n Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con...\n --CHILD--> [1C1D.0] Primary yaws\n Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developi...", "[1C1D.0] Primary yaws\n Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or โ€˜mother' yaw) before developi...\n --PARENT--> [1C1D] Yaws\n Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con...\n --CHILD--> [1C1D.1] Secondary yaws\n Def: Secondary yaws results from lymphatic and haematogenous spread of Treponema pallidum subsp. pertenue spirochaetes from the initial inoculation site and appears from a few weeks to 2 years after the pr..." ]
QA48.1
Care or examination of lactating mother
[ { "from_icd11": "QA48.1", "icd10_code": "Z391", "icd10_title": "Encounter for care and examination of lactating mother" }, { "from_icd11": "KB60.1", "icd10_code": "P701", "icd10_title": "Syndrome of infant of a diabetic mother" }, { "from_icd11": "1C1D.0", "icd10_code": "A660", "icd10_title": "Initial lesions of yaws" }, { "from_icd11": "KD35", "icd10_code": "P961", "icd10_title": "Neonatal withdrawal symptoms from maternal use of drugs of addiction" }, { "from_icd11": "KB60.0", "icd10_code": "P700", "icd10_title": "Syndrome of infant of mother with gestational diabetes" }, { "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" } ]
Z391
Encounter for care and examination of lactating mother
To perform the procedure, the patient was placed in the lateral decubitus position and stabilized on an air-fluidized body fixation system (Magic bedโ„ข, Nikko Fines Industries Co Ltd, Tokyo, Japan [same as the Vac-Pacโ„ข Surgical Positioning System; Olympic Medical Co Ltd, Seattle, WA, USA]). Fluoroscopy confirmed the site and location of the osteotomy for chisel placement and assisted in evaluating the acetabular reduction and fixation intraoperatively. A direct lateral approach to the hip was used for exposure. The skin incision began distally in the anterodistal border of the greater trochanter and extended proximally via a curved line over the trochanter . The total length of the incision ranged from 10 to 15 cm, depending on the thickness of the subcutaneous fat and depth to the acetabulum. The fascia lata often was incised using a y shape along the anterior border of the gluteus medius muscle to expose the anterior inferior iliac spine. It was unnecessary to incise the superficial aponeurosis of the tensor fasciae latae, which was left intact to protect the lateral cutaneous femoral nerve during surgery. An osteotomy of the greater trochanter was done by using a 3-cm-wide chisel and the trochanter was proximally reflected with the gluteus medius and minimus muscles. The rectus femoris muscle was not detached from the anterior inferior iliac spine. The ilium (acetabulum) was exposed by retraction of the gluteus medius muscle without detachment from its origin on the ilium and iliac crest. The short rotator muscles and their tendons, except for the piriformis, were not released but rather retracted distally during the ischial osteotomy. The gluteus minimus muscle was separated from the capsule of the hip by blunt dissection. Then, the gluteus medius and minimus muscles were reflected proximally from the joint space or the acetabular rim and held with large custom-made retractors during acetabular osteotomy. The ilium and ischium were spherically cut in continuity. The osteotomy line was started just proximal to the inferior anterior iliac spine and passed through a point approximately 2.5 cm proximal (approximately 1.5 finger breadths) from the joint space . The proximal thickness of the osteotomized acetabulum was at least 1.5 cm because Trousdale et al. and Hasegawa et al. reported that osteonecrosis of the osteotomized acetabulum might occur if thickness of the acetabulum was too thin. Then, the line was passed through the midpoint between the posterior acetabular ridge and the greater sciatic notch and ended at the innominate sulcus of the ischium. The osteotomy was performed by using a specially curved chisel introduced by Ninomiya and Tagawa after decortication using a straight chisel. Osteotomy of corpus of the pubis and the iliopectineal ridge were performed under careful palpation and image intensification, as they could not be observed directly during the surgical procedure. We used a special wooden hammer introduced by Murase et al. to listen carefully to the sound of the hammer to detect when the tip of the osteotome had reached the inner cortex of the ilium and to avoid excessive penetration into the intrapelvic space. Visible bleeding indicative of a good blood supply often was observed from the anterior part of the osteotomized acetabulum where the rectus femoris muscle was attached . If necessary, the lateral part of the osteotomized ilium (acetabulum) was cut in a lunate (lateral view) and a trapezoid (AP view) shape to fashion the bone graft instead of using the outer cortical table of the iliac wing . The size of the graft was estimated based on preoperative planning and measurement. After fluoroscopic confirmation of adequate coverage of the femoral head by the rotated acetabulum and the medially shifted femoral head, several Kirschner wires, 1.8 mm in diameter, were used to transfix the osteotomized acetabulum and the lunate-form bone graft to the pelvis. The operative field was irrigated with saline solution and the osteotomized greater trochanter was repositioned and fixed with two cannulated cancellous hip (CCH) screws. For the patients with abductor weakness including the two patients with a concomitant proximal femoral valgus osteotomy, distal transposition of the greater trochanter was performed simultaneously to gain effective excursion of the medial gluteus muscle. The indication for the valgus osteotomy was based on the description by Ninomiya and Tagawa . Fig. 1 The skin incision begins distally in the anterodistal border of the greater trochanter and extends proximally via a curved line over the trochanter. Fig. 2 The osteotomy line (arrows) is shown on the left pelvis. The thickness of the osteotomized acetabulum is approximately 2.5 cm to the joint space at the proximal (cephalad) portion. A lunate (lateral view) and trapezoid (AP view) shaped bone graft (asterisk) can be obtained from the lateral part of the osteotomized fragment. Fig. 3 The osteotomy line lies approximately 2.5 cm (1.5 finger breadths) cephalad to the joint space (left side). Fig. 4 A bone graft from the lateral part of the osteotomized acetabulum (asterisk) is shifted (curved arrow) and transfixed by Kirschner wires (left hip). Bleeding from the anterior part of the osteotomized acetabulum indicates blood supply from the rectus femoris muscle. Fig. 5 An AP postoperative radiograph of the left hip shows the osteotomized acetabulum is rotated anterolaterally (lower arrow) with a trapezoid-shaped bone graft (asterisk) from the lateral part of the osteotomized fragment (upper arrow).
4.199219
0.47876
sec[1]/p[1]
en
0.999996
23008024
https://doi.org/10.1007/s11999-012-2599-6
[ "acetabulum", "osteotomized", "osteotomy", "trochanter", "muscle", "greater", "line", "gluteus", "part", "graft" ]
[ { "code": "FA37.Y", "title": "Other specified certain joint disorders, not elsewhere classified" }, { "code": "NB52.13", "title": "Fracture of acetabulum without disruption of pelvic ring" }, { "code": "NC73.1Y", "title": "Other specified strain or sprain of hip" }, { "code": "FB82.1", "title": "Osteochondrosis or osteochondritis dissecans" }, { "code": "NC73.0Z", "title": "Dislocation of hip, unspecified" }, { "code": "NC72.3Z", "title": "Fracture of unspecified trochanteric section of femur" }, { "code": "EH90.0&XA4TQ2", "title": "Pressure ulceration grade 1 of trochanter" }, { "code": "EH90.5&XA4TQ2", "title": "Pressure ulceration, ungradable of trochanter" }, { "code": "EH90.1&XA4TQ2", "title": "Pressure ulceration grade 2 of trochanter" }, { "code": "NC72.3Y", "title": "Fracture of other specified trochanteric section of femur" } ]
=== ICD-11 CODES FOUND === [FA37.Y] Other specified certain joint disorders, not elsewhere classified Also known as: Other specified certain joint disorders, not elsewhere classified | Calcification of joint | Periarticular calcification | Periarticular ossification | Fistula of joint [NB52.13] Fracture of acetabulum without disruption of pelvic ring Also known as: Fracture of acetabulum without disruption of pelvic ring | acetabulum fracture | acetabular fracture | Sequelae of fracture of acetabulum [NC73.1Y] Other specified strain or sprain of hip Also known as: Other specified strain or sprain of hip | Strain of hip | Strain of acetabulum of innominate bone | Sprain of acetabulum of innominate bone | Pubofemoral strain [FB82.1] Osteochondrosis or osteochondritis dissecans Definition: Note: Osteochondroses are typically referred to by eponyms. The most common eponyms are indexed to osteochondrosis with specification identified by the site and time in life. Also known as: Osteochondrosis or osteochondritis dissecans | osteochondral lesion | Osteochondrosis not specified as adult or juvenile, of unspecified site | osteochondrosis NOS | Juvenile osteochondrosis [NC73.0Z] Dislocation of hip, unspecified Also known as: Dislocation of hip, unspecified | Dislocation of hip | dislocation of hip joint | traumatic dislocation of hip joint | dislocation of hip NOS [NC72.3Z] Fracture of unspecified trochanteric section of femur Also known as: Fracture of unspecified trochanteric section of femur | Fracture of trochanteric section of femur | femoral trochanteric fracture | trochanter fracture | Trochanteric fracture [NC72.3Y] Fracture of other specified trochanteric section of femur Also known as: Fracture of other specified trochanteric section of femur | Fracture of greater trochanter === GRAPH WALKS === --- Walk 1 --- [FA37.Y] Other specified certain joint disorders, not elsewhere classified --PARENT--> [FA37] Certain joint disorders, not elsewhere classified --EXCLUDES--> [?] Calcific tendinitis Def: This is a disorder characterised by deposits of hydroxyapatite in any tendon of the body causing inflammation and pain.... --- Walk 2 --- [FA37.Y] Other specified certain joint disorders, not elsewhere classified --PARENT--> [FA37] Certain joint disorders, not elsewhere classified --EXCLUDES--> [?] Calcific tendinitis Def: This is a disorder characterised by deposits of hydroxyapatite in any tendon of the body causing inflammation and pain.... --- Walk 3 --- [NB52.13] Fracture of acetabulum without disruption of pelvic ring --PARENT--> [NB52.1] Fracture of pelvic bone without disruption of posterior arch of pelvic ring --CHILD--> [NB52.11] Fracture of coccyx --- Walk 4 --- [NB52.13] Fracture of acetabulum without disruption of pelvic ring --PARENT--> [NB52.1] Fracture of pelvic bone without disruption of posterior arch of pelvic ring --CHILD--> [NB52.10] Fracture of sacrum without disruption of pelvic ring --- Walk 5 --- [NC73.1Y] Other specified strain or sprain of hip --PARENT--> [NC73.1] Strain or sprain of hip Def: A collective term for muscle and ligament injuries of the tissues associated with the hip without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptu... --CHILD--> [NC73.10] Iliofemoral ligament strain or sprain of hip --- Walk 6 --- [NC73.1Y] Other specified strain or sprain of hip --PARENT--> [NC73.1] Strain or sprain of hip Def: A collective term for muscle and ligament injuries of the tissues associated with the hip without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptu... --CHILD--> [NC73.1Y] Other specified strain or sprain of hip
[ "[FA37.Y] Other specified certain joint disorders, not elsewhere classified\n --PARENT--> [FA37] Certain joint disorders, not elsewhere classified\n --EXCLUDES--> [?] Calcific tendinitis\n Def: This is a disorder characterised by deposits of hydroxyapatite in any tendon of the body causing inflammation and pain....", "[FA37.Y] Other specified certain joint disorders, not elsewhere classified\n --PARENT--> [FA37] Certain joint disorders, not elsewhere classified\n --EXCLUDES--> [?] Calcific tendinitis\n Def: This is a disorder characterised by deposits of hydroxyapatite in any tendon of the body causing inflammation and pain....", "[NB52.13] Fracture of acetabulum without disruption of pelvic ring\n --PARENT--> [NB52.1] Fracture of pelvic bone without disruption of posterior arch of pelvic ring\n --CHILD--> [NB52.11] Fracture of coccyx", "[NB52.13] Fracture of acetabulum without disruption of pelvic ring\n --PARENT--> [NB52.1] Fracture of pelvic bone without disruption of posterior arch of pelvic ring\n --CHILD--> [NB52.10] Fracture of sacrum without disruption of pelvic ring", "[NC73.1Y] Other specified strain or sprain of hip\n --PARENT--> [NC73.1] Strain or sprain of hip\n Def: A collective term for muscle and ligament injuries of the tissues associated with the hip without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptu...\n --CHILD--> [NC73.10] Iliofemoral ligament strain or sprain of hip", "[NC73.1Y] Other specified strain or sprain of hip\n --PARENT--> [NC73.1] Strain or sprain of hip\n Def: A collective term for muscle and ligament injuries of the tissues associated with the hip without dislocation or fracture; a joint injury in which some of the fibers of a supporting ligament are ruptu...\n --CHILD--> [NC73.1Y] Other specified strain or sprain of hip" ]
FA37.Y
Other specified certain joint disorders, not elsewhere classified
[ { "from_icd11": "NB52.13", "icd10_code": "S32422A", "icd10_title": "Displaced fracture of posterior wall of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32402D", "icd10_title": "Unspecified fracture of left acetabulum, subsequent encounter for fracture with routine healing" }, { "from_icd11": "NB52.13", "icd10_code": "S32492A", "icd10_title": "Other specified fracture of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32425A", "icd10_title": "Nondisplaced fracture of posterior wall of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32491A", "icd10_title": "Other specified fracture of right acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32402A", "icd10_title": "Unspecified fracture of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32421A", "icd10_title": "Displaced fracture of posterior wall of right acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32412A", "icd10_title": "Displaced fracture of anterior wall of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32401A", "icd10_title": "Unspecified fracture of right acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32432A", "icd10_title": "Displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32434A", "icd10_title": "Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32415A", "icd10_title": "Nondisplaced fracture of anterior wall of left acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32461A", "icd10_title": "Displaced associated transverse-posterior fracture of right acetabulum, initial encounter for closed fracture" }, { "from_icd11": "NB52.13", "icd10_code": "S32421S", "icd10_title": "Displaced fracture of posterior wall of right acetabulum, sequela" }, { "from_icd11": "NB52.13", "icd10_code": "S32435A", "icd10_title": "Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture" } ]
S32422A
Displaced fracture of posterior wall of left acetabulum, initial encounter for closed fracture
The association between Addisonโ€™s disease and other endocrinopathies was probably first described in 1886. In 1926, Schmidt presented two cases of Addisonโ€™s disease with cortical atrophy and lymphocytic infiltration of the adrenal, as well as lymphoid infiltration in the thyroid . APS2 is rare, because it necessarily requires the presence of Addisonโ€™s disease. Considering that the prevalence of idiopathic Addisonโ€™s disease has been suspected to be 30 to 60 cases/million inhabitants and that about 50% to 75% of Addisonian patients may be affected by thyroid autoimmune disease and insulin dependent diabetes or both, it may be estimated that APS2 occurs in 15 to 45 cases per million inhabitants in the general population. The syndrome may occur at all ages and in both sexes but is most commonly found in middle-aged women. Inheritance is consistent with autosomal dominance with incomplete penetrance. These patients have an increased frequency of the HLA A1, B8 and DR3 haplotypes . An unexpected fall in insulin requirement in patients with T1DM may be the earliest sign of adrenal failure. Our index case developed recurrent hypoglycemia attacks without any change in his treatment or physical activity. Hypoglycemic attacks are considered to be caused by enhanced insulin sensitivity secondary to glucocorticoid deficiency . Hashimotoโ€™s thyroiditis was diagnosed in our case on findings of seropositivity for Tg and TPO autoantibodies, and slightly high TSH accompanied by morphological changes seen on thyroid ultrasound . Symptoms and signs of hypothyroidism and hypoadrenalism are often non-specific. Since early diagnosis and treatment of these hormonal insufficiencies are vital, it is essential to always consider an association. Adrenal insufficiency should be considered in patients with autoimmune thyroid disease or T1DM who develop non-specific illness or become seriously ill, or in diabetic patients whose insulin requirements fall inexplicably . The hyperpigmention of the skin and mucous membranes was not obvious in our case. The absence or presence of hyperpigmentation in Addisonโ€™s disease is related to the duration of the illness and the time taken to stimulate the pituitary to produce ACTH. Although pigmentation is a very useful sign in Addisonโ€™s disease, its absence by no means excludes the diagnosis. It seems that only an awareness of the possibility of the disease will lead to an early diagnosis . Our case showed vitiligo over the chest and abdomen which is a chronic disorder that causes patchy hypopigmentation of the skin. It occurs when the melanocytes, which are derived from the neural crest, die or are unable to function. The precise pathogenesis of vitiligo is not yet fully understood but an autoimmune etiology is the most widely accepted. It is mandatory to actively look for, and if necessary, investigate patients with vitiligo for other autoimmune diseases . In Egypt, HCV infection in diabetic children is considered a health-related infection; with a prevalence of anti-HCV among diabetic children of 3.5%, it may be attributed to repeated hospitalization, insulin injections, shared insulin vials and shared spring-triggered devices for capillary blood glucose monitoring . Our case was diagnosed with chronic hepatitis C. We suggest that the risk factors for contraction of hepatitis C in our case were frequent hospital admissions and circumcision by a barber which is a common practice in villages in Upper Egypt. These suggestions are supported by Kalil et al. and Medhat et al. in their study regarding risk factors of acquisition of hepatitis C in children in Upper Egypt. HCV seems to be the virus usually associated with the appearance of autoimmune diseases, and the relationship between chronic HCV infection and some autoimmune disease has been studied. For some of these disorders their association with HCV infection is well recognized while for others it remains probable or weak . HCV infection has been associated with Type 2 diabetes mellitus; however, Chen et al. reported T1DM one year after a blood transfusion-related HCV infection. The exact mechanisms underlying HCV-mediated T1DM still are not well understood and several investigators have proposed that cross reactive mechanisms are operating in the generation of autoimmunity in HCV infection. This hypothesis is supported by the discovery of remarkable amino acid similarities between HCV and glutamic acid decarboxylase 65 (GAD65), protein tyrosine phosphatase islet cell antigen-2 and phogrin . Identification of the type and extent of autoimmune disorders in children with HCV infection is important for the following reasons: First, this awareness can result in rapid diagnosis and treatment of these diseases. Second, the existence of an autoimmune disorder in patients with HCV infection requires clinicians with good experience in the management of such cases. Third, patients presenting with these disorders can be targeted for HCV testing . Our case presents three very interesting and unusual aspects. First, given that APS2 occurs most often in middle-aged women, its presentation in a boy during childhood is uncommon. In this communication, we report the case of a 14-year-old boy with APS2 with HCV infection. Second, the association of APS2 with chronic hepatitis C in our case would suggest adding APS2 to the list of autoimmune diseases apparently associated with chronic hepatitis C. Finally, hepatic dysfunction in Egyptian children with APS2 is not necessarily due to autoimmune hepatitis but can be attributed to HCV infection.
4.425781
0.498535
sec[2]/p[0]
en
0.999998
22839422
https://doi.org/10.1186/1752-1947-6-221
[ "infection", "autoimmune", "that", "patients", "addison", "insulin", "these", "hepatitis", "children", "association" ]
[ { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "4A4Z", "title": "Nonorgan specific systemic autoimmune disorders, unspecified" }, { "code": "4A01.21", "title": "Immune dysregulation syndromes presenting primarily with autoimmunity" }, { "code": "8E4A.0", "title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord" }, { "code": "9A75", "title": "Autoimmune keratitis" }, { "code": "DA96.0Y", "title": "Other specified intestinal malabsorption" } ]
=== ICD-11 CODES FOUND === [1H0Z] Infection, unspecified Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS [1G40] Sepsis without septic shock Definition: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Also known as: Sepsis without septic shock | sepsis without septic shock with known organism | Sepsis-associated hypotension | Unspecified sepsis | general septic intoxication Excludes: Septicaemia | Sepsis of fetus or newborn [FA10.Z] Direct infections of joint, unspecified Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection [1D9Z] Unspecified viral infection of unspecified site Also known as: Unspecified viral infection of unspecified site | viral infection NOS | viral disorder NOS | disease caused by virus | unspecified viremia [1A40.Z] Infectious gastroenteritis or colitis without specification of infectious agent Also known as: Infectious gastroenteritis or colitis without specification of infectious agent | Gastroenteritis or colitis without specification of infectious agent | diarrhoea and gastroenteritis of presumed infectious origin | diarrhoeal enteritis | GE - [gastroenteritis] [4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified Also known as: Nonorgan specific systemic autoimmune disorders, unspecified | systemic autoimmune disease | systemic collagen vascular disease | systemic vascular disease | autoimmune disease NOS [4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity Also known as: Immune dysregulation syndromes presenting primarily with autoimmunity | Syndrome with autoimmunity | Immunodeficiency syndromes presenting primarily with autoimmunity | FADD-related immunodeficiency | X-linked immune dysregulation โ€“ polyendocrinopathy โ€“ enteropathy [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 โ€˜autoimmuneโ€™ 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 [9A75] Autoimmune keratitis Also known as: Autoimmune keratitis | Autoimmune interstitial keratitis | Peripheral ulcerative keratitis [DA96.0Y] Other specified intestinal malabsorption Also known as: Other specified intestinal malabsorption | Certain intestinal malabsorption | Autoimmune enteropathy | Structural enterocyte defects due to other diseases | Collagenous sprue === GRAPH WALKS === --- Walk 1 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --- Walk 2 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --CHILD--> [?] Predominantly sexually transmitted infections --- Walk 3 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --- Walk 4 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --PARENT--> [?] Bacteraemia Def: The presence of bacteria in the blood. This can be detected, for example, by a positive blood culture.... --- Walk 5 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --CHILD--> [FA10.0] Bacterial infection of joint --- Walk 6 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Postinfectious arthropathies
[ "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] 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 ...", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --CHILD--> [?] Predominantly sexually transmitted infections", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --PARENT--> [?] Bacteraemia\n Def: The presence of bacteria in the blood. This can be detected, for example, by a positive blood culture....", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --CHILD--> [FA10.0] Bacterial infection of joint", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Postinfectious arthropathies" ]
1H0Z
Infection, unspecified
[ { "from_icd11": "1H0Z", "icd10_code": "B999", "icd10_title": "Unspecified infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A312", "icd10_title": "Disseminated mycobacterium avium-intracellulare complex (DMAC)" }, { "from_icd11": "1H0Z", "icd10_code": "B998", "icd10_title": "Other infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A249", "icd10_title": "Melioidosis, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "R6511", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "R6510", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "A318", "icd10_title": "Other mycobacterial infections" }, { "from_icd11": "1H0Z", "icd10_code": "A319", "icd10_title": "Mycobacterial infection, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B948", "icd10_title": "Sequelae of other specified infectious and parasitic diseases" }, { "from_icd11": "1H0Z", "icd10_code": "B949", "icd10_title": "Sequelae of unspecified infectious and parasitic disease" }, { "from_icd11": "1H0Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "N771", "icd10_title": "Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B94", "icd10_title": "Sequelae of other and unspecified infectious and parasitic diseases" } ]
B999
Unspecified infectious disease
On intraoral examination, a fluctuant swelling was observed on the buccal mucosa in close proximity to tooth #26, which had extensive dental caries. Notably, the affected area exhibited heightened sensitivity upon palpation. The coronal restoration was displaced. The measurements of periodontal probing depths were within the normal range. The radiographic analysis indicated that tooth #26 had inadequate obturation in the mesiobuccal, distal, and palatal canals, accompanied by the presence of periapical radiolucency . Tooth #26 was diagnosed with acute suppurative apical periodontitis. After a thorough evaluation of the patientโ€™s clinical signs and radiographic findings, it was determined that a non-surgical endodontic retreatment was the most appropriate course of action. The patient was provided with a detailed explanation of the treatment protocol and subsequently agreed to proceed. Before initiating a non-surgical endodontic retreatment, thorough consideration was given to alternative multidisciplinary treatment methods, which were subsequently deemed ineffective. Upon obtaining informed consent from the patient, it was determined to proceed with the retreatment operation. After administration of the suitable anesthesia and isolation with a rubber dam, access was regained . H-files (Dentsply, Maileffer, USA) were used to remove the loosely packed root filling, together with the use of GP solvent (GP Cleanse, Deor) to facilitate the softening of the gutta-percha before the utilization of H-files . A purulent discharge was evacuated through the access cavity and facilitated by the use of a sterile saline flush administered via a side vent needle (EndoTop, Cerkamed, Stalowa Wola, Poland). Working length was established by employing an apex locator (Root ZX, J. Morita Inc., USA). The canals were meticulously prepared using manual hand k-files (Dentsply, Maileffer, USA) and RaCe NiTi rotary files, following a crown-down technique. Various clinical techniques and methodologies have been employed to improve the visualization of the MB2 canal in the mesiobuccal root. However, these endeavors have not yielded successful results. Consequently, we recommended that the patient undergo a cone-beam computed tomography scan to obtain an accurate anatomical three-dimensional image , facilitating the identification of the MB2 canal. Subsequently, it was determined that only one canal existed in the mesiobuccal root, so we proceeded with the preparation of all three canals using the crown-down approach. During cleaning and shaping, approximately 8 mm of a size #0.04/20 RaCe NiTi file separated within the distobuccal canal. A radiographic image was obtained to verify the extent of the instrumentโ€™s separation . The instrument was observed to be within the middle third of the distobuccal canal. The proposed procedure was the retrieval of the instrument, which was accomplished by preparing a staging platform at the most coronal aspect of the fragment using modified Gates Glidden burs (no. 2-4). The ProUltra ultrasonic tip No. 4 (Dentsply Tulsa Dental in Tulsa, OK) was utilized at reduced power levels at no. 6 setting to effectively remove dentin and send vibrations to dislodge the separated fragment. The experimental protocol was conducted using magnifying loupes with a magnification factor of 2.5 (Heine, Germany). Intermittent irrigation with normal saline was performed to effectively remove debris from the canal and provide a cooling effect. After approximately 40 minutes of applying ultrasonic tips and sufficient irrigation, the instrument loosened but did not completely disengage from the canal despite the use of copious amounts of irrigation. Consequently, we opted to utilize a different approach known as the file braiding technique which employs multiple H-files braided around separated files that would apply a strong grasping force, enabling the extraction of a separated file. This method is successful when the fragment is located deep within the canal and is not visible. The operator relies on tactile sensation or when the fragment is loose but cannot be retrieved using other methods such as microtube extraction devices, ultrasonics, or pliers/forceps. Two no. 20 H-files were introduced, one from the buccal side and the other from the lingual side. The files were then twisted together clockwise to secure the file section inside the canal. After rotating in a clockwise direction, they were extracted from the canal. The separated file segment emerged from the canal in conjunction with the H-files which was measured to be around 8 mm . The radiographic image was obtained after the successful retrieval of the separated file . After the application of calcium hydroxide (CH) paste as an intracanal dressing, the patient was scheduled for a follow-up appointment two weeks later. During the subsequent examination, there were no apparent indications of discomfort, tenderness, or edema. The root canal was treated using a combination of 2.5% sodium hypochlorite ultrasound-activated irrigation and negative apical pressure facilitated by the EndoVac device to effectively remove the calcium hydroxide paste. The canal was dried using a sterile paper point and subsequently sealed using appropriate gutta-percha master cones and DIA-ROOT BIO (DiaDent Group International, South Korea) bioceramic sealer . After the obturation procedure, the tooth was subsequently rebuilt using a resin composite restoration (MultiCore Flow, Ivoclar Vivadent). A follow-up radiograph taken after one year showed sufficient healing .
4.066406
0.958984
sec[1]/p[1]
en
0.999998
38186462
https://doi.org/10.7759/cureus.50140
[ "canal", "files", "using", "root", "file", "separated", "which", "that", "subsequently", "tooth" ]
[ { "code": "DB7Z", "title": "Diseases of anal canal, unspecified" }, { "code": "LB17.Z", "title": "Structural developmental anomalies of anal canal, unspecified" }, { "code": "DB51", "title": "Stenosis of anal canal" }, { "code": "DB7Y", "title": "Other specified diseases of anal canal" }, { "code": "LA22.2", "title": "Aplasia or hypoplasia of external auditory canal" }, { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "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" } ]
=== ICD-11 CODES FOUND === [DB7Z] Diseases of anal canal, unspecified Also known as: Diseases of anal canal, unspecified [LB17.Z] Structural developmental anomalies of anal canal, unspecified Also known as: Structural developmental anomalies of anal canal, unspecified | Structural developmental anomalies of anal canal | Malformations of anal canal [DB51] Stenosis of anal canal Also known as: Stenosis of anal canal | stricture of anal sphincter | anal stricture | anus occlusion | pectenosis [DB7Y] Other specified diseases of anal canal Also known as: Other specified diseases of anal canal [LA22.2] Aplasia or hypoplasia of external auditory canal Also known as: Aplasia or hypoplasia of external auditory canal | anomaly of osseous meatus | Congenital absence of external auditory canal | absence of external auditory canal | absence of auditory canal Excludes: Microtia | Anotia [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified Also known as: Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, alcohols | alcohol poisoning | alcohol toxicity | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, Ethanol Excludes: corrosions | Bacterial foodborne intoxications [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 === GRAPH WALKS === --- Walk 1 --- [DB7Z] Diseases of anal canal, unspecified --PARENT--> [?] Diseases of anal canal --CHILD--> [?] Acquired anatomical alterations of the anal canal Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal.... --- Walk 2 --- [DB7Z] Diseases of anal canal, unspecified --PARENT--> [?] Diseases of anal canal --RELATED_TO--> [?] Structural developmental anomalies of anal canal --- Walk 3 --- [LB17.Z] Structural developmental anomalies of anal canal, unspecified --PARENT--> [LB17] Structural developmental anomalies of anal canal --CHILD--> [LB17.2] Persistent cloaca Def: A congenital anomaly in which the intestinal, urinary, and reproductive ducts open into a common cavity, a result of the failure of the urorectal septum to form during prenatal development. They occur... --- Walk 4 --- [LB17.Z] Structural developmental anomalies of anal canal, unspecified --PARENT--> [LB17] Structural developmental anomalies of anal canal --CHILD--> [LB17.0] Anorectal malformations Def: Anorectal malformations (ARMs) are birth defects (due to alterations in embryo development of hindgut or proctodeum) where the anus and rectum (the lower end of the digestive tract) do not develop pro... --- Walk 5 --- [DB51] Stenosis of anal canal --PARENT--> [?] Acquired anatomical alterations of the anal canal Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal.... --RELATED_TO--> [?] Open wound of anus Def: A wound of anal regions in which the injured tissues are exposed to the air.... --- Walk 6 --- [DB51] Stenosis of anal canal --PARENT--> [?] Acquired anatomical alterations of the anal canal Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal.... --EXCLUDES--> [?] Structural developmental anomalies of anal canal
[ "[DB7Z] Diseases of anal canal, unspecified\n --PARENT--> [?] Diseases of anal canal\n --CHILD--> [?] Acquired anatomical alterations of the anal canal\n Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....", "[DB7Z] Diseases of anal canal, unspecified\n --PARENT--> [?] Diseases of anal canal\n --RELATED_TO--> [?] Structural developmental anomalies of anal canal", "[LB17.Z] Structural developmental anomalies of anal canal, unspecified\n --PARENT--> [LB17] Structural developmental anomalies of anal canal\n --CHILD--> [LB17.2] Persistent cloaca\n Def: A congenital anomaly in which the intestinal, urinary, and reproductive ducts open into a common cavity, a result of the failure of the urorectal septum to form during prenatal development. They occur...", "[LB17.Z] Structural developmental anomalies of anal canal, unspecified\n --PARENT--> [LB17] Structural developmental anomalies of anal canal\n --CHILD--> [LB17.0] Anorectal malformations\n Def: Anorectal malformations (ARMs) are birth defects (due to alterations in embryo development of hindgut or proctodeum) where the anus and rectum (the lower end of the digestive tract) do not develop pro...", "[DB51] Stenosis of anal canal\n --PARENT--> [?] Acquired anatomical alterations of the anal canal\n Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....\n --RELATED_TO--> [?] Open wound of anus\n Def: A wound of anal regions in which the injured tissues are exposed to the air....", "[DB51] Stenosis of anal canal\n --PARENT--> [?] Acquired anatomical alterations of the anal canal\n Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....\n --EXCLUDES--> [?] Structural developmental anomalies of anal canal" ]
DB7Z
Diseases of anal canal, unspecified
[ { "from_icd11": "LB17.Z", "icd10_code": "Q423", "icd10_title": "Congenital absence, atresia and stenosis of anus without fistula" }, { "from_icd11": "LB17.Z", "icd10_code": "Q422", "icd10_title": "Congenital absence, atresia and stenosis of anus with fistula" }, { "from_icd11": "LB17.Z", "icd10_code": "Q420", "icd10_title": "Congenital absence, atresia and stenosis of rectum with fistula" }, { "from_icd11": "LB17.Z", "icd10_code": "Q421", "icd10_title": "Congenital absence, atresia and stenosis of rectum without fistula" }, { "from_icd11": "LB17.Z", "icd10_code": "Q428", "icd10_title": "Congenital absence, atresia and stenosis of other parts of large intestine" }, { "from_icd11": "LB17.Z", "icd10_code": "Q429", "icd10_title": "Congenital absence, atresia and stenosis of large intestine, part unspecified" }, { "from_icd11": "LB17.Z", "icd10_code": "Q436", "icd10_title": "Congenital fistula of rectum and anus" }, { "from_icd11": "DB51", "icd10_code": "K624", "icd10_title": "Stenosis of anus and rectum" }, { "from_icd11": "LA22.2", "icd10_code": "Q161", "icd10_title": "Congenital absence, atresia and stricture of auditory canal (external)" }, { "from_icd11": "NE61", "icd10_code": "T5802XA", "icd10_title": "Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T550X2A", "icd10_title": "Toxic effect of soaps, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61781A", "icd10_title": "Other shellfish poisoning, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T551X2A", "icd10_title": "Toxic effect of detergents, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T5891XA", "icd10_title": "Toxic effect of carbon monoxide from unspecified source, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63711A", "icd10_title": "Toxic effect of contact with venomous marine plant, accidental (unintentional), initial encounter" } ]
Q423
Congenital absence, atresia and stenosis of anus without fistula
We performed an epidural anesthesia in a patient with ACMโ€1,5 to implant a hip prosthesis. Our main goal was to keep intracranial pressure and hemodynamics as stable as possible. We also wanted to avoid the respiratory problems that the patient already manifested in the previous recent GA. In fact, GA can lead to respiratory complications in patients with ACM malformation, considering that they can develop obstructive apnea and central apnea. Obstructive apnea is usually reversed with an optimally functioning ventriculoperitoneal shunt, whereas central apnea does not respond to cervical decompression. 5 Regards anesthesiological approach, Ramsis et al. 8 to avoid progression of the herniation due to increased intracranial pressure (ICP) during head and neck movements and laryngoscopy, led to an awake fiberoptic intubation was performed under generous topical anesthesia and defined also that in ACM patients it is important to prevent coughing and bucking during endotracheal extubation at the end of GA. Extubation under deep anesthesia may decrease the risk of coughing, but it may increase the risk of gastric aspiration and sudden apnea episodes. 8 However, GA can cause systemic hypotension and consequently increased ICP, not desiderable in patients with ACMโ€1,5. Starting from these considerations, as the type of intervention allowed us, we preferred neuraxial anesthesia. In particular, we preferred epidural anesthesia because it consented greater hemodynamic stability and because it reduced impact on CSF pressure, since any deliquoration was avoided. With an extradural approach we avoided fluctuations of ICP, we avoided breathing problems and neck movements, the patient was awake and cooperative throughout the intervention and we also avoided opioids administration, reducing the risk of respiratory depression. The alternative choice would be to perform a SA with a 27 gauge Whitacre spinal needle. However, we could not be sure to perform a single, atraumatic puncture, and therefore, we could not predict and quantify the real reflux of liquor. Furthermore, the hemodynamic impact of the SA would have been greater and less controllable compared to epidural anesthesia. Finally, to make sure we had a good anesthetic plan for the duration of the surgery, we would use an adjuvant in subarachnoid space, with further impact on hemodynamics. The procedure for positioning the epidural catheter was carried out by an expert anesthesiologist. The risk of accidental dural puncture was 0.49% like reported in literature. The incidence was related to puncture level of spine and age. 9 In case of accidental puncture of the dura mater, the catheter would have been positioned in the subarachnoid space and continuous SA would have been conducted. In fact, the insertion of the catheter in the subarachnoid space and the continuous SA reduce the consequences related to the accidental puncture of the dura. 10 Miqi et al. 11 affirm that epidural anesthesia might raise the intracranial hypertension when a bolus of local anesthetic is given due to dural compression in the epidural space with a shift of CSF into the cranium. To reduce this risk, our approach involved small doses and slow injection of anesthetic into the peridural space. We decided to use a higher anesthetic concentration (ropivacaine 0.75%), in order to reduce the total injected volume (15 ml). We also injected the anesthetic solution in two times (7.5 ml slow boluses 10 min apart). In support of our anesthesiological management, Margarido et al. 12 affirm that in patients with postโ€traumatic syringomyelia, epidural anesthesia may offer several advantages over SA and GA. These benefits include safety of the airway, reduced rate of incidence of hypotension and deterioration of autonomic neuropathy, and minimal change in the existing CSF pressure relationship if the medication is titrated gradually. We inserted the epidural catheter into the epidural space for 5 cm, as recommended by the literature evidence. 13 We performed epidural test dose with lidocaine 2% 3 ml and epinephrine 15 mg to rule out accidental placement in the subarachnoid space or in a blood vessel, as recommended by the literature studies. 14 Lastly, we could practice lumbar plexus block in order to avoid any risk of dural puncture. Bin Mei et al. 15 used this technique during hip surgery when it was preferable to avoid neuroaxial approach. In our case, we risked to not obtain a longโ€lasting anesthesiological coverage; also, we would not obtain adequate coverage of postoperative pain without using opioids, which would increase the risk of respiratory depression. Although a Erector spinae block combined with lumbar plexus block, paravertebral block, and sacral plexus blocks with the support of sedoanalgesia could be performed in this case to minimize the risk of hemodynamic fluctuations and dural puncture related to NA, however the risk of local anesthetic toxicity would be effectively increased considering the total volume and dose administration. 16 , 17 , 18 Epidural anesthesia was therefore our choice because it may offer several advantages over SA and GA in patients with ACMโ€1,5. These advantages include avoidance the risk of difficult intubation and unsuccessful airway protection, reduced incidence of hypotension and deterioration of autonomic neuropathy, and minimal change in intracranial pressure if the anesthetic is titrated gradually. Also with the extradural approach, it does not alter the CSF pressure because the dura mater is not punctured and there is no CSF leakage.
4.207031
0.727051
sec[2]/p[0]
en
0.999997
PMC8815281
https://doi.org/10.1002/ccr3.5194
[ "epidural", "risk", "anesthesia", "puncture", "anesthetic", "space", "pressure", "that", "patients", "apnea" ]
[ { "code": "NA07.5", "title": "Traumatic epidural haemorrhage" }, { "code": "1D04.5", "title": "Intraspinal epidural granuloma" }, { "code": "1D03.4", "title": "Intraspinal epidural abscess" }, { "code": "2A02.Z", "title": "Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified" }, { "code": "8B03", "title": "Nontraumatic epidural haemorrhage" }, { "code": "QC4Y", "title": "Personal history of other specified health problems" }, { "code": "QA43.Z", "title": "Supervision of high-risk pregnancy, unspecified" }, { "code": "QA43.Y", "title": "Other specified supervision of high-risk pregnancy" }, { "code": "QD84.Z", "title": "Occupational exposure to risk-factors, unspecified" }, { "code": "MB26.A", "title": "Suicidal ideation" } ]
=== ICD-11 CODES FOUND === [NA07.5] Traumatic epidural haemorrhage Also known as: Traumatic epidural haemorrhage | extradural haemorrhage | traumatic epidural haematoma | traumatic extradural haemorrhage | extradural brain haematoma [1D04.5] Intraspinal epidural granuloma Definition: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epidural space. This condition may present with neurological deficits. Also known as: Intraspinal epidural granuloma | Bacterial epidural granuloma | Mycobacterial epidural granuloma | Fungal epidural granuloma | Parasitic epidural granuloma [1D03.4] Intraspinal epidural abscess Definition: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the epidural space. This condition presents with symptoms depending on the location of the abscess. Transmission is through haematogenous spread of the infectious agent commonly from a cutaneous or mucosal source. Also known as: Intraspinal epidural abscess | epidural abscess | epidural abscess of spinal cord | spinal epidural abscess | epidural embolic abscess of spinal cord, any part [2A02.Z] Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified Also known as: Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system, unspecified | Primary neoplasm of spinal cord, cranial nerves, paraspinal nerves or remaining parts of central nervous system | Neoplasm of uncertain or unknown behaviour of spinal cord | Epidural cancer NOS [8B03] Nontraumatic epidural haemorrhage Also known as: Nontraumatic epidural haemorrhage | nontraumatic extradural brain haematoma | nontraumatic epidural brain haematoma | nontraumatic extradural haemorrhage [QC4Y] Personal history of other specified health problems Also known as: Personal history of other specified health problems | Personal history of diseases of the circulatory system | history of disease or disorder of circulatory system | personal history of conditions classifiable as diseases of the circulatory system | Personal history of diseases of the respiratory system [QA43.Z] Supervision of high-risk pregnancy, unspecified Also known as: Supervision of high-risk pregnancy, unspecified | Supervision of high-risk pregnancy [QA43.Y] Other specified supervision of high-risk pregnancy Also known as: Other specified supervision of high-risk pregnancy | Supervision of pregnancy with grand multiparity | pregnancy management affected by grand multiparity | multiparity affecting management of pregnancy, labour and delivery | pregnancy supervision for multiparity [QD84.Z] Occupational exposure to risk-factors, unspecified Also known as: Occupational exposure to risk-factors, unspecified | Occupational exposure to risk-factors | problem with occupational physical environment [MB26.A] Suicidal ideation Definition: Thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans. Also known as: Suicidal ideation | suicidal tendency | suicidal tendencies | suicidal ideation tendencies | suicide risk Excludes: Suicide attempt | Personal history of self-harm === GRAPH WALKS === --- Walk 1 --- [NA07.5] Traumatic epidural haemorrhage --RELATED_TO--> [?] Extradural or epidural haemorrhage due to birth injury Def: Haemorrhage in the plane between the skull bone and the periosteum on the inner surface of the skull from injury to the middle meningeal artery from birth trauma... --PARENT--> [?] Intracranial laceration or haemorrhage due to birth injury Def: A group of conditions characterised as a traumatic brain injury occurring when the tissue of the brain is mechanically cut or torn and bleeds in a newly delivered child due to physical pressure or inj... --- Walk 2 --- [NA07.5] Traumatic epidural haemorrhage --PARENT--> [NA07] Intracranial injury Def: Damage inflicted on the tissues of the brain as the direct or indirect result of an external force, with or without disruption of structural continuity.... --CHILD--> [NA07.2] Traumatic cerebral oedema --- Walk 3 --- [1D04.5] Intraspinal epidural granuloma Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi... --PARENT--> [1D04] Infectious granulomas of the central nervous system --RELATED_TO--> [?] Tuberculous granuloma of brain --- Walk 4 --- [1D04.5] Intraspinal epidural granuloma Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi... --PARENT--> [1D04] Infectious granulomas of the central nervous system --RELATED_TO--> [?] Meningeal tuberculoma Def: Meningeal tuberculomas are conglomerate caseous foci within the meninges of the brain, caused by dissemination of tuberculosis to the central nervous system.... --- Walk 5 --- [1D03.4] Intraspinal epidural abscess Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ... --PARENT--> [1D03] Infectious abscess of the central nervous system Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc... --CHILD--> [1D03.0] Intraspinal intramedullary abscess --- Walk 6 --- [1D03.4] Intraspinal epidural abscess Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ... --PARENT--> [1D03] Infectious abscess of the central nervous system Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc... --CHILD--> [1D03.1] Intraspinal subdural abscess
[ "[NA07.5] Traumatic epidural haemorrhage\n --RELATED_TO--> [?] Extradural or epidural haemorrhage due to birth injury\n Def: Haemorrhage in the plane between the skull bone and the periosteum on the inner surface of the skull from injury to the middle meningeal artery from birth trauma...\n --PARENT--> [?] Intracranial laceration or haemorrhage due to birth injury\n Def: A group of conditions characterised as a traumatic brain injury occurring when the tissue of the brain is mechanically cut or torn and bleeds in a newly delivered child due to physical pressure or inj...", "[NA07.5] Traumatic epidural haemorrhage\n --PARENT--> [NA07] Intracranial injury\n Def: Damage inflicted on the tissues of the brain as the direct or indirect result of an external force, with or without disruption of structural continuity....\n --CHILD--> [NA07.2] Traumatic cerebral oedema", "[1D04.5] Intraspinal epidural granuloma\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi...\n --PARENT--> [1D04] Infectious granulomas of the central nervous system\n --RELATED_TO--> [?] Tuberculous granuloma of brain", "[1D04.5] Intraspinal epidural granuloma\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by an organised collection of macrophages within the epi...\n --PARENT--> [1D04] Infectious granulomas of the central nervous system\n --RELATED_TO--> [?] Meningeal tuberculoma\n Def: Meningeal tuberculomas are conglomerate caseous foci within the meninges of the brain, caused by dissemination of tuberculosis to the central nervous system....", "[1D03.4] Intraspinal epidural abscess\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ...\n --PARENT--> [1D03] Infectious abscess of the central nervous system\n Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc...\n --CHILD--> [1D03.0] Intraspinal intramedullary abscess", "[1D03.4] Intraspinal epidural abscess\n Def: A condition of the epidural space, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition is characterised by a focal accumulation of purulent material within the ...\n --PARENT--> [1D03] Infectious abscess of the central nervous system\n Def: A focal suppurative process of the brain parenchyma, the intracranial or spinal epidural or subdural space, and less commonly the spinal cord parenchyma. The suppurative process is most commonly assoc...\n --CHILD--> [1D03.1] Intraspinal subdural abscess" ]
NA07.5
Traumatic epidural haemorrhage
[ { "from_icd11": "NA07.5", "icd10_code": "S064X9A", "icd10_title": "Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X0A", "icd10_title": "Epidural hemorrhage without loss of consciousness, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X2A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X6A", "icd10_title": "Epidural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X1A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X7A", "icd10_title": "Epidural hemorrhage with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X9S", "icd10_title": "Epidural hemorrhage with loss of consciousness of unspecified duration, sequela" }, { "from_icd11": "NA07.5", "icd10_code": "S064X0S", "icd10_title": "Epidural hemorrhage without loss of consciousness, sequela" }, { "from_icd11": "NA07.5", "icd10_code": "S064X9D", "icd10_title": "Epidural hemorrhage with loss of consciousness of unspecified duration, subsequent encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X5A", "icd10_title": "Epidural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X8A", "icd10_title": "Epidural hemorrhage with loss of consciousness of any duration with death due to other causes prior to regaining consciousness, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X3A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064X4A", "icd10_title": "Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter" }, { "from_icd11": "NA07.5", "icd10_code": "S064", "icd10_title": "Epidural hemorrhage" }, { "from_icd11": "8B03", "icd10_code": "I621", "icd10_title": "Nontraumatic extradural hemorrhage" } ]
S064X9A
Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter
A 64 year-old Caucasian female former smoker (4 pack-year) originally presented to the emergency department with painless jaundice. Physical exam revealed an afebrile female with scleral icterus and jaundice. Her abdomen was soft, non-tender, and non-distended in all quadrants with normal bowel sounds and no organomegaly. CT imaging demonstrated a large (10 cm) retroperitoneal mass, necessitating biliary stenting. Fine needle aspiration of the mass revealed a CD10 + clonal B cell population by flow cytometry, consistent with presumptive B cell lymphoma. During the staging workup for the lymphoma, right-sided cervical level IIA and III lymphadenopathy was found incidentally during a routine dental check-up, which was initially thought to be of the same disease process. She had no supraclavicular or axillary lymphadenopathy. CT demonstrated right level II/III LN and possible right base of tongue (BOT) mass. Flexible laryngoscopy revealed an exophytic mass involving the right BOT that extended to the right glosso-tonsillar sulcus and beyond the midline measuring approximately 3 cm . Excisional biopsy of two right cervical lymph nodes unexpectedly demonstrated squamous cell cancer (SCC) that was positive for p16 and HPV. Subsequently, positron emission tomography/computed tomography (PET/CT) demonstrated an FDG-avid right BOT mass (2.3 ร— 0.9 cm) with right-sided level IIA, IIB and III lymphadenopathy (all < 3 cm), consistent with biopsy-proven HPV-associated SCC . There was also an intensely FDG-avid retroperitoneal mass (8.2 ร— 13.4 ร— 10.7 cm) along with left mesenteric, left periaortic, and left retroperitoneal lymph nodes . Laparoscopic biopsy of gastroepiploic, mesenteric, and gastrocolic lymph nodes confirmed follicular lymphoma. Pathology showed relatively low number of centroblasts (fewer than 15 per high power field) compatible with low grade follicular lymphoma (WHO grade 1โ€“2) with significantly elevated Ki-67 proliferation index (~ 80%) suggesting clinical behavior similar to WHO grade 3 follicular lymphoma. Omentum and liver were not involved. Therefore, a diagnosis of synchronous stage IV T2N2bM0 HPV + SCC of right BOT and stage IIAX follicular lymphoma was made. At the time, she was relatively asymptomatic from the BOT cancer. She denied dysphagia, odynophagia, trismus, otalgia, or speech or voice change. She also denied night sweats, fevers, significant weight loss, or infectious symptoms. Videofluoroscopic swallow study evaluation was normal. ECOG performance status was 1. After stenting, the patientโ€™s bilirubin normalized and she was asymptomatic. Her case was discussed at multidisciplinary case conferences, and the initial plan was to treat the BOT cancer first due to its likely curability and shorter treatment course. Fig. 1 Flexible nasopharyngolaryngoscopy view of the right BOT mass before treatment ( a ), after 3 cycles of R-CHOP chemotherapy ( b ) and after the completion of 6 cycles of R-CHOP chemotherapy ( c ) Fig. 2 a Baseline head and neck maximum intensity projection (MIP) image demonstrating focal FDG uptake in the patientโ€™s BOT HNSCC (red arrow) as well as ipsilateral cervical adenopathy (red arrowhead). b Representative axial PET/CT slice from the same time point as in ( a ) which delineates the BOT HNSCC (red arrow) and also highlights one of the right-sided cervical lymph nodes (red arrowhead). c Head and neck MIP image following 3 cycles of R-CHOP demonstrates complete metabolic response in the patientโ€™s BOT HNSCC and partial response in the ipsilateral cervical adenopathy (red arrowhead). d Axial PET/CT image from the same time point as ( c ) shows no abnormal uptake at the BOT (persistently FDG-avid cervical nodes are not shown on this slice). e Head and neck MIP image following completion of R-CHOP therapy demonstrates very subtle increased uptake in the BOT HNSCC (red arrow, barely visible) and increasing uptake in ipsilateral cervical lymph nodes (red arrowhead). Note normal physiologic activity in the vocal cords (thin red arrow). f Representative axial PET/CT image through the neck shows an FDG-avid right level III lymph node compatible with residual HNSCC. g Head and neck MIP and ( h ) axial PET/CT images following completion of chemoradiation therapy show no evidence of metabolically active primary or nodal HNSCC Fig. 3 a Baseline whole-body MIP image demonstrating intense FDG uptake in a large retroperitoneal mass (red arrow) compatible with patientโ€™s follicular lymphoma. b Representative axial PET/CT image from the same time point as in ( a ) showing the large, FDG-avid mass (red arrow). Note the common bile duct stent (red arrowhead) that is markedly anteriorly displaced by the lymphomatous mass and explains the patientโ€™s presentation with obstructive jaundice. c Whole-body MIP image following three cycles of R-CHOP shows no residual metabolically active lymphoma. d Representative axial PET/CT image from the same time point as in ( c ) is notable for the presence of minimal residual abnormal soft tissue in the retroperitoneum (red arrow, Lugano 2), with uptake equal to blood pool, compatible with a complete metabolic response. The common bile duct stent is in near-orthotopic location now that the retroperitoneal mass has dramatically reduced in size (red arrowhead). e Whole-body MIP image at the end of therapy, again demonstrating no metabolically active tumor. f Representative axial PET/CT image from the same time point as in ( e ) again depicts the complete metabolic response (Lugano 1) and also the removal of the common bile duct stent
4.039063
0.978516
sec[1]/p[0]
en
0.999995
31093355
https://doi.org/10.1186/s41199-018-0028-6
[ "lymphoma", "cervical", "arrow", "axial", "lymph", "nodes", "time", "uptake", "hnscc", "arrowhead" ]
[ { "code": "2B33.5", "title": "Malignant lymphoma, not elsewhere classified" }, { "code": "2A80.Z", "title": "Follicular lymphoma, unspecified" }, { "code": "2B30.Z", "title": "Hodgkin lymphoma, unspecified" }, { "code": "2A86.0", "title": "Malignant lymphoma of B cell type, not elsewhere classified" }, { "code": "2B33.5&XA9780", "title": "Lymphoma of duodenum" }, { "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" } ]
=== ICD-11 CODES FOUND === [2B33.5] Malignant lymphoma, not elsewhere classified Also known as: Malignant lymphoma, not elsewhere classified | Lymphoma NOS | NHL - [non-Hodgkin lymphoma] | non-Hodgkin lymphoma | Non-Hodgkin lymphoma, NOS [2A80.Z] Follicular lymphoma, unspecified Also known as: Follicular lymphoma, unspecified | Follicular lymphoma | Brill-Symmers' disease | large cell follicular non-Hodgkin lymphoma | diffuse follicle centre lymphoma [2B30.Z] Hodgkin lymphoma, unspecified Also known as: Hodgkin lymphoma, unspecified | Hodgkin lymphoma | Hodgkin disease | malignant lymphogranuloma | malignant lymphogranulomatosis [2A86.0] Malignant lymphoma of B cell type, not elsewhere classified Also known as: Malignant lymphoma of B cell type, not elsewhere classified | B-cell lymphoma NOS [GA04] Cervicitis Also known as: Cervicitis | inflammation of cervix | inflammation of cervix uteri | Ulcer of cervix with cervicitis | Acute cervicitis [FB1Y] Other specified conditions associated with the spine Also known as: Other specified conditions associated with the spine | Other recurrent vertebral subluxation | Interspinous ligament syndrome | Spondylitis muscularis | Posterior longitudinal ligament calcification === GRAPH WALKS === --- Walk 1 --- [2B33.5] Malignant lymphoma, not elsewhere classified --RELATED_TO--> [?] Enteropathy associated T-cell lymphoma Def: An uncommon mature T-cell lymphoma of intraepithelial lymphocytes. It usually arises from the small intestine, most commonly the jejunum or ileum. Other less frequent primary anatomic sites include th... --PARENT--> [?] T-cell lymphoma of small intestine --- Walk 2 --- [2B33.5] Malignant lymphoma, not elsewhere classified --PARENT--> [2B33] Malignant haematopoietic neoplasms without further specification --CHILD--> [2B33.0] Acute leukaemia, not elsewhere classified --- Walk 3 --- [2A80.Z] Follicular lymphoma, unspecified --PARENT--> [2A80] Follicular lymphoma Def: Follicular lymphoma (FL) is a neoplasm composed of follicle centre (germinal centre) B-cells (typically both centrocytes and centroblasts/large transformed cells), which usually has at least a partial... --PARENT--> [?] Mature B-cell neoplasms Def: Non-Hodgkin lymphomas that originate from mature B lymphocytes. May reside in lymph nodes, lymphatic tissue of different organs or bone marrow and blood (then frequently called leukaemia).... --- Walk 4 --- [2A80.Z] Follicular lymphoma, unspecified --PARENT--> [2A80] Follicular lymphoma Def: Follicular lymphoma (FL) is a neoplasm composed of follicle centre (germinal centre) B-cells (typically both centrocytes and centroblasts/large transformed cells), which usually has at least a partial... --CHILD--> [2A80.1] Follicular lymphoma grade 2 --- Walk 5 --- [2B30.Z] Hodgkin lymphoma, unspecified --PARENT--> [2B30] Hodgkin lymphoma Def: Hodgkin lymphomas, previously known as Hodgkin's disease, characterised by the presence of large tumour cells in an abundant admixture of nonneoplastic cells. There are two distinct subtypes: nodular ... --PARENT--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 6 --- [2B30.Z] Hodgkin lymphoma, unspecified --PARENT--> [2B30] Hodgkin lymphoma Def: Hodgkin lymphomas, previously known as Hodgkin's disease, characterised by the presence of large tumour cells in an abundant admixture of nonneoplastic cells. There are two distinct subtypes: nodular ... --CHILD--> [2B30.Z] Hodgkin lymphoma, unspecified
[ "[2B33.5] Malignant lymphoma, not elsewhere classified\n --RELATED_TO--> [?] Enteropathy associated T-cell lymphoma\n Def: An uncommon mature T-cell lymphoma of intraepithelial lymphocytes. It usually arises from the small intestine, most commonly the jejunum or ileum. Other less frequent primary anatomic sites include th...\n --PARENT--> [?] T-cell lymphoma of small intestine", "[2B33.5] Malignant lymphoma, not elsewhere classified\n --PARENT--> [2B33] Malignant haematopoietic neoplasms without further specification\n --CHILD--> [2B33.0] Acute leukaemia, not elsewhere classified", "[2A80.Z] Follicular lymphoma, unspecified\n --PARENT--> [2A80] Follicular lymphoma\n Def: Follicular lymphoma (FL) is a neoplasm composed of follicle centre (germinal centre) B-cells (typically both centrocytes and centroblasts/large transformed cells), which usually has at least a partial...\n --PARENT--> [?] Mature B-cell neoplasms\n Def: Non-Hodgkin lymphomas that originate from mature B lymphocytes. May reside in lymph nodes, lymphatic tissue of different organs or bone marrow and blood (then frequently called leukaemia)....", "[2A80.Z] Follicular lymphoma, unspecified\n --PARENT--> [2A80] Follicular lymphoma\n Def: Follicular lymphoma (FL) is a neoplasm composed of follicle centre (germinal centre) B-cells (typically both centrocytes and centroblasts/large transformed cells), which usually has at least a partial...\n --CHILD--> [2A80.1] Follicular lymphoma grade 2", "[2B30.Z] Hodgkin lymphoma, unspecified\n --PARENT--> [2B30] Hodgkin lymphoma\n Def: Hodgkin lymphomas, previously known as Hodgkin's disease, characterised by the presence of large tumour cells in an abundant admixture of nonneoplastic cells. There are two distinct subtypes: nodular ...\n --PARENT--> [?] 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...", "[2B30.Z] Hodgkin lymphoma, unspecified\n --PARENT--> [2B30] Hodgkin lymphoma\n Def: Hodgkin lymphomas, previously known as Hodgkin's disease, characterised by the presence of large tumour cells in an abundant admixture of nonneoplastic cells. There are two distinct subtypes: nodular ...\n --CHILD--> [2B30.Z] Hodgkin lymphoma, unspecified" ]
2B33.5
Malignant lymphoma, not elsewhere classified
[ { "from_icd11": "2B33.5", "icd10_code": "C8593", "icd10_title": "Non-Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes" }, { "from_icd11": "2B33.5", "icd10_code": "C8592", "icd10_title": "Non-Hodgkin lymphoma, unspecified, intrathoracic lymph nodes" }, { "from_icd11": "2B33.5", "icd10_code": "C8591", "icd10_title": "Non-Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck" }, { "from_icd11": "2B33.5", "icd10_code": "C8599", "icd10_title": "Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites" }, { "from_icd11": "2B33.5", "icd10_code": "C8598", "icd10_title": "Non-Hodgkin lymphoma, unspecified, lymph nodes of multiple sites" }, { "from_icd11": "2B33.5", "icd10_code": "C8594", "icd10_title": "Non-Hodgkin lymphoma, unspecified, lymph nodes of axilla and upper limb" }, { "from_icd11": "2B33.5", "icd10_code": "C8597", "icd10_title": "Non-Hodgkin lymphoma, unspecified, spleen" }, { "from_icd11": "2B33.5", "icd10_code": "C8590", "icd10_title": "Non-Hodgkin lymphoma, unspecified, unspecified site" }, { "from_icd11": "2B33.5", "icd10_code": "C857", "icd10_title": "" }, { "from_icd11": "2B33.5", "icd10_code": "C859", "icd10_title": "Non-Hodgkin lymphoma, unspecified" }, { "from_icd11": "2A80.Z", "icd10_code": "C8288", "icd10_title": "Other types of follicular lymphoma, lymph nodes of multiple sites" }, { "from_icd11": "2A80.Z", "icd10_code": "C8284", "icd10_title": "Other types of follicular lymphoma, lymph nodes of axilla and upper limb" }, { "from_icd11": "2A80.Z", "icd10_code": "C8280", "icd10_title": "Other types of follicular lymphoma, unspecified site" }, { "from_icd11": "2A80.Z", "icd10_code": "C8283", "icd10_title": "Other types of follicular lymphoma, intra-abdominal lymph nodes" }, { "from_icd11": "2A80.Z", "icd10_code": "C8285", "icd10_title": "Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb" } ]
C8593
Non-Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes
The patient was a 76-year-old male who presented to Lanzhou University First Hospital on August 5, 2021, with upper abdominal bloating and mild pain persisting for over one month. He reported no other symptoms, and an abdominal ultrasound conducted at another local hospital indicated the presence of a liver mass. His medical history included chronic hepatitis B for over 30 years, hypertension, diabetes, and cataract surgery with intraocular lens implantation. Upon physical examination, the patient exhibited normal skin and mucosal color without jaundice, a flat abdomen devoid of abdominal wall varices, and no remarkable gastrointestinal contour or peristalsis. There was no tenderness upon abdominal palpation, and the liver was palpable below the rib margin. Murphyโ€™s sign was negative, and bowel sounds were noted at a rate of four times per minute. Laboratory tests revealed the following values within normal limits: white blood cell count (WBC: 5.03 ร— 10^9/L), neutrophil ratio (NEUT%: 68.8%), hemoglobin (HGB: 124 g/L), and platelet count (PLT: 205 ร— 10^9/L). Tumor markers were elevated, including alpha-fetoprotein (AFP: 289 U/mL), carbohydrate antigen 19-9 (CA 19-9: 109 U/mL), carcinoembryonic antigen (CEA: 1.4 ng/mL), and ferritin (519 ng/mL). Biochemical analysis indicated that aspartate aminotransferase (AST: 67 U/L), alanine aminotransferase (ALT: 216 U/L), total bilirubin (TBIL: 16.4 ยตmol/L), direct bilirubin (DBIL: 4.8 ยตmol/L), alkaline phosphatase (ALP: 216 U/L), gamma-glutamyl transferase (GGT: 371 U/L), and glucose (GLU: 6.59 mmol/L) were outside normal ranges. Tests for hepatitis B (2+, 5+) and hepatitis B virus DNA (HBV DNA < 100 IU/mL) were negative. Brain natriuretic peptide (BNP: 143.4 pg/mL) was outside the normal range. The enhanced abdominal CT scan revealed a large mass-like abnormal enhancement in the right lobe of the liver, suggesting hepatocellular carcinoma (HCC) with portal vein thrombosis in the main trunk as well as the left and right branches, cirrhosis, and portal hypertension (including esophageal and gastric fundus varices). Magnetic resonance imaging (MRI) of the liver revealed a large abnormally enhanced mass in the right lobe, suggesting hepatocellular carcinoma (HCC) with intratumoral hemorrhage and portal vein thrombosis in the main trunk as well as the left and right branches; cirrhosis, splenomegaly, a small amount of ascites, liver disease, and gallbladder disease . The patient was diagnosed with HCC of the right lobe, post-hepatitis B cirrhosis, grade 3 hypertension (very high risk), and type 2 diabetes, classified as stage IIIa according to the CNLC staging system . An initial multidisciplinary team (MDT) discussion resulted in a treatment plan that included hepatic artery infusion chemotherapy (HAIC) treatment (FOLFOX), combined with 200 mg sintilimab and sorafenib 0.4 g bid targeted therapy. The patient was discharged on August 16 th , 2021. After discharge, oral sorafenib 0.4g bid targeted therapy was prescribed. On the second admission, a second MDT discussion was held to adjust the protocol: HAIC treatment and percutaneous liver puncture for radioactive 125 I particle implantation, combined with 200 mg sintilimab and sorafenib targeted therapy. After the fifth admission, there was no significant change in the portal vein tumor thrombus. The third MDT was conducted, and on March 29, 2022, โ€œpercutaneous hepatic puncture radioactive 125I particle implantationโ€ radiation therapy was performed. Additionally, because the patient could not tolerate bisphosphonates, the treatment was changed to once-daily targeted therapy with 8 mg of lenvatinib. The patient underwent abdominal CT (plain + enhanced) at the sixth admission on June 21, 2022, compared with the previous scan on March 28, 2022 showed a lesion in the right lobe of the liver with little change, along with occlusion of the main portal vein and portal spongiosis, which remained little changed from the previous scan . After comprehensive consideration of the timing of surgical resection following successful conversion, the decision was made to perform surgical treatment. Subsequently, another preoperative evaluation was conducted, which included gastroscopy, revealing a 0-Ia+IIc type lesion can be seen near the anterior wall of the cardia, with a size of about 3 ร— 2 cm and chronic atrophic gastritis . After the fourth MDT, the gastric tumor was initially resected via laparoscopy combined with endoscopy under general anesthesia on July 4, 2022 (endoscopic mucosal resection, partial gastrectomy, and D1 lymph node dissection). Due to the patientโ€™s poor cardiopulmonary function during the operation, the laparoscopic surgery was interrupted and converted into an open procedure for right hepatectomy and cholecystectomy . The postoperative gastric histopathology report indicated ectopic hyperplasia of adenoepithelial hyperdifferentiated epithelial endothelium and focal carcinomatous lesions . Two trans arterial chemoembolization (TACE) procedures were performed on September 13, 2022, and April 3, 2023, as adjuvant treatment following hepatic resection, in accordance with the Guidelines for the Diagnosis and Treatment of Primary Hepatocellular Carcinoma . Postoperative abdominal CT and MRI were performed on December 18, 2023, which revealed the disappearance of the portal vein thrombus and widening of the hepatic fissure . Remarkably, the patient demonstrated a favorable prognosis, recovering well and remaining free of tumor recurrence or metastasis during over eight months of follow-up.
4.023438
0.976563
sec[1]/p[0]
en
0.999996
39655079
https://doi.org/10.3389/fonc.2024.1440171
[ "abdominal", "liver", "portal", "vein", "hepatitis", "tumor", "lobe", "hepatic", "targeted", "over" ]
[ { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" }, { "code": "DB9Z", "title": "Diseases of liver, unspecified" }, { "code": "DB97.Z", "title": "Inflammatory liver disease, unspecified" }, { "code": "DB99.7", "title": "Hepatic failure without mention whether acute or chronic" }, { "code": "LB20.0Y", "title": "Other specified structural developmental anomalies of liver" }, { "code": "LB20.0Z", "title": "Structural developmental anomalies of liver, unspecified" } ]
=== ICD-11 CODES FOUND === [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 [DB9Z] Diseases of liver, unspecified Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy [DB97.Z] Inflammatory liver disease, unspecified Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS [DB99.7] Hepatic failure without mention whether acute or chronic Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS [LB20.0Y] Other specified structural developmental anomalies of liver Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity [LB20.0Z] Structural developmental anomalies of liver, unspecified Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver === GRAPH WALKS === --- Walk 1 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --CHILD--> [MD81.0] Abdominal tenderness --- Walk 2 --- [MD81.3] Acute abdomen Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases... --PARENT--> [MD81] Abdominal or pelvic pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region.... --CHILD--> [MD81.2] Generalised abdominal pain Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, or cramps, spasmodic contraction causing severe pain in the abdominal area in general.... --- Walk 3 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Maternal care for viable fetus in abdominal pregnancy --PARENT--> [?] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --- Walk 4 --- [JA01.0] Abdominal pregnancy Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy.... --EXCLUDES--> [?] Maternal care for viable fetus in abdominal pregnancy --PARENT--> [?] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --- Walk 5 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --CHILD--> [ME04.Y] Other specified ascites --- Walk 6 --- [ME04.Z] Ascites, unspecified --PARENT--> [ME04] Ascites Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma... --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen
[ "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --CHILD--> [MD81.0] Abdominal tenderness", "[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --CHILD--> [MD81.2] Generalised abdominal pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, or cramps, spasmodic contraction causing severe pain in the abdominal area in general....", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Maternal care for viable fetus in abdominal pregnancy\n --PARENT--> [?] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....", "[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --EXCLUDES--> [?] Maternal care for viable fetus in abdominal pregnancy\n --PARENT--> [?] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.Y] Other specified ascites", "[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen" ]
MD81.3
Acute abdomen
[ { "from_icd11": "MD81.3", "icd10_code": "R100", "icd10_title": "Acute abdomen" }, { "from_icd11": "JA01.0", "icd10_code": "O0000", "icd10_title": "Abdominal pregnancy without intrauterine pregnancy" }, { "from_icd11": "JA01.0", "icd10_code": "O000", "icd10_title": "Abdominal pregnancy" }, { "from_icd11": "ME04.Z", "icd10_code": "R180", "icd10_title": "Malignant ascites" }, { "from_icd11": "ME04.Z", "icd10_code": "R18", "icd10_title": "Ascites" }, { "from_icd11": "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" } ]
R100
Acute abdomen
A 1-year-old girl was born uneventfully and at term. At 1 month of age, she experienced brief tonic seizures of the upper limbs with eye deviation several times a day. At 2 months of age, she developed spasms in clusters following a series of three or four brief tonic seizures a day. The patient was admitted to our hospital at the age of 4 months. At this point, zonisamide and clonazepam treatments were initiated. However, the spasms that occurred in clusters were refractory to these treatments and increased to approximately 10 times a day. Typically, each spasm episode was accompanied by the following: slightly tonic limb contraction, head adverse motion, and eye deviation to the right. These seizures lasted around 1 min. The periodic spasms that occurred in clusters consisted of a brief symmetrical contraction of the axial muscles that was associated with intense head nodding. At this point, she could gaze and track subjects. However, after the onset of this type of seizure, her development arrested. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain revealed a calcified lesion in the right frontal lobe and similar small calcified lesions in the left frontal lobe and subventricular regions. This massive tuber seemed to overlap the rolandic area . DNA that was isolated from the patientโ€™s blood revealed a heterozygous mutation, IVS29 + 1 G > A, which has been reported as a splicing mutation of intron 29. On the basis of these radiological findings and the genetic analysis, the patient was diagnosed with tuberous sclerosis (TS). Single-photon emission computed tomography (SPECT) revealed increased blood flow in the right frontal lobe . We performed magnetoencephalography (MEG) while the patient was in sedated sleep with Triclofos Sodium. We used a whole-head neuromagnetometer (NeuromagSystem, Elekta Neuromag Oy, Helsinki, Finland) that consisted of 102 identical sensors, each of which contained two planar gradiometers that were positioned at right angles to each other and one magnetometer. We analyzed the spikes using equivalent current dipole modeling and superimposed MEG spike sources (MEGSSs) on the patientโ€™s MRI. We used local sensors to place the MEGSSs with a goodness of fit of more than 80%. MEG showed dipole sources that were distributed in the right parietotemporal areas and that were concordant with the peritubular region . There was no spike source in the left hemisphere. The patient had no clinical seizures during the MEG recording. We recorded the scalp EEG with a digital sampling frequency of 500 Hz for 8 h using a Nihon Kohden Neurofax (Nihon Kohden Corporation, Tokyo, Japan) using the international 10โ€“20 scalp electrode system. The interictal paroxysmal discharges showed repeated high-voltage polyspikes and spike and wave complexes that occurred every 10โ€“20 s over the right centroparietotemporal areas. The adverse head motions and eye deviations to the right that were followed by spasms were recorded thrice, and the seizures involving tonic limb contractions that were not followed by spasms were recorded twice. On the ictal EEG, theta bursts preceded the adverse head motions and eye deviations. At the beginning of the periodic spasms, the recordings showed no preceding spikes but showed slow waves that were superimposed with low-amplitude fast activity over the right parietotemporal region . During the periodic spasms, the EEG showed independent high-amplitude slow waves from the right and left hemispheres. We exported the scalp EEG video data sections that were recorded from around the time of the seizures with spasms and performed an MBFA using Short Spectrum Eye software (Gram Corporation, Saitama, Japan) in order to analyze the frequency and distribution of FOs. We analyzed the power spectrograms of the frequency bands between 5.7 (time constant, 0.03 s) and 120 Hz with a frequency resolution of 2 Hz and a temporal resolution of 10 ms and measured the amplitude of each frequency in order to calculate the power in ฮผV 2 in 26 episodes of spasms . As a result, in 14 spasm episodes, the analysis showed FOs of 60โ€“70 Hz with high spectral power that were predominantly over the right centroparietotemporal areas 100โ€“200 ms before each spasm . In nine spasms, the records were contaminated with movement artifacts and/or muscle activity, and their interpretation was difficult. The remaining three spasms lacked clear gamma activity despite minimal artifacts and occurred mostly in the ending part of a series. This region was approximately concordant with the area around the cortical tuber that was seen on MRI, the area of high blood perfusion observed on ictal SPECT, and the cluster of spike sources observed on MEG. None of the FOs appeared at the beginning of the subsequent tonic motion (data not shown). We were not able to detect interictal high gamma activity, although we analyzed the 20 min of interictal EEG. At the age of 5 months, tuber resection was performed. Three months postoperatively, the periodic spasms had completely disappeared, and another type of brief tonic or partial myoclonus seizure that occurred once a day remained. In the analysis of the ictal EEG performed at this time, high gamma activity was not detected over the right lobes, but other high gamma activity appeared in the left central and parietal areas. One year postoperatively, the brief tonic seizures decreased to monthly, and she could sit with support. One year and seven months postoperatively, the brief tonic seizures disappeared, and she has been seizure-free.
4.230469
0.880859
sec[1]/p[0]
en
0.999998
22553953
https://doi.org/10.1186/1824-7288-38-15
[ "that", "spasms", "tonic", "seizures", "brief", "this", "activity", "occurred", "head", "frequency" ]
[ { "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": "MB47.3", "title": "Cramp or spasm" }, { "code": "8A62.0", "title": "Infantile spasms" }, { "code": "DB72.0", "title": "Anal spasm" }, { "code": "MD81.4", "title": "Other and unspecified abdominal pain" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" } ]
=== 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 [MB47.3] Cramp or spasm Also known as: Cramp or spasm | cramp | crampy | spasm | Facial hemispasm Excludes: Infantile spasms | carpopedal spasm [8A62.0] Infantile spasms Definition: Syndrome characterised by the subacute onset of brief, repeated seizures with axial or limb flexion, occurring in clusters. EEG shows hypsarrhythmia, i.e., chaotic, high voltage slowing multifocal spikes, with ictal abrupt decremental pattern. Various structural brain pathologies may be present, or no cause may be found. Two-thirds of children have subsequent cognitive deficits. Also known as: Infantile spasms | West syndrome | IS -[infantile spasm] | salaam spasm | salaam tic [DB72.0] Anal spasm Definition: Spasm of the anal sphincter muscle. Also known as: Anal spasm | proctospasm | anorectal spasm | rectal spasm [MD81.4] Other and unspecified abdominal pain Also known as: Other and unspecified abdominal pain | abdominal colic | abdominal cramp | abdominal crisis | abdominal distress Excludes: Infantile colic | Chronic primary abdominal pain syndrome | Chronic primary visceral pain [GA16.Y] Other specified acquired abnormalities of uterus, except cervix Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus === GRAPH WALKS === --- Walk 1 --- [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--> [8A80.1] Migraine with aura Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso... --- Walk 3 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --- Walk 4 --- [QA76] Medication or substance that is known to be an allergen without injury or harm Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.... --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm --CHILD--> [QA71] Underdosing without injury or harm Def: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccur... --- Walk 5 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.1] Underdosing, as mode of injury or harm --- Walk 6 --- [PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm Def: Incorrect dose - too high...
[ "[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--> [8A80.1] Migraine with aura\n Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso...", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance", "[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [QA71] Underdosing without injury or harm\n Def: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccur...", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm", "[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high..." ]
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
At one month follow-up in rheumatology clinic, the patient was started on additional steroid-sparing therapy with monthly infusions of cyclophosphamide (750 mg/m 2 ) given systemic SLE with cutaneous manifestations. After completing four cycles of cyclophosphamide and steroid taper, cardiac MRI was repeated after 3 months to assess interval activity. His severely impaired LVEF and pericardial effusions were resolved with no evidence of myocardial scarring or evidence suggesting active SLE on LGE and edema sequences. Echocardiogram after 6 months also showed normal LVEF > 55%, left ventricular diastolic function and mass, wall motion, and global longitudinal strain similar to his baseline findings. Laboratory evaluation showed a significant improvement in his inflammatory markers and cytopenias (leukopenia and anemia) shown in Table 2 . His SLE is currently treated with mycophenolate mofetil 100 mg bid (transitioned from cyclophosphamide given favorable side effect profile with potentially long-term therapy) for maintenance therapy with a prednisone taper (60 mg daily for three weeks, taper by 10 mg every two weeks down to 10 mg daily), hydroxychloroquine 400 mg daily, and aforementioned heart failure guideline-directed medical therapy. His functional status is classified as New York Heart Association (NYHA) class I with continued clinical recovery (Table 3 ). Table 2 Laboratory work-up performed at 3-month outpatient rheumatology follow-up Laboratory test index Results Reference ranges Total WBC count 7.9 ร— 10 3 mcL 4.0โ€“10.5 ร— 10 3 mcL Neutrophils 55% 40.0โ€“80.0% Lymphocytes 29% 15.0โ€“45.0% Absolute lymphocyte count 2.29 ร— 10 3 mcL 1.0โ€“4.5 ร— 10 3 mcL Hb 15.1 g/dL 13.8โ€“17.0 g/dL Platelets 239 ร— 10 3 mcL 150โ€“450 ร— 10 3 mcL C3 104 mg/dL 90โ€“180 mg/dL C4 21 mg/dL 10โ€“40 mg/dL DNA double stranded Ab 69 IU/mL 0โ€“9 IU/mL Urine protein/creatinine ratio 120 mg/24 h < 0.2 mg/24 h WBC, white blood count; Hb, hemoglobin, C3, complement c3; C4, complement c4 Table 3 Timeline sequence of patientโ€™s critical clinical events September 2019 Patient was diagnosed with SLE based on EULAR/ACR criteria and started on hydroxychloroquine after presenting with arthritis, alopecia, rash, and serologic evaluation. Findings of skin biopsy were suggestive of cutaneous SLE 3.7.20. HD#1 Patient presented to the emergency department of an outside facility with pleuritic chest pain, fatigue, dyspnea, fevers, and worsening rash. Laboratory workup was suggestive of SLE flare and sepsis likely secondary to MSSA bacteremia with a skin source. Broad-spectrum antibiotics and pulse dose corticosteroids (solumedrol 1 mg/kg for three days) initiated. Initial transthoracic echocardiogram demonstrated normal LVEF > 55% with no valvular pathology 3.9.20. HD #3 Patient was transferred to our facility per his insurance eligibility in a hemodynamically stable condition. Intravenous cefazolin was continued for MSSA bacteremia. Repeat blood and surveillance blood cultures were negative. TEE showed LVEF of > 45% but no evidence of valvular pathology 3.12.21. HD #6 With recurrence of dyspnea and pleuritic chest pain and hemodynamic instability, the patient was transferred to the ICU. A CT chest with pulmonary embolism protocol demonstrated possible pulmonary embolism, bilateral pleural effusions, dense consolidations with pulmonary nodules, and pericardial effusions. Serial TTE on the same day showed interval decline in LVEF of 45% down to 25% and worsening pericardial effusions. Treatment with heparin drip for possible pulmonary emboli, broad-spectrum IV antibiotics for possible septic emboli, solumedrol 500 mg IV q12h for severe SLE co-activity was started, hydroxychloroquine 400 mg daily was continued, and vasopressors for cardiogenic shock were initiated 3.13.20. HD #7 Guideline directed medical therapy for heart failure was escalated. A cardiac MRI demonstrated a reduced LVEF 25% and moderate global hypokinesis with worsening pericardial effusions; however, this limited study did not reveal an etiology explain his decompensation. The patient was transferred to an institution with capabilities to treat advanced heart failure 3.14.20. HD #8 A repeat TTE showed markedly decreased LVEF 10% with severe global hypokinesis. Intravenous steroids and guideline-directed heart failure therapy was continued 3.17.20. HD #11 In efforts to further explain cause of decompensation and unrevealing CMR, endomyocardial biopsy was performed along with a concurrent Left and right heart catheterization. Coronary angiogram showed normal cardiac output, cardiac index, left and right-sided filling pressures, and non-obstructive coronary arteries 3.18.20. HD #12 With improving hemodynamics on SLE and heart failure- targeted therapy, the patient was weaned off vasopressors, and repeat TTE showed mildly dilated left ventricle with improved LVEF 45% from previously 10%. The patient was discharged on oral medical therapy of heart failure, hydroxychloroquine, and prednisone for SLE, and IV antibiotics for MSSA bacteremia in a stable condition Late Marchโ€“April 2020 The patient was transitioned to four cycles of steroid-sparing therapy with Cyclophosphamide and later transitioned to mycophenolate mofetil due to favorable side effect risk profile. Hydroxychloroquine, and heart failure therapy were continued Septemberโ€“November 2020 A repeat Cardiac MRI and TTE to assess interval SLE activity showed normal left ventricular systolic function and no evidence of myocardial scarring or pericardial effusions. Patient returned to normal baseline functional status
4.085938
0.950684
sec[1]/p[2]
en
0.999997
34120592
https://doi.org/10.1186/s12872-021-02102-6
[ "heart", "lvef", "failure", "effusions", "cardiac", "pericardial", "hydroxychloroquine", "cyclophosphamide", "evidence", "laboratory" ]
[ { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "BC4Z", "title": "Diseases of the myocardium or cardiac chambers, unspecified" }, { "code": "BD1Z", "title": "Heart failure, unspecified" }, { "code": "LA8Z", "title": "Structural developmental anomaly of heart or great vessels, unspecified" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "DA96.05", "title": "Intestinal failure" }, { "code": "MG4A", "title": "Multi organ failure" }, { "code": "CB41", "title": "Respiratory failure" }, { "code": "CB41.2Z", "title": "Respiratory failure, unspecified" }, { "code": "GB6Z", "title": "Kidney failure, unspecified" } ]
=== ICD-11 CODES FOUND === [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified Also known as: Diseases of the myocardium or cardiac chambers, unspecified | Heart disease NOS | cardiac disease NOS [BD1Z] Heart failure, unspecified Also known as: Heart failure, unspecified | myocardial failure | cardiac decompensation | cardiac failure | cardiac failure NOS [LA8Z] Structural developmental anomaly of heart or great vessels, unspecified Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [DA96.05] Intestinal failure Definition: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth. Also known as: Intestinal failure [MG4A] Multi organ failure Definition: Failure of function of more than one organ or organ system, not otherwise specified Also known as: Multi organ failure | MODS - [multi organ dysfunction syndrome] | multiple organ failure | multisystem organ failure | multiorgan failure syndrome [CB41] Respiratory failure Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high. Also known as: Respiratory failure | lung failure NOS | pulmonary failure Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn [CB41.2Z] Respiratory failure, unspecified Also known as: Respiratory failure, unspecified | Respiratory failure, unspecified as acute or chronic | respiration failure | respiratory failure NOS | respiration failed [GB6Z] Kidney failure, unspecified Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS === GRAPH WALKS === --- Walk 1 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- Walk 2 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --CHILD--> [?] Ischaemic heart diseases --- Walk 3 --- [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --CHILD--> [BC42] Myocarditis Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an... --- Walk 4 --- [BC4Z] Diseases of the myocardium or cardiac chambers, unspecified --PARENT--> [?] Diseases of the myocardium or cardiac chambers Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as... --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 5 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --CHILD--> [BD12] High output syndromes Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure.... --- Walk 6 --- [BD1Z] Heart failure, unspecified --PARENT--> [?] Heart failure --CHILD--> [BD11] Left ventricular failure Def: A clinical syndrome characterised by abnormalities of left ventricular function resulting in pulmonary congestion and fluid retention....
[ "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --CHILD--> [?] Ischaemic heart diseases", "[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC42] Myocarditis\n Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...", "[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --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...", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --CHILD--> [BD12] High output syndromes\n Def: Increased cardiac output above normal associated with anaemia, arteriovenous fistulas, thyrotoxicosis and other syndromes. May result in heart failure....", "[BD1Z] Heart failure, unspecified\n --PARENT--> [?] Heart failure\n --CHILD--> [BD11] Left ventricular failure\n Def: A clinical syndrome characterised by abnormalities of left ventricular function resulting in pulmonary congestion and fluid retention...." ]
BE2Y
Other specified diseases of the circulatory system
[ { "from_icd11": "BC4Z", "icd10_code": "I5181", "icd10_title": "Takotsubo syndrome" }, { "from_icd11": "BC4Z", "icd10_code": "I5189", "icd10_title": "Other ill-defined heart diseases" }, { "from_icd11": "BC4Z", "icd10_code": "I519", "icd10_title": "Heart disease, unspecified" }, { "from_icd11": "BC4Z", "icd10_code": "I510", "icd10_title": "Cardiac septal defect, acquired" }, { "from_icd11": "BC4Z", "icd10_code": "I515", "icd10_title": "Myocardial degeneration" }, { "from_icd11": "BC4Z", "icd10_code": "I51", "icd10_title": "Complications and ill-defined descriptions of heart disease" }, { "from_icd11": "BC4Z", "icd10_code": "I516", "icd10_title": "" }, { "from_icd11": "BC4Z", "icd10_code": "I518", "icd10_title": "Other ill-defined heart diseases" }, { "from_icd11": "BD1Z", "icd10_code": "I5023", "icd10_title": "Acute on chronic systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5030", "icd10_title": "Unspecified diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5031", "icd10_title": "Acute diastolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5022", "icd10_title": "Chronic systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5084", "icd10_title": "End stage heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5020", "icd10_title": "Unspecified systolic (congestive) heart failure" }, { "from_icd11": "BD1Z", "icd10_code": "I5021", "icd10_title": "Acute systolic (congestive) heart failure" } ]
I5181
Takotsubo syndrome
Immunocompromised patients are at risk of developing hyperinfection syndrome and disseminated strongyloidiasis that can be fatal, mostly due to Gram-negative bacteremia and sepsis . Severe strongyloidiasis typically follows corticosteroid therapy, but has also been described in patients with lymphoma, leukemia, human T-cell lymphotropic virus (HTLV) and HIV infection, malnutrition, chronic renal failure and end-stage renal disease, alcoholism, diabetes mellitus, advanced age, and in solid organ transplant recipients . Therefore, it is mandatory to diagnose and treat chronic carriers, in order to prevent the hyperinfection syndrome if immunosuppressive treatment is planned . With treatment, the mortality rate of hyperinfection is close to 60%; without effective treatment, it is likely to be around 100% . Our patient had HIV infection diagnosed 3 months earlier (with a satisfactory CD4 count and undetectable HIV viral load) and a localized T cell lymphoma. Other potential risk factors for S. stercoralis infection, such as systemic lymphoma, other malignancies, or alcohol addiction, were investigated and excluded. Unfortunately, HTLV-1 and HTLV-2 serology was not performed during his hospital stay. However, considering that the Strongyloides hyperinfection, as well as the T-cell lymphoma are frequently associated with HTLV-1/2 infection, it would have been ideal to screen the patient for HIV/HTLV1/2-coinfection, especially since the immune status of the patient was rather good. According to the classical definition, the case described complies with a severe form of Strongyloides hyperinfection: exacerbation of gastrointestinal and pulmonary symptoms was seen, and increased numbers of larvae were found in stool and sputum. Larvae in non-disseminated hyperinfection are increased in numbers but confined to the organs normally involved in the pulmonary autoinfective cycle (i.e., gastrointestinal tract, peritoneum, lungs). The term โ€˜disseminated infectionโ€™ is often used to refer to migration of larvae to organs beyond the range of the pulmonary autoinfective cycle: larvae are also found in the central nervous system, kidneys, liver, and almost any other organ. In our patient, urine and other body fluids were not tested for Strongyloides , because neither brain nor abdominal CT showed any renal or encephalic injury. Moreover, the elevated value of serum creatinine at admission was immediately normalized after adequate hydration. The drug of choice for strongyloidiasis is ivermectin, which paralyses nematodes by increasing membrane permeability to chloride ions. Nevertheless, there are no subcutaneous formulations of these drugs approved for use in humans, and the appropriate dose, pharmacokinetics, and potential toxicity are unknown. However, in severe Strongyloides infection, there is often extensive larval infiltration of the small bowel that can cause a paralytic ileus and malabsorption, including impaired oral absorption of antihelmintic agents. This may explain why, despite the proper use of antihelmintic therapy with ivermectin via nasogastric tube, our patient did not show any clinical improvement. Conversely, the very high concentration of ivermectin (62.7 ng/mL) achieved after subcutaneous administration of ivermectin led to a rapid improvement in his clinical condition and rapid disappearance of the parasite from biological samples, without any adverse reaction. In our patient, we delayed the start of subcutaneous ivermectin because we thought that prolonged oral treatment would suffice. In addition, the use of veterinary drugs required an approval of the hospital Ethics Committee, and the supply was rather slow. Although data on the pharmacokinetics of subcutaneous ivermectin in humans are lacking, the use of veterinary subcutaneous ivermectin formulation in patients with hyperinfection syndrome and disseminated strongyloidiasis failing oral treatment should be considered promptly, as a life-saving option. In a recent report, Barret et al. summarized the published reports of subcutaneous ivermectin use (200 ฮผg/kg daily or on alternate days) in 22 patients with severe strongyloidiasis or hyperinfection . Treatment course length was generally dictated by clinical response, and varied from 3 to 11 doses. Only five case reports include serum ivermectin concentrations, although there is a lack of consistency in the timing of measurement of levels . Serum ivermectin concentrations measured during treatment vary from 2 ng/mL after the first doses of 200 ฮผg/kg , to 35.4 ng/mL after seven doses of 200 ฮผg/kg . There is no consensus on how subcutaneous ivermectin should be monitored, and the majority of pharmacokinetic studies are in farm animals. Ivermectin is protein-bound, so pharmacokinetics are altered by hypoalbuminaemia, a common result of severe Strongyloides i nfection. However, serum ivermectin concentrations and signs and symptoms of neurotoxicity should be carefully monitored . Our patient had a complete resolution of symptoms, and direct examination of multiple stool samples remained negative. However, microscopic stool examination is inadequate, owing to low sensitivity to exclude an eventually persisting infection. A combination of concentration methods, like the Baermann method and/or agar plate culture (in particular, the technique described by Koga) with or without polymerase chain reaction (PCR), are more sensitive, but less commonly used techniques. PCR is not available at all diagnostic centers and, at the moment, is only applicable in research settings .
4.367188
0.523438
sec[1]/p[1]
en
0.999995
30274442
https://doi.org/10.3390/tropicalmed3020046
[ "ivermectin", "hyperinfection", "infection", "subcutaneous", "strongyloidiasis", "strongyloides", "patients", "disseminated", "that", "lymphoma" ]
[ { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "1G40", "title": "Sepsis without septic shock" }, { "code": "FA10.Z", "title": "Direct infections of joint, unspecified" }, { "code": "1D9Z", "title": "Unspecified viral infection of unspecified site" }, { "code": "1A40.Z", "title": "Infectious gastroenteritis or colitis without specification of infectious agent" }, { "code": "EB90.40", "title": "Dystrophic calcification of the skin of uncertain or unspecified aetiology" }, { "code": "ND56.0", "title": "Superficial injury of unspecified body region" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "EM0Z", "title": "Skin disease of unspecified nature" }, { "code": "EB90.2Z", "title": "Cutaneous or subcutaneous xanthomata of unspecified type" } ]
=== ICD-11 CODES FOUND === [1H0Z] Infection, unspecified Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS [1G40] Sepsis without septic shock Definition: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Also known as: Sepsis without septic shock | sepsis without septic shock with known organism | Sepsis-associated hypotension | Unspecified sepsis | general septic intoxication Excludes: Septicaemia | Sepsis of fetus or newborn [FA10.Z] Direct infections of joint, unspecified Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection [1D9Z] Unspecified viral infection of unspecified site Also known as: Unspecified viral infection of unspecified site | viral infection NOS | viral disorder NOS | disease caused by virus | unspecified viremia [1A40.Z] Infectious gastroenteritis or colitis without specification of infectious agent Also known as: Infectious gastroenteritis or colitis without specification of infectious agent | Gastroenteritis or colitis without specification of infectious agent | diarrhoea and gastroenteritis of presumed infectious origin | diarrhoeal enteritis | GE - [gastroenteritis] [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 [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 [EM0Z] Skin disease of unspecified nature Also known as: Skin disease of unspecified nature | Diseases of cutaneous vasculature | Diseases of subcutaneous tissue | Diseases of the dermis | Diseases of the epidermis [EB90.2Z] Cutaneous or subcutaneous xanthomata of unspecified type Also known as: Cutaneous or subcutaneous xanthomata of unspecified type | Cutaneous or subcutaneous xanthomata | Xanthoma due to specified disorder of lipid metabolism === GRAPH WALKS === --- Walk 1 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --- Walk 2 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified --- Walk 3 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Sepsis of fetus or newborn --CHILD--> [?] Sepsis of fetus or newborn due to Staphylococcus aureus infection --- Walk 4 --- [1G40] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --EXCLUDES--> [?] Septicaemia --EXCLUDES--> [?] Sepsis without septic shock Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.... --- Walk 5 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Reactive arthropathies Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti... --- Walk 6 --- [FA10.Z] Direct infections of joint, unspecified --PARENT--> [FA10] Direct infections of joint Def: Hematogenic or non-hematogenic infections of joints.... --EXCLUDES--> [?] Reactive arthropathies Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti...
[ "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --EXCLUDES--> [?] Infection arising from device, implant or graft, not elsewhere classified", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Sepsis of fetus or newborn\n --CHILD--> [?] Sepsis of fetus or newborn due to Staphylococcus aureus infection", "[1G40] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....\n --EXCLUDES--> [?] Septicaemia\n --EXCLUDES--> [?] Sepsis without septic shock\n Def: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection....", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Reactive arthropathies\n Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti...", "[FA10.Z] Direct infections of joint, unspecified\n --PARENT--> [FA10] Direct infections of joint\n Def: Hematogenic or non-hematogenic infections of joints....\n --EXCLUDES--> [?] Reactive arthropathies\n Def: A disease of the joints, caused by an infection in another part of the body, auto-immune disease, or post-vaccination. This disease is characterised by a secondary inflammation of the joints in reacti..." ]
1H0Z
Infection, unspecified
[ { "from_icd11": "1H0Z", "icd10_code": "B999", "icd10_title": "Unspecified infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A312", "icd10_title": "Disseminated mycobacterium avium-intracellulare complex (DMAC)" }, { "from_icd11": "1H0Z", "icd10_code": "B998", "icd10_title": "Other infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A249", "icd10_title": "Melioidosis, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "R6511", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "R6510", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "A318", "icd10_title": "Other mycobacterial infections" }, { "from_icd11": "1H0Z", "icd10_code": "A319", "icd10_title": "Mycobacterial infection, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B948", "icd10_title": "Sequelae of other specified infectious and parasitic diseases" }, { "from_icd11": "1H0Z", "icd10_code": "B949", "icd10_title": "Sequelae of unspecified infectious and parasitic disease" }, { "from_icd11": "1H0Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "N771", "icd10_title": "Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B94", "icd10_title": "Sequelae of other and unspecified infectious and parasitic diseases" } ]
B999
Unspecified infectious disease
A 13-year-old female from Binh Duong province, northwest of Ho Chi Minh City, presented in February 2022 with a history of 06 days of high fever. She was diagnosed with ฮฒ-thalassemia major at a tertiary pediatric hospital in Ho Chi Minh City at the age of 07 years. She received periodic blood transfusions, as indicated by a hematologist. Her main symptoms included persistently high fever, malaise, loss of appetite, vomiting, dark-colored loose stool, and petechiae, and she was undergoing cyclic menstruation. On admission to the provincial hospital, she was alert, with critically pale skin and mucosa, hepatosplenomegaly, increased heart rate of 130 beats per minute, blood pressure of 90/65 mm Hg, normal heart and lung sounds, and a soft abdomen. Laboratory results revealed pancytopenia (white blood cells, 2.7 ร— 10 9 /L, hemoglobin 4.1 g/dL, hematocrit 17%; platelets, 86 ร— 10 9 /L), positive dengue NS1 antigen and IgM ELISA-based tests, elevated transaminase (aspartate transaminase [AST], 468 U/L and alanine transaminase [ALT], 170 U/L), serum albumin 35 g/L, normal coagulation function tests, serum creatinine 67 ยตmol/L, cardiac troponin I 191 pg/mL, and creatine kinase-MB 30 U/L. Her bedside POCUS revealed normal cardiac structures, no signs of cardiac effusion, and normal systolic and diastolic functions, with an ejection fraction (EF) of 70%. The patient was diagnosed with dengue hemorrhagic fever. She was initially treated with a nasal oxygen cannula, red blood cell transfusion, and judicious normal saline infusion, in accordance with the World Health Organization guidelines. Fifteen hours after hospitalization, her clinical status progressively worsened with significant breathing difficulty, bilateral decreases in lung sound, marked ascites, mild pericardial effusion, and EF 64% on bedside sonography. The monitored laboratory tests revealed a dramatic reduction in platelet count of 25 ร— 10 9 /L, hematocrit of 31%, substantially elevated transaminase levels , marked dysfunction of coagulation tests (prothrombin time 53%, activated partial thromboplastin time 47%, and international normalized ratio [INR] 1.52), and a significant increase in cardiac troponin I of 1933 pg/mL, indicating myocarditis. Therefore, she was managed with nasal continuous positive airway pressure, commenced with colloid solution (dextran) and vasopressor infusion (noradrenalin 0.1 ยตg/kg per minute). At 24 hours after admission, her respiratory status progressively deteriorated and the abdominal pressure increased significantly; therefore, mechanical ventilation was indicated and a positive end-expiratory pressure of 12 cmH 2 0 and inspiratory pressure of 19 cmH 2 0 were achieved. Chest radiography revealed bilateral pulmonary interstitial congestion and a relatively small cardiac silhouette , and the Repeated POCUS revealed substantial fluid accumulation in the pleural and abdominal cavities, mild pericardial effusion, significantly empty left and right ventricles, hyperdynamic heart, and an EF of 50% , substantial distention of the inferior vena cava (IVC), and IVC diameter was nearly half that of the juxtaposed descending aorta (Fig. 2 C; Supplemental Digital Content 1, http://links.lww.com/MD/H760 . Nevertheless, her clinical status abruptly deteriorated after 4 hours of mechanical ventilation, presenting with restlessness, cold clammy skin, rapid weak pulse (170 beats per minute), invasive arterial blood pressure of 83/68 mm Hg, and capillary refill time >3 seconds. At this time, repeat laboratory test revealed the hematocrit 25%, blood lactate 5.1 mmol/L, and the arterial blood gases showed pH 7.36, pCO 2 26 mm Hg, HCO 3 - 15 mmol/L and base excess โˆ’9.4 (Table 1 ). The ascites was dramatic, and the intra-abdominal pressure was as high as 28 cmH 2 0. Dengue obstructive shock syndrome resulting from high pressure in the thoracic and abdominal cavities has been established. Two mini-fluid challenge tests with colloid solutions (5 mL/kg in 15 minutes) resulted in a significant increase in invasive arterial blood pressure (118/47 mm Hg) and a decrease in pulse rate (130 beats per minute), indicating low intravascular blood volume and decreased blood flow into the cardiac chambers. On this basis, dengue obstructive shock in this patient was managed with high-dose colloid fluid (10 mL/kg/h ร— 2 hour), then sustained at 05 mL/kg/h. In addition, peritoneal drainage was performed to decompress the intra-abdominal pressure, positive end-expiratory pressure was adjusted to 10 cmH 2 0 according to the decompressed intra-abdominal pressure, and the vasopressor dose was also slightly scaled up to achieve the target for abdominal perfusion pressure. As a result, the patientโ€™s clinical status of shock improved dramatically, with a marked increase in peripheral perfusion, a strong pulse of 130 beats per minute, and a blood pressure of 100/60 mm Hg. Repeated chest radiography after shock management showed considerable mitigation of pulmonary congestion . In addition, further POCUS revealed significant improvement in the early diastolic wall motion of the left ventricle and an EF of 65% , good distention, and less variability in the IVC (Fig. 2 D; Supplemental Digital Content 2, http://links.lww.com/MD/H761 . However, she later developed severe acute kidney failure (anuria, serum creatinine 371 ยตmol/L, glomerular filtration rate 11 mL/min/1.73 m 2 ) and underwent continuous renal replacement therapy. The patient experienced gradual clinical improvement over 3 weeks and was discharged without complications.
4.042969
0.975098
sec[1]/sec[0]/p[0]
en
0.999995
36316901
https://doi.org/10.1097/MD.0000000000031322
[ "pressure", "blood", "abdominal", "cardiac", "minute", "beats", "dengue", "transaminase", "status", "time" ]
[ { "code": "EH90.Z", "title": "Pressure ulcer of unspecified grade" }, { "code": "MB23.L", "title": "Pressured speech" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "CB22.Y", "title": "Other specified diseases of mediastinum, not elsewhere classified" }, { "code": "BA2Z", "title": "Hypotension, unspecified" }, { "code": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" }, { "code": "MF50.4Z", "title": "Haematuria, unspecified" }, { "code": "MA12.1", "title": "Finding of cocaine in blood" }, { "code": "MA12.4", "title": "Finding of steroid agent in blood" }, { "code": "MA12.2", "title": "Finding of hallucinogen in blood" } ]
=== ICD-11 CODES FOUND === [EH90.Z] Pressure ulcer of unspecified grade Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer [MB23.L] Pressured speech Definition: Speech in which the person feels undue pressure to get the words out. The personโ€™s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening. Also known as: Pressured speech Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure [CB22.Y] Other specified diseases of mediastinum, not elsewhere classified Also known as: Other specified diseases of mediastinum, not elsewhere classified | Hernia of mediastinum | mediastinal hernia | mediastinal herniation | Infectious mediastinitis [BA2Z] Hypotension, unspecified Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure [3C0Z] Diseases of the blood or blood-forming organs, unspecified Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS [MF50.4Z] Haematuria, unspecified Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS [MA12.1] Finding of cocaine in blood Also known as: Finding of cocaine in blood | cocaine in blood [MA12.4] Finding of steroid agent in blood Also known as: Finding of steroid agent in blood | steroid in blood [MA12.2] Finding of hallucinogen in blood Also known as: Finding of hallucinogen in blood | hallucinogen in blood === GRAPH WALKS === --- Walk 1 --- [EH90.Z] Pressure ulcer of unspecified grade --PARENT--> [EH90] Pressure ulceration Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th... --CHILD--> [EH90.2] Pressure ulceration grade 3 Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may... --- Walk 2 --- [EH90.Z] Pressure ulcer of unspecified grade --PARENT--> [EH90] Pressure ulceration Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th... --PARENT--> [?] Skin disorders provoked by external factors Def: A large group of skin disorders due to exposure of the skin to various external physical, chemical or environmental insults including chemical irritants and allergens, poisons, pressure, cold, heat, s... --- Walk 3 --- [MB23.L] Pressured speech Def: Speech in which the person feels undue pressure to get the words out. The personโ€™s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person t... --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour --RELATED_TO--> [?] Speech dysfluency Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi... --- Walk 4 --- [MB23.L] Pressured speech Def: Speech in which the person feels undue pressure to get the words out. The personโ€™s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person t... --EXCLUDES--> [?] Schizophrenia or other primary psychotic disorders Def: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusi... --CHILD--> [?] Schizotypal disorder Def: Schizotypal disorder is characterised by an enduring pattern (i.e. characteristic of the personโ€™s functioning over a period of at least several years) of eccentricities in behaviour, appearance and sp... --- Walk 5 --- [MD30.Z] Chest pain, unspecified --PARENT--> [MD30] Pain in throat or chest Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx.... --RELATED_TO--> [?] Musculoskeletal chest pain --- Walk 6 --- [MD30.Z] Chest pain, unspecified --PARENT--> [MD30] Pain in throat or chest Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx.... --RELATED_TO--> [?] Precordial pain
[ "[EH90.Z] Pressure ulcer of unspecified grade\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --CHILD--> [EH90.2] Pressure ulceration grade 3\n Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...", "[EH90.Z] Pressure ulcer of unspecified grade\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --PARENT--> [?] Skin disorders provoked by external factors\n Def: A large group of skin disorders due to exposure of the skin to various external physical, chemical or environmental insults including chemical irritants and allergens, poisons, pressure, cold, heat, s...", "[MB23.L] Pressured speech\n Def: Speech in which the person feels undue pressure to get the words out. The personโ€™s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person t...\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --RELATED_TO--> [?] Speech dysfluency\n Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...", "[MB23.L] Pressured speech\n Def: Speech in which the person feels undue pressure to get the words out. The personโ€™s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person t...\n --EXCLUDES--> [?] Schizophrenia or other primary psychotic disorders\n Def: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusi...\n --CHILD--> [?] Schizotypal disorder\n Def: Schizotypal disorder is characterised by an enduring pattern (i.e. characteristic of the personโ€™s functioning over a period of at least several years) of eccentricities in behaviour, appearance and sp...", "[MD30.Z] Chest pain, unspecified\n --PARENT--> [MD30] Pain in throat or chest\n Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx....\n --RELATED_TO--> [?] Musculoskeletal chest pain", "[MD30.Z] Chest pain, unspecified\n --PARENT--> [MD30] Pain in throat or chest\n Def: Pain in throat and chest means having pain sensation in throat or chest. Throat is a tube that carries food to oesophagus and air to windpipe and larynx. The technical name for throat is pharynx....\n --RELATED_TO--> [?] Precordial pain" ]
EH90.Z
Pressure ulcer of unspecified grade
[ { "from_icd11": "EH90.Z", "icd10_code": "L89623", "icd10_title": "Pressure ulcer of left heel, stage 3" }, { "from_icd11": "EH90.Z", "icd10_code": "L89621", "icd10_title": "Pressure ulcer of left heel, stage 1" }, { "from_icd11": "EH90.Z", "icd10_code": "L89899", "icd10_title": "Pressure ulcer of other site, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L89620", "icd10_title": "Pressure ulcer of left heel, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89622", "icd10_title": "Pressure ulcer of left heel, stage 2" }, { "from_icd11": "EH90.Z", "icd10_code": "L89892", "icd10_title": "Pressure ulcer of other site, stage 2" }, { "from_icd11": "EH90.Z", "icd10_code": "L89519", "icd10_title": "Pressure ulcer of right ankle, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L89891", "icd10_title": "Pressure ulcer of other site, stage 1" }, { "from_icd11": "EH90.Z", "icd10_code": "L89610", "icd10_title": "Pressure ulcer of right heel, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89893", "icd10_title": "Pressure ulcer of other site, stage 3" }, { "from_icd11": "EH90.Z", "icd10_code": "L89890", "icd10_title": "Pressure ulcer of other site, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89629", "icd10_title": "Pressure ulcer of left heel, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L89619", "icd10_title": "Pressure ulcer of right heel, unspecified stage" }, { "from_icd11": "EH90.Z", "icd10_code": "L8945", "icd10_title": "Pressure ulcer of contiguous site of back, buttock and hip, unstageable" }, { "from_icd11": "EH90.Z", "icd10_code": "L89894", "icd10_title": "Pressure ulcer of other site, stage 4" } ]
L89623
Pressure ulcer of left heel, stage 3
Eight years ago, a 65-year-old man with hypertension on therapy with candesartan 16 mg/hydrochlorothiazide 12.5 mg and benign prostatic hyperplasia treated with alfuzosin started complaining discomfort in the left part of the neck where he noticed a lump. He was evaluated by his general practitioner who palpated a large, hard left thyroid nodule and referred the patient to the thyroid out-patient clinic of our hospital. The patient reported no family history of thyroid disease or cancer. US revealed a multinodular goitre with a prevalent 4 cm hypoechoic nodule with taller-than-wide shape in the mid-lower part of left thyroid lobe which was deemed at high risk for malignancy (European Thyroid Imaging and Reporting Data System (EU-TIRADS) 5) ( Figure 1(a) ); no pathological lymph nodes were detected. FT4 levels were in the lower normal range: 1 ng/dl (n.v. 1.1โ€“1.7), whereas TSH levels were slightly increased: 4.9 ฮผ U/ml (n.v. 0.3โ€“4.2), and L-thyroxine therapy (up to 75 ฮผ g/day) was started. Further examinations showed normal calcitonin levels, absence of thyroid autoantibodies, and very low serum Tg levels: 1.4 ng/ml (n.v. 1.4โ€“78). Because of the suspicious features of the left thyroid nodule, 18F-FDG PET/CT was performed, which showed intense uptake (standardized uptake value (SUV) max: 14; SUV ratio: 7.3; this latter defined as the ratio between the SUV of the nodule and that of the contralateral normal thyroid parenchyma) ( Figure 1(b) ). US-guided FNAC results revealed normal thyrocytes, fibrin, and histiocytes, and the nodule was classified as benign (Thyroid (Thy) 2). However, due to the clinical features, total thyroidectomy was performed. On histology, the large left thyroid nodule proved to be a tall-cell variant of PTC (pT3 pNx) which infiltrated the capsule, reached the fatty tissue, and invaded the vessels ( Figure 2(a) ). The tumour was deemed multifocal on the basis of the finding of another 6 mm neoplastic nodule in the right lobe. Immunohistochemistry showed scattered cytoplasmatic positivity for Tg ( Figure 2(b) ) and diffuse strong cytoplasmatic and membrane positivity for cytokeratin 19 ( Figure 2(c) ), an integral protein of the cytoskeleton of the epithelial cells which is highly expressed in PTC . The thyroid tumour was classified as stage II, and the patient as being at intermediate risk of recurrence. L-thyroxine (up to 150/175 ฮผ g on alternate days) was started in order to maintain TSH levels between 0.1 and 0.5 ฮผ U/ml. Nearly two months after surgery, L-throxine was withdrawn until TSH levels >30 ฮผ U/ml, and he was treated with ablative dose of 131I therapy (3.7 GBq). The preablative Tg level was 0.3 ng/ml, and anti-Tg antibodies were negative. Posttherapy whole-body scan (WBS) was performed 2 days after the administration of 131I and did not show any uptake. Over the first three years following surgery/RAI while on suppressive L-thyroxine therapy, Tg levels were undetectable (ultrasensitive immunoassay, analytical sensitivity: 0.04 ng/ml), and anti-Tg antibodies were absent. During the fourth year of follow-up, neck US revealed a few (diameter 1.0โ€“1.5 cm) oval laterocervical lymph nodes, with no visible hilum and focal hyperechogenicity at levels III and IV (Figures 3(a) and 3(b) ), which aroused the suspicion of recurrence; serum Tg levels on L-thyroxine therapy and anti-Tg antibodies remained undetectable. An rh-TSH stimulation test (0.9 mg intramuscularly on two consecutive days) did not result in increase in Tg levels (baseline <0.04 ng/ml, +72 h: 0.3 ng/ml). FNAC was performed on the prevalent lymph node, together with the assay of Tg levels in 1 ml of normal saline washout fluid. Washout Tg levels proved โ€œnegativeโ€ (0.24 ng/ml); by contrast, FNAC showed epithelial cells with irregular nuclei and nuclear pseudoinclusions suggestive of PTC metastasis . Left laterocervical lymphadenectomy (levels II, III, and IV) was performed, and 21 lymph nodes (8 of levels II and 13 of levels III and IV) were removed; on histopathology, one of the level III nodes and one of the level IV nodes showed PTC metastasis (maximum diameter 1.5 cm) ( Figure 5(a) ) and had scattered positivity for Tg ( Figure 5(b) ) and diffuse strong positivity for CK 19 ( Figure 5(c) ). The next year following lymphadenectomy, neck US was unremarkable, and serum Tg levels remained undetectable. Nevertheless, two years after the first recurrence, a left supraclavicular lymph node was palpated. US confirmed a 20 mm pathological (hypoechoic, with irregular shape, no visible hilum, and focal hyperechogenicity) lymph node in the left supraclavicular region (level IV) ( Figure 6(a) ) and a smaller one (10 mm) with the same features in the paratracheal region (level VI). 18F-FDG PET/CT showed significant tracer uptake (SUV max: 20.7) by left supraclavicular lymph node and, to a lesser extent (SUV max: 11), by left paratracheal lymph node ( Figure 6(b) ). FNAC of the left larger supraclavicular lymph node showed epithelial cells with enlarged and hyperchromatic nuclei that were diagnostic of metastatic PTC; this diagnosis was strengthened by the finding of increased Tg levels: 220 ng/ml in the washout fluid, in the presence of undetectable serum Tg levels. Lymphadenectomy (level IV and level VI) was performed, and histology confirmed the cytological findings. Imaging procedures six months (neck US and 18F-FDG PET/CT) and one year later (neck US) were negative, and unstimulated serum Tg was undetectable. The patient is healthy, and imaging and hormonal follow-up have been scheduled.
4.167969
0.964844
sec[1]/p[0]
en
0.999997
33101736
https://doi.org/10.1155/2020/8827503
[ "thyroid", "lymph", "nodule", "node", "neck", "which", "nodes", "serum", "undetectable", "thyroxine" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "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 === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [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 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.0] Acute thyroiditis Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial.... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.1] Subacute thyroiditis Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection.... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --PARENT--> [?] Endocrine diseases --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A02] Thyrotoxicosis Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone... --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.2] Autoimmune thyroiditis Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.0] Acute thyroiditis\n Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --PARENT--> [?] Endocrine diseases", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A02] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.2] Autoimmune thyroiditis\n Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
We herein report the case of an 81-year-old hypertensive female who was admitted to the Intensive Care Unit (ICU) at our institute (an academic tertiary referral center), in January 2019, and managed by the pulmonary and critical care team as a case of type II respiratory failure. On admission her oxygen saturation was 78% on rom air, and her arterial blood gases (ABGs) were: pH = 7.32, PaCO 2 = 61 mmHg, Pa O 2 = 45 mmHg, and HCO3 = 33 mEq/L. The ABGs readings reflected acute on top of chronic hypercapnic respiratory failure. Surgical consultation was received upon the discovery, on chest x-ray (CXR), of a large mediastinal mass narrowing the trachea and displacing it to the left . The patient reported a history of subtotal thyroidectomy for Graves' disease. However, she was not on thyroxine replacement therapy and her thyroid stimulating hormone (TSH) level was 0.7 IU/L (normal range 0.35โ€“3.0 IU/L). Her main complaint was shortness of breath of 4-month duration, but, no dysphagia, or dysphonia. She had no palpable mass in her neck. The radiographic appearance was classical for retrosternal goiter (RG). However, in view of her history of thyroid surgery we opt to confirm the thyroid origin of the mass by scintigraphy prior to proceeding to computed tomography (CT) with intravenous contrast to avoid thyroid stunning (Wolf-Chaikoff effect) . Indeed, thyroid origin was confirmed by scintigraphy. CT of the neck and chest, with the arms on the sides, was then performed for further characterization of the retrosternal extension, and to assess the need for sternotomy. It demonstrated a secondary right-sided RG extending below the carina, as well as into the posterior mediastinum. The volume of the RG was estimated to be 375 mL on CT . Despite the history of a previous neck surgery and the considerable anatomical extent of the mass in the mediastinum, the decision was made to operate via a cervicotomy. Nevertheless, on-site Thoracic Surgeon standby was arranged. Prior to surgery, the pulmonary team commenced non-invasive ventilation by BI-PAP for 5 days. The patients' ABGs improved to become: pH = 7.42, PaCO 2 = 50 mmHg, Pa O 2 = 57 mmHg, and HCO3 = 38 mEq/L, and her oxygen saturation became 89% on room air. trans -Nasal flexible fiberoptic laryngoscopic evaluation of the vocal folds demonstrated normal and symmetrically mobile vocal cords. The American Society of Anesthesiology (ASA) category 3 patient underwent fiberoptic intubation followed by a successful right-sided hemithyroidectomy conducted through the neck using the LigaSureโ„ข small-jaw sealer and divider. The procedure was performed by a high-volume Endocrine Surgeon (SB) who has an annual case-load in excess of 300 procedures. The procedural steps of the operative technique applied included: 1. Section of the superior pedicle 2. Division of the isthmus for further mobilization and medialization of the thyroid lobe 3. Identification of the recurrent laryngeal nerve (RLN) superiorly, and dissecting it caudally 4. Release of lateral thyroid attachments using the energy-based device 5. Concomitant pulling of the gland using the left hand, and blunt dissection of lateral and postero-lateral adhesions using the right hand which aids in delivering the gland from the thorax. It is worth mentioning at this point that the distal edge of the RG was way beyond the reach of the surgeon's finger. This implies a cautious and meticulous dissection and delivery of the lobe due to possible attachments to great vessels in the thorax beyond the surgeon's visual field and reach. Therefore, forceful delivery in the presence of resistance should always be avoided not to inflict harm resulting from potential inadvertent intrathoracic vascular injury. A size 10 Readivacยฎ drain was placed. Operative time was 30 min from incision to closure. Fig. 3 demonstrates the resected right thyroid lobe. The patient's respiratory parameters, on the anesthesia monitor, improved immediately following resection of the RG. The patient was transferred to the ward. Post-operatively, her oxygen saturation on room air was 96%, and her ABGs were: pH = 7.42, PaCO 2 = 42 mmHg, Pa O 2 = 77 mmHg. Her post-operative chest x-ray is displayed in Fig. 4 . The drain-output was 30 cc of serosanguinous fluid on the morning following surgery, therefore, it was removed. She was discharged on the first post-operative day without morbidity. Thyroxine replacement therapy was given applying the weight adjusted dose for elderly (1.2 x Body weight). One-week post-surgery the patient expressed complete satisfaction with the outcome of her surgery, and was content with the cosmetic appearance of her surgical site . The histologic examination of the surgically resected specimen reported that the specimen weighed 497 g, and that the longitudinal axis of the retrosternal component measured 15 cm. There was no evidence of malignancy. Fig. 1 Chest x-ray demonstrating a widened mediastinum with tracheal deviation to the left. Fig. 1 Fig. 2 (A) Coronal view: extension below the carina (B) Sagittal view: extension into the posterior mediastinum (C) Axial view: extension below the aortic arch. Fig. 2 Fig. 3 (A) Lateral view of the resected right thyroid lobe with its cervical and retrosternal components. (B) Superior view of the surgical specimen. Fig. 3 Fig. 4 Post-operative chest x-ray with a centrally located trachea and no mediastinal mass. Fig. 4 Fig. 5 The patient one-week post-surgery with a cosmetically favorable result. This image is published with the patient's consent. Fig. 5
3.972656
0.975586
sec[1]/p[0]
en
0.999997
35462150
https://doi.org/10.1016/j.ijscr.2022.107104
[ "thyroid", "mmhg", "view", "chest", "abgs", "neck", "retrosternal", "extension", "mediastinum", "surgeon" ]
[ { "code": "5A03.Z", "title": "Thyroiditis, unspecified" }, { "code": "5A0Z", "title": "Disorders of the thyroid gland or thyroid hormones system, unspecified" }, { "code": "5A03.Y", "title": "Other specified thyroiditis" }, { "code": "5A00.2Z", "title": "Acquired hypothyroidism, unspecified" }, { "code": "5A03.0", "title": "Acute thyroiditis" }, { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" } ]
=== ICD-11 CODES FOUND === [5A03.Z] Thyroiditis, unspecified Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified [5A03.Y] Other specified thyroiditis Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma [5A00.2Z] Acquired hypothyroidism, unspecified Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea [5A03.0] Acute thyroiditis Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial. Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure === GRAPH WALKS === --- Walk 1 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --EXCLUDES--> [?] Acquired hypothyroidism Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth.... --- Walk 2 --- [5A03.Z] Thyroiditis, unspecified --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --RELATED_TO--> [?] Postpartum thyroiditis Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp... --- Walk 3 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A01] Nontoxic goitre Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis... --- Walk 4 --- [5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors.... --CHILD--> [5A01] Nontoxic goitre Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis... --- Walk 5 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --CHILD--> [5A03.2] Autoimmune thyroiditis Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies.... --- Walk 6 --- [5A03.Y] Other specified thyroiditis --PARENT--> [5A03] Thyroiditis Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation... --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....
[ "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....", "[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A01] Nontoxic goitre\n Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis...", "[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A01] Nontoxic goitre\n Def: Enlargement of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis...", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.2] Autoimmune thyroiditis\n Def: A chronic inflammatory disorder of the thyroid gland associated with abnormal circulatory antibodies....", "[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors...." ]
5A03.Z
Thyroiditis, unspecified
[ { "from_icd11": "5A03.Z", "icd10_code": "E069", "icd10_title": "Thyroiditis, unspecified" }, { "from_icd11": "5A03.Z", "icd10_code": "E064", "icd10_title": "Drug-induced thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E065", "icd10_title": "Other chronic thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E06", "icd10_title": "Thyroiditis" }, { "from_icd11": "5A03.Z", "icd10_code": "E062", "icd10_title": "Chronic thyroiditis with transient thyrotoxicosis" }, { "from_icd11": "5A0Z", "icd10_code": "E0781", "icd10_title": "Sick-euthyroid syndrome" }, { "from_icd11": "5A0Z", "icd10_code": "E0789", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E079", "icd10_title": "Disorder of thyroid, unspecified" }, { "from_icd11": "5A0Z", "icd10_code": "E034", "icd10_title": "Atrophy of thyroid (acquired)" }, { "from_icd11": "5A0Z", "icd10_code": "E00-E07", "icd10_title": "" }, { "from_icd11": "5A0Z", "icd10_code": "E07", "icd10_title": "Other disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E078", "icd10_title": "Other specified disorders of thyroid" }, { "from_icd11": "5A0Z", "icd10_code": "E35", "icd10_title": "Disorders of endocrine glands in diseases classified elsewhere" }, { "from_icd11": "5A00.2Z", "icd10_code": "E033", "icd10_title": "Postinfectious hypothyroidism" }, { "from_icd11": "5A03.0", "icd10_code": "E060", "icd10_title": "Acute thyroiditis" } ]
E069
Thyroiditis, unspecified
A 7-year-old girl presented with painful eyelid swelling and decreased vision in the left eye (OS). The medical history was unremarkable except for a history of blunt trauma at a swing set when the swing hit the left side of her face about 2 weeks prior to presentation. VA was 20/20 in right eye (OD) and counting fingers (CF) at 1โ€™ in OS. IOP was 9 mmHg in OD and 13 mmHg in OS. There was significant proptosis as well as mild restriction of extraocular movements (EOMs) in OS. Slit-lamp examination (SLE) was unremarkable in OD, while the presence of 2 + anterior chamber (AC) cells was noted in OS. Fundus examination revealed optic disc edema (ODE) with elevated appearance of macula in OS . Optical coherence tomography (OCT) showed significant subretinal fluid (SRF) in macula as well as increased peripapillary retinal nerve fiber layer (RNFL) thickness consistent with ODE in OS. B-scan ultrasound (US) demonstrated T-sign in OS . MRI demonstrated T2 and T1 hypointense and hyper-enhancing tissue along the left posterior retina and along the posterior aspect of the globe extending into the intraconal fat, concerning for posterior scleritis and periorbital inflammation in the intraconal fat and along the orbital segment of the optic nerve . In addition, asymmetric enhancement of the left lacrimal gland was noted. The patient was afebrile with no evidence of systemic infection and had no joint symptoms or rashes. Additional work-up showed elevated erythrocyte sedimentation rate (ESR) (32 mm/h) and C-reactive protein (CRP) (1.7 mg/L) levels, and remaining testing were unremarkable including complete blood count, complete metabolic panel, urinalysis, syphilis, HIV, QuantiFERON, HSV/VZV/CMV PCR, Toxoplasma, Lyme, Bartonella, chest X-ray, ACE, lysozyme, ANA, anti-dsDNA, ANCA, proteinase-3 and myeloperoxidase antibodies, C3 and C4. The patient was diagnosed with posterior scleritis in OS and subsequently started on intravenous methylprednisolone 30 mg/kg/day for 3 days, along with prednisolone acetate 8 times daily and cyclopentolate 2 times daily in OS, which led to improvement of proptosis, EOM restriction , as well as AC cells, ODE and SRF in macula in OS . Fluorescein angiography (FA) performed following resolution of periorbital swelling showed optic disc leakage in OS . The patient was then switched to oral prednisone 30 mg daily (1 mg/kg/day) with slow tapering and started on methotrexate (MTX) 15 mg weekly along with folic acid supplementation considering the severe course of ocular inflammation. At 1.5 months of follow-up, VA improved to 20/30 in OS with resolution of EOM restriction and proptosis. AC was quiet and there was a complete resolution of SRF in OS. However, FA showed persistence of leakage from the optic disc along with mild peripheral retinal vascular leakage in OS. Thus, MTX was increased to 20 mg weekly; oral prednisone 10 mg daily and prednisolone acetate twice daily in OS were continued with further tapering and cyclopentolate was discontinued in OS. At 2.5 months of follow-up, the patient once again presented with painful eyelid swelling in OS, when she was at MTX 20 mg weekly and oral prednisone 10 mg daily, and later improved with the increment of oral prednisone to 30 mg daily and stable dose of methotrexate 20 mg weekly. However, three weeks later, her symptoms worsened again with severe painful eyelid swelling in OS, when she was on MTX 20 mg weekly, oral prednisone 20 mg daily, and prednisolone acetate 2 times daily. VA was 20/20 in both eyes (OU). The patient had recurrence of proptosis (Hertel (108 mm) = 18 mm in OD, 21 mm in OS) , as well as mildly restricted EOMs in OS. SLE revealed mild scleral injection temporally and 0.5 + AC cells in OS. Fundus examination was unremarkable, OCT did not show SRF, and FA was stable as mild leakage from the optic disc in OS . Systemic evaluation did not show any evidence of infection. However, CRP level was elevated further to 2.8 mg/L. Given the concern for chronic orbital inflammation in OS, serum immunoglobulin G (IgG) (total + subgroups) levels were ordered, which revealed elevated serum IgG4 levels at 149.9 mg/dL (range, 1โ€“99). The patient was diagnosed as โ€˜possibleโ€™ IgG4-related ophthalmic disease (IgG4-ROD) . Immunomodulatory therapy (IMT) was escalated and she was started on infliximab (IFX) 7.5 mg/kg/month along with IV methylprednisolone (IVMP) 30 mg/kg/day for 3 days a month, and continued MTX 20 mg weekly with slower tapering of oral prednisone 20 mg daily and prednisolone acetate 2 times daily. After first cycle of IFX and IVMP therapy , CRP returned to normal range (< 0.3 mg/L). IgG4 level was also reduced even though slightly elevated at 122.1 mg/dL. Follow-up MRI after 2 cycles of IFX and IVMP therapy showed complete resolution of left uveoscleral enhancement and left ocular proptosis, as well as marked decrease in left retrobulbar and left optic nerve sheath enhancement. Whole body PET/CT scan was also performed to investigate other tissue site involvement which revealed no evidence of metabolically active inflammatory processes; specifically, no evidence of FDG avid activity involving the left orbit or the vasculature. At the latest follow-up (after 5 cycles of IFX therapy), VA was 20/20 in OU without proptosis or EOM restriction. SLE and fundus examination were unremarkable in OU including OCT . FA showed resolution of optic disc leakage in OS. The patient was planned to continue IFX and IVMP infusions, as well as MTX 20 mg weekly and continued tapering of oral prednisone 7.5 mg daily.
4.015625
0.979492
sec[1]/p[0]
en
0.999996
40146480
https://doi.org/10.1186/s12348-025-00459-9
[ "daily", "optic", "along", "oral", "prednisone", "weekly", "proptosis", "well", "unremarkable", "disc" ]
[ { "code": "QF21", "title": "Difficulty or need for assistance with general life tasks or life management" }, { "code": "8A83", "title": "Other primary headache disorder" }, { "code": "QB42", "title": "Dependence on renal dialysis" }, { "code": "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": "MD11.8Z", "title": "Mouth breathing, unspecified" }, { "code": "DA01.00", "title": "Oral leukoplakia" } ]
=== ICD-11 CODES FOUND === [QF21] Difficulty or need for assistance with general life tasks or life management Also known as: Difficulty or need for assistance with general life tasks or life management | difficulty with carrying out tasks and daily routine | life management problem | difficulty with life management tasks | Difficulty with dealing with change such as relocation Includes: difficulty with carrying out tasks and daily routine [8A83] Other primary headache disorder Definition: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attributed to direct physical but innocuous stimuli; epicranial headaches; and other miscellaneous primary headache disorders. Also known as: Other primary headache disorder | Primary cough headache | Primary exercise headache | Primary headache associated with sexual activity | Preorgasmic headache [QB42] Dependence on renal dialysis Also known as: Dependence on renal dialysis | renal dialysis status | presence of arteriovenous shunt for dialysis | dependence on haemodialysis | Dependence on renal dialysis, acute haemodialysis Includes: renal dialysis status Excludes: dialysis preparation, treatment or session [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 [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 --- [QF21] Difficulty or need for assistance with general life tasks or life management --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management --- Walk 2 --- [QF21] Difficulty or need for assistance with general life tasks or life management --PARENT--> [?] Difficulty or need for assistance with activities Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment.... --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management --- Walk 3 --- [8A83] Other primary headache disorder Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri... --PARENT--> [?] Headache disorders --CHILD--> [8A80] Migraine Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a... --- Walk 4 --- [8A83] Other primary headache disorder Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri... --PARENT--> [?] Headache disorders --EXCLUDES--> [?] Headache, not elsewhere classified Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above.... --- Walk 5 --- [QB42] Dependence on renal dialysis --EXCLUDES--> [?] Care involving dialysis Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education... --CHILD--> [?] Care involving peritoneal dialysis --- Walk 6 --- [QB42] Dependence on renal dialysis --PARENT--> [?] Dependence on enabling machines or devices --PARENT--> [?] Reasons for contact with the health services
[ "[QF21] Difficulty or need for assistance with general life tasks or life management\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[QF21] Difficulty or need for assistance with general life tasks or life management\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF21] Difficulty or need for assistance with general life tasks or life management", "[8A83] Other primary headache disorder\n Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri...\n --PARENT--> [?] Headache disorders\n --CHILD--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...", "[8A83] Other primary headache disorder\n Def: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attri...\n --PARENT--> [?] Headache disorders\n --EXCLUDES--> [?] Headache, not elsewhere classified\n Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....", "[QB42] Dependence on renal dialysis\n --EXCLUDES--> [?] Care involving dialysis\n Def: Care involving dialysis includes the preparation and maintenance of the patient and carer(s) on dialysis whether extracorporeal or peritoneal dialysis. This includes, but is not confined to: education...\n --CHILD--> [?] Care involving peritoneal dialysis", "[QB42] Dependence on renal dialysis\n --PARENT--> [?] Dependence on enabling machines or devices\n --PARENT--> [?] Reasons for contact with the health services" ]
QF21
Difficulty or need for assistance with general life tasks or life management
[ { "from_icd11": "QF21", "icd10_code": "Z742", "icd10_title": "Need for assistance at home and no other household member able to render care" }, { "from_icd11": "QF21", "icd10_code": "Z600", "icd10_title": "Problems of adjustment to life-cycle transitions" }, { "from_icd11": "8A83", "icd10_code": "G44209", "icd10_title": "Tension-type headache, unspecified, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G44221", "icd10_title": "Chronic tension-type headache, intractable" }, { "from_icd11": "8A83", "icd10_code": "G44229", "icd10_title": "Chronic tension-type headache, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G44201", "icd10_title": "Tension-type headache, unspecified, intractable" }, { "from_icd11": "8A83", "icd10_code": "G44219", "icd10_title": "Episodic tension-type headache, not intractable" }, { "from_icd11": "8A83", "icd10_code": "G442", "icd10_title": "Tension-type headache" }, { "from_icd11": "QB42", "icd10_code": "Z992", "icd10_title": "Dependence on renal dialysis" }, { "from_icd11": "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" } ]
Z742
Need for assistance at home and no other household member able to render care
A female of 44 years and of Asian origin was admitted with fever, a two-week history of bloody diarrhea and abdominal pain. She further complained of general weakness, night sweats and weight loss. The previously healthy patient had undergone breast augmentation surgery many years before. Rupture of the breast implants had caused the formation of lymph node siliconomas and the implants had subsequently been replaced. One year after implant replacement and four years prior to presentation, the patient had first developed cervical, thoracic and axillary lymphadenopathy. NTM lymphadenitis had been diagnosed after Mycobacterium abscessus and goodii were cultured from lymph node biopsies and a connection with the silicone lymphadenopathy, assuming secondary infection had been made. Again, the implants had been surgically removed, but no mycobacteria could be cultured from intraoperative swabs or implant material. Response to the following antibiotic treatment had been slow and incomplete despite of fully drug-sensitive strains. With the new symptoms mentioned above, the patient was admitted for further diagnostic testing . On admission the patient presented in a reduced general condition with fever of 39.1 ยฐC. Persistent cervical and axillary lymphadenopathy was palpable with callous, non-tender masses. Several non-tender subcutaneous masses of up to 2 cm in diameter were also palpable alongside the abdominal wall without further skin changes present. General abdominal tenderness was notable. Stool frequency was reported as four to six times daily with bloody and mushy stools, associated with spasmodic pain. Laboratory work-up showed signs of an inflammatory process with a white blood cell count of 24,000 / ฮผl , a c-reactive protein of 21.1 mg/dl (normal < 0.5) and a 1 h erythrocyte sedation rate of 105 (normal range 0 โ€“ 20). Stool diagnostics revealed the simultaneous presence of a cytomegalovirus (CMV) as well as Salmonella typhimurium infection. Both pathogens were also detected in blood samples: CMV-DNA polymerase chain reaction (PCR) from EDTA blood was positive and Salmonella typhimurium was detected in blood cultures. Colonoscopy showed severe colitis with multiple ulcerous lesions and a biopsy confirmed CMV colitis . A positron emission tomography computed tomography (PET-CT) scan was obtained, showing both thoracic and abdominal, metabolically highly active lymphadenopathy . In line with the diagnosis of a CMV colitis, wall thickening and increased metabolic activity was present in the colon and rectum. A bronchoscopy with endobronchial ultrasound was performed to obtain diagnostic material from the enlarged mediastinal lymph nodes for further testing. While histological assessment of the lymph node biopsies showed only unspecific inflammatory changes, Mycobacterium intracellulare was cultured and confirmed by molecular genetics. Further, a biopsy and histological analysis of a subcutaneous lesion was performed showing acid-fast bacilli and โ€œnaked granulomasโ€ with only sparse inflammatory surrounding tissue reaction . In summary, a simultaneous disseminated NTM infection, CMV reactivation and non-typhoidal salmonella blood stream infection was diagnosed, prompting further diagnostics regarding an underlying immunodeficiency. Testing for HIV was negative. Peripheral blood and bone marrow flow cytometry analysis showed unremarkable populations of T and B cells and did not indicate an underlying lymphoma. Quantitative assessment of immunoglobulins revealed a polyclonal increase in IgG . On extended testing, high-titer IgG neutralizing autoantibodies against IFNฮณ were detected in the patientโ€™s serum. Functional analyses demonstrated the neutralizing effect of these autoantibodies, as presence of the patientโ€™s serum significantly impaired IFNฮณ signaling both in patient as well as healthy control cells, resulting in reduced induction of pSTAT1 and interleukin 12 (IL-12) after stimulation. Consequently, the diagnosis of AIIA was made. Multidrug therapy was initiated for the concurrent treatment of three simultaneous infections: a) antimycobacterial therapy with azithromycin (500 mg q.d.), rifabutin (300 mg q.d.) and ethambutol (600 mg q.d.), b) virostatic therapy with valganciclovir (450 mg q.d.) and c) antibiotic therapy with cefuroxime (500 mg b.i.d.). Additionally, B-cell-depleting therapy with rituximab was initiated after several months of anti-infective therapy as a targeted treatment approach to inhibit further production of IFNฮณ autoantibodies and was well tolerated. The patientโ€™s general condition gradually improved under therapy and treatment was continued in an outpatient setting. Symptoms improved continuously and a normalization in inflammatory laboratory markers was observed. Follow-up imaging showed stable findings regarding thoracic lymphadenopathy, while blood CMV-PCR remained negative without ongoing ganciclovir continuation therapy. Fig. 1 Timeline of case presentation Fig. 2 Findings in colonoscopy and PET-CT imaging. a Colonoscopy showing severe, ulcerating colitis due to simultaneous CMV and Salmonella typhimurium infections. b Metabolically highly active mediastinal lymphadenopathy in bioptically confirmed disseminated Mycobacterium intracellulare lymphadenitis Fig. 3 Impaired granuloma formation in a patient with IFNฮณ autoantibodies. a Skin biopsy from abdominal wall showing immature granulomas with sparse inflammatory surrounding tissue reaction. b Ziehl-Neelsen staining uncovers a pathogen rich mycobacterial infection. Scale bar = 100 ฮผm
4.121094
0.974609
sec[2]/p[0]
en
0.999996
33176707
https://doi.org/10.1186/s12879-020-05553-y
[ "blood", "lymphadenopathy", "abdominal", "infection", "inflammatory", "general", "lymph", "testing", "simultaneous", "salmonella" ]
[ { "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": "MA01.Z", "title": "Enlarged lymph nodes, unspecified" }, { "code": "MA01.0", "title": "Localised lymph node enlargement" }, { "code": "MA01.1", "title": "Generalised lymph node enlargement" }, { "code": "BD90.Y", "title": "Other specified lymphadenitis" }, { "code": "1B12.6", "title": "Tuberculous peripheral lymphadenopathy" } ]
=== 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 [MA01.Z] Enlarged lymph nodes, unspecified Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy [MA01.0] Localised lymph node enlargement Also known as: Localised lymph node enlargement | regional lymphadenopathy | Localised lymphadenopathy | Occipital lymph node enlargement | Occipital lymphadenopathy [MA01.1] Generalised lymph node enlargement Also known as: Generalised lymph node enlargement | generalised lymphadenopathy Excludes: Human immunodeficiency virus disease associated with generalised lymphadenopathy [BD90.Y] Other specified lymphadenitis Also known as: Other specified lymphadenitis | Dermatopathic lymphadenopathy | lipomelanotic reticulosis | Infective inguinal bubo | bubo [1B12.6] Tuberculous peripheral lymphadenopathy Definition: A disease of the peripheral lymph nodes, caused by an infection with the bacteria Mycobacterium tuberculosis. This disease is characterised by inflammation of the peripheral lymph nodes, typically the cervical lymph nodes. Transmission is through haematogenous spread to the peripheral lymph nodes after inhalation of infected respiratory secretions. Confirmation is by identification of Mycobacterium tuberculosis from lymph node biopsies. Also known as: Tuberculous peripheral lymphadenopathy | tuberculous lymphadenitis | tuberculous lymphadenopathy | tuberculous lymphangitis | tuberculous lymph node Includes: Tuberculous adenitis Excludes: Tuberculosis of intrathoracic lymph nodes, confirmed bacteriologically or histologically | Tuberculosis of intrathoracic lymph nodes, without mention of bacteriological or histological confirmation === 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--> [MF50.41] 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--> [MF50.41] Microscopic haematuria --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --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--> [MF50.41] 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--> [MF50.41] Microscopic haematuria", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
In April 2020, a 60-year-old Hispanic patient developed severe COVID-19 pneumonia that was treated at home because the healthcare system was oversaturated. The initial CT scan revealed bilateral ground-glass opacities (GGO) and lung parenchymal consolidations . A year after the acute infection, the patient had persistent dyspnea, fatigue, and a limited ability to resume daily activities. The PFTs revealed restrictive lung disease with a moderate decrease in DLCO, significant desaturation, and poor performance on the 6-min walk test (Table 1 ). CT scans of the chest revealed air trapping during the expiratory phase as well as structural lesions in the parenchyma: bilateral diffuse GGO associated with bronchiectasis and interlobular septal thickening . The patient was given corticosteroids, which were gradually tapered off, oxygen via a nasal cannula, and pulmonary rehabilitation (PR). Fig. 1 Initial computed tomography (CT) scan showing bilateral consolidations and ground-glass opacities involving most of the lung parenchyma Table 1 Pulmonary function tests during 36 months follow-up Pulmonary function tests Months of follow-up post-acute COVID-19 infection 3 6 10 12 16 22 24 26 36 Spirometry FVC [L] Absolute value 1.06 a 1.38 a 1.57 a 1.43 a 1.63 a โ€“ 1.65 a โ€“ 1.64 a Predicted (%) 39 a 51 a 59 a 53 a 62 a โ€“ 62 a โ€“ 62 a FEV1 [L] Absolute value 0.92 a 1.13 a 1.24 a 1.14 a 1.30 a โ€“ 1.35 a โ€“ 1.32 a Predicted (%) 44 a 54 a 60 a 55 a 63 a โ€“ 66 a โ€“ 65 a FEV1/FVC [%] Absolute value 87 81.7 79.5 79.9 79.9 โ€“ 82 โ€“ 80.5 Predicted (%) 113 106 101 102 102 โ€“ 105 โ€“ 103 DLCO DLCO [ml/min/mmHg] Absolute value 8.3 a 11.7 a 10.3 a 10.6 a 11.3 a โ€“ 17.1 โ€“ 15.2 Predicted (%) 41 a 58 a 51 a 52 a 56 a โ€“ 85 โ€“ 76 DLCO/VA (KCO) [ml/min/mmHg] Absolute value 4.52 4.32 4.24 4.84 4.73 โ€“ 4.45 โ€“ 4.87 Predicted (%) 85 82 80 91 89 โ€“ 84 โ€“ 92 TLC sb [L] Absolute value 2 2.86 2.59 a 2.34 a 2.55 a โ€“ 4 โ€“ 3.26 Predicted (%) 51 72 65 59 65 โ€“ 101 โ€“ 83 6MWT 6-MWD (m) 264 359 390 โ€“ 390 โ€“ 339 โ€“ 405 Performance (%) 55 75 81 โ€“ 85 โ€“ 72 โ€“ 87 Basal SpO 2 (%) 93 97 97 โ€“ 95 โ€“ 97 โ€“ 98 Maximum desaturation 82 92 92 โ€“ 95 โ€“ 91 โ€“ 94 MBW FRC mb [L] Absolute value โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 1.01 a 1.21 a 1.31 a Predicted (%) โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 49 a 58 a 63 a LCI Absolute value โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 11.86 a 13.57 a 11.55 a Predicted (%) โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 178 a 203 a 173 a FOT Rrs5 [cmH 2 O/(L/s)] insp Z score โ€“ โ€“ โ€“ โ€“ โ€“ 1.91 a 1.42 0.96 1.51 exp Z score โ€“ โ€“ โ€“ โ€“ โ€“ 2.09 a 1.14 1.45 1.4 tot Z score โ€“ โ€“ โ€“ โ€“ โ€“ 2.01 a 1.25 1.26 1.45 Xrs5 [cmH 2 O/(L/s)] insp Z score โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 3.09 a โˆ’ 3.01 a โˆ’ 2.31 a 32.64 a exp Z score โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 2.3 a โˆ’ 2.19 a โˆ’ 0.74 โˆ’ 2.25 a tot Z score โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 2.67 a โˆ’ 2.54 a โˆ’ 1.37 โˆ’ 2.38 a Rrs11 [cmH 2 O/(L/s)] insp Z score โ€“ โ€“ โ€“ โ€“ โ€“ 1.15 0.41 0.03 โ€“ exp Z score โ€“ โ€“ โ€“ โ€“ โ€“ 1.98 a 1.02 1.27 1 tot Z score โ€“ โ€“ โ€“ โ€“ โ€“ 1.65 a 0.78 0.85 1.3 Xrs11 [cmH2O/(L/s)] insp Z score โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 3.05 a โˆ’ 2.49 a โˆ’ 2.19 a โˆ’ 2.42 a exp Z score โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 2.72 a โˆ’ 2.59 a โˆ’ 2.23 a โˆ’ 2.5 a tot Z score โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 2.88 a โˆ’ 2.55 a โˆ’ 2.22 a โˆ’ 2.5 a Rrs19 [cmH 2 O/(L/s)] insp Z score โ€“ โ€“ โ€“ โ€“ โ€“ 0.92 โˆ’ 0.04 โˆ’ 0.19 0.73 exp Z score โ€“ โ€“ โ€“ โ€“ โ€“ 1.72 a 0.71 1.27 1.03 tot Z score โ€“ โ€“ โ€“ โ€“ โ€“ 1.4 0.42 0.78 0.92 ฮ”Xrs (M) โ€“ โ€“ โ€“ โ€“ โ€“ โˆ’ 0.48 โˆ’ 0.49 โˆ’ 0.87 โˆ’ 0.23 R5-R19 insp (M) โ€“ โ€“ โ€“ โ€“ โ€“ 2.09 2.28 1.71 โ€“ Cardiopulmonary exercise testing Peak V O 2 , mL/min/kg โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 16.2 a Peak V O 2 , % predicted โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 56 a AT, mL/min/kg โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 14.5 AT, % predicted โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 54.5 Breathing reserve, % โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 19.3 HRR, % โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ < 1 Peak heart rate, beats/min โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 6.4 a Peak HR, % predicted โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 57.4 a Peak O 2 pulse, mL/beat โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 35.7 a Peak O 2 pulse, % predicted โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 80.69 a VE/VCO 2 slope โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 162 a VE/MVV, % โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 103.18 a Peak HR, % predicted โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 57.4 a Peak O 2 pulse, mL/beat โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 35.7 a Peak O 2 pulse, % predicted โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 80.69 a VE/VCO 2 slope โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 162 a VE/MVV, % โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 103.18 a a Indicates value outside the normal range FVC forced vital capacity, FEV1 forced expiratory volume in 1 s, DLCO diffusing capacity of carbon monoxide, VA alveolar ventilation, DLCO/VA (KCO) carbon monoxide transfer coefficient, TLC total lung capacity, 6-MWT 6-min walking test, 6-MWD 6-min walking distance, SpO2 peripheral oxygen saturation, FOT forced oscillation technique, Rrs5 resistance of respiratory system at 5 Hz, Xrs5 reactance of respiratory system at 5 Hz, Rrs11 resistance of respiratory system at 11 Hz, Xrs11 reactance of respiratory system at 11 Hz, Rrs19 resistance of respiratory system at 19 Hz, MBW multiple breath washout, FRC functional residual capacity, LCI lung clearance index, VO 2 oxygen consumption, AT anaerobic threshold, HRR heart rate reserve, HR heart rate, VE/VCO 2 ventilatory efficiency, VE/MVV ventilatory reserve Fig. 2 12-month follow-up computed tomography scan showing mild, diffuse, bilateral ground-glass opacities associated with bronchiectasis in the upper and lower lobes of the lungs. Air trapping area in the posterior segments of the upper lobes and in the basal segments of the anterior lower lobes, evident in the expiratory phase Fig. 3 24-month computed tomography scan follow-up with mild, diffuse, bilateral ground-glass opacities associated with septal thickening interlobular as well as traction bronchiectasis in the lower lobes with a right predominance and images dense subpleural lines, compatible with areas of pneumonitis associated with pulmonary interstitial changes, with images of bilateral air trapping
4.238281
0.931152
sec[1]/p[0]
en
0.999997
37691104
https://doi.org/10.1186/s13256-023-04113-7
[ "score", "predicted", "peak", "absolute", "system", "dlco", "insp", "lung", "respiratory", "scan" ]
[ { "code": "MB20.1&XC87", "title": "Glasgow Coma Scale, eyes opening, never" }, { "code": "KD30.0", "title": "Birth depression with 5 minute Apgar score 0-3" }, { "code": "KD30.1", "title": "Birth depression with 5 minute Apgar score 4-6" }, { "code": "MB20.1", "title": "Coma" }, { "code": "KB21.0", "title": "Severe birth asphyxia" }, { "code": "DB95.Z", "title": "Drug-induced or toxic liver disease, unspecified" }, { "code": "CA22.Z", "title": "Chronic obstructive pulmonary disease, unspecified" }, { "code": "CA22.1&XS50", "title": "Other specified chronic obstructive pulmonary disease, very severe airflow limitation" }, { "code": "CA22.0&XS50", "title": "Chronic obstructive pulmonary disease with acute exacerbation, unspecified, very severe airflow limitation" }, { "code": "CA22.1&XS80", "title": "Other specified chronic obstructive pulmonary disease, mild airflow limitation" } ]
=== ICD-11 CODES FOUND === [KD30.0] Birth depression with 5 minute Apgar score 0-3 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 0-3 [KD30.1] Birth depression with 5 minute Apgar score 4-6 Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth. Also known as: Birth depression with 5 minute Apgar score 4-6 [MB20.1] Coma Definition: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Motor responses to noxious stimulation are limited to reflexive behaviour. Etiologies include but are not limited to traumatic, anoxic, infectious, neoplastic, vascular, inflammatory and metabolic brain injuries. Also known as: Coma | comatose | exanimation | Coma, NOS | Unconsciousness, NOS Excludes: Diabetic coma | Hepatic coma | Neonatal coma [KB21.0] Severe birth asphyxia Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent. Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia [DB95.Z] Drug-induced or toxic liver disease, unspecified Also known as: Drug-induced or toxic liver disease, unspecified | Drug-induced or toxic liver disease | toxic disease of liver | toxic disorder of liver | drug-induced toxic liver disease [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] === GRAPH WALKS === --- Walk 1 --- [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --- Walk 2 --- [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --- Walk 3 --- [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.... --- Walk 4 --- [KD30.1] Birth depression with 5 minute Apgar score 4-6 Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.... --PARENT--> [KD30] Birth depression Def: A condition characterised by cardiorespiratory and neurological depression in a newborn.... --CHILD--> [KD30.2] Birth depression with associated metabolic acidaemia of cord blood --- Walk 5 --- [MB20.1] Coma Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot... --EXCLUDES--> [?] Diabetic coma --PARENT--> [?] Acute complications of diabetes mellitus --- Walk 6 --- [MB20.1] Coma Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot... --EXCLUDES--> [?] Hepatic encephalopathy Def: Hepatic encephalopathy is a complication of liver cirrhosis and a hallmark of acute liver failure, and is also observed in patients with portosystemic shunts without cirrhosis. Hepatic encephalopathy ... --CHILD--> [?] Hepatic encephalopathy, stage 2
[ "[KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....", "[KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....", "[KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.0] Birth depression with 5 minute Apgar score 0-3\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth....", "[KD30.1] Birth depression with 5 minute Apgar score 4-6\n Def: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth....\n --PARENT--> [KD30] Birth depression\n Def: A condition characterised by cardiorespiratory and neurological depression in a newborn....\n --CHILD--> [KD30.2] Birth depression with associated metabolic acidaemia of cord blood", "[MB20.1] Coma\n Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot...\n --EXCLUDES--> [?] Diabetic coma\n --PARENT--> [?] Acute complications of diabetes mellitus", "[MB20.1] Coma\n Def: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Mot...\n --EXCLUDES--> [?] Hepatic encephalopathy\n Def: Hepatic encephalopathy is a complication of liver cirrhosis and a hallmark of acute liver failure, and is also observed in patients with portosystemic shunts without cirrhosis. Hepatic encephalopathy ...\n --CHILD--> [?] Hepatic encephalopathy, stage 2" ]
MB20.1&XC87
Glasgow Coma Scale, eyes opening, never
[ { "from_icd11": "KD30.0", "icd10_code": "P210", "icd10_title": "" }, { "from_icd11": "KD30.1", "icd10_code": "P211", "icd10_title": "" }, { "from_icd11": "MB20.1", "icd10_code": "R402142", "icd10_title": "Coma scale, eyes open, spontaneous, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402362", "icd10_title": "Coma scale, best motor response, obeys commands, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402252", "icd10_title": "Coma scale, best verbal response, oriented, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R402412", "icd10_title": "Glasgow coma scale score 13-15, at arrival to emergency department" }, { "from_icd11": "MB20.1", "icd10_code": "R4020", "icd10_title": "Unspecified coma" }, { "from_icd11": "MB20.1", "icd10_code": "R402141", "icd10_title": "Coma scale, eyes open, spontaneous, in the field [EMT or ambulance]" }, { "from_icd11": "MB20.1", "icd10_code": "R402361", "icd10_title": "Coma scale, best motor response, obeys commands, in the field [EMT or ambulance]" }, { "from_icd11": "MB20.1", "icd10_code": "R402251", "icd10_title": "Coma scale, best verbal response, oriented, in the field [EMT or ambulance]" }, { "from_icd11": "MB20.1", "icd10_code": "R402413", "icd10_title": "Glasgow coma scale score 13-15, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402143", "icd10_title": "Coma scale, eyes open, spontaneous, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402243", "icd10_title": "Coma scale, best verbal response, confused conversation, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402363", "icd10_title": "Coma scale, best motor response, obeys commands, at hospital admission" }, { "from_icd11": "MB20.1", "icd10_code": "R402433", "icd10_title": "Glasgow coma scale score 3-8, at hospital admission" } ]
P210
A 71โ€“year-old male patient was admitted to hospital for hoarseness for > 1 month. Ultrasound showed that the right thyroid was enlarged, bilateral thyroid nodules were present, the right larger nodules were about 4.5 ร— 3.5 cm, belonging to TI-RADS 4a type, and the left nodules belonged to TI-RADS 3 type . Enhanced computed tomography (CT) showed a space-occupying lesion in the right thyroid area, invading the trachea and mediastinum . Auxiliary examination showed that blood calcium was 2.34 (2.0โ€“2.69) mmol/L, blood phosphorus 1.02 (0.87โ€“1.45) mmol/L, PTH 89.1 (12.0โ€“65.0) pg/ml, and tumor markers and other tests were all normal. Postoperative PTH was 40.9 (12.0โ€“65.0) pg/ml, and serum calcium was 2.11 (2.0โ€“2.69) mmol/L. Intraoperative exploration revealed a large mass of about 6 cm in the right thyroid area , with unclear boundary, invading the esophagus and trachea,intraoperative frozen section pathology showed a malignant tumor with necrosis in the right thyroid area, which was confirmed by routine test and immunohistochemistry. Postoperative pathology suggested a malignant tumor in the right thyroid area, combined with immunohistochemical results, which was consistent with carcinosarcoma composed of rhabdomyosarcoma, and this case was of parathyroid origin . Immunohistochemical results were as follows: cytokeratin CK5/6 (โˆ’), P63 (โˆ’),thyroglobulin(TG) (โˆ’), PAX8 (โˆ’), CK7 (โˆ’), CD 30(โˆ’), Ki-67(40%+++), Bcl-2 (โˆ’), cyclin D1 (+), HMB 45 (โˆ’), S-100 (โˆ’), melan A (โˆ’), transcription termination factor-1 (โˆ’), CK (Pan) (partial +), smooth muscle actin (โˆ’), desmin (partial +), MyoD1 (partial +), myogenin (partial +), epithelial membrane antigen (EMA) (partial +), CGA (partial +), Syn (partial +), TFE3 (โˆ’), GATA-3 (+), p53 (โˆ’) . In this case, the capsule was thickened and parathyroid carcinoma cells were arranged in a diffuse sheet and trabecular manner. The tumor cells with clear cytoplasm and those with deviated eosinophilic nuclei were in a mixed, diffuse lamellar arrangement and central necrosis was seen. The tumor cells are large islands and sheets with foci of coagulative necrosis. Many cells with water-clear cytoplasm and sharp cell membrane, some of the cells are obviously eosinophilic, resembling rhabdomyoblasts, nuclei deviated, nucleoli are obvious, tumor cell nuclear division is not significant . The anaplastic thyroid carcinoma (undifferentiated carcinoma) usually has diverse morphology, obvious cell atypia, easy to see mitotic images, immunohistochemical PAX8 positive (36โ€“76%), but this case has obvious clear cells, mitotic images are rare, PAX8 Negative, but GATA3 positive, which further proves that the tumor originates from the parathyroid gland. In addition to the classic microscopic features of PC, there were rhabdomyoid tumor cells with eosinophilic cytoplasm, nuclear deviation and obvious nucleoli . During the operation, invasion of peripheral organs, elevated PTH, multiple positive immunohistochemical markers and genes were found, with rhabdomyosarcoma-like differentiation. After comprehensive consideration, Final diagnosis is parathyroid carcinoma with sarcomatoid differentiation(PCSD). Fig. 1 Ultrasonography showed a right thyroid mass Fig. 2 CT showed a large space-occupying lesion in the right thyroid region with invasion of the esophagus and mediastinum Fig. 3 Gross image of the case Fig. 4 a Tumor cells with clear cytoplasm and rhabdomyoid tumor cells with eosinophilic nuclei intermingled with diffuse patchy arrangement and necrosis in the center [hematoxylin and eosin (HE) 100ร—]. b Junction between the typical parathyroid carcinoma cell region and the differentiated cell region of rhabdoid sarcoma (HE, 50ร—). c Rhabdoid tumor cells, eosinophilic cytoplasm, nuclear deviation, and obvious nucleolus (HE, 400ร—). d obvious characteristics of parathyroid glands: small cubic clear cells, abundant slender fibrovascular compartments (inside the red oval).(HE, 200ร—) Table 1 antibodies list including clone and manufacturer in our case Antibody Result Manufacturer Product number Clone CK5/6 โ€“ OriGene China ZM-0313 OTI1C7 P63 โ€“ Shanghai Long Island Antibody Diagnostica M-0654 TP63/1786 TG โ€“ Shanghai Long Island Antibody Diagnostica M-0495 SPM517 PAX-8 โ€“ OriGene China ZM0468 OTI6H8 CK7 โ€“ Shanghai Long Island Antibody Diagnostica 0332 OV-TL12/30 CD30 โ€“ OriGene China ZM-0043 UMAB256 Ki-67 40%+++ OriGene China ZM-0167 MIB1 Bcl-2 โ€“ OriGene China ZM0010 bcl-2/100/D5 Cyclin D1 + OriGene China ZA-0101 EP12 HMB45 โ€“ OriGene China ZM-0187 HMB45 S-100 โ€“ OriGene China ZA-0225 Rabbit polyclonal Melan-A โ€“ Shanghai Long Island Antibody Diagnostica 0373 A103 TTF-1 โ€“ OriGene China ZM-0270 SPT24 CK(pan) partially + Shanghai Long Island Antibody Diagnostica 0349 AE1/AE3 SMA โ€“ OriGene China ZM-0003 UMAB237 Desmin partially + OriGene China ZA-0610 EP15 MyoD1 partially + OriGene China ZA0585 EP212 Myogenin partially + OriGene China ZA-0592 EP162 EMA partially + OriGene China ZM0095 UMAB57 CGA partially + Shanghai Long Island Antibody Diagnostica 0202 CGA/413 Syn partially + OriGene China ZA-0506 EP158 TFE3 โ€“ OriGene China ZA-0657 EP285 GATA-3 + OriGene China ZM-0498 OTI5C11 P53 โ€“ Shanghai Long Island Antibody Diagnostica 0430 SPM514 โ€œ-โ€œrepresents negative,โ€ +โ€ represents positive Fig. 5 a Ki 67 proliferation index was about 40%(original magnificationร— 200). b Desmin partially positive (original magnificationร— 200). c GATA-3 positive (original magnificationร— 200). d MyoD1 partially positive (original magnificationร— 200). e myogenin partially positive (original magnificationร— 100)
4.109375
0.965332
sec[1]/p[0]
en
0.999996
33317559
https://doi.org/10.1186/s13000-020-01060-5
[ "origene", "china", "tumor", "cells", "partially", "thyroid", "antibody", "partial", "shanghai", "long" ]
[ { "code": "1F6B", "title": "Strongyloidiasis" }, { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" } ]
=== ICD-11 CODES FOUND === [1F6B] Strongyloidiasis Definition: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be asymptomatic. Transmission is by direct contact through penetration of the skin (generally the feet) with larvae from faecally contaminated soil, or autoinfection of an established infection. Confirmation is by identification of Strongyloides larvae in faecal samples, duodenal fluid samples, sputum, Also known as: Strongyloidiasis | Gastric strongyloides stercoralis | Glomerular disorders in strongyloidiasis | Cutaneous strongyloidiasis | Strongyloidal ground itch Excludes: Trichostrongyliasis [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [MF9Y] Other specified clinical findings on examination of urine, without diagnosis Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine [5C56.20] Mucolipidosis Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2 Excludes: Sialidosis (mucolipidosis type 1) [3A51.1] Sickle cell disease without crisis Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing. Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease] [9A96.3] Primary anterior uveitis Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid. Also known as: Primary anterior uveitis | anterior chamber cell === GRAPH WALKS === --- Walk 1 --- [1F6B] Strongyloidiasis Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ... --PARENT--> [?] Diseases due to nematodes --PARENT--> [?] Helminthiases --- Walk 2 --- [1F6B] Strongyloidiasis Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ... --EXCLUDES--> [?] Trichostrongyliasis Def: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion... --CHILD--> [?] Trichostrongyliasis due to Trichostrongylus axei --- Walk 3 --- [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 4 --- [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 5 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis --- Walk 6 --- [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
[ "[1F6B] Strongyloidiasis\n Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ...\n --PARENT--> [?] Diseases due to nematodes\n --PARENT--> [?] Helminthiases", "[1F6B] Strongyloidiasis\n Def: A disease caused by the parasitic worm Strongyloides. This disease presents with symptoms depending on the site of infection (gastrointestinal tract, pulmonary system, dermis, or systemic), or may be ...\n --EXCLUDES--> [?] Trichostrongyliasis\n Def: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion...\n --CHILD--> [?] Trichostrongyliasis due to Trichostrongylus axei", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system" ]
1F6B
Strongyloidiasis
[ { "from_icd11": "1F6B", "icd10_code": "B789", "icd10_title": "Strongyloidiasis, unspecified" }, { "from_icd11": "1F6B", "icd10_code": "B780", "icd10_title": "Intestinal strongyloidiasis" }, { "from_icd11": "1F6B", "icd10_code": "B78", "icd10_title": "Strongyloidiasis" }, { "from_icd11": "1F6B", "icd10_code": "B781", "icd10_title": "Cutaneous strongyloidiasis" }, { "from_icd11": "1F6B", "icd10_code": "B787", "icd10_title": "Disseminated strongyloidiasis" }, { "from_icd11": "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" } ]
B789
Strongyloidiasis, unspecified
A 16-year-old girl presented to our consultation with complaints of long-term severe spontaneous vomiting and regurgitation during sports or mundane movements, such as leaning forward to tie shoes. Moreover she reports regular retrosternal pain, acid mouth taste along with a body weight loss (BMI 17.5). These symptoms led to food fear, quick satiety and a clearly reduced quality of life. Two years prior she underwent a phase of bulimia with self-induced vomiting accompanied by recurrent abdominal pain and weight loss (BMI 10.5). Psychotherapy and behavioral therapy helped overcome this phase successfully leading to weight gain (BMI 18.5) and renewed desire and pleasure to regularly eat. She was also under drug therapy with Mirtazapine for a depression. Physical examination was inconspicuous and laboratory values within normal limits. Esophageal contrast intestinal series showed a large axial hernia with gastro-esophageal reflux , compatible with an anatomical cause of gastro-esophageal-reflux-disease, and a normal gastric emptying. A laparoscopic axial hernia reduction, hiatoplasty and anterior hemifundoplication initially led to symptoms relief, but recurrent postprandial nausea and vomiting reoccurred 4 weeks postoperatively. The postoperative upper gastrointestinal contrast series were unsuspicious . The patient experienced subjectively reduction of symptoms under oral therapy with erythromycin, taking advantage of its propulsive side-effect with almost no significant antibiotic effect at low doses (3 mg/kg, 4 times a day), after unsatisfactory propulsive oral medication attempts with dimenhydrinate, and dietary changes with frequent and small food servings. Due to persisting symptoms for 5 months, despite these conservative treatment attempts, the patient underwent abdominal MRI study. This revealed a dilated stomach and duodenum, with a duodenal change in caliber underrunning the mesenteric root, compatible with a duodenal obstruction between the superior mesenteric artery and the abdominal aorta caused by a smaller angle between the two vessels of 14ยฐ (normal angle values 40โ€“60ยฐ ) . These findings were compatible with a Wilkieโ€™s syndrome (WS) diagnosis. An upper gastrointestinal tract endoscopic study revealed significant gastric food leftovers despite oral food waiver for approximately 24 h, excluded a tangible anatomical luminal duodenal obstruction and provided a radiological and endoscopic proof of an inconspicuous intestinal passage into the proximal jejunal loops . At this point indication for surgery was set, based on the patient restricted quality of life with difficulties to conduct a normal daily routine and the impossibility to enable a clinical satisfied state by conservative approaches over several months. The patient underwent laparotomy with confirmation of a functional duodenal obstruction and duodenal change in caliber underpassing the mesenterial root . A standardized side-to-side duodeno-jejunostomy with a continuous double-layer resorbable monofilament suture (PDS 4-0, Ethicon, Norderstedt, Germany) was performed to bypass the duodenal obstruction . The postoperative course was uneventful and the patient was discharged on the sixth postoperative day. No complications, adverse or unanticipated events occurred at short term. At 8 weeks follow-up the patient is free of significant symptoms, regained body weight (BMI 19.5) and reports a subjectively normal quality of life. Further follow-ups for clinical investigations are planned . Fig. 1 Upper gastrosintestinal contrast series (A) prior to laparoscopic surgery showing a large axial hernia with gastro-esophageal reflux (arrow) and (B) four weeks after successful laparoscopic hernia reduction, hiatoplasty and anterior hemifundoplication, showing successful hernia reduction and antireflux therapy. Fig. 1 Fig. 2 Abdominal MRI showing (A) a dilated stomach (arrows), (B) a dilated duodenum (arrow) with change in caliber from before (*) to after (**) under passing the mesenteric root. Further an duodenal obstruction (C) between the superior mesenteric artery (*) and the abdominal aorta (**) can be seen. This duodenal obstruction is caused by a aorto-mesenteric angle of 14ยฐ, which is compared to normal angle values of 40โ€“55ยฐ. These findings are compatible with a Wilkieโ€™s syndrome (superior mesenteric artery syndrome) diagnosis. Fig. 2 Fig. 3 Endoscopy showing (A) significant gastric food leftovers despite oral food waiver for approximately 24 h, (B) exclusion of a tangible anatomical luminal duodenal stricture and (C) radiological and endoscopic proof of an inconspicuous complete intestinal into the proximal jejunal loops. Fig. 3 Fig. 4 Intraoperative view showing (A) manually pulled out (large arrow) duodenum from under the mesenteric root presenting a change in caliber and a clear demarcation line towards the jejunum (small arrow); (B) graphic illustration of the bypass operation between duodenum an proximal jejunum to obviate the duodenal stenosis at the height of the mesenteric root; (C) side-to-side duodeno-jejunostomy with a continuous double-layer resorbable monofilament suture. Fig. 4 Fig. 5 Graphic illustration of (A) the normal angle of 40โ€“60ยฐ between the superior mesenteric artery (SMA) and the aorta allowing a regular luminal diameter of the duodenum (D), in contrast to (B) a pathological low angle of <25ยฐ in Wilkieโ€™s syndrome resulting in duodenal compression, and (C) an angle of 14ยฐ in the here present case, resulting in a clinical relevant duodenal compression (arrow). Fig. 5
4.0625
0.975586
sec[1]/p[0]
en
0.999997
31726254
https://doi.org/10.1016/j.ijscr.2019.10.038
[ "duodenal", "mesenteric", "angle", "food", "obstruction", "abdominal", "hernia", "side", "duodenum", "root" ]
[ { "code": "DA5Z", "title": "Diseases of duodenum, unspecified" }, { "code": "DA51.Z", "title": "Duodenitis, unspecified" }, { "code": "DA50.0", "title": "Obstruction of duodenum" }, { "code": "DA63.Z", "title": "Duodenal ulcer, unspecified" }, { "code": "QF01.Y", "title": "Other specified acquired absence of organs" }, { "code": "DC51.Y&XA43V8", "title": "Mesentery rupture" }, { "code": "LB18", "title": "Congenital anomalies of intestinal fixation" }, { "code": "DD31.0Z", "title": "Non-occlusive mesenteric ischaemia, unspecified" }, { "code": "DD30.0", "title": "Acute mesenteric arterial infarction" }, { "code": "DC51.1&XA43V8", "title": "Adhesion of mesentery" } ]
=== ICD-11 CODES FOUND === [DA5Z] Diseases of duodenum, unspecified Also known as: Diseases of duodenum, unspecified | disorder of duodenum | duodenum disease NOS | duodenal disease NOS | duodenopathy NOS [DA51.Z] Duodenitis, unspecified Also known as: Duodenitis, unspecified | Duodenitis | nonspecific duodenitis | Inflammation of duodenum | dodecadactylitis [DA50.0] Obstruction of duodenum Definition: Hindrance of the passage of luminal contents in the duodenum. Obstruction of duodenum can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is associated with diminished or stopped flow of luminal contents. Strangulating obstruction is associated with impaired blood flow to the duodenum in addition to obstructed flow of luminal contents. Also known as: Obstruction of duodenum | duodenal obstruction | obstructed duodenum | Aortomesenteric duodenum occlusion syndrome | Duodenal ileus Excludes: congenital stenosis of duodenum [DA63.Z] Duodenal ulcer, unspecified Also known as: Duodenal ulcer, unspecified | Duodenal ulcer | duodenal peptic ulcer [QF01.Y] Other specified acquired absence of organs Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball [LB18] Congenital anomalies of intestinal fixation Definition: A condition caused by failure of the intestines to correctly develop during the antenatal period. This condition may present with intermittent abdominal pain, vomiting, or diarrhoea. Confirmation is through observation of intestinal rotation by imaging. Also known as: Congenital anomalies of intestinal fixation | Congenital malrotation of large intestine | Congenital intestinal malrotation | Volvulus of midgut | Volvulus neonatorum [DD31.0Z] Non-occlusive mesenteric ischaemia, unspecified Also known as: Non-occlusive mesenteric ischaemia, unspecified | Non-occlusive mesenteric ischaemia | NOMI - [non-occlusive mesenteric ischaemia] | mesenteric ischaemia [DD30.0] Acute mesenteric arterial infarction Definition: Acute mesenteric arterial infarction is an ischemic disorder of sudden interruption of mesenteric arterial flow because of occlusion of mesenteric artery. This may be further subdivided into acute mesenteric arterial embolus (AMAE) and acute mesenteric arterial thrombosis (AMAT). Also known as: Acute mesenteric arterial infarction | OMAI - [occlusive mesenteric arterial ischemia] | mesenteric arterial occlusion | mesenteric infarct | mesenteric infarction === GRAPH WALKS === --- Walk 1 --- [DA5Z] Diseases of duodenum, unspecified --PARENT--> [?] Diseases of duodenum Def: This is a group of conditions characterised as being in or associated with the duodenum, the first portion of the small intestine.... --CHILD--> [DA52] Vascular disorders of the duodenum Def: This group incorporates vascular disorders principally affecting the blood vessels of the duodenum. They include vascular disorders of arteries, veins and capillaries that carry blood to and from the ... --- Walk 2 --- [DA5Z] Diseases of duodenum, unspecified --PARENT--> [?] Diseases of duodenum Def: This is a group of conditions characterised as being in or associated with the duodenum, the first portion of the small intestine.... --CHILD--> [DA50] Acquired anatomical alterations of the duodenum Def: This group incorporates duodenal disorders principally due to acquired morphological changes of the duodenum.... --- Walk 3 --- [DA51.Z] Duodenitis, unspecified --PARENT--> [DA51] Duodenitis Def: Duodenitis is an injury of duodenal mucosa that involves epithelial damage and mucosal inflammation except for any epithelial defect. Duodenitis is caused by various factors such as high acid secretio... --CHILD--> [DA51.0] Helicobacter-pylori associated duodenitis Def: Duodenitis with Helicobacter pylori infection. H. pylori can be colonized on gastric metaplasia epithelium at bulb, and induce duodenitis.... --- Walk 4 --- [DA51.Z] Duodenitis, unspecified --PARENT--> [DA51] Duodenitis Def: Duodenitis is an injury of duodenal mucosa that involves epithelial damage and mucosal inflammation except for any epithelial defect. Duodenitis is caused by various factors such as high acid secretio... --CHILD--> [DA51.0] Helicobacter-pylori associated duodenitis Def: Duodenitis with Helicobacter pylori infection. H. pylori can be colonized on gastric metaplasia epithelium at bulb, and induce duodenitis.... --- Walk 5 --- [DA50.0] Obstruction of duodenum Def: Hindrance of the passage of luminal contents in the duodenum. Obstruction of duodenum can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is associated with di... --EXCLUDES--> [?] Atresia of duodenum Def: Duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. In 30-52% of infants it is an isolated anomaly, but it is often associated with othe... --PARENT--> [?] Structural developmental anomalies of duodenum Def: Any congenital defect of duodenum that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in ... --- Walk 6 --- [DA50.0] Obstruction of duodenum Def: Hindrance of the passage of luminal contents in the duodenum. Obstruction of duodenum can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is associated with di... --EXCLUDES--> [?] Atresia of duodenum Def: Duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. In 30-52% of infants it is an isolated anomaly, but it is often associated with othe... --PARENT--> [?] Structural developmental anomalies of duodenum Def: Any congenital defect of duodenum that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in ...
[ "[DA5Z] Diseases of duodenum, unspecified\n --PARENT--> [?] Diseases of duodenum\n Def: This is a group of conditions characterised as being in or associated with the duodenum, the first portion of the small intestine....\n --CHILD--> [DA52] Vascular disorders of the duodenum\n Def: This group incorporates vascular disorders principally affecting the blood vessels of the duodenum. They include vascular disorders of arteries, veins and capillaries that carry blood to and from the ...", "[DA5Z] Diseases of duodenum, unspecified\n --PARENT--> [?] Diseases of duodenum\n Def: This is a group of conditions characterised as being in or associated with the duodenum, the first portion of the small intestine....\n --CHILD--> [DA50] Acquired anatomical alterations of the duodenum\n Def: This group incorporates duodenal disorders principally due to acquired morphological changes of the duodenum....", "[DA51.Z] Duodenitis, unspecified\n --PARENT--> [DA51] Duodenitis\n Def: Duodenitis is an injury of duodenal mucosa that involves epithelial damage and mucosal inflammation except for any epithelial defect. Duodenitis is caused by various factors such as high acid secretio...\n --CHILD--> [DA51.0] Helicobacter-pylori associated duodenitis\n Def: Duodenitis with Helicobacter pylori infection. H. pylori can be colonized on gastric metaplasia epithelium at bulb, and induce duodenitis....", "[DA51.Z] Duodenitis, unspecified\n --PARENT--> [DA51] Duodenitis\n Def: Duodenitis is an injury of duodenal mucosa that involves epithelial damage and mucosal inflammation except for any epithelial defect. Duodenitis is caused by various factors such as high acid secretio...\n --CHILD--> [DA51.0] Helicobacter-pylori associated duodenitis\n Def: Duodenitis with Helicobacter pylori infection. H. pylori can be colonized on gastric metaplasia epithelium at bulb, and induce duodenitis....", "[DA50.0] Obstruction of duodenum\n Def: Hindrance of the passage of luminal contents in the duodenum. Obstruction of duodenum can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is associated with di...\n --EXCLUDES--> [?] Atresia of duodenum\n Def: Duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. In 30-52% of infants it is an isolated anomaly, but it is often associated with othe...\n --PARENT--> [?] Structural developmental anomalies of duodenum\n Def: Any congenital defect of duodenum that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in ...", "[DA50.0] Obstruction of duodenum\n Def: Hindrance of the passage of luminal contents in the duodenum. Obstruction of duodenum can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is associated with di...\n --EXCLUDES--> [?] Atresia of duodenum\n Def: Duodenal atresia is an embryopathy of the cranial intestine that leads to a complete absence of the duodenal lumen. In 30-52% of infants it is an isolated anomaly, but it is often associated with othe...\n --PARENT--> [?] Structural developmental anomalies of duodenum\n Def: Any congenital defect of duodenum that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary greatly in ..." ]
DA5Z
Diseases of duodenum, unspecified
[ { "from_icd11": "DA51.Z", "icd10_code": "K2980", "icd10_title": "Duodenitis without bleeding" }, { "from_icd11": "DA51.Z", "icd10_code": "K2981", "icd10_title": "Duodenitis with bleeding" }, { "from_icd11": "DA51.Z", "icd10_code": "K2990", "icd10_title": "Gastroduodenitis, unspecified, without bleeding" }, { "from_icd11": "DA51.Z", "icd10_code": "K2991", "icd10_title": "Gastroduodenitis, unspecified, with bleeding" }, { "from_icd11": "DA51.Z", "icd10_code": "K29", "icd10_title": "Gastritis and duodenitis" }, { "from_icd11": "DA51.Z", "icd10_code": "K298", "icd10_title": "Duodenitis" }, { "from_icd11": "DA51.Z", "icd10_code": "K299", "icd10_title": "Gastroduodenitis, unspecified" }, { "from_icd11": "DA50.0", "icd10_code": "K315", "icd10_title": "Obstruction of duodenum" }, { "from_icd11": "DA63.Z", "icd10_code": "K265", "icd10_title": "Chronic or unspecified duodenal ulcer with perforation" }, { "from_icd11": "DA63.Z", "icd10_code": "K269", "icd10_title": "Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation" }, { "from_icd11": "DA63.Z", "icd10_code": "K264", "icd10_title": "Chronic or unspecified duodenal ulcer with hemorrhage" }, { "from_icd11": "DA63.Z", "icd10_code": "K260", "icd10_title": "Acute duodenal ulcer with hemorrhage" }, { "from_icd11": "DA63.Z", "icd10_code": "K261", "icd10_title": "Acute duodenal ulcer with perforation" }, { "from_icd11": "DA63.Z", "icd10_code": "K267", "icd10_title": "Chronic duodenal ulcer without hemorrhage or perforation" }, { "from_icd11": "DA63.Z", "icd10_code": "K266", "icd10_title": "Chronic or unspecified duodenal ulcer with both hemorrhage and perforation" } ]
K2980
Duodenitis without bleeding
A 42 years old Caucasian woman, without any previous medical history or any risk factors for coronary artery disease presented to a district general hospital, with no cardiac catheter laboratory facilities, complaining about a sudden-onset substernal chest pain lasting for the past 2 h. Her ECG findings on admission were ST elevation in leads I, aVL, aVF, V2-V6 . A thrombolytic agent was administered immediately, with regression of the angina and almost normalization of the ECG changes. The patient was not transferred to a hospital with PCI-capability for pharmaco-invasive strategy at that time, for unknown reasons. On the eighth in-hospital day, the patient complained of another episode of substernal chest pain, with hypotension and signs of left ventricular heart failure. The ECG showed extensive ST elevation in leads I, aVL, V1-V6 . Treatment with intravenous inotropic amines and re-thrombolysis (half-dose) was initiated and she was transferred to our hospital. On arrival to the coronary care unit, the patient was in cardiogenic shock. Echo on admission displayed anterior, apex and anteroseptum akinesia and severely impaired left ventricular function. The ejection fraction of the patient was 25% with moderate mitral regurgitation. She was electively intubated, an intra-aortic balloon pump (IABP) was advanced and she was urgently transferred to the cardiac catheterization laboratory. Coronary angiography revealed the presence of a long dissection of the left coronary trunk (LCT) with a double distal extension: a. Towards the anterior left descending coronary artery (LAD), the proximal third of which was occluded (TIMI-1 flow) and b. towards the circumflex artery (Cx) with slowed distal flow (TIMI-2 flow), . The right coronary artery (RCA) was normal. The diagnosis of a spontaneous coronary artery dissection was prompt, with these angiographic findings. The use of intravascular ultrasound (IVUS) or optical coherence tomography (OCT) was not plausible due to the emergency of the case. After a quick briefing with the heart team, immediate stenting was decided due to the hemodynamic compromise of the patient. Angioplasty and stenting with a drug eluting stent (DES) was therefore performed. After positioning a Q 3.5 SH 7Fr (Boston Scientific, Natick, MA, USA) guiding catheter using a Runthrough (Terumo Corporation, Tokyo, Japan) guide wire, the true lumen was crossed and the wire was placed in the distal Cx with free movement of the tip . It was extremely difficult to place another guide wire to the distal LAD (despite multiple attempts and various J) and since there was a high risk of further extending the dissection, we decided to proceed with direct stenting of the left main. A 3.0 ร— 24 mm Taxus Element (Boston Scientific, Natick, MA, USA) stent was deployed at 14 atms into the left main and proximal Cx . Due to the proximal sealing of the dissection, there was flow improvement in the LAD . An Asahi Pro Water (Asahi Intecc, Japan) guide wire easily crossed the struts of the stent and was placed to the distal LAD, followed by inflations of two Sapphire (Orbus Neich Medical, B.V The Netherlands) 2.0 ร— 10 mm and a 2.5 ร— 15 mm balloons at the ostium and proximal of the LAD. A second Taxus Element 3.0X16mm was deployed, due to residual stenosis distally to the implanted stent of the Cx, overlapping it . The procedure was concluded by placing a Taxus Element 3.0 ร— 16 mm stent, into the LAD, with TAP technique (T And Protrusion) . The benefit of this combined technique is that the opportunity to first perform single-stenting is preserved, while side-branch stenting can be performed only if required. Final result was excellent, with no residual dissection and TIMI 3 flow in to the LAD and Cx. . She was discharged (day 8) on dual antiplatelet therapy, ฮฒ-blocker, ACE inhibitor and statin. The patient remained asymptomatic at 3 months follow up and a MSCT coronary angiography showed the absence of restenosis in the segments treated with stents, followed by an improvement of left ventricular systolic function . A follow up cardiac catheterization angiography was recommended (class IIb) after 6 months according to European Society of Cardiology guidelines for high risk PCI (unprotected LM). Figure 1 ECG findings on admission were ST elevation in leads I, aVL, aVF, V2-V6. Figure 2 On the eighth in-hospital day, the patient suffered another episode of substernal chest pain. The ECG showed extensive ST elevation in leads I, aVL, V1-V6. Figure 3 Coronary angiography revealed the presence of a long dissection with intimal flap (arrows) of the left coronary trunk (LCT) with a double distal extension to the left anterior descending and circumflex arteries. Figure 4 PCI with TAP technique (T And Protrusion), step by step analysis. A : The true lumen was crossed and the wire was placed in the distal Cx. B : A 3.0 ร— 24 mm Taxus Element stent was deployed at 14 atms into the left main and proximal LCx C : Due to the proximal sealing of the dissection (arrow), there was flow improvement in the LAD D : A second Taxus Element 3.0ร—16mm was deployed, due to residual stenosis distally to the implanted stent of the LCx, overlapping it E , F : The procedure was concluded by placing a Taxus Element 3.0 ร— 16 mm stent, into the LAD, with TAP technique (T And Protrusion). Figure 5 Final result was excellent, with no residual dissection and TIMI 3 flow in to the LAD and LCx. Figure 6 A MSCT coronary angiography showed the absence of restenosis in the segments treated with stents at 3 months.
3.935547
0.976074
sec[0]/sec[0]/p[0]
en
0.999997
25519008
https://doi.org/10.1186/1471-2261-14-191
[ "coronary", "dissection", "stent", "flow", "taxus", "element", "artery", "angiography", "stenting", "wire" ]
[ { "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": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "BA82", "title": "Coronary artery dissection" }, { "code": "BD50.Z", "title": "Aortic aneurysm or dissection, unspecified" }, { "code": "8B22.0&XA2K99", "title": "Dissection of basilar artery" }, { "code": "BD50.3Z", "title": "Thoracic aortic aneurysm, without mention of perforation or rupture" } ]
=== 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 [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 [BA82] Coronary artery dissection Definition: Coronary artery dissection results from a tear in the inner layer of the coronary artery, the tunica intima. This allows blood to penetrate and cause an intramural hematoma in the central layer, the tunica media, and restriction in the size of lumen. Also known as: Coronary artery dissection | spontaneous coronary artery dissection | Acute coronary artery dissection | Chronic coronary artery dissection Includes: spontaneous coronary artery dissection Excludes: Injury or harm arising from a procedure, not elsewhere classified | Injury of blood vessels of thorax [BD50.Z] Aortic aneurysm or dissection, unspecified Also known as: Aortic aneurysm or dissection, unspecified | Aortic aneurysm or dissection | Perforation of dissecting aneurysm of aorta | Aortic aneurysm syndrome, Loeys-Dietz type | Loeys-Dietz syndrome type 1 [BD50.3Z] Thoracic aortic aneurysm, without mention of perforation or rupture Also known as: Thoracic aortic aneurysm, without mention of perforation or rupture | Thoracic aortic aneurysm | aneurysm of thoracic aorta | intrathoracic aneurysm | thoracic aorta aneurysm === 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--> [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 2 --- [BA8Z] Diseases of coronary artery, unspecified --PARENT--> [?] Diseases of coronary artery Def: Conditions affecting the blood perfusion of the heart.... --RELATED_TO--> [?] Coronary atherosclerosis Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i... --- Walk 3 --- [BA4Z] Acute ischaemic heart disease, unspecified --PARENT--> [?] Acute ischaemic heart disease --CHILD--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --- Walk 4 --- [BA4Z] Acute ischaemic heart disease, unspecified --PARENT--> [?] Acute ischaemic heart disease --CHILD--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --- Walk 5 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --CHILD--> [BA41.1] Acute non-ST elevation myocardial infarction --- Walk 6 --- [BA41.Z] Acute myocardial infarction, unspecified --PARENT--> [BA41] Acute myocardial infarction Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o... --CHILD--> [BA41.0] Acute ST elevation myocardial infarction Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:...
[ "[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --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...", "[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --RELATED_TO--> [?] Coronary atherosclerosis\n Def: Atherosclerosis is the build up inside the coronary arteries of cholesterol, fatty acids, calcium, fibrous connective tissue and cells (mostly macrophages), referred to as plaque. The effect of this i...", "[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...", "[BA4Z] Acute ischaemic heart disease, unspecified\n --PARENT--> [?] Acute ischaemic heart disease\n --CHILD--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.1] Acute non-ST elevation myocardial infarction", "[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --CHILD--> [BA41.0] Acute ST elevation myocardial infarction\n Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:..." ]
BA8Z
Diseases of coronary artery, unspecified
[ { "from_icd11": "BA4Z", "icd10_code": "I248", "icd10_title": "Other forms of acute ischemic heart disease" }, { "from_icd11": "BA4Z", "icd10_code": "I256", "icd10_title": "Silent myocardial ischemia" }, { "from_icd11": "BA4Z", "icd10_code": "I249", "icd10_title": "Acute ischemic heart disease, unspecified" }, { "from_icd11": "BA4Z", "icd10_code": "I24", "icd10_title": "Other acute ischemic heart diseases" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A1", "icd10_title": "Myocardial infarction type 2" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A9", "icd10_title": "Other myocardial infarction type" }, { "from_icd11": "BA41.Z", "icd10_code": "I2109", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2119", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2111", "icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2102", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2129", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I2121", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2101", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I214", "icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I213", "icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site" } ]
I248
Other forms of acute ischemic heart disease
In this patient, hypertension was more prominent than proteinuria. A 3-year-old patient with severe hypertension not associated with obesity was considered to have secondary hypertension in the first place. After performing tests (Tables 1 and 2 ), combined with the childโ€™s medical history and physical examination, we analyzed the etiology of the patientโ€™s hypertension. Table 1 Initial laboratories Variable Results on admission Reference range Urinary System 24 h urine Urine protein quantitation, mg/24 h 1107 0โ€“150 UCa, mg/kg/24 h 12 0โ€“4 Random urine Retinol-binding protein, mg/L 0.73 0โ€“0.70 ฮฑ1-microglobulin, mg/L < 6 < 6 ฮฒ2-microglobulin, mg/L 0.5 0.1โ€“0.3 Microalbumin, mg/L 359.9 0โ€“20.0 Transferrin, mg/L 17.8 < 5 N-acetyl-ฮฒ-D-glucosidase, U/L 15.5 0.3โ€“12.0 NGAL, ng/mL 7 0โ€“100 Microalbumin/urine creatinine 970 0โ€“30 Plasma Urea, mmol/L 5.34 1.78โ€“6.42 Serum creatinine, ฮผmol/L 42 23โ€“37 ฮฒ2-microglobulin, mg/L 1.38 0.80โ€“2.20 Cystatin C, mg/L 0.7 0.59โ€“1.03 eGFR, ml/(minยท1.73 m 2 ) 77.8 80.0โ€“120.0 Electrolyte Na, mmol/L 136 137โ€“147 K, mmol/L 3.24 3.50โ€“5.30 Cl, mmol/L 91.3 99.0โ€“110.0 Ca, mmol/L 2.32 2.20โ€“2.70 P, mmol/L 1.05 1.10โ€“1.95 Mg, mmol/L 0.82 0.70โ€“0.95 Venous blood gas analysis pH 7.569 7.320โ€“7.420 BEblood, mmol/L 9.7 โˆ’ 3.0โ€“3.0 Blood routine WBC count, 10 9 cells per L 9.23 4.00โ€“10.00 Neutrophils, % 44 45โ€“47 Lymphocytes, % 44 20โ€“40 Inflammatory index C-reactive protein, mg/L 0.6 0โ€“5.0 Procalcitonin, ng/L 0.04 0โ€“0.05 Erythrocyto sedimentation rate, mm/h 13 0โ€“20 Pathogenic detection Fungus 1,3-ฮฒ-D-Glucan, pg/ml < 10 0โ€“60 Virus Negative Negative IgM of Flu A, Flu B, Parainflu, ADV, and RSV Negative Negative DNA of EBV, HBV and HSV, copies/ml < 10 3 < 10 3 HCVcAg, HCV-Ab Negative Negative Atypical pathogens IgM of MP, CPn, COX, LP Negative Negative Bacteria Urine culture Negative Negative Antistreptolysin O, IU/ml 7 0โ€“150 Tuberculosis-DNA, copies/ml < 10 3 < 10 3 PPD Negative Negative Endocrine system Cortisol, nmol/L 416 133โ€“537(tACQ:6amโ€“10am) ACTH, pg/mL 5.9 7.2โ€“63.3 17-OHP, ng/mL < 3.0 < 3.0 PTH, pmol/L 7.05 1.60โ€“6.90 Thyroid function TT3, nmol/L 2.90 1.34โ€“2.73 TT4, nmol/L 186.1 78.4โ€“157.4 FT3, pmol/L 8.79 3.69โ€“7.62 FT4, pmol/L 21.56 9.92โ€“19.54 TSH, mIU/L 3.27 0.38โ€“5.33 Hormones Follicle-stimulating hormone, IU/L 6.15 0.80โ€“6.22 Luteinizing hormone, IU/L 0.56 0.02โ€“1.84 Prolactin, mIU/L 202.52 63.18โ€“457.92 Estradial, pmol/L 134.0 0โ€“73.4 Testosterone, pmol/L 0.29 0โ€“0.88 RAAS (vertical position) Renin, ฮผIU/mL > 1000 3.11โ€“41.2 Angiotensin I, ng/mL/h 31.58 - Angiotensin II, pg/mLI 652.8 50.0โ€“120.0 Aldosterone, pg/mL 1748 70โ€“300 Vanilmandelic acid, mg/24 h 5.11 0โ€“13.60 Karyotype 46, XX 46,XX Adrenal B ultrasound Normal - Thyroid B ultrasound Multiple calcification lesions - Cardiovascular Electrocardiograph High left ventricular voltage - Echocardiogram Left ventricular hypertrophy - Creatine kinase, U/L 99 40โ€“200 Creative kinase MB, U/L 1 0โ€“24 Creative kinase MB mass, ng/mL 1.70 0โ€“5.04 Hydroxybutyrate dehydrogenase, U/L 365 72โ€“182 Glutamic oxalacetic transaminase, U/L 34 13โ€“35 Lactate dehydrogenase, U/L 454 120โ€“300 Myohemoglobin, ng/mL < 21 25โ€“28 Troponin T, ng/mL < 0.003 0โ€“0.022 Nervous system Head MRI Normal - Immunological indicators Antinuclear antibody profile Negative Negative Antineutrophil cytoplasmic antibody profile Negative Negative Anticardiolipin antibody Negative Negative Ig A, g/L 1.27 0.2โ€“1.0 Complement 3, g/L 1.04 0.9โ€“1.8 Complement 4, g/L 0.25 0.1โ€“0.4 Metabolic disorders Ceruloplasmin, g/L 0.27 0.16โ€“0.45 Blood screening for inherited metabolic diseases, tandem mass spectrometry Negative Negative Urine screening for inherited metabolic diseases, gas chromatography / mass spectrometry Negative Negative Other Indicators Serum lipid Total cholesterol, mmol/L 5.72 0โ€“5.2 Triglyceride, mmol/L 1.2 0โ€“2.26 High-density lipoprotein, mmol/L 1.48 > 1.86 Low density lipoprotein, mmol/L 3.85 0โ€“2.59 Liver enzymes Gamma-glutamyl transpeptidase, U/L 10 7โ€“45 Alanine transaminase, U/L 11 7โ€“40 Total bile acid, ฮผmol/L 22 1โ€“10 Total bilirubin, ฮผmol/L 4.3 0โ€“21 Total protein, g/L 65.1 60โ€“80 Albumin, g/L 37.3 38โ€“54 Ig immunoglobulin, Flu A influenza A virus, Flu B influenza B virus, Parainflu parainfluenza virus, ADV adenoviridae, RSV respiratory syncytial virus, EBV EB virus, HSV herpes simplex virus, HBV hepatitis B virus, HCV hepatitis C virus, MP Myocoplasima pneumonia, CPn Chlamydia pneumoniae, COX Coxiella burnetiid, LP Legionella pneumophilia, ACTH adrenocorticotropic hormone, 17-OHP 17-hydroxyprogesterone, PTH parathyroid hormone, TT3 serum total triiodothyronic acid, TT4 total serum thyroxine, FT3 free triiodothyronine, FT4 free thyroxine, TSH thyroid stimulating hormone, UCa urinary calcium quantification, NGAL neutrophil gelatinase-associated lipid carrier protein Table 2 Changes in laboratory findings Variable D1 D3 D4 D5 D6 D8 D11 D13 D17 Reference range K, mmol/L 3.24 3.18 - 3.91 - 5.01 - 3.93 3.4 3.5โ€“5.3 Na, mmol/L 136 136 - 133 - 135 - 134 134 137โ€“147 Ca, mmol/L 2.32 2.59 - 2.57 - 2.56 - 2.52 2.33 2.2โ€“2.7 P, mmol/L 1.05 1.37 - 1.57 - 1.39 - 1.09 1.28 1.1โ€“1.95 pH 7.569 7.476 7.480 7.466 7.363 7.421 7.451 7.420 7.519 7.32โ€“7.42 BEb, mmol/L 9.7 6.1 4.4 3.6 0.4 2.4 5.6 3.7 3.3 โˆ’ 3โ€“3 Urea, mmol/L 5.34 3.2 - 4.3 - 3.74 3.47 2.86 - 1.78โ€“6.42 Scr, ฮผmol/L 42 40 - 36 - 36 24 22 - 23โ€“37 PTH, ng/mL - 7.05 - - - - 2.63 - - 1.6โ€“6.9 24hUP, mg/24 h - 1107 - - 189.4 - - 122.1 - 0โ€“150 UCa, mg/kg/24 h - 12 - - 9.6 - - 8.34 - 0โ€“4 BEb BEeblood, Scr serum creatinine, PTH parathyroid hormone, 24hUP 24-h urinary protein, UCa urinary calcium quantification; -, items not tested
4.144531
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sec[1]/p[0]
en
0.999996
38165475
https://doi.org/10.1007/s00467-023-06230-3
[ "mmol", "virus", "urine", "protein", "hormone", "total", "serum", "pmol", "hypertension", "urinary" ]
[ { "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": "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" }, { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "MF50.6Z", "title": "Difficulties with micturition, 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 [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 [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 === 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 โ€œat riskโ€ pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 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 โ€œat riskโ€ pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --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 --RELATED_TO--> [?] Neonatal hyperglycaemia
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --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 --RELATED_TO--> [?] Neonatal hyperglycaemia" ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "1D9Z", "icd10_code": "B348", "icd10_title": "Other viral infections of unspecified site" }, { "from_icd11": "1D9Z", "icd10_code": "B349", "icd10_title": "Viral infection, unspecified" }, { "from_icd11": "1D9Z", "icd10_code": "B344", "icd10_title": "Papovavirus infection, unspecified" }, { "from_icd11": "1D9Z", "icd10_code": "B333", "icd10_title": "Retrovirus infections, not elsewhere classified" }, { "from_icd11": "1D9Z", "icd10_code": "B34", "icd10_title": "Viral infection of unspecified site" }, { "from_icd11": "1E1Z", "icd10_code": "B338", "icd10_title": "Other specified viral diseases" }, { "from_icd11": "1E1Z", "icd10_code": "B25-B34", "icd10_title": "" }, { "from_icd11": "1E1Z", "icd10_code": "B33", "icd10_title": "Other viral diseases, not elsewhere classified" }, { "from_icd11": "1E1Z", "icd10_code": "M015", "icd10_title": "" }, { "from_icd11": "1E1Y", "icd10_code": "B9789", "icd10_title": "Other viral agents as the cause of diseases classified elsewhere" }, { "from_icd11": "1D85.Z", "icd10_code": "B3324", "icd10_title": "Viral cardiomyopathy" }, { "from_icd11": "1D85.Z", "icd10_code": "B3323", "icd10_title": "Viral pericarditis" }, { "from_icd11": "1D85.Z", "icd10_code": "B332", "icd10_title": "Viral carditis" }, { "from_icd11": "KA62.Z", "icd10_code": "P35", "icd10_title": "Congenital viral diseases" }, { "from_icd11": "KA62.Z", "icd10_code": "P358", "icd10_title": "Other congenital viral diseases" } ]
B348
Other viral infections of unspecified site
A 64-year-old non-smoking man was admitted into our hospital as a result of a mass in the left lower lung lobe identified by chest radiography in physical examination. Chest CT revealed only two masses in the left lower lung lobe, with no metastases in the mediastinal lymph nodes . The patient was thus performed lobectomy of the left lower lung. Mediastinal lymph node dissection (LND) demonstrated no evidence of residual lung squamous-cells , but 2 of 4 interlobar lymph nodes were involved, and the lesions were staged as pT3N1M0, IIIA squamous-cell NSCLC. Afterward, the patient had received adjuvant chemotherapy using paclitaxel and carboplatin for four cycles from June 2017 to August 2017. Chest CT in August 2017 revealed no metastases in the lung or mediastinal lymph node . Three months after treatment, the CEA level was found to increase to 61.61 ng/ml. In addition, positron emission tomography-CT revealed fludeoxyglucose F 18 -positive lesions in the anastomotic region and right iliac bone region , respectively, which were suspected of disease recurrence. Moreover, tests for EGFR mutation and ALK fluorescence in situ hybridization showed negative results. To alleviate bone pain, palliative radiotherapy was applied in both the anastomotic region and the right iliac bone region. However, chest CT in January 2018 revealed many new lung nodules in the entire lung . The patient was then treated with rh-endostain (30 mg d1โ€“7 CIV) combined with docetaxel (120 mg d4 IV) every 3 weeks. Eventually, the patient suffered from rapid disease progression and symptom aggravation, cough, and dyspnea were included . Biomarkers, including PD-L1 expression, tumor TMB, and high microsatellite instability, could be used to forecast the therapeutic effect of immune checkpoint blockade . To further identify the potential therapeutic targets, immunohistochemistry was used to analyze the PD-L1 and MMR-related proteins, including MSH2, MSH6, MLH1, and PMS2 . PD-L1 expression was determined using the companion diagnostic PD-L1 IHC 22C3 pharmDx assay. PD-L1 expression was determined based on percentage of tumor cells with positive membranous staining and was reported as the tumor proportion score (TPS). Among them, PD-L1 was weakly stained, TPS was 2%; by contrast, four MMR-related proteins were strongly stained, suggesting no MMR deficiency in the tumor. Moreover, the next-generation sequencing (NGS) technology, along with a gene panel involving 416 genes associated with cancer, was utilized to analyze the postoperative tumor samples from patients in January 2018. The large panel can comprehensively and accurately detect variations involving gene mutations, amplifications, and fusions with clear clinical relevance to tumors. Typically, the libraries were prepared using the Hyper Prep Kit (Kapa) before sequencing on the Hiseq 4000 NGS platforms (Illumina). More importantly, the co-mutations of TP53 (pY220C, MAF = 11.07%) and KRAS (pG12V, MAF = 19.37%) were detected in the tumor; Unfortunately, the results showed no detected mutations in core genes associated with lung cancer (EGFR, ALK, c-Met, ROS1, BRAF and STK11). TMB was referred to as the total counts of non-silencing somatic mutations in the coding regions. Panel TMB was counted by summing all base substitutions and indels in the coding region of targeted genes, including synonymous alterations to reduce sampling noise and excluding known driver mutations as they are over-represented in the panel, as previously described .In our case, the TMB was 3.2 mutations/Mb (< 10), which belonged to the low tumor mutational burden (TMB-low). Therefore, a decision was made to proceed with chemotherapy combined with immunotherapy according to the following regimen, gemcitabine (1.4 g d1,8 IV) combined with pembrolizumab (150 mg d1 IV) every 3 weeks for 4 cycles, before pembrolizumab (150 mg) every 3 weeks since April 2018. The symptoms of cough and dyspnea in the patient were reported to be substantially alleviated. After two cycles of treatments, CT revealed a decreased size and number of lung nodules, and the response had persisted at 7 months, which had met the criteria of RECIST partial response . Fig. 1 CT scans of the patient. a , c CT scan before lobectomy. Two masses in the left lower lung lobe were noted; and b , d CT scan after lobectomy Fig. 2 CT scans of the patient. a , b , c CT scan after four cycles of adjuvant chemotherapy with paclitaxel and carboplatin in August 2017. None metastases were observed in the lung or mediastinal lymph node. d , e , f CT scan 5 months after adjuvant chemotherapy, from which many new lung metastases in the entire lung were noted. g , h , i CT scan after two cycles of rh-endostain and docetaxel chemotherapy. The lung metastases became evidently larger Fig. 3 PET/CT scan showed typical imaging alternations in the anastomotic region ( a , c ) and right iliac bone region ( b , d ), which was suspected of disease recurrence Fig. 4 Pathological examination of postoperative tumor tissue revealed of lung adenocarcinoma and immunostaining of PD-L1 ( a ) and MMR-related proteins, including MSH2 ( b ), MSH6 ( c ), MLH1 ( d ), and PMS2 ( e ) in postoperative tumor tissue Fig. 5 CT revealed a decreased size and number of lung nodules. Lung metastases in the entire lung were noted ( a , b , c ); CT scan after two cycles ( d , e , f ), four cycles ( g , h , i ) and six cycles ( j , k , l ) of pembrolizumab plus gemcitabine, the masses were markedly smaller and a marked response lasting for over 7 months
4.316406
0.771484
sec[1]/p[0]
en
0.999997
31619231
https://doi.org/10.1186/s12920-019-0592-6
[ "lung", "tumor", "cycles", "region", "scan", "metastases", "mutations", "lymph", "chemotherapy", "which" ]
[ { "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": "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 === [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 [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 --- [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 --CHILD--> [CB40.2] Pulmonary collapse --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.2] Congenital hypoplasia of lung --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.1] 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 ... --CHILD--> [CA40.0] Bacterial pneumonia Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --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 --CHILD--> [CB40.2] Pulmonary collapse", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.1] 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 --CHILD--> [CA40.0] Bacterial pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to..." ]
CB40.Y
Other specified diseases of the respiratory system
[ { "from_icd11": "LA75.1", "icd10_code": "Q333", "icd10_title": "Agenesis of lung" }, { "from_icd11": "CA40.Z", "icd10_code": "J189", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J181", "icd10_title": "Lobar pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J188", "icd10_title": "Other pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J168", "icd10_title": "Pneumonia due to other specified infectious organisms" }, { "from_icd11": "CA40.Z", "icd10_code": "J180", "icd10_title": "Bronchopneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J17", "icd10_title": "Pneumonia in diseases classified elsewhere" }, { "from_icd11": "CA40.Z", "icd10_code": "J182", "icd10_title": "Hypostatic pneumonia, unspecified organism" }, { "from_icd11": "CA40.Z", "icd10_code": "J16", "icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified" }, { "from_icd11": "CA40.Z", "icd10_code": "J171", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J173", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J178", "icd10_title": "" }, { "from_icd11": "CA40.Z", "icd10_code": "J18", "icd10_title": "Pneumonia, unspecified organism" }, { "from_icd11": "CB41", "icd10_code": "J9622", "icd10_title": "Acute and chronic respiratory failure with hypercapnia" }, { "from_icd11": "CB41", "icd10_code": "J9620", "icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia" } ]
Q333
Agenesis of lung
A 23-year-old male patient ingested about 300 mL (180 g) of 60% phorate emulsion 4 h before admission at our hospital. Family members brought him to our hospitalโ€™s emergency department immediately after he was discovered. On hospital arrival, the patient exhibited deliriousness, restlessness, urinary incontinence, sweating, tears, dyspnea, but no fever. His blood pressure was 164/112 mmHg, heart rate was 132 times/min, SpO2 was 96%, bilateral pupil diameter was 0.2 cm, and the patient showed a light response. We gave him atropine with a maintenance pump, warm water for gastric lavage , PAM for intravenous drip treatment , and prepared for blood perfusion treat1ment. 15 min later, the patient experienced violent vomiting, which led to dyspneic and comatose, with a SpO2 of 81%. Blood gas analysis revealed a pH of 7.21, PaO2 of 53 mmHg, PaCO2 of 78 mmHg, base excess of โˆ’5.6 mmol/L, and lactate concentration of 8.7 mmol/L. Endotracheal intubation and ventilator-assisted ventilation were performed. The patient was moved into ICU after the first blood perfusion in the emergency room. Physical examination upon transfer into ICU revealed deep coma, GCS scale 4, Apache II score 22, bilateral pupil diameter of 0.4 cm, slow response to light, dry skin, thick breath sound in both lungs, non-obvious dry and wet rales, heart rate of 125 times/min, blood pressure of 98/65 mmHg, no swelling on both legs, low tension in limbs, and bilateral Babinski sign is absent. Blood gas analysis revealed a pH of 7.12, PaO2 of 182 mmHg, PaCO2 of 54 mmHg, base excess of โˆ’8.2 mmol/L, lactate concentration of 10.5 mmol/L, and serum cholinesterase at 268 U/L . The patient was continued on twice daily clear water gastric lavage for 4 days, continuous blood perfusion, PAM intravenous drip, atropine maintenance pump push and symptom-relieving treatment. Atropine treatment was administered using a continuous micropump until atropinize (pupil expands to a diameter of 0.4 cm, the heart rate is 100โ€“120 beats per minute, the skin is dry, the face is flushed and the lung rale disappears). In the first 19 days, in order to maintain atropinization, the dosage of atropine was 3โ€“5 mg per hour (about 70โ€“120 mg/day). After the increase in cholinesterase, the dosage was gradually reduced. On the 27th day, the dosage was reduced to 1 mg every 8 h by subcutaneous injection. The total dosage of atropine during the course of the disease was about 1560 mg. During the initial 5 days post-admission, the dosage of PAM was 0.5 g per hour. On the sixth day, the concentration of PAM was significantly increased, and the inactivated cholinesterase was difficult to recover. The dosage was then reduced to 1.0 g intravenously every 8 h to prevent the newly produced cholinesterase from being inactivated again. The drug was discontinued on the 16th day.On the third day after admission, the patientโ€™s consciousness improved, but he was restless and was therefore sedated with dexmedetomidine and midazolam. From the first to the fifth day of admission, HP was done for 6 hours, once daily . We employed the CVVHDF (Continuous Veno-Venous Hemodiafiltration) mode with post-dilution. The substitution volume was set at 1800 mL/h (the patientโ€™s weight was 78 kg, approximately 23.1 mL/kg/h), and the dialysis volume was 1000 mL/h. The blood flow rate was initially set at 120 mL/min for the first 30 min and gradually increased to 180 mL/h. The transmembrane pressure (TMP) was maintained between 50โ€“380 mmHg. Low-molecular-weight heparin (LMWH) was chosen as the anticoagulant, with an initial dose of 2,500 U and a maintenance dose of 250 U/h. Coagulation function was monitored at the third and sixth hours to maintain the activated partial thromboplastin time (APTT) between 1.5โ€“2.5 times the normal value (35โ€“60 s) .HP was stopped on the sixth to 10th day due to objection from the patientโ€™s family. After explaining the benefits of HP, the family agreed to continue treatment. Blood was perfused for 4 h daily from the 11th to the 22nd. During the treatment, serum levels of cholinesterase, phorate, and its metabolites, atropine and PAM, were continuously monitored. On the eighth day after admission, cholinesterase levels remained between 200 and 300 U/L.The patient experienced psychiatric symptoms due to the administration of a large dose of atropine, rendering him unable to cooperate with treatment and agitated. To ensure treatment safety, sedative medication was required. However, high-dose medication could cause respiratory depression, and the patient had a pulmonary infection with poor sputum expectoration, so a tracheotomy was performed. . Cholinesterase levels remained very low for 19 days after admission but steadily rose from the 20th day. Thus, sedatives were gradually withdrawn, and the patient began to regain consciousness. By the 23rd day, cholinesterase levels had reached 1,634 U/L, and blood perfusion was stopped. At the same time, a ventilator was gradually trained. On the 26th day, the tracheotomy was closed. On the 27th day, cholinesterase levels had reached 3592 U/L. Atropine was subcutaneously injected at 1 mg per 8 h, and the patient was transferred to the general ward for further treatment. By the 34th day, the patient recovered well, did not complain of discomfort, had no positive physical signs, and all tests had returned to normal. Cholinesterase levels had risen to 4,821 U/L. The levels of phorate and its metabolites in the serum were <10 ng/mL. The patient was hospitalized for 34 days, of which 27 were in ICU .
3.851563
0.976074
sec[1]/p[0]
en
0.999997
PMC12098374
https://doi.org/10.3389/ftox.2025.1581362
[ "blood", "cholinesterase", "atropine", "mmhg", "perfusion", "mmol", "gradually", "about", "phorate", "family" ]
[ { "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": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "5C59.Y", "title": "Other specified inborn errors of neurotransmitter metabolism" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "PB28", "title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance" }, { "code": "PC98", "title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance" } ]
=== ICD-11 CODES FOUND === [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 [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 [5C59.Y] Other specified inborn errors of neurotransmitter metabolism Also known as: Other specified inborn errors of neurotransmitter metabolism | Metabolic disease involving other neurotransmitter deficiency | Folinic acid-responsive seizures | Butyrylcholinesterase deficiency [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug [PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose [PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] 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... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.2] Finding of hallucinogen in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] 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 --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
Upon admission, his body temperature was 36.9 ยฐC, and his blood pressure was 120/60 mmHg. Anemia, edema, and symmetrically distributed palpable purpura of the lower extremities were observed. He had no characteristic physical findings of infective endocarditis, such as Osler nodes, Roth spots, and Janeway lesions. Cardiac auscultation revealed 2/6 systolic reflux murmur at the cardiac apex. Blood analysis showed that the patientโ€™s serum creatinine level was elevated at 2.34 mg/dl, and his serum hemoglobin level was reduced at 7.6 g/dl. Urinalysis showed proteinuria at 0.74 g/g Cr and microscopic hematuria. PR3-ANCA level was elevated at 163 IU/ml (normal range, < 10 IU/ml). The patient had negative test results for hepatitis B antigen, hepatitis C antibody, cryoglobulin, antistreptolysin O, antinuclear antibody, immune complex, and myeloperoxidase-ANCA. Serum complement C3 was mildly decreased, whereas C4 was normal. Laboratory data obtained at admission are summarized in Table 1 . No abnormalities were found in the patientโ€™s chest x-ray or electrocardiogram. Streptococcus species was detected from two separate blood culture bottles. On the third hospital day, renal biopsy was performed. Histological analysis revealed that 54% (6 of 11) of glomeruli showed partial fibrinoid necrosis with fragmentation of glomerular tufts , and 27% (3 of 11) of glomeruli showed cellular crescents . No fibrocellular or fibrous crescents and no endocapillary proliferation were found. The mesangium showed no increase in cells or matrix. The tubulointerstitium partially showed neutrophilic and lymphocytic infiltration in the peritubular capillary and atrophy . Fibrinoid necrosis was not observed in vessel walls. Immunofluorescence microscopy showed no deposition of immunoglobulins and complement factors. Electron microscopy showed small amounts of nonspecific electron-dense deposits in subendothelial areas and the paramesangial area. At this point, the patient met the modified Duke criteria for definitive infective endocarditis (mitral valve vegetation on echocardiography, two positive blood cultures of Streptococcus species drawn 3 days apart, glomerulonephritis). On the eighth hospital day, transesophageal echocardiography revealed mitral valve vegetation. On the 12th hospital day, spinal magnetic resonance imaging showed pyogenic spondylitis at T7/T8 and L4/L5. On the basis of these findings, the patient was diagnosed with rapidly progressive PR3-ANCA-positive necrotizing crescentic glomerulonephritis complicated by Streptococcus infective endocarditis. Antibiotic therapy including cefazolin and penicillin G followed by oral administration of ampicillin was provided without immunosuppressive agents. Thereafter, his renal disease, endocarditis, and pyogenic spondylitis improved. He was discharged from our center on the 73rd hospital day. He has since received regular outpatient treatment in our department. At 7 months after discharge, his serum creatinine level had decreased to 1.43 mg/dl, his proteinuria had decreased to 0.15 g/g Cr, and his hematuria had decreased to 1.1 red blood cells per high-power field. His PR3-ANCA level had decreased to within the normal range . Table 1 Laboratory findings upon admission Complete blood count and blood chemistry Value WBC 13,600/ฮผL Bands 2% Segments 82% Eosinophils 0% Basophils 0% Lymphocytes 7% Monocytes 8% RBC 323 ร— 10 4 /ฮผL Hemoglobin 7.6 g/dL Hematocrit 29.2% Platelet 12.0 ร— 10 4 /ฮผL Total protein 7.0 g/dL Albumin 2.6 g/dL AST 35 IU/L ALT 23 IU/L CRP 7.57 mg/dL Na + 130 mmol/L K + 5.3 mmol/L Cl โˆ’ 101 mmol/L Ca 2+ 7.7 mg/dL Phosphate 3.8 mg/dL BUN 25 mg/dL Cr 2.52 mg/dL eGFR 20.8 ml/minute/1.73 m 2 Uric acid 6.3 mg/dL HbA1c 6.3% Glucose 106 mg/dL ASO 73 IU/mL Hepatitis B antigen < 0.04 Hepatitis C antibody < 0.29 IgG 2692 mg/dL IgA 340 mg/dL IgM 350 mg/dL Anti-DNA antibody < 10 Anti-RNP antibody Negative Anti-Sm antibody Negative C3 50 mg/dL C4 17 mg/dL CH50 23.4 U/mL Antinuclear antibody 160 PR3-ANCA 163 IU/mL MPO-ANCA < 1.0 IU/mL Anti-GBM antibody < 2.0 IU/mL ESR 86 mm/hour Rheumatoid factor 86 IU/mL Urinary analysis RBC Numerous (dysmorphic)/HPF WBC 1โ€“4/HPF Protein 0.74 g/g Cr ฮฒ 2 -MG 12,133 ฮผg/L Abbreviations : ALT alanine aminotransferase, ASO antistreptolysin O, AST aspartate aminotransferase, ฮฒ 2 -MG ฮฒ 2 -microglobulin, BUN blood urea nitrogen, CH50 50% homolytic unit of complement, Cr creatinine, CRP C-reactive protein, C3 complement component 3, C4 complement component 4, eGFR estimated glomerular filtration rate, ESR erythrocyte sedimentation rate, GBM antiglomerular basement membrane antibody, HbA1c hemoglobin A1c, HPF high-power field, Ig immunoglobulin, MPO-ANCA myeloperoxidase antineutrophil cytoplasmic antibody, PR3-ANCA proteinase 3 antineutrophil cytoplasmic antibody, RBC red blood cells, RNP ribonucleoprotein, Sm Smith, WBC white blood cells Fig. 1 Renal biopsy findings. a Glomerulus with partial fibrinoid necrosis with fragmentation of glomerular tufts ( arrows ) (periodic acid-methenamine silver stain; original magnification, 400ร—). b Glomerulus with cellular crescentic formation ( arrows ) (periodic acid-Schiff stain; magnification, original magnification, 400ร—). c Tubulointerstitium with sporadic neutrophil infiltration in the peritubular capillary ( arrows ) and atrophy ( broken line ) (periodic acid-Schiff stain; original magnification, 100ร—) Fig. 2 The patientโ€™s clinical course. ABPC Ampicillin, CEZ Cefazolin, Cr Creatinine, PCG Penicillin G, PR3-ANCA Proteinase 3-antineutrophil cytoplasmic antibody
4.082031
0.973633
sec[1]/p[1]
en
0.999996
31801609
https://doi.org/10.1186/s13256-019-2287-1
[ "antibody", "blood", "anca", "complement", "endocarditis", "serum", "creatinine", "hepatitis", "cells", "acid" ]
[ { "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.... --CHILD--> [JA86.0] Maternal care for red cell antibodies Def: Maternal care for rhesus or other isoimmunization... --- Walk 2 --- [JA86.Y] Maternal care for other specified fetal problems --PARENT--> [JA86] Maternal care for other fetal problems Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus.... --EXCLUDES--> [?] Labour or delivery complicated by fetal distress --- Walk 3 --- [MA14.14] Anti-nuclear antibody positive --PARENT--> [MA14.1] Certain specified immunological findings --CHILD--> [MA14.11] Anticitrullinated protein antibody negative --- Walk 4 --- [MA14.14] Anti-nuclear antibody positive --PARENT--> [MA14.1] Certain specified immunological findings --CHILD--> [MA14.11] Anticitrullinated protein antibody negative --- 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--> [MA14.11] Anticitrullinated protein antibody negative
[ "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.0] Maternal care for red cell antibodies\n Def: Maternal care for rhesus or other isoimmunization...", "[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress", "[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.11] Anticitrullinated protein antibody negative", "[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.11] Anticitrullinated protein antibody negative", "[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--> [MA14.11] Anticitrullinated protein antibody negative" ]
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
A 57-year-old woman consulted a physician with a chief complaint of abdominal pain and a history of gallstones, renal pelvic stones, and chronic renal failure. An 18F-fluorodeoxyglucose-positron emission tomography revealed a large tumor in the descending colon with extensive thoracoabdominal wall involvement including the ribs and diaphragm with no distant metastases. The patient was treated with antibacterial agents, but the inflammation did not improve. She was subsequently referred to our hospital. The tumor had perforated the abdominal wall and formed an abscess; therefore, emergency surgery was performed. An abdominal wall incision was made to drain the abscess, and laparoscopic colostomy of the transverse colon was performed. Histopathological examination of biopsy specimens from the tumor revealed well-differentiated and moderately differentiated tubular adenocarcinomas. In addition to primary colon cancer, disseminated lesions from primary pancreatic cancer, gynecology-related adenocarcinoma, and peritoneal cancer were considered as differential diagnoses. The positive expression of both CDX2 and CK20 was confirmed using immunohistochemistry. The patient was subsequently diagnosed with descending colon cancer, cT4b (diaphragm, ribs, abdominal wall muscles, and Gerotaโ€™s fascia) N1 M0 cStage IIIc. Genetic examination revealed MSI-high, Kras mutation (F12G), and wild-type BRAF. After the inflammation had resolved, chemotherapy was started to shrink the tumor . The creatinine clearance rate on admission was 19.5 mL/min. Due to renal dysfunction, an irinotecan-based regimen (FOLFIRI: irinotecan and 5FU were reduced in one step) instead of an oxaliplatin-based one was selected. After chemotherapy, the creatinine clearance remained at approximately 30 mL/min and did not interfere with the continuation of chemotherapy. However, the tumor grew rapidly after FOLFIRI therapy . As a second-line treatment, nivolumab (240 mg) and ipilimumab (1 mg/kg) combination therapy was started. This combination therapy was administered once every 3 weeks. After four cycles of combined therapy, the patient was administered nivolumab (240 mg) alone, according to the optimal clinical use guidelines based on the results of clinical trials. . Sufficient tumor shrinkage was observed, and new lesions were not detected after five cycles of nivolumab monotherapy (ycT4b [diaphragm, ribs, abdominal wall muscles, Gerotaโ€™s fascia] N0M0 ycStage IIc). An abdominal wall defect associated with tumor resection was deemed tolerable; therefore, radical surgery was performed. After closing the colostomy, the intraperitoneal cavity was laparoscopically observed. Disseminated or metastatic lesions were not observed in the abdominal cavity. The omental bursa was resected, and we confirmed that the tumor had not invaded the spleen or the pancreas. The mesentery of the transverse colon was isolated from the inferior border of the pancreas. The mesocolon and retroperitoneum were dissected from the dorsal side of the inferior mesenteric vein. The left colonic artery, descending mesentery, and descending colon were then dissected. We planned to resect part of the abdominal wall, diaphragm, ribs, and Gerotaโ€™s fascia, which had been invaded by the tumor in preoperative treatment, along with the primary tumor. The extent of tumor invasion was confirmed by tissue firmness under laparoscopy, and the abdominal wall was dissected outside the tumor-infiltrated tissue. The dorsal side of the tumor was resected along with perirenal adipose tissues . The transversus abdominis muscle was dissected from the abdominal cavity into the external oblique muscle . The surgical margins were examined by a pathologist and confirmed to be free from malignant cells intraoperatively. The extent of dissection was confirmed using a needle and was marked on the skin. The skin and ribs were incised, including the fistula, and the abdominal subcutaneous tissue, thoracic wall, and ribs were resected in conjunction with the tumor . Intestinal anastomosis was then performed. Preoperative treatment reduced the size of the tumor, thus reducing the extent of resection and the abdominal wall defect. The abdominal wall defect was repaired using a fascia lata-free flap and direct suturing of the skin and diaphragm was performed. Pathological examination revealed mucus components and fibrous tissue in the area where the tumor was thought to have existed, but no malignant cells were found, indicating that a pathological complete response (pCR) had been achieved . The patient was discharged on postoperative day 14. The patient had a good postoperative course and returned to work after being discharged. Postoperative adjuvant chemotherapy was not administered. No recurrence was observed 6 months postoperatively. Fig. 1 Computed tomography and pictures of the tumor according to the course of anticancer therapy. a Before treatment. b After two cycles of FOLFIRI therapy. c After four cycles of nivolumab and ipilimumab combination therapy and five cycles of nivolumab monotherapy Fig. 2 Laparoscopic tumor resection and surgical repair of the thoracic and abdominal wall defect using a fascia lata-free flap. a Perirenal adipose tissue dissection. b Dissection of the abdominal wall. c Tumor removal from the body surface. d A fascia lata-free flap repair Fig. 3 a Resected specimen. b Pathological findings. Mucus components and fibrous tissue were found in the area where the tumor was thought to have existed, but no malignant cells were found
3.972656
0.973145
sec[1]/p[0]
en
0.999996
36574162
https://doi.org/10.1186/s40792-022-01580-w
[ "tumor", "abdominal", "wall", "colon", "ribs", "fascia", "tissue", "diaphragm", "nivolumab", "cycles" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "MD81.3", "title": "Acute abdomen" }, { "code": "JA01.0", "title": "Abdominal pregnancy" }, { "code": "ME04.Z", "title": "Ascites, unspecified" }, { "code": "NB51.0&XA3KX0", "title": "Laceration without foreign body of abdominal wall" }, { "code": "NB9Y", "title": "Other specified injuries to the abdomen, lower back, lumbar spine or pelvis" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [MD81.3] Acute abdomen Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain [JA01.0] Abdominal pregnancy Definition: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy. Also known as: Abdominal pregnancy | abdomen pregnancy | intraperitoneal pregnancy Excludes: Maternal care for viable fetus in abdominal pregnancy | Delivery of viable fetus in abdominal pregnancy [ME04.Z] Ascites, unspecified Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS [NB9Y] Other specified injuries to the abdomen, lower back, lumbar spine or pelvis Also known as: Other specified injuries to the abdomen, lower back, lumbar spine or pelvis | Abdominal wall trauma | Injury of pelvic floor | pelvic floor blunt injury | pelvic floor blunt trauma === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Lymphadenitis --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fatty apron --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --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 --EXCLUDES--> [?] Lymphadenitis", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fatty apron", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 9-year-old male castrated domestic shorthair weighing 5 kg was presented to a university teaching hospital for a 1-day history of lethargy and anorexia. The cat had a 5-year history of chronic kidney disease, International Renal Interest Society stage 3 (non-hypertensive, non-proteinuric), with a baseline creatinine of 2.9 g/dl, 256 ฮผmol/L (RI, 0.5โ€“1.8 mg/dl; 35โ€“124 ฮผmol/L) 1 month prior to presentation. On presentation, the cat's vital signs were within normal limits, temperature 100.8 F, heart rate 210 bpm and respiratory rate of 50 bpm. A grade II/VI left systolic parasternal was noted with no other abnormalities appreciated on presenting physical exam. Point-of-care bloodwork was performed and revealed an anemia with a packed cell volume (PCV) of 20% (RI, 35%โˆ’45%) and a total solid (TS) of 9.0 g/dl (RI, 5.2โ€“8.2 g/dl). A venous blood gas was performed which revealed a mild metabolic acidosis (pH: 7.270; RI, 7.31โ€“7.46; base excess: โˆ’10.3; RI โˆ’4 to 4) with a hyperlactatemia (3.64 mmol/L; RI, 0โ€“2.5 mmol/L). Focused assessment with sonography for trauma, tracking and triage (FAST) scan was negative for abdominal or thoracic effusion at presentation. The cat was hospitalized on intravenous fluids with a balanced isotonic crystalloid at 85 ml/kg/day and ondansetron 1 (1 mg/kg IV q8h). Recheck lactate 8 h following presentation was 2.6 mmol/L (RI, 0โ€“2.5 mmol/L). Abdominal radiographs performed 12 h after presentation revealed moderate peritoneal effusion and mild generalized hepatomegaly. Repeat FAST scan 12 h following presentation revealed peritoneal effusion with a fluid score of 4/4 and sampling was confirmatory for a hemoabdomen with a PCV of 25%. Coagulation times pre-operatively were prolonged [prothrombin time (PT): 44 s, RI 11โ€“17 s; partial thromboplastin time (PTT): 239 s, RI 72โ€“102 s] so the patient was administered a type specific fresh frozen plasma (FFP; 8 ml/kg IV) and type specific fresh whole blood (WB; 13 ml/kg IV) in the perioperative period . Due to the noted hepatomegaly and lack of exposure to rodenticide or other toxins the cat was taken to exploratory laparotomy. The cat was induced under general anesthesia and an exploratory laparotomy found a bleeding mass involving both the left medial and lateral liver lobes. The affected liver lobes were ligated, resected, and removed for histopathology. The remainder of the liver parenchyma was grossly pale, tan, and friable. Multifocal hemorrhage was noted with minimal manipulation and two topical hemostatic agents were applied 2 , 3 to minimize further bleeding. During anesthesia, indirect mean arterial pressure (MAP) was 60 mmHg and a dopamine 4 /dobutamine 5 constant rate infusion (CRI; 3โ€“10 mcg/kg/min IV) was initiated to maintain a MAP of 65โ€“80 mmHg. A type specific packed red blood cell (PRBC) transfusion (7 ml/kg IV) was administered intraoperatively as well as a second dose of type specific FFP (9 ml/kg IV), ~90 min after induction of anesthesia. The cat additionally received a total 500 mg of calcium gluconate IV and 1.5 mEq of magnesium sulfate following completion of the PRBC and FFP. Overall, the patient was estimated to lose ~38 ml/kg of blood during the procedure. An initial dose of aminocaproic acid 6 (100 mg/kg IV) was administered during surgery. Upon recovery, the patient was hypotensive, the CRI of dopamine/dobutamine was discontinued and a norepinephrine 7 CRI (0.5โ€“1.0 mcg/kg/min) was initiated. The PCV immediately post-operatively was 16% (RI, 35%โˆ’45%) with a total solid of 5.0 g/dl (RI, 5.2โ€“8.2 g/dl) and a lactate of 1.5 mmol/L (RI, 0โ€“2.5 mmol/L). The norepinephrine CRI was continued following recovery. One hour following recovery, the patient was noted to be progressively anemic with a PCV of 14% (RI, 35%โˆ’45%) and a total solid of 5.0 g/dl (RI, 5.2โ€“8.2 g/dl) with progressive peritoneal fluid accumulation. Due to the combination of progressive anemia, peritoneal effusion progression, cardiovascular instability, and multifocal hemorrhage noted in surgery the patient was given another type specific fresh WB transfusion (9 ml/kg IV), a xenotransfusion of canine lyophilized platelets 8 (0.9 ร— 10 9 particles/kg) and an additional FFP transfusion (9 ml/kg IV) and a 0.45 mg (0.09 mg/kg IV) dose of rFVIIa. 9 All transfusions were well tolerated with no immediate transfusion reactions noted. Following administration of canine lyophilized platelets, rFVIIa and completion of the fresh WB transfusion, the patient's PCV was 18% (RI, 35%โˆ’45%) and TS were 6.3 g/dl (RI, 5.2โ€“8.2 g/dl). Additionally, the patient's hypotension resolved, and norepinephrine was discontinued. Post-operatively the patient was managed with ondansetron 1 mg/kg IV q8h, maropitant 10 1 mg/kg IV q24, aminocaproic acid 6 30 mg/kg IV q4h, fentanyl 11 3 mcg/kg/h, ketamine 12 0.3 mg/kg/h and a balanced isotonic crystalloid fluid at a rate of 85 ml/kg/day. Thirteen hours post lyophilized platelet and rFVIIa administration the patient's PCV was 22% (RI, 35%โˆ’45%) with a TS of 6.6 g/dl (RI, 5.2โ€“8.2 g/dl) and the abdominal effusion was noted to be subjectively static. The day following surgery the patient's PCV was 16% (RI, 35%โˆ’45%) and remained static for the first 3 days post-operatively. Approximately 64 h following recovery from surgery the patient's PCV was 13% (RI, 35%โˆ’45%) and TS 6.8 (RI, 5.2โ€“8.2 g/dl) so the patient was administered a cross-match compatible PRBC transfusion (7 ml/kg IV) over 4 h. Histopathology of liver lobes revealed microvascular dysplasia with portal venule hypoplasia and amyloidosis.
4.054688
0.971191
sec[1]/p[0]
en
0.999998
PMC9942615
https://doi.org/10.3389/fvets.2023.1113846
[ "mmol", "transfusion", "effusion", "type", "specific", "total", "blood", "peritoneal", "operatively", "fresh" ]
[ { "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": "NE80.Z", "title": "Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified, unspecified" }, { "code": "JA8A.0", "title": "Placental transfusion syndromes" }, { "code": "KA02.4", "title": "Fetus or newborn affected by placental transfusion syndromes" }, { "code": "PL14.4", "title": "Other problem associated with transfusion" }, { "code": "QB63.7", "title": "Presence of transfused blood" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "1D01.Z", "title": "Infectious meningitis, 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 [NE80.Z] Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified, unspecified Also known as: Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified, unspecified | Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified | transfusion reaction NOS | Blood transfusion reaction not elsewhere classified | blood transfusion reaction NOS [JA8A.0] Placental transfusion syndromes Also known as: Placental transfusion syndromes | placental transfusion | placenta transfusion syndrome | Twin to twin transfusion syndrome | Feto-fetal transfusion syndrome [KA02.4] Fetus or newborn affected by placental transfusion syndromes Definition: Twin-to-twin transfusion syndrome (TTTS) occurs in monozygotic twins while they are in the uterus. It occurs when blood travels from one twin to the other, and the twin that loses blood is the donor twin, while the twin that receives blood is the recipient twin. Depending on the severity of the transfusion, both infants may experience problems, such as anaemia, paleness, and dehydration in the donor twin, and redness and an increased blood pressure in the recipient twin. Also known as: Fetus or newborn affected by placental transfusion syndromes | Placental and cord abnormalities resulting in twin-to-twin or other transplacental transfusion | fetal transfusion syndrome | placental transfusion in fetus or newborn | placental transfusion syndrome in fetus or newborn Includes: Placental and cord abnormalities resulting in twin-to-twin or other transplacental transfusion [PL14.4] Other problem associated with transfusion Also known as: Other problem associated with transfusion [QB63.7] Presence of transfused blood Also known as: Presence of transfused blood | blood transplant status | blood transfusion status | presence of transplanted blood [FA36.Z] Effusion of joint, unspecified Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis [1D01.Z] Infectious meningitis, unspecified Also known as: Infectious meningitis, unspecified | Infectious meningitis, not elsewhere classified | acute meningomyelitis | septic meningitis NOS | infectious meningitis NEC === 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 โ€œat riskโ€ 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 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 โ€œat riskโ€ pat... --CHILD--> [GB42.Y] Other specified persistent proteinuria or albuminuria --- 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 โ€œat riskโ€ pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ 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 --CHILD--> [MA18.0Y] Other specified elevated blood glucose level --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Postprocedural hypoinsulinaemia Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus....
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ 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...", "[GB42.1] 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 โ€œat riskโ€ pat...\n --CHILD--> [GB42.Y] Other specified persistent proteinuria or albuminuria", "[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 โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ 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 --CHILD--> [MA18.0Y] Other specified elevated blood glucose level", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Postprocedural hypoinsulinaemia\n Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus...." ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "NE80.Z", "icd10_code": "T80A11A", "icd10_title": "Non-ABO incompatibility with delayed hemolytic transfusion reaction, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80219A", "icd10_title": "Unspecified infection due to central venous catheter, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8089XA", "icd10_title": "Other complications following infusion, transfusion and therapeutic injection, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8029XA", "icd10_title": "Infection following other infusion, transfusion and therapeutic injection, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80818A", "icd10_title": "Extravasation of other vesicant agent, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T801XXA", "icd10_title": "Vascular complications following infusion, transfusion and therapeutic injection, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80212A", "icd10_title": "Local infection due to central venous catheter, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8092XA", "icd10_title": "Unspecified transfusion reaction, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80218A", "icd10_title": "Other infection due to central venous catheter, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80211D", "icd10_title": "Bloodstream infection due to central venous catheter, subsequent encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80910A", "icd10_title": "Acute hemolytic transfusion reaction, unspecified incompatibility, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T80218D", "icd10_title": "Other infection due to central venous catheter, subsequent encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T881XXA", "icd10_title": "Other complications following immunization, not elsewhere classified, initial encounter" }, { "from_icd11": "NE80.Z", "icd10_code": "T8089XS", "icd10_title": "Other complications following infusion, transfusion and therapeutic injection, sequela" }, { "from_icd11": "NE80.Z", "icd10_code": "T80810A", "icd10_title": "Extravasation of vesicant antineoplastic chemotherapy, initial encounter" } ]
T80A11A
Non-ABO incompatibility with delayed hemolytic transfusion reaction, initial encounter
Her neurodevelopment was normal. However, linear growth was poor and dentition delayed; her first tooth erupted at 16 months. At 1 year of age, her length was 65.5cms (SDS โˆ’3.5) Figs. 3 and 4 demonstrate the height and head circumference respectively. Macrocrania was more pronounced during infancy and plateaued after 2 years of age although the head circumference continued to be disproportionate to the height. There was no family history of short stature, macrocephaly, skeletal and nail deformities or hypoparathyroidism. Parents were clinically unaffected with maternal height of 162.5cms and paternal height of 182.9cms, the predicted mid-parental target height was 166.2cms (SDS 0.4). Figure 5 demonstrates the overnight growth hormone (GH) study performed at 2.6 years of age. It showed a normal GH reserve with a peak of 15 ฮผg/L with serum insulin-like growth factor 1 (IGF-1) of 57 ฮผg/L (SDS โˆ’1.9). GH was measured using a solid-phase, two-site chemiluminescent immunoassay on the Immulite 2000 XPi (Siemens Healthcare Diagnostics Inc, Deerfield, IL). IGF-1 was measured by chemiluminescent immunoassay on the automated analyser Diasorin Liaison (Diasorin Inc, Stillwater, MN). At 3 years and 2 months, her height was 80cms (SDS โˆ’3.86) (<3 rd percentile on WHO growth chart, <1 st percentile on CDC growth chart) with a height velocity of 5cms/year. GH treatment was commenced at 3 years and 3 months with a starting dose of 4.9 mg/m 2 /week (0.2 mg/kg/week) , under the Pharmaceutical Benefits Scheme Growth Hormone Program for โ€˜Short stature and slow growthโ€™ . This category utilises the following auxological parameters on the CDC growth charts; height <1 st percentile on the CDC growth chart and low height velocity (<3 rd percentile CDC growth chart). There were no side effects and good compliance with administration of injections was maintained. Fig. 3 Figure 3 demonstrates the growth and the response of the patient to growth hormone ( plotted on the CDC growth chart ). Inset: Height SDS following growth hormone therapy Fig. 4 Figure 4 shows the head circumference of the patient Fig. 5 Figure 5 shows the overnight growth hormone ( GH ) test. Blood sample is collected every 20 min for GH and the physiological surge in GH is profiled. GH levels during waking hours are normally low. During sleep, there are usually several pulses of GH >20 mU/L (7.7 ฮผg/L), usually associated with slow wave sleep. A peak GH response <10 mU/L (3.9 ฮผg/L) suggests GH deficiency; a response of 10โ€“20 mU/L (3.9โ€“7.7 ฮผg/L) may suggest partial GH deficiency; a response >20 mU/L (>7.7 ฮผg/L) is regarded as normal.(1 mU/L ร— 0.385 = 1 ฮผg/L) Investigations : Initial investigations included a normal echocardiogram, renal ultrasound and MRI brain. There was also a persistent normocytic anaemia with haemoglobin of 95gm/L (NR: 110โ€“145) with normal iron stores and haemoglobin electrophoresis. Karyotype and FISH for 22q11.2 deletion were normal. There was no pathogenic variant demonstrated on CASR , PTH and GCMB gene analysis. Chromosomal microarray revealed a small paternally inherited micro-duplication of chromosome 17p13.2 not known to cause any of the described phenotypic features. The probandโ€™s father is asymptomatic, not dysmorphic and has normal calcium and PTH levels. A skeletal survey performed in the neonatal period was inconclusive; however, the repeat survey at 2 years of age was suggestive of KCS with overtubulated long bones, metacarpals and metatarsals with very little medullary space as shown in Fig. 6 . The anterior fontanelle was widely patent with multiple Wormian bones. Further genetic testing revealed a novel de novo heterozygous mutation c.1622C > A (p. Ser541Tyr) in FAM111A . This genetic variant was predicted to be probably damaging by PolyPhen (score 0.99) , deleterious by SIFT (score 0.0) and damaging by FATHMM (score โˆ’3.50) suggesting that the mutation may be damaging. Furthermore, this variant is not present in the ExAC , 1000 Genomes Project , and NHLBI GO Exome Sequencing Project databases , supporting the putative dominant effect of this mutation. The variant lies in the peptidase domain of FAM111A , where a pathogenic variant for KCS type 2 was previously identified as shown in Fig. 7 . Fig. 6 Figure 6 a shows relatively poor ossification of skull vault, patent metopic suture, widely separated sagittal sutures on anteroposterior view of X-ray Skull. Figure 6 b shows tubulated long bones with reduced medullary space and cortical thickening on anteroposterior view X-ray Tibia Fig. 7 Figure 7 a shows the FAM111A protein and Figures 7 b and c show the 3D model. a The FAM111A protein is made up of 611 amino acid residues. Residues 329 to 492 and 529 to 603 are part of an InterPro domain named Peptidase S1, PA clan . Our novel variant p.Ser541Tyr lies in the same domain as a previously identified genetic variant, p.Arg569His, which has been associated with KCS Type 2. b and c SWISS-MODEL was used to generate a putative 3D model of FAM111A using the model template 4ic6.1, a protease that had the highest sequence identity (23.79%) to FAM111A. Only the peptidase domain of FAM111A could be modelled. Residue Ser541 is shown in 5B and Arg569 in Figure 7 c Follow-up : Hypoparathyroidism was treated with oral calcium and calcitriol supplementation. Apart from early echogenic changes in the renal pelvis at 2 years of age, there has been no evidence of nephrocalcinosis or nephrolithiasis on follow-up at 4.6 years of age with normal renal function and urinary calcium excretion.
4.207031
0.900879
sec[1]/p[1]
en
0.999996
28138333
https://doi.org/10.1186/s13633-016-0041-7
[ "growth", "height", "variant", "hormone", "chart", "percentile", "this", "response", "domain", "model" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "MG44.1Z", "title": "Lack of expected normal physiological development, unspecified" }, { "code": "5A61.3", "title": "Growth hormone deficiency" }, { "code": "8C7Y", "title": "Other specified primary disorders of muscles" }, { "code": "FB86.Z", "title": "Disorders associated with bone growth, unspecified" }, { "code": "PG51", "title": "Fall or jump of undetermined intent from a height of 1 metre or more" }, { "code": "6B03", "title": "Specific phobia" }, { "code": "PG5Z", "title": "Fall or jump of undetermined intent, height unspecified" }, { "code": "PA6Z", "title": "Unintentional fall from unspecified height" }, { "code": "PA60", "title": "Unintentional fall on the same level or from less than 1 metre" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [MG44.1Z] Lack of expected normal physiological development, unspecified Also known as: Lack of expected normal physiological development, unspecified | Lack of expected normal physiological development | delayed physiological development | unspecified delay in development | development arrest [5A61.3] Growth hormone deficiency Definition: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficiency. Includes idiopathic, inborn and acquired forms of growth hormone deficiency. Also known as: Growth hormone deficiency Excludes: Hypopituitarism [8C7Y] Other specified primary disorders of muscles Also known as: Other specified primary disorders of muscles | Certain specified primary disorders of muscles | Myopathy due to calsequestrin or SERCA1 protein overload | Delayed muscle maturation | delayed muscle growth [FB86.Z] Disorders associated with bone growth, unspecified Also known as: Disorders associated with bone growth, unspecified | Disorders associated with bone growth [PG51] Fall or jump of undetermined intent from a height of 1 metre or more Also known as: Fall or jump of undetermined intent from a height of 1 metre or more | jumped from height NOS | Fall or jump of undetermined intent from ladder or scaffolding equipment | Fall or jump of undetermined intent from building or structure | Fall or jump of undetermined intent from tree [6B03] Specific phobia Definition: Specific phobia is characterised by a marked and excessive fear or anxiety that consistently occurs upon exposure or anticipation of exposure to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result Also known as: Specific phobia | Simple phobia | isolated phobia | Acarophobia | Acrophobia Includes: Simple phobia Excludes: Body dysmorphic disorder | Hypochondriasis [PG5Z] Fall or jump of undetermined intent, height unspecified Also known as: Fall or jump of undetermined intent, height unspecified | fall from height NOS | Falling, jumping or pushed from a high place, undetermined intent | victim falling from one level to another, undetermined intent [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 [PA60] Unintentional fall on the same level or from less than 1 metre Also known as: Unintentional fall on the same level or from less than 1 metre | ground level fall | fell while ambulating | fall from standing height | fall from standing position Excludes: Fall in health care | Fall while in hospital | Fall from hospital bed === 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 --- [MG44.1Z] Lack of expected normal physiological development, unspecified --PARENT--> [MG44.1] Lack of expected normal physiological development Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang... --EXCLUDES--> [?] Disorders of intellectual development Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ... --- Walk 4 --- [MG44.1Z] Lack of expected normal physiological development, unspecified --PARENT--> [MG44.1] Lack of expected normal physiological development Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang... --PARENT--> [MG44] Symptoms peculiar to infancy --- 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... --EXCLUDES--> [?] Postprocedural hypopituitarism Def: This is the postprocedural decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pi...
[ "[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", "[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --EXCLUDES--> [?] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...", "[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --PARENT--> [MG44] Symptoms peculiar to infancy", "[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 --EXCLUDES--> [?] Postprocedural hypopituitarism\n Def: This is the postprocedural decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pi..." ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6250", "icd10_title": "Unspecified lack of expected normal physiological development in childhood" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6259", "icd10_title": "Other lack of expected normal physiological development in childhood" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6251", "icd10_title": "Failure to thrive (child)" }, { "from_icd11": "MG44.1Z", "icd10_code": "R6252", "icd10_title": "Short stature (child)" }, { "from_icd11": "MG44.1Z", "icd10_code": "R62", "icd10_title": "Lack of expected normal physiological development in childhood and adults" }, { "from_icd11": "MG44.1Z", "icd10_code": "R628", "icd10_title": "" }, { "from_icd11": "MG44.1Z", "icd10_code": "R629", "icd10_title": "" }, { "from_icd11": "FB86.Z", "icd10_code": "M89761", "icd10_title": "Major osseous defect, right lower leg" }, { "from_icd11": "FB86.Z", "icd10_code": "M89772", "icd10_title": "Major osseous defect, left ankle and foot" } ]
D487
Neoplasm of uncertain behavior of other specified sites
A 62-year-old Chinese man presented with gingival bleeding in August 2012. Physical examination revealed skin ecchymosis and enlarged lymph nodes in his cervical, axillary, and inguinal areas, the largest of which was 3 ร— 2 cm. Neither hepatosplenomegaly nor splenomegaly was noted. A complete blood count showed pancytopenia with a hemoglobin level of 11.1 g/dL, white blood cell (WBC) count of 2.92 ร— 10 9 /L (47.9 % neutrophils, 1.7 % monocytes, and 47.2 % lymphocytes), and platelet count of 21 ร— 10 9 /L. A bone marrow (BM) aspirate was hypercellular with 75.5 % myeloid cells, 19.5 % erythroid cells, and 4.5 % lymphocytes. Abnormal hematopoiesis was present in the granulocyte, erythroid, and megakaryocytic series to different extents, with 3 % blasts . However, flow cytometry (FCM) immunophenotyping of the BM showed no obvious abnormalities. A BM cytogenetic study revealed a 46, XY karyotype. Fluorescence in situ hybridization of the BM showed no myelodysplastic syndrome-associated karyotype [i.e., del (5q), del (20q), or +8 or del (7q)]. Total-body FDG-PET imaging revealed systemic lymphadenopathy (maximum standardized uptake value of 6.4). A right cervical lymph node biopsy showed disrupted node structure with effacement by diffuse distribution of pleomorphic neoplastic cells, most of which were large, and round to oval in shape. Some neoplastic giant cells were observed. The cytoplasm was usually abundant, and the nuclei were generally large and round with a prominent nucleolus. The chromatin was hyperchromatic, coarse, and granular. Mitotic figures were easily observed. Remaining lymphoid follicles were found. IHC phenotypes showed the following results: CD68++, MAC387++, lysozyme+, vimentin+, CKโ€“, CD4โ€“, CD5โ€“, CD10โ€“, CD15โ€“, CD21โ€“, CD23โ€“, CD35โ€“, CD30โ€“, CD38โ€“, CD138โ€“, CD163โ€“, CD56โ€“, ALKโ€“, CD79aโ€“, CD1aโ€“, TDTโ€“, myeloperoxidaseโ€“, LCAโ€“, CD20โ€“, CD3โ€“, HMB45โ€“, S-100โ€“, and Ki67 25 % . The patient was therefore diagnosed with HS. He received systemic chemotherapy (CHOP regimen), consisting of vindesine, cyclophosphamide, and epirubicin on day 1 and prednisone on days 1โ€“5. After 2 courses of chemotherapy, the enlarged cervical lymph nodes appeared to shrink and his peripheral blood parameters improved. After 4 courses, FDG-PET reexamination showed partial remission; BM showed disappearance of abnormal hematopoiesis, although 2 % blasts remained . As the patient refused to undergo stem cell transplantation, he underwent 4 additional courses of chemotherapy. His lymphadenopathy and pancytopenia recurred in March 2013, just a month after his last chemotherapy dose. The patient refused to undergo another lymph node biopsy. He was diagnosed with recurrent HS and treated successively with ICE, GDP, and Dexa-BEAM chemotherapy regimens, during which his peripheral WBC and blasts in BM gradually increased, although his lymph nodes shrunk. He was hospitalized again with body aches in December 2013. A complete blood count showed leukocytosis (WBC count: 50.72 ร— 10 9 /L; hemoglobin: 9.9 g/d; platelets 49 ร— 10 9 /L; 41 % blasts), and BM showed hypercellularity with 50 % blasts, the cytoplasm of which contained many Auer bodies, whereas the erythroid and megakaryocytic series were suppressed. These blast cells were positive for peroxidase and non-specific esterase ; periodic acid-Schiff staining showed fine grains. FCM analysis showed abnormal cells positive for CD117, CD13, CD33, HLA-DR, CD34, CD11c, CD38, and myeloperoxidase, but negative for CD68. Based on the morphologic and FCM findings, the patient was diagnosed with AMoL-M5, and treated with low-dose cytarabine, aclarubicin, and granulocyte colony-stimulating factor (CAG) regimen combined with decitabine. He died of severe pneumonia and hepatic failure in May 2014. Fig. 1 Comparison of cytology of bone marrow cells before and after treatment of HS (ร—1,000, Wrightโ€“Giemsa stain). a A bone marrow smear on first admission showed there were granulocytic predominance and no significant increase in monocytes. There was abnormal hematopoiesis in granulocyte, erythroid and megakaryocytic series in different extent with 3 % blasts. b A bone marrow smear after 4 courses of CHOP chemotherapy showed abnormal hematopoiesis was disappeared, although 2 % blasts remained Fig. 2 Histologic picture and immunohistochemistry panel of a right cervical lymph node. The node structure was disrupted with effacement by diffuse distribution of pleomorphic neoplastic cells (ร—200, H&E) ( a ), most of which were large, and round to oval in shape. Some neoplastic giant cells were observed. The cytoplasm was usually abundant, and the nuclei were generally large and round with a prominent nucleolus. The chromatin was hyperchromatic, coarse, and granular. Mitotic figures were easily observed. Remaining lymphoid follicles were found (ร—400, H&E) ( b ). IHC phenotype of neoplastic cells show positive for CD68 ( c ), MAC387 ( d ), lysozyme ( e ), but negative for myeloperoxidase ( f ) Fig. 3 A smear preparation of a bone marrow aspirate in leukemic-phase in December, 2013. a The peripheral blood showed atypical blast cells with rich plasma, irregular nuclei and conspicuous nucleoli. The percentage of blast cells amounted to 41 % ( ร—1,000, Wrightโ€“Giemsa stain). b Bone marrow was packed with pleomorphic large cells with abundant and basophilic cytoplasm containing some Auer bodies (ร—1,000, Wrightโ€“Giemsa stain). c These cells are positive for peroxidase staining (ร—1,000). d These cells are positive for non-specific esterase as monocytes (ร—1,000)
4.175781
0.961426
sec[1]/p[0]
en
0.999997
26187047
https://doi.org/10.1186/s13000-015-0350-9
[ "cells", "blasts", "lymph", "bone", "marrow", "chemotherapy", "which", "blood", "count", "node" ]
[ { "code": "MF9Y", "title": "Other specified clinical findings on examination of urine, without diagnosis" }, { "code": "5C56.20", "title": "Mucolipidosis" }, { "code": "3A51.1", "title": "Sickle cell disease without crisis" }, { "code": "9A96.3", "title": "Primary anterior uveitis" }, { "code": "3A61.Z", "title": "Acquired pure red cell aplasia, unspecified" }, { "code": "NA07.0Z", "title": "Concussion, unspecified" }, { "code": "NF04.Y", "title": "Other specified effects of air pressure or water pressure" }, { "code": "ND56.Y", "title": "Other specified injury of unspecified body region" }, { "code": "2B33.0", "title": "Acute leukaemia, not elsewhere classified" }, { "code": "NB32.33", "title": "Primary blast injury of lung" } ]
=== 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 [NA07.0Z] Concussion, unspecified Also known as: Concussion, unspecified | Concussion | Commotio cerebri | brain concussion | brain blast [NF04.Y] Other specified effects of air pressure or water pressure Also known as: Other specified effects of air pressure or water pressure | Altitude sickness | Alpine sickness | Acosta disease | Andes disease [ND56.Y] Other specified injury of unspecified body region Also known as: Other specified injury of unspecified body region | Ictal traumatic injuries | Bone injury, not elsewhere classified | Blast injury, unspecified site | Injury from underwater blast, unspecified site [2B33.0] Acute leukaemia, not elsewhere classified Also known as: Acute leukaemia, not elsewhere classified | acute leukaemia of unspecified cell type without mention of remission | blast cell leukaemia | blast leukaemia | blastic leukaemia [NB32.33] Primary blast injury of lung Also known as: Primary blast injury of lung === 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 --CHILD--> [MF90] Acetonuria Def: Acetonuria is a medical condition in which acetone is present in the urine.... --- 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--> [?] 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 ... --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy --- Walk 6 --- [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr... --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ... --CHILD--> [3A51.1] Sickle cell disease without crisis Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
[ "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....", "[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF90] Acetonuria\n Def: Acetonuria is a medical condition in which acetone is present in the urine....", "[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--> [?] 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 --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy", "[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr..." ]
MF9Y
Other specified clinical findings on examination of urine, without diagnosis
[ { "from_icd11": "3A51.1", "icd10_code": "D571", "icd10_title": "Sickle-cell disease without crisis" }, { "from_icd11": "3A61.Z", "icd10_code": "D609", "icd10_title": "Acquired pure red cell aplasia, unspecified" }, { "from_icd11": "3A61.Z", "icd10_code": "D608", "icd10_title": "Other acquired pure red cell aplasias" }, { "from_icd11": "3A61.Z", "icd10_code": "D60", "icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]" }, { "from_icd11": "ND56.Y", "icd10_code": "T148XXA", "icd10_title": "Other injury of unspecified body region, initial encounter" }, { "from_icd11": "2B33.0", "icd10_code": "C9500", "icd10_title": "Acute leukemia of unspecified cell type not having achieved remission" }, { "from_icd11": "2B33.0", "icd10_code": "C950", "icd10_title": "Acute leukemia of unspecified cell type" } ]
D571
Sickle-cell disease without crisis
A 47-year-old male patient was admitted to the hospital with lower back pain for more than 3 months, which had worsened with a subcutaneous hemorrhage for 1 day. On June 23, 2022, the patient developed lower back pain without an obvious cause, accompanied by intermittent rib pain that was previously untreated. In July 2022, the pain worsened, and activities of daily living were limited. Computed tomography (CT) performed at another hospital showed focal bone destruction in the thoracic vertebrae and right transverse process . Routine blood tests at that time showed a white blood cell (WBC) count, 9.8 ร— 10 9 /L; hemoglobin (Hb) level, 142 g/L; and platelet (Plt) count, 106 ร— 10 9 /L. After symptomatic analgesic treatment, the symptoms were relieved but soon aggravated again. Moreover, a subcutaneous hemorrhage occurred 1 day before admission. The laboratory test results revealed a WBC count of 14.5 ร— 10 9 /L, 41% primitive blast cells, Hb level, 139 g/L, Plt count 7.0 ร— 10 9 /L, and normal renal function. The serum calcium level was 3.0 mmol/L (2.17โ€“2.54). Bone marrow cytology showed that primitive immature lymphocytes accounted for 83% of cells . Flow cytometry of bone marrow cells showed that blast cells accounted for approximately 37.6% of the total nuclear cells and expressed cluster of differentiation (CD)10, CD19, CD34, and HLA-DR. They were negative for CD2, CD3, CD5, CD7, CD8, CD11b, CD13, CD14, CD15, CD16, CD20, CD33, CD56, CD64, and CD117, consistent with the immunophenotype of B-cell ALL. The karyotype was 76 (3n), XX, -Y, +2, +4, +6, -7, +8, t (9:22) (q34.1:q11.2), +13, -15, +16, +17, +20, +21, +22 ( 4 )/46, XY ( 5 ). Leukemia fusion gene detection revealed BCR-ABL1 (P190) positivity. The WT1 mutation, CDKN2A (chr9p21.3) copy number deletion , and CDKN2B (chr9p21.3) . The patient was diagnosed with BCR-ABL-positive (P190) B-ALL (a high-risk group with WT1 and CDKN2A mutations and a triploid karyotype) and hypercalcemia. After treatment with salmon calcitonin at the local hospital, the patient was administered VDCLP regimen on September 20, 2022 (vindesine 2.8 mg/m 2 , days 1, 8, 15, and 22; daunorubicin 40 mg/m 2 , days 1โ€“3; cyclophosphamide 750 mg/m 2 , days 1 and 15; pegaspargase 3,750 U, days 1 and 15; dexamethasone 10 mg, days 1โ€“14; and tapered off on day 15). Severe pulmonary infection occurred during chemotherapy. Therefore, the patient was transferred to our hospital on October 18, 2022, after receiving anti-infection treatment. Routine blood test at admission showed a WBC count, 8.5 ร— 10 9 /L; Hb level, 73 g/L; and Plt count, 389 ร— 10 9 /L. The serum calcium level was 1.9 mmol/L. Chest CT revealed scattered infection in both lungs, focal bone destruction in the thoracic vertebrae and right transverse process, and uneven bilateral bone density in multiple ribs . Magnetic resonance imaging of the thoracic spine revealed osteopenia, an abnormal signal in the T10 vertebral body and its adnexa, and the T9 adnexa. Combined with the patientโ€™s medical history, it was surmised that the leukemic infiltration involved the vertebral body as well as localized endplate defects at the upper edge of the L3 vertebral body, the upper and lower edges of the L4 vertebral body, and the upper edge of the L5 vertebral body . Bone marrow re-examination on October 20, 2022 revealed complete remission (CR), and the proportion of blast lymphocytes was approximately 1.5% . After admission, the patient was administered anti-infective treatment with cefoperazone-sulbactam, voriconazole, amphotericin, and caspofungin. However, the patient still had recurrent fever and cough. Fiberoptic bronchoalveolar lavage and NGS were performed for P. carinii infection. Dasatinib, 100 mg q.d., combined with a VP regimen (vindesine 4 mg, dexamethasone 10 mg, days 1โ€“4, 8โ€“11, 15โ€“16, and 21โ€“24) was administered on November 3, 2022. Bone marrow cytology re-examination after chemotherapy showed CR (proportion of naรฏve lymphocytes). The BCR-ABL1 (P190) test was negative. On December 9, cerebrospinal fluid (CSF) common, biochemical, and CSF flow cell immunotyping were performed, and no abnormalities were found; chemotherapy drugs (methotrexate 50 mg plus cytarabine 30 mg plus dexamethasone 5 mg) were also injected intrathecally to prevent central nervous system leukemia. However, pain persisted in the sternum, ribs, and lumbar spine, and tramadol hydrochloride was required for pain relief. Whole-body bone imaging revealed multiple foci of increased bone metabolism throughout the body, and extensive bone infiltration by hematologically malignant tumors was suspected . A bone biopsy of the T10 vertebral body revealed dysplastic lymphocytes with obvious fibrosis. Immunohistochemistry showed that dysplastic lymphocytes were sometimes positive for CD20, CD3, CD79a, TDT, CD99, CD7, MPO, PAX-5, and Ki-67 (approximately 3%โ€“5%), consistent with the B-ALL cell phenotype and supported leukemic cell infiltration . Serum protein electrophoresis revealed an M protein band of 2.4%, with content of 1.39 g/L. The serum-free light chain combination consisted of kappa light chain (25.28 mg/L) and free lambda (36.34 mg/L). Serum immunofixation electrophoresis revealed IgG-k type. No abnormalities were observed in the urinary free light chain assemblies, and no M protein was detected using urinary protein electrophoresis. The presence of M proteins in patientsโ€™ peripheral blood is considered to be related to B lymphocytes or the immune response to antigens encountered during infection ( 6 ).
4.207031
0.95459
sec[1]/p[0]
en
0.999994
38450181
https://doi.org/10.3389/fonc.2024.1356311
[ "bone", "body", "pain", "that", "count", "lymphocytes", "vertebral", "cell", "cells", "serum" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "ND51.Y", "title": "Other specified injuries of spine or trunk, level unspecified" }, { "code": "MG20.Z", "title": "Cachexia, unspecified" }, { "code": "ND56.Z", "title": "Unspecified injury to unspecified part of trunk, limb or body region" }, { "code": "8A22", "title": "Lewy body disease" }, { "code": "ME86.Z", "title": "Problem of unspecified body part" } ]
=== ICD-11 CODES FOUND === [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 [ND51.Y] Other specified injuries of spine or trunk, level unspecified Also known as: Other specified injuries of spine or trunk, level unspecified | Superficial injury of trunk, level unspecified | multiple superficial injuries of trunk | Abrasion of trunk, level unspecified | Contusion of trunk, level unspecified [MG20.Z] Cachexia, unspecified Also known as: Cachexia, unspecified | Cachexia | cachectic | general body deterioration | inanition [ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region Also known as: Unspecified injury to unspecified part of trunk, limb or body region | Injury of unspecified body region | injury NOS | trauma NOS | traumatic injury NOS [8A22] Lewy body disease Definition: Lewy body disease is a neurodegenerative disorder and the second most common form of dementia in the elderly after Alzheimer disease. Lewy bodies are histologically defined as intracytoplasmic eosinophilic neuronal inclusions in the cortex or brainstem. Also known as: Lewy body disease | Lewy body | DLBD - [diffuse Lewy body disease] | diffuse Lewy body disease | CLBD - [cortical Lewy body disease] [ME86.Z] Problem of unspecified body part Also known as: Problem of unspecified body part | Symptom or complaint of a body part === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics --- Walk 2 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --CHILD--> [?] 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.... --- Walk 3 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Inflammatory conditions of jaws --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --CHILD--> [FB84.2] Subacute osteomyelitis --- Walk 5 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopenia --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --PARENT--> [?] Osteopathies or chondropathies
[ "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --CHILD--> [?] 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....", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Inflammatory conditions of jaws", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --CHILD--> [FB84.2] Subacute osteomyelitis", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopenia", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --PARENT--> [?] Osteopathies or chondropathies" ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
A preterm male infant was born by cesarean section at 30 and 5/7 weeks' gestation weighing 1,140 grams, of which the monochorionic diamniotic twin pregnancy was complicated by twin-to-twin transfusion syndrome (grade I) and severe intrauterine growth restriction. Maternal antibiotics and betamethasone were administered prior to delivery. Apgar scores of 7 and 9 were assigned at 1 and 5 minutes of life. He knew a good start with a spontaneous heart activity and received 30% oxygen and PEEP by Neopuff, which was replaced by nasal continuous positive pressure ventilation (CPAP), which persisted during his stable transport to the neonatal intensive care unit (NICU) and continued until day 4. He was started on caffeine for prevention of apnea and bradycardia, and it could be stopped on day of life (DOL) 16. Due to immaturity of preterm intestinal mucosa and risk for development of NEC minimal enteral feeds were initiated on DOL 2 and only on DOL 7 the quantity was prudently increased, reaching full enteral feeds by DOL 17. On DOL 29 he had an acute onset of progressive abdominal distention and general malaise, clinical and radiologic compatible with NEC stage IIb (modified Bell's staging). Abdominal RX findings included explicit signs of pneumatosis intestinalis at the right hypochondrium and the left flank and residual air at the level of the vena porta bifurcation. Enteral feeds were stopped, and gastric decompression with continuous suctioning and a sepsis workup was initiated. A complete blood count, metabolic profile, blood gas, and blood culture were drawn, which revealed anemia (8.6 g/dL, normal range: 10.7โ€“17.1 g/dL) and thrombocytopenia (26.10 E 9 /L, normal range: 150โ€“450.10 E 9 /L). He was started on IV cefotaxime, vancomycin, and metronidazole, serial abdominal exams were performed, and the pediatric surgical team was consulted. Blood cultures remained negative. Seven days after initiation of medical therapy (DOL 36), the surgical team reevaluated the infant. It was decided to proceed with an exploratory laparotomy given the progressive clinical decline and respiratory alerts. Intraoperative findings included malodorous and purulent free fluid present in abdomen, clear necrotizing enterocolitis (NEC grade IIIb) affecting the whole colon (with 4 covered perforations) and the distal small bowel, with intra-abdominal leakage of feces and excessive bleeding leading to a complete colectomy until the sigmoid, while creating a jejunostomy and small fistula. On postoperative day 6, a focal fluid collection was detected by ultrasonography. Peritoneal fluid culture was positive for Enterobacter cloacae complex, while peripheral blood cultures remained negative. The antimicrobial therapy was changed to IV meropenem, amikacin, and fluconazole based on E. cloacae complex susceptibilities (Minimal Inhibitory Concentration (MIC): 1 ฮผ g/mL ( E -test)). Based on the severity of the situation, appropriate meropenem dosage was optimized by means of real-time TDM monitoring. Serum samples were analysed using a validated High-Performance Liquid Chromatography method with Diode-Array Detection. Meropenem was initially administered as a 30-minute infusion of 20 mg/kg, every 8 h. TDM monitoring, conducted 1 h after the infusion of the fourth dose, revealed the complete absence of meropenem. The optimal transport conditions (immediately after collection of the blood it was transported on ice and toxicological analysis began) were respected. Therefore the dose was increased to 30 mg/kg ( Table 1 ). However based on the further clinical deterioration of the patient and the objectivation of fast metabolization of the antibiotic, the meropenem protocol was switched to a 4 h prolonged infusion of 40 mg/kg, every 8 h . The calculated elimination half-life was approximately 1.2 h. A 4 h prolonged infusion of 40 mg/kg meropenem, every 8 h, will achieve an adequate antibiotic exposure against E. cloacae complex with T > MIC: 50% of time > 4 ฮผ g/mL and 75% of time > 2 ฮผ g/mL (creatinine value: 0.29 mg/dL; normal range: 0.31โ€“0.88 mg/dL). Based on the infected intra-abdominal collection and increase of inflammatory parameters (CRP: 122 mg/L; normal range: <5 mg/L) a new laparotomy was performed on DOL 52 for drainage of it. Intraoperatively the infected collection and the existing but necrotic jejunostomy were removed. The frailty of the bowel was too high to create a new stoma, so a first Petzer sonde was placed in the terminal ileum and sorted cutaneously, and a second Petzer sonde was placed for a more proximal perforation. In the light of the infectious problem, very difficult wound healing and complete dehiscence of the wound suture were observed, followed by slow granulation over the following weeks. Peritoneal fluid cultures remained positive for E. cloacae complex with a gradual increase of MIC until an intermediate susceptibility value, 6 ฮผ g/mL (EUCAST), but with negative molecular carbapenemase producing Enterobacteriaceae screening. On DOL 59, after complete eradication of E. cloacae complex (repeated negative cultures), the antibiotic regimen was switched to IV ciprofloxacin and metronidazole for a 14-day course, after 18 days of extended meropenem infusion. A fourth laparotomy followed aiming to create a distal stoma, while during the same intervention the proximal stoma was closed. The patient received 5 weeks of broad-spectrum antibiotics in total. He was discharged in a stable clinical condition at 36 weeks of postmenstrual age weighing 4,370 grams.
3.943359
0.975098
sec[1]/p[0]
en
0.999998
27703820
https://doi.org/10.1155/2016/6207487
[ "meropenem", "blood", "abdominal", "complete", "cloacae", "complex", "infusion", "which", "range", "cultures" ]
[ { "code": "MG50.92", "title": "Carbapenem resistant Salmonella" }, { "code": "MG50.02", "title": "Carbapenem resistant Acinetobacter baumannii" }, { "code": "MG50.54", "title": "Carbapenem resistant Klebsiella pneumoniae" }, { "code": "MG50.24", "title": "Carbapenem resistant Escherichia coli" }, { "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" } ]
=== ICD-11 CODES FOUND === [MG50.92] Carbapenem resistant Salmonella Also known as: Carbapenem resistant Salmonella | Doripenem resistant Salmonella | Ertapenem resistant Salmonella | Imipenem resistant Salmonella | Meropenem resistant Salmonella [MG50.02] Carbapenem resistant Acinetobacter baumannii Also known as: Carbapenem resistant Acinetobacter baumannii | Doripenem resistant Acinetobacter baumannii | Imipenem resistant Acinetobacter baumannii | Meropenem resistant Acinetobacter baumannii [MG50.54] Carbapenem resistant Klebsiella pneumoniae Also known as: Carbapenem resistant Klebsiella pneumoniae | Doripenem resistant Klebsiella pneumoniae | Ertapenem resistant Klebsiella pneumoniae | Imipenem resistant Klebsiella pneumoniae | Meropenem resistant Klebsiella pneumoniae [MG50.24] Carbapenem resistant Escherichia coli Also known as: Carbapenem resistant Escherichia coli | Doripenem resistant Escherichia coli | Ertapenem resistant Escherichia coli | Imipenem resistant Escherichia coli | Meropenem resistant Escherichia coli [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 === GRAPH WALKS === --- Walk 1 --- [MG50.92] Carbapenem resistant Salmonella --PARENT--> [MG50.9] Antibiotic resistant Salmonella --CHILD--> [MG50.90] Fluoroquinolone resistant Salmonella --- Walk 2 --- [MG50.92] Carbapenem resistant Salmonella --PARENT--> [MG50.9] Antibiotic resistant Salmonella --CHILD--> [MG50.92] Carbapenem resistant Salmonella --- Walk 3 --- [MG50.02] Carbapenem resistant Acinetobacter baumannii --PARENT--> [MG50.0] Antibiotic resistant Acinetobacter baumannii --CHILD--> [MG50.01] Aminoglycoside resistant Acinetobacter baumannii --- Walk 4 --- [MG50.02] Carbapenem resistant Acinetobacter baumannii --PARENT--> [MG50.0] Antibiotic resistant Acinetobacter baumannii --CHILD--> [MG50.00] Tetracycline resistant Acinetobacter baumannii --- Walk 5 --- [MG50.54] Carbapenem resistant Klebsiella pneumoniae --PARENT--> [MG50.5] Antibiotic resistant Klebsiella pneumoniae --CHILD--> [MG50.50] Sulfonamide or trimethoprim resistant Klebsiella pneumoniae --- Walk 6 --- [MG50.54] Carbapenem resistant Klebsiella pneumoniae --PARENT--> [MG50.5] Antibiotic resistant Klebsiella pneumoniae --CHILD--> [MG50.50] Sulfonamide or trimethoprim resistant Klebsiella pneumoniae
[ "[MG50.92] Carbapenem resistant Salmonella\n --PARENT--> [MG50.9] Antibiotic resistant Salmonella\n --CHILD--> [MG50.90] Fluoroquinolone resistant Salmonella", "[MG50.92] Carbapenem resistant Salmonella\n --PARENT--> [MG50.9] Antibiotic resistant Salmonella\n --CHILD--> [MG50.92] Carbapenem resistant Salmonella", "[MG50.02] Carbapenem resistant Acinetobacter baumannii\n --PARENT--> [MG50.0] Antibiotic resistant Acinetobacter baumannii\n --CHILD--> [MG50.01] Aminoglycoside resistant Acinetobacter baumannii", "[MG50.02] Carbapenem resistant Acinetobacter baumannii\n --PARENT--> [MG50.0] Antibiotic resistant Acinetobacter baumannii\n --CHILD--> [MG50.00] Tetracycline resistant Acinetobacter baumannii", "[MG50.54] Carbapenem resistant Klebsiella pneumoniae\n --PARENT--> [MG50.5] Antibiotic resistant Klebsiella pneumoniae\n --CHILD--> [MG50.50] Sulfonamide or trimethoprim resistant Klebsiella pneumoniae", "[MG50.54] Carbapenem resistant Klebsiella pneumoniae\n --PARENT--> [MG50.5] Antibiotic resistant Klebsiella pneumoniae\n --CHILD--> [MG50.50] Sulfonamide or trimethoprim resistant Klebsiella pneumoniae" ]
MG50.92
Carbapenem resistant Salmonella
[ { "from_icd11": "MG50.02", "icd10_code": "U828", "icd10_title": "" }, { "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" } ]
U828
While very few envenomings to the tongue of patients were previously reported , this is a severe case of Russellโ€™s viper envenoming to the patientโ€™s tongue, which resulted because of worshipping a live snake based on the advice of an astrologist. Notably, the tongue was deeply incised as a means of first aid to counteract the envenomation effects. The patient experienced the usual envenomation effects (e.g., coagulopathy) of the Russellโ€™s viper alongside the unusual side effects of the bite being located on the tongue. As indicated above, Russellโ€™s viper venom contains a large amount of PLA 2 and proteolytic enzymes that act on blood coagulation . As a result, they induce rapid consumption coagulopathy and subsequently, severe bleeding. In this patient, the deep incision made on the tongue following the bite exacerbated bleeding, leading to airway obstruction. The laboratory investigations indicated prolonged coagulation parameters as well as a large increase in creatinine kinase levels, suggesting significant tissue damage in the tongue, which is a skeletal muscle. Notably, the platelet level did not reduce as expected in this case due to a large amount of bleeding. While the clinicians saved this patient and their tongue, this case emphasises the urgent need to create SBE awareness among rural communities and develop/enforce appropriate policies to mitigate such extreme actions. For many people, the appearance of snakes in dreams is perceived as a bad omen. Traditional beliefs surrounding snakes go back thousands of years and are prominent in the history and mythology of almost all cultures . Snakes are regarded as the representatives of gods, divine beings, bringers of fortune or misfortune, and their statues are worshipped in many parts of the world . However, worshipping live venomous snakes and their mishandling is associated with serious consequences. Therefore, these aspects need attention from relevant health and forest authorities. According to the Wildlife Protection Act of 1972, it is illegal to keep snakes and other wild animals in captivity without the relevant licenses in India , but these rules are often overlooked in the case of religious centres . Policy surrounding the use of venomous snakes for religious reasons requires updating to avoid hugely dangerous ceremonies such as those documented here. Therefore, the law should be enforced when necessary to mitigate such dangerous actions of using snakes for live worship and educate the communities to improve their awareness about snakes and SBE. Moreover, many misbeliefs are associated with the use of inappropriate first aid, which exacerbates SBE-induced complications . In several cases, medical staff not only have to treat the complications arising from SBE but also handle the damaging effects of inappropriate first aid or treatments . Indeed, incisions as well as tourniquets, blood-sucking, and burning bite sites have been proven to not be an effective first aid for SBE, although they are still being practised . In this case, the deep incision to the tongue and laceration of the lingual artery complicated the treatment by inducing excessive bleeding and additional swelling of the tongue. This prevented the initial attempts to manually ventilate the patient. Therefore, the patient had to be nasally intubated with the help of trained healthcare professionals. Moreover, surgical procedures had to be used to reconnect the incised tongue. The clinical guidelines for restoring respiration dictate a sequential treatment plan, becoming increasingly complicated and invasive with each failed attempt . Indeed, the difficult airway guidelines proposed by the American Society of Anaesthesiologists and other authorities were not useful in this case due to severe bleeding and swelling. The available standard airway management algorithms largely depend on the visualisation of glottis directly or indirectly , and they were not suitable in this case due to profuse bleeding. If the medical staff were not trained to tackle this critical issue and act promptly to intubate the patient nasally then the situation would have been even worse. Similarly, the SBE treatment protocols mainly focus on tackling the envenomation effects by administering suitable antivenoms and blood products. They do not provide guidelines for managing such rare complications, which could be compounded by inappropriate first aid. Overall, this is a unique case when compared to any of the previously reported SBEs in the tongue. A snake charmer who was bitten by a Taiwanโ€“Chinese cobra ( Naja naja atra ) on their tongue displayed minimal swelling and envenomation effects without any breathing difficulties . The administration of antivenom and other supportive care successfully treated them. In contrast, a 41-year-old man who was bitten by Crotalus atrox displayed upper airway obstruction due to oedema of the tongue but was successfully treated with nasotracheal intubation, antivenom and supportive care . A European common adder bite in a 24-year-old man caused swelling and compromised airway resulting in respiratory failure which was tackled by acute tracheotomy and antivenom treatment . Sadly, a snake catcher who was bitten by a cobra in the Philippines on their tongue died promptly . In a state of India, a cobra was made to bite a devoteeโ€™s tongue in a festival to please the god . While this person was spitting a large amount of blood, the news article confirms that they did not suffer any further envenomation effects.
4.246094
0.841309
sec[2]/p[0]
en
0.999996
36548714
https://doi.org/10.3390/toxins14120817
[ "tongue", "this", "snakes", "effects", "bleeding", "their", "which", "envenomation", "bite", "they" ]
[ { "code": "DA03.Z", "title": "Diseases of tongue, unspecified" }, { "code": "DA03.0", "title": "Glossitis" }, { "code": "NA0Z&XA1T19", "title": "Injury of tongue" }, { "code": "LA31.Z", "title": "Structural developmental anomalies of mouth or tongue, unspecified" }, { "code": "NA01.Z&XA1T19", "title": "Laceration of tongue" }, { "code": "4A01.03", "title": "Transient hypogammaglobulinaemia of infancy" }, { "code": "NE61", "title": "Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified" }, { "code": "PA78&XE9H6", "title": "Contact with venomous snake" }, { "code": "PA78&XE1PT", "title": "Contact with venomous snakes or lizards" }, { "code": "8B42", "title": "Myelopathy" } ]
=== ICD-11 CODES FOUND === [DA03.Z] Diseases of tongue, unspecified Also known as: Diseases of tongue, unspecified | Diseases of tongue | disorder of tongue | Glossopathy | unspecified condition of the tongue [DA03.0] Glossitis Definition: Inflammation of the tongue Also known as: Glossitis | inflammation of tongue | tongue inflammation | glazed tongue | Papillitis of tongue Excludes: atrophic glossitis [LA31.Z] Structural developmental anomalies of mouth or tongue, unspecified Also known as: Structural developmental anomalies of mouth or tongue, unspecified | Structural developmental anomalies of mouth or tongue | malformations of mouth or tongue | structural developmental anomalies of mouth NOS | malformations of mouth NOS [4A01.03] Transient hypogammaglobulinaemia of infancy Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy] [NE61] Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified Also known as: Harmful effects of or exposure to noxious substances, chiefly nonmedicinal as to source, not elsewhere classified | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, alcohols | alcohol poisoning | alcohol toxicity | Harmful effects of or exposure to noxious substances chiefly nonmedicinal as to source, Ethanol Excludes: corrosions | Bacterial foodborne intoxications [8B42] Myelopathy Also known as: Myelopathy | Myelopathy due to compression | spinal cord compression | spondylogenic compression of spinal cord | spondylogenic myelopathy === GRAPH WALKS === --- Walk 1 --- [DA03.Z] Diseases of tongue, unspecified --PARENT--> [DA03] Diseases of tongue Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions.... --RELATED_TO--> [?] Sublingual varices Def: Varicose veins on the underside of the tongue... --- Walk 2 --- [DA03.Z] Diseases of tongue, unspecified --PARENT--> [DA03] Diseases of tongue Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions.... --EXCLUDES--> [?] Leukoedema of oral mucosa Def: leukoedema a variant condition of the buccal mucosa, consisting of an increase in thickness of the epithelium and intracellular oedema of the stratum spinosum or stratum germinativum... --- Walk 3 --- [DA03.0] Glossitis Def: Inflammation of the tongue... --EXCLUDES--> [?] Atrophy of tongue papillae --PARENT--> [?] Diseases of tongue Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions.... --- Walk 4 --- [DA03.0] Glossitis Def: Inflammation of the tongue... --EXCLUDES--> [?] Atrophy of tongue papillae --PARENT--> [?] Diseases of tongue Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions.... --- Walk 5 --- [LA31.Z] Structural developmental anomalies of mouth or tongue, unspecified --PARENT--> [LA31] Structural developmental anomalies of mouth or tongue Def: Embryo fetal anomalies affecting structure of maxillo-labial or mandibular tissues or the tongue.... --CHILD--> [LA31.2] Ankyloglossia Def: A condition of the tongue, caused by short, tight, lingual frenulum or fusion of the tongue to the floor of the mouth. This condition is characterised by difficulty in speech articulation due to limit... --- Walk 6 --- [LA31.Z] Structural developmental anomalies of mouth or tongue, unspecified --PARENT--> [LA31] Structural developmental anomalies of mouth or tongue Def: Embryo fetal anomalies affecting structure of maxillo-labial or mandibular tissues or the tongue.... --PARENT--> [?] Structural developmental anomalies of the face, mouth or teeth Def: Any condition caused by failure of the face, mouth and teeth to correctly develop during the antenatal period....
[ "[DA03.Z] Diseases of tongue, unspecified\n --PARENT--> [DA03] Diseases of tongue\n Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions....\n --RELATED_TO--> [?] Sublingual varices\n Def: Varicose veins on the underside of the tongue...", "[DA03.Z] Diseases of tongue, unspecified\n --PARENT--> [DA03] Diseases of tongue\n Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions....\n --EXCLUDES--> [?] Leukoedema of oral mucosa\n Def: leukoedema a variant condition of the buccal mucosa, consisting of an increase in thickness of the epithelium and intracellular oedema of the stratum spinosum or stratum germinativum...", "[DA03.0] Glossitis\n Def: Inflammation of the tongue...\n --EXCLUDES--> [?] Atrophy of tongue papillae\n --PARENT--> [?] Diseases of tongue\n Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions....", "[DA03.0] Glossitis\n Def: Inflammation of the tongue...\n --EXCLUDES--> [?] Atrophy of tongue papillae\n --PARENT--> [?] Diseases of tongue\n Def: Any pathological process affecting the structural tissues of the tongue with or without interference of its normal functions....", "[LA31.Z] Structural developmental anomalies of mouth or tongue, unspecified\n --PARENT--> [LA31] Structural developmental anomalies of mouth or tongue\n Def: Embryo fetal anomalies affecting structure of maxillo-labial or mandibular tissues or the tongue....\n --CHILD--> [LA31.2] Ankyloglossia\n Def: A condition of the tongue, caused by short, tight, lingual frenulum or fusion of the tongue to the floor of the mouth. This condition is characterised by difficulty in speech articulation due to limit...", "[LA31.Z] Structural developmental anomalies of mouth or tongue, unspecified\n --PARENT--> [LA31] Structural developmental anomalies of mouth or tongue\n Def: Embryo fetal anomalies affecting structure of maxillo-labial or mandibular tissues or the tongue....\n --PARENT--> [?] Structural developmental anomalies of the face, mouth or teeth\n Def: Any condition caused by failure of the face, mouth and teeth to correctly develop during the antenatal period...." ]
DA03.Z
Diseases of tongue, unspecified
[ { "from_icd11": "DA03.0", "icd10_code": "K140", "icd10_title": "Glossitis" }, { "from_icd11": "4A01.03", "icd10_code": "D807", "icd10_title": "Transient hypogammaglobulinemia of infancy" }, { "from_icd11": "NE61", "icd10_code": "T5802XA", "icd10_title": "Toxic effect of carbon monoxide from motor vehicle exhaust, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T550X2A", "icd10_title": "Toxic effect of soaps, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T61781A", "icd10_title": "Other shellfish poisoning, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T551X2A", "icd10_title": "Toxic effect of detergents, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T5891XA", "icd10_title": "Toxic effect of carbon monoxide from unspecified source, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63711A", "icd10_title": "Toxic effect of contact with venomous marine plant, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63712A", "icd10_title": "Toxic effect of contact with venomous marine plant, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63713A", "icd10_title": "Toxic effect of contact with venomous marine plant, assault, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63714A", "icd10_title": "Toxic effect of contact with venomous marine plant, undetermined, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63791A", "icd10_title": "Toxic effect of contact with other venomous plant, accidental (unintentional), initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63792A", "icd10_title": "Toxic effect of contact with other venomous plant, intentional self-harm, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63793A", "icd10_title": "Toxic effect of contact with other venomous plant, assault, initial encounter" }, { "from_icd11": "NE61", "icd10_code": "T63794A", "icd10_title": "Toxic effect of contact with other venomous plant, undetermined, initial encounter" } ]
K140
Glossitis
A 77-year-old man presented to our attention complaining of weakness and myalgia of the lower limbs for about a month. His past medical history revealed ischemic heart disease in 2017 (when he was started on secondary prevention statin therapy), thyroidectomy, localised colorectal cancer resection 10 years before, benign prostate hyperplasia, and abdominal aorta aneurysm. At the time of admission, medications include atorvastatin 40 mg/day, aspirin 100 mg/day, ramipril 2.5 mg/day, levothyroxine 50 ฮผ g/day and 75 ฮผ g/day on alternate days, alfuzosin 10 mg/day, and dutasteride 0.5 mg/day. On examination, the patient showed good muscle tone according to his age in both upper and lower limbs. Lower limb strength was graded 4/5 on the Medical Research Council (MRC) scale at the gluteus muscles and the iliopsoas. At that point, there was neither power loss of muscle strength in the upper limbs nor clear gait impairment while patient referred to easy exhaustion when walking. Blood tests showed a considerable increase in creatine phosphokinase (CK), lactate dehydrogenase (LDH), and alanine aminotransferase (ALT) levels which were 4598 IU/L, 695 IU/L, and 401 IU/L, respectively. Whereas full blood count, inflammatory markers, coagulation tests, renal function, urea, electrolytes, and liver function were normal. Thyroid function tests unveiled a poorly controlled hypothyroidism with TSH level of 11.49 mIU/L (n.v. 0.270โ€“4.200 mIU/L) and T4 level of 8.02 ng/L (n.v. 9.30โ€“17 ng/L); therefore, levothyroxine dose was increased up to 75 ฮผ g per day. Atorvastatin was immediately suspended. Autoimmunity tests reported the presence of anti-nucleus antibodies (ANA) with a titre of 1 : 160 and mixed speckled/nucleolar pattern. Myositis antibody panel was negative ( Table 1 ). In order to rule out malignancy in the context of a paraneoplastic syndrome, we performed a CT scan of the chest and abdomen, which proved negative. Considering the clinical stability of the patient and the flattened CK levels, after 10 days, the patient was discharged with the plan of undergoing an MRI scan of the lower limbs and a muscle biopsy. Also, serum samples were sent to the closest facility performing an anti-HMGCR antibodies assay, and the results were pending. After one week, the patient was hospitalized again due to worsening symptoms. Lower limb weakness slightly progressed (gluteus muscles strength: 3/5; iliopsoas strength: 4/5) while waddling gait was evident. He could barely stand up without help, and to get a sitting position from lying on the bed, he required the use of alternative, distal muscles. Furthermore, he complained of mild upper-limb functional impairment and dysphagia with solid food. CK levels markedly increased up to 6978 IU/L. An MRI scan of the lower limbs showed bilateral intramuscular oedema with patchy distribution involving the gluteus minimus and medius muscles, the insertional area of gluteus maximum, iliopsoas, the adductor magnus, adductor longus, obturator externus, obturator internus muscles, and the central aponeurosis of rectus femoris muscles . There was an initial fatty replacement involving the gluteus muscles and the adductor magnus. The alterations were more evident along the intramuscular aponeurosis and myotendinous junctions. Electromyography showed myopathic changes, whereas muscle biopsy highlighted the presence of necrosis with macrophages infiltration and thickening of connective tissue with mild inflammatory changes . Anti-HMGCR antibody titre was 299.7 CU/ml (n.v. <20 CU/mL). Based on these results, a diagnosis of statin-induced autoimmune necrotizing myopathy (SINAM) was made, and the patient was prescribed with prednisone 1 mg/kg/day (60 mg/day). In the following 5 days, CK levels dropped to 3032 IU/L in stark contrast with the clinical picture that only minimally improved. On the 13th day of steroid treatment, we witnessed a further clinical deterioration. The patient was no longer able to lift both legs against gravity and could only walk with assistance. Despite the overall stability of CK levels, intravenous immunoglobulin therapy was started at the dose of 0.4 g/kg per day for 5 days. At the end of the cycle, we challenged the patient with a three-day course of 0.5 g of methylprednisolone before returning to the previous dosage of prednisone. After a few days, methotrexate was added at the dosage of 10 mg per week. In light of a slow but persistent clinical and laboratory improvement, we began a careful tapering of prednisone with the plan of reducing the dosage by approximately 5 mg each month. An important aspect to highlight is the challenge we found in creating a rehabilitation plan for this patient, given the lack of clear evidence. During the acute phase of disease, we opted for a resting strategy limiting physical activity to preserve muscle tissue from further damage. In the second stage, during disease remission, our patient started a gradual rehabilitation process with progressive active physiotherapy. The patient was discharged after a second cycle of immunoglobulins with CK levels of 880 IU/L. Since then, we are following the patient in our outpatient unit. He recently completed the 6 th monthly infusion of immunoglobulins out of the twelve planned. CK levels completely normalised and upper limb function has fully recovered . Minimal weakness of the proximal lower limbs still remains without affecting the patient's gait. A three-year follow-up for cancer screening has been scheduled and will be recommended.
4.023438
0.977051
sec[1]/p[0]
en
0.999997
38145276
https://doi.org/10.1155/2023/6550473
[ "muscles", "limbs", "muscle", "gluteus", "limb", "strength", "function", "weakness", "iliopsoas", "gait" ]
[ { "code": "FB3Z", "title": "Disorders of muscles, unspecified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" }, { "code": "8C70.Z", "title": "Muscular dystrophy, unspecified" }, { "code": "FB32.2Z", "title": "Ischaemic infarction of muscle, unspecified" }, { "code": "FB56.2", "title": "Myalgia" }, { "code": "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 === [FB3Z] Disorders of muscles, unspecified Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia [8C70.Z] Muscular dystrophy, unspecified Also known as: Muscular dystrophy, unspecified | Muscular dystrophy | Gower's muscular dystrophy | progressive musclular dystrophy | pseudohypertrophic atrophy [FB32.2Z] Ischaemic infarction of muscle, unspecified Also known as: Ischaemic infarction of muscle, unspecified | Ischaemic infarction of muscle | muscle infarction [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain [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 --- [FB3Z] Disorders of muscles, unspecified --PARENT--> [?] Disorders of muscles --CHILD--> [FB31] Calcification or ossification of muscle --- Walk 2 --- [FB3Z] Disorders of muscles, unspecified --PARENT--> [?] Disorders of muscles --CHILD--> [FB31] Calcification or ossification of muscle --- Walk 3 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --CHILD--> [FB32.1] Spontaneous rupture of muscle Def: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma.... --- Walk 4 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --CHILD--> [FB32.1] Spontaneous rupture of muscle Def: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma.... --- Walk 5 --- [8C70.Z] Muscular dystrophy, unspecified --PARENT--> [8C70] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --RELATED_TO--> [?] Epidermolysis bullosa simplex with muscular dystrophy Def: Epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) is an autosomal recessive basal subtype of EBS due to mutations the PLEC gene encoding plectin. It is characterised by generalised bliste... --- Walk 6 --- [8C70.Z] Muscular dystrophy, unspecified --PARENT--> [8C70] Muscular dystrophy Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f... --PARENT--> [?] Primary disorders of muscles Def: Disorders in which the primary symptom of muscle weakness is secondary to a specific dysfunction of a muscle fiber....
[ "[FB3Z] Disorders of muscles, unspecified\n --PARENT--> [?] Disorders of muscles\n --CHILD--> [FB31] Calcification or ossification of muscle", "[FB3Z] Disorders of muscles, unspecified\n --PARENT--> [?] Disorders of muscles\n --CHILD--> [FB31] Calcification or ossification of muscle", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --CHILD--> [FB32.1] Spontaneous rupture of muscle\n Def: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma....", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --CHILD--> [FB32.1] Spontaneous rupture of muscle\n Def: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma....", "[8C70.Z] Muscular dystrophy, unspecified\n --PARENT--> [8C70] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...\n --RELATED_TO--> [?] Epidermolysis bullosa simplex with muscular dystrophy\n Def: Epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) is an autosomal recessive basal subtype of EBS due to mutations the PLEC gene encoding plectin. It is characterised by generalised bliste...", "[8C70.Z] Muscular dystrophy, unspecified\n --PARENT--> [8C70] Muscular dystrophy\n Def: Progressive, hereditary skeletal muscle diseases characterised by muscle weakness, wasting, defects in muscle proteins, necrosis of muscle tissue and replacement of muscle tissue with connective and f...\n --PARENT--> [?] Primary disorders of muscles\n Def: Disorders in which the primary symptom of muscle weakness is secondary to a specific dysfunction of a muscle fiber...." ]
FB3Z
Disorders of muscles, unspecified
[ { "from_icd11": "FB3Z", "icd10_code": "M60831", "icd10_title": "Other myositis, right forearm" }, { "from_icd11": "FB3Z", "icd10_code": "M60869", "icd10_title": "Other myositis, unspecified lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M60811", "icd10_title": "Other myositis, right shoulder" }, { "from_icd11": "FB3Z", "icd10_code": "M6080", "icd10_title": "Other myositis, unspecified site" }, { "from_icd11": "FB3Z", "icd10_code": "M60851", "icd10_title": "Other myositis, right thigh" }, { "from_icd11": "FB3Z", "icd10_code": "M6010", "icd10_title": "Interstitial myositis of unspecified site" }, { "from_icd11": "FB3Z", "icd10_code": "M6018", "icd10_title": "Interstitial myositis, other site" }, { "from_icd11": "FB3Z", "icd10_code": "M6088", "icd10_title": "Other myositis, other site" }, { "from_icd11": "FB3Z", "icd10_code": "M60862", "icd10_title": "Other myositis, left lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M60861", "icd10_title": "Other myositis, right lower leg" }, { "from_icd11": "FB3Z", "icd10_code": "M6089", "icd10_title": "Other myositis, multiple sites" }, { "from_icd11": "FB3Z", "icd10_code": "M60852", "icd10_title": "Other myositis, left thigh" }, { "from_icd11": "FB3Z", "icd10_code": "M60821", "icd10_title": "Other myositis, right upper arm" }, { "from_icd11": "FB3Z", "icd10_code": "M60871", "icd10_title": "Other myositis, right ankle and foot" }, { "from_icd11": "FB3Z", "icd10_code": "M60812", "icd10_title": "Other myositis, left shoulder" } ]
M60831
Other myositis, right forearm
Patient lay in the supine position under general anesthesia. For open repair, classical technique was used: incising the skin, Scarpaโ€™s fascia, external oblique aponeurosis; dissecting and seperating the sac from the spermatic cord; high ligating the sac neck at the level of the internal ring. For laparoscopic operation, the surgeon stood at the left side of the patient regardless of the affected side of the hernia. The screen was placed at the patient feet side. One cm arc incision along the lower edge of the umbilicus was made. After blunt dissection of the subcutaneous tissue with a mosquito clamp, a pneumoperitoneum needle was inserted through the incision to the abdominal cavity. Then, carbon dioxide was poured into the cavity with a pressure of 8โ€“12 mmHg. When the abdominal cavity was distended, the pneumoperitoneum needle was withdrawn and lamp trocar (10 mm, 30ยฐ optics) was inserted through the umbilical incision. Peritoneal cavity was inspected first to preclude accidental injuries to the abdominal wall and peritoneal viscera. Re-confirmation of the affected side was made through a direct vision image. The image of the cavity was captured by the camera lens and appeared on the screen. In our group, through a careful groin examination and an ultrasound inspection, we found no diagnostic neglection of the bilateral hernias preoperatively. A tiny incision of 2 mm was made on the affected groin side. The incision was accurately positioned just above the level of the internal ring with the help of the camera lens. An epidural needle with a 3โ€“0 Prolene loop inside the barrel was used. The 3โ€“0 Prolene loop was inserted into the barrel by the operator beforehand. The epidural needle was characteristic with the followings: 1.8 mm ร— 80 mm, TUORen, Medical Instrument Group Corporation, MengGang Reed Garden Industrial District, ChangHeng County, Henan, China. The operator held the needle with one hand; a towel forceps stretching the groin skin with the other hand. The needle was pierced to the preperitoneal space through the groin tiny incision. Under the view of the laparoscopic lens, with the streching help by the towel forceps, the needle passed through a semicircle of the internal ring preperitoneally. Then, the needle tip pierced the peritoneum into the peritoneal cavity. The Prolene loop was pushed into the peritoneal cavity through the barrel of the needle. Maintaining the loop in the cavity, the needle was withdrawn carefully out of the body until the two ends of the 3โ€“0 Prolene seperated from the needle. The needle was introduced again from the same tiny incision of the groin skin and pierced into the site of the preperitoneal space, nearly the same site with the first time. Then, the needle was passed through the other semicircle of the internal ring preperitoneally. When the needle tip reached the previously pierced point of the peritoneum where the loop was still inside, it was managed to pierce the peritoneum and pass through the loop. Maintaining the tip inside the loop of 3โ€“0 Prolene, one 2โ€“0 Prolene was inserted into the barrel and continuously into the loop of the 3โ€“0 Prolene for a suitable length. Maintaining the 2โ€“0 Prolene trapped by the 3โ€“0 Prolene loop, the needle was withdrawn once more outside of the body until the other end of the 2โ€“0 Prolene seperating from the needle. The operator took the two ends of the loop and pulled them outwards. When the loop was pulled outside of the body, one end of the trapped 2โ€“0 Prolene in the loop will be brought out of the preperitoneal cavity simultaneously. At this moment, two ends of the 2โ€“0 Prolene were all outside of the body at the tiny incision site. A circle had been formed preperitoneally at the level of the internal ring . Knot tying of the 2โ€“0 Prolene was made outside of the body and buried under the groin skin. Then the internal ring closing preperitoneally was completed . A schematic diagram demonstrating the main steps and principle of the technique was shown in Fig. 3 . Commonly, the round ligament will be included into the cerclage. The umbilical incision and the puncturing tiny incision were closed with absorbable suture by subcutaneous suture and intradermal suture. The incision was covered with a waterproof dressing. During the whole procedure, extreme care was taken not to damage the inferior epigastric or femoral vessels. Fig. 1 Thread circling of the internal ring. The image shows a Prolene thread has circled the internal ring preperitoneally Fig. 2 Closure of the internal ring. The image shows the Prolene thread has been tied outside of the body to close the internal ring Fig. 3 Schematic diagram illustrating the principle of the technique. a . Puncturing instrument with a towel assistance. The image shows the epidural needle with a Prolene loop inside of the barrel is puncturing preperitoneally, with a towel forceps stretching of the groin skin as an assistance. This maneuver inclines the operator to establish an eye-hand coordination. b . Circling thread capture by the thread loop. The image shows the circling thread has been trapped by the Prolene thread loop. c . Thread circling completion by the thread loop. The image shows the single Prolene thread has been trapped and pulled out of the body by the Prolene thread loop. This single Prolene thread has circled the internal ring completely. d . The internal ring closure. The image shows the single Prolene thread is being knot-tied to close the internal ring outside of the body at the groin site
3.958984
0.616211
sec[1]/sec[1]/p[0]
en
0.999997
32560649
https://doi.org/10.1186/s12893-020-00800-0
[ "prolene", "needle", "loop", "ring", "thread", "incision", "cavity", "groin", "body", "preperitoneally" ]
[ { "code": "MB40.3", "title": "Anaesthesia of skin" }, { "code": "PA83.2&XE8D1", "title": "Accidental contact with needle" }, { "code": "LD25.1", "title": "Fronto-otopalatodigital syndromes" }, { "code": "QA8F", "title": "Needle stick without injury or harm" }, { "code": "PK81.F", "title": "Needle stick associated with injury or harm in therapeutic use" }, { "code": "DB30.1", "title": "Volvulus of large intestine" }, { "code": "NE60", "title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified" }, { "code": "LA81", "title": "Abnormal ventricular relationships" }, { "code": "DA96.00", "title": "Bacterial overgrowth syndrome" }, { "code": "DA91.1", "title": "Volvulus of small intestine" } ]
=== ICD-11 CODES FOUND === [MB40.3] Anaesthesia of skin Definition: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy. Also known as: Anaesthesia of skin | Hypoaesthesia of skin | Loss of cutaneous sensation | Numbness of skin | Loss of sensation Includes: Numbness of skin [LD25.1] Fronto-otopalatodigital syndromes Also known as: Fronto-otopalatodigital syndromes | Frontometaphyseal dysplasia | Melnick-Needles osteodysplasty | Otopalatodigital syndrome | Otopalatodigital syndrome type 1 [QA8F] Needle stick without injury or harm Also known as: Needle stick without injury or harm Excludes: Needle stick associated with injury or harm in therapeutic use [PK81.F] Needle stick associated with injury or harm in therapeutic use Also known as: Needle stick associated with injury or harm in therapeutic use [DB30.1] Volvulus of large intestine Definition: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vessels and so make the involved loop particularly susceptible to strangulation and gangrene, with resulting perforation, peritonitis, and sepsis. The classical sites of large intestinal volvulus are the caecum and the sigmoid colon, although there are reports of volvulus of the transverse colon and the Also known as: Volvulus of large intestine | bowel volvulus | colon volvulus | knotting of intestine, bowel, or colon | strangulation of intestine, bowel, or colon [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 [LA81] Abnormal ventricular relationships Definition: A congenital cardiovascular malformation in which the ventricular positions relative to each other or their laterality (sidedness) are abnormal. Also known as: Abnormal ventricular relationships | Right hand pattern ventricular topology | D-bulboventricular loop | D-loop ventricles | Dextro-ventricular looping [DA96.00] Bacterial overgrowth syndrome Definition: Bacterial overgrowth syndrome is a term that describes clinical manifestations that occur when poor movement of intestinal contents allows certain normal intestinal bacteria to grow excessively, causing diarrhoea and poor absorption of nutrients (malabsorption). Various etiological processes can disrupt mechanisms that keep the number of these bacteria low. These include structural abnormalities (congenital or surgical) and disorders that cause decreased gastric acidity, reduced peristaltic acti Also known as: Bacterial overgrowth syndrome | Blind loop syndrome | Contaminated small bowel syndrome | Lane syndrome | Stagnant loop syndrome [DA91.1] Volvulus of small intestine Definition: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vessels and so make the involved loop particularly susceptible to strangulation and gangrene, with resulting perforation, peritonitis, and sepsis. Also known as: Volvulus of small intestine | small bowel loop | small bowel strangulation | SBO - [small bowel obstruction] strangulated === GRAPH WALKS === --- Walk 1 --- [MB40.3] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --PARENT--> [MB40] Sensation disturbance --CHILD--> [MB40.2] Anacusis --- Walk 2 --- [MB40.3] Anaesthesia of skin Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.... --PARENT--> [MB40] Sensation disturbance --CHILD--> [MB40.2] Anacusis --- Walk 3 --- [LD25.1] Fronto-otopalatodigital syndromes --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature --EXCLUDES--> [?] Freeman-Sheldon syndrome Def: Freeman-Sheldon syndrome is a rare congenital myopathic craniofacial syndrome. Considerable variability in severity is observed in this condition, but diagnosis requires the following: microstomia, wh... --- Walk 4 --- [LD25.1] Fronto-otopalatodigital syndromes --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature --CHILD--> [LD25.0] Oromandibular-limb anomaly syndrome Def: A syndrome caused by failure of the face and limbs to correctly develop during the antenatal period. This syndrome is characterised by malformations of the tongue, mandible, and limbs.... --- Walk 5 --- [QA8F] Needle stick without injury or harm --EXCLUDES--> [?] Needle stick associated with injury or harm in therapeutic use --PARENT--> [?] Certain medical procedures associated with injury or harm in therapeutic use --- Walk 6 --- [QA8F] Needle stick without injury or harm --PARENT--> [?] Circumstances associated with other aspects of care influencing the episode of care without injury or harm --CHILD--> [QA80] Non-administration of necessary drug without injury or harm Def: Prescribed drug not given. Missed dose, drug not started, drug delayed resulting in missed dose, but no documented injury or harm resulted....
[ "[MB40.3] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.2] Anacusis", "[MB40.3] Anaesthesia of skin\n Def: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy....\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.2] Anacusis", "[LD25.1] Fronto-otopalatodigital syndromes\n --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature\n --EXCLUDES--> [?] Freeman-Sheldon syndrome\n Def: Freeman-Sheldon syndrome is a rare congenital myopathic craniofacial syndrome. Considerable variability in severity is observed in this condition, but diagnosis requires the following: microstomia, wh...", "[LD25.1] Fronto-otopalatodigital syndromes\n --PARENT--> [LD25] Syndromes with face or limb anomalies as a major feature\n --CHILD--> [LD25.0] Oromandibular-limb anomaly syndrome\n Def: A syndrome caused by failure of the face and limbs to correctly develop during the antenatal period. This syndrome is characterised by malformations of the tongue, mandible, and limbs....", "[QA8F] Needle stick without injury or harm\n --EXCLUDES--> [?] Needle stick associated with injury or harm in therapeutic use\n --PARENT--> [?] Certain medical procedures associated with injury or harm in therapeutic use", "[QA8F] Needle stick without injury or harm\n --PARENT--> [?] Circumstances associated with other aspects of care influencing the episode of care without injury or harm\n --CHILD--> [QA80] Non-administration of necessary drug without injury or harm\n Def: Prescribed drug not given. Missed dose, drug not started, drug delayed resulting in missed dose, but no documented injury or harm resulted...." ]
MB40.3
Anaesthesia of skin
[ { "from_icd11": "MB40.3", "icd10_code": "R200", "icd10_title": "Anesthesia of skin" }, { "from_icd11": "MB40.3", "icd10_code": "R201", "icd10_title": "Hypoesthesia of skin" }, { "from_icd11": "PA83.2&XE8D1", "icd10_code": "W461XXA", "icd10_title": "Contact with contaminated hypodermic needle, initial encounter" }, { "from_icd11": "PA83.2&XE8D1", "icd10_code": "W460XXA", "icd10_title": "Contact with hypodermic needle, initial encounter" }, { "from_icd11": "PA83.2&XE8D1", "icd10_code": "W46", "icd10_title": "Contact with hypodermic needle" }, { "from_icd11": "LD25.1", "icd10_code": "Q8789", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "LD25.1", "icd10_code": "Q8781", "icd10_title": "Alport syndrome" }, { "from_icd11": "LD25.1", "icd10_code": "Q878", "icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified" }, { "from_icd11": "QA8F", "icd10_code": "XXI", "icd10_title": "" }, { "from_icd11": "DB30.1", "icd10_code": "K562", "icd10_title": "Volvulus" }, { "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" } ]
R200
Anesthesia of skin
The patient under discussion is a 33-year-old woman who complained of progressive dyspnea, palpitations and chest tightness. Laboratory data revealed increased markers of inflammation and elevated Dโ€‘dimer. Chest Xโ€‘ray showed a large pleural effusion on the right; CT scan ruled out pulmonary embolism but revealed an opacity and multiple cysts in the left lung. The absence of ascites strongly suggests a problem of pulmonary or pleural etiology. Laboratory analysis of the milky pleural fluid revealed a right-sided chylothorax (i.e. accumulation of chyle within the pleural space). According to the appearance of a pleural effusion, different tests are indicated (Table 2 ) . Chyle is described classically as having a white, milky or opalescent appearance . A chylous effusion has a high concentration of triglycerides (>110 mg/dL), lymphocytes and immunoglobulins (Table 1 ) . If triglyceride levels are below 50 mg/dL, it is not a chylothorax. If a conclusive diagnosis cannot be made, lipoprotein analysis should be performed. The presence of chylomicrons establishes the diagnosis of a chylothorax . Chylous pleural effusion or chylothorax occurs when flow in the thoracic duct, which carries fat after being absorbed in the intestine up to the superior vena cava, is compromised. It develops from disruption or obstruction of the thoracic duct or its tributaries with leakage of chyle from the ductal system into the pleural space. Chylothorax has various causes and is usually attributable to one of four etiologies : (1) malignancy, (2) trauma (including surgery), (3) miscellaneous disorders and (4) idiopathic. Malignancy is the most common cause of chylothorax with lymphoma accounting for 37โ€“75%, and bronchogenic carcinoma being the second most common reason . The proximity of the thoracic duct to the esophagus, aorta and spine, along with its variable anatomy, makes it particularly vulnerable during surgical procedures performed near these anatomical structures. Postoperative chylothorax has been described after nearly every known thoracic surgery as well as after neck surgery , but in rare cases may also occur after partial hepatectomy (Table 3 ). Moreover, a wide variety of diseases, such as sarcoidosis, tuberous sclerosis, different infections or various lymphatic disorders have been associated with chylous pleural effusion (Table 3 ) . Although the majority of causes for chylothorax listed in Table 3 can be excluded as a diagnosis in the discussed patient because of a negative history or lacking clinical features, it should be kept in mind that the patient had been diagnosed with a mass in the retroperitoneum 2 months before admission. However, since (1) laboratory data did not suggest lymphoma or leukemia, (2) there were no signs or symptoms indicating another malignancy (such as bronchogenic cancer) and (3) the described mass was anatomically not located in the proximity of the thoracic duct and, therefore, cannot be responsible for the development of the chylothorax, a malignancy seems very unlikely as the underlying cause of the chylous pleural effusion in this patient. Indeed, in this case the described mass is probably related to the patientโ€™s endometriosis. Although the discussed patient had an increased level of Dโ€‘dimer, and subclavian venous thrombosis could basically lead to chylous pleural effusion, this diagnosis can also be ruled out because no thrombosis of the chest vessels was found on the CT scan. Table 2 Tests indicated based on the appearance of the pleural effusion Appearance of fluid Test indicated Interpretation Cloudy or turbid Turbid supernatant Centrifugation Triglyceride levels Turbid supernatant โ†’ high lipid levels >110 mg/dL โ†’ chylothorax >50 mg/dL but โ‰ค110 mg/dL โ†’ obtain lipoprotein analysis Presence of chylomicrons โ†’ chylothorax โ‰ค50 mg/dL and cholesterol >250 mg/dL โ†’ pseudochylothorax Bloody Hematocrit <1% โ†’ non-significant 1โ€“20% โ†’ cancer, pulmonary embolism, trauma >50% of peripheral hematocrit: hemothorax Putrid odor Stain and culture Infection Table 3 Etiologies of chylothorax [ 5 โ€“ 9 ] Malignancy Lymphoma, chronic lymphocytic leukemia Lung cancer Metastatic disease Traumatic Surgery for congenital heart disease, cardiovascular surgery (e.g. aortic procedures, coronary artery bypass graft surgery, valve replacement), esophagectomy, resection for lung cancer, lung transplantation, resection of mediastinal mass (e.g. neuronal tumor, thymoma, neuroblastoma, cystic hygroma, ganglioneuroma, metastatic tonsillar carcinoma), mediastinoscopy and lymphadenectomy, spinal surgery, central line placement, pacemaker implantation (via subclavian vein), embolization procedure for pulmonary arteriovenous malformation, partial hepatectomy, blunt chest trauma and other external injury Miscellaneous disorders Sarcoidosis, tuberous sclerosis, pulmonary lymphangioleiomyomatosis, congestive heart failure, Kaposi sarcoma, radiation therapy of the mediastinum, (Granulomatous) Infections: tuberculosis, histoplasmosis, filariasis Subclavian venous thrombosis Congenital or acquired lymphatic disorders: Gorhamโ€™s disease, Milroy disease, congenital lymphatic hypoplasia Various lymphatic diseases: lymphangiomatosis, yellow nail syndrome, lymphangioma, thoracic duct cyst Secondary to chylous ascites (due to e.g. alcoholic or cryptogenic cirrhosis, hepatitis C infection, primary biliary cholangitis, primary sclerosing cholangitis, cholangiocarcinoma, pancreatic carcinoma) Idiopathic Congenital (neonatal) Cases with no clear cause
4.34375
0.867188
sec[1]/sec[0]/p[0]
en
0.999999
33119872
https://doi.org/10.1007/s00508-020-01753-3
[ "chylothorax", "pleural", "effusion", "chylous", "thoracic", "pulmonary", "duct", "malignancy", "chest", "lung" ]
[ { "code": "CB24", "title": "Chylous effusion" }, { "code": "CB04.1", "title": "Pulmonary lymphatic dysplasia syndromes" }, { "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" }, { "code": "FA36.Z", "title": "Effusion of joint, unspecified" }, { "code": "1D01.Z", "title": "Infectious meningitis, unspecified" }, { "code": "FA36.Y", "title": "Other specified effusion of joint" } ]
=== ICD-11 CODES FOUND === [CB24] Chylous effusion Definition: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylothorax, whereas a triglyceride concentration below 50 mg per decilitre makes chylothorax highly unlikely. Also known as: Chylous effusion | Chylothorax | Chyliform effusion | pleurisy with chylous effusion Includes: Chyliform effusion [CB04.1] Pulmonary lymphatic dysplasia syndromes Also known as: Pulmonary lymphatic dysplasia syndromes | Congenital chylothorax [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 [FA36.Z] Effusion of joint, unspecified Also known as: Effusion of joint, unspecified | Effusion of joint | effusion into joint | effusion of joint, site unspecified | hydrarthrosis [1D01.Z] Infectious meningitis, unspecified Also known as: Infectious meningitis, unspecified | Infectious meningitis, not elsewhere classified | acute meningomyelitis | septic meningitis NOS | infectious meningitis NEC [FA36.Y] Other specified effusion of joint Also known as: Other specified effusion of joint | Non aspirated effusion of joint | Effusion of joint without blood | Effusion of joint, multiple sites | Effusion of joint, shoulder region === GRAPH WALKS === --- Walk 1 --- [CB24] Chylous effusion Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho... --PARENT--> [?] Pleural, diaphragm or mediastinal disorders Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin... --CHILD--> [CB20] Pleural plaque Def: Deposits of hyalinized collagen fibres in the parietal pleura that result from chronic inflammation. Most commonly associated with past exposure to asbestos, typically becoming visible years after inh... --- Walk 2 --- [CB24] Chylous effusion Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho... --PARENT--> [?] Pleural, diaphragm or mediastinal disorders Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin... --PARENT--> [12] Diseases of the respiratory system --- Walk 3 --- [CB04.1] Pulmonary lymphatic dysplasia syndromes --RELATED_TO--> [?] Congenital pulmonary lymphangiectasia Def: Congenital pulmonary lymphangiectasia is a rare developmental disorder involving the lung and characterised by pulmonary subpleural, interlobar, perivascular, and peribronchial lymphatic dilatation.... --CHILD--> [?] Primary pulmonary lymphangiectasia --- Walk 4 --- [CB04.1] Pulmonary lymphatic dysplasia syndromes --RELATED_TO--> [?] Congenital pulmonary lymphangiectasia Def: Congenital pulmonary lymphangiectasia is a rare developmental disorder involving the lung and characterised by pulmonary subpleural, interlobar, perivascular, and peribronchial lymphatic dilatation.... --CHILD--> [?] Primary pulmonary lymphangiectasia --- Walk 5 --- [CB2Z] Pleural, diaphragm or mediastinal disorders, unspecified --PARENT--> [?] Pleural, diaphragm or mediastinal disorders Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin... --CHILD--> [CB21] Pneumothorax Def: Pneumothorax is an abnormal collection of air or gas in the pleural space that separates the lung from the chest wall, and that may interfere with normal breathing.... --- Walk 6 --- [CB2Z] Pleural, diaphragm or mediastinal disorders, unspecified --PARENT--> [?] Pleural, diaphragm or mediastinal disorders Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin... --CHILD--> [CB22] Diseases of mediastinum, not elsewhere classified Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora...
[ "[CB24] Chylous effusion\n Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho...\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --CHILD--> [CB20] Pleural plaque\n Def: Deposits of hyalinized collagen fibres in the parietal pleura that result from chronic inflammation. Most commonly associated with past exposure to asbestos, typically becoming visible years after inh...", "[CB24] Chylous effusion\n Def: A chylothorax (chylous effusion) signifies leakage of chyle from the thoracic duct. A pleural fluid triglyceride concentration of more than 110 mg per decilitre signifies a high likelihood of chylotho...\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --PARENT--> [12] Diseases of the respiratory system", "[CB04.1] Pulmonary lymphatic dysplasia syndromes\n --RELATED_TO--> [?] Congenital pulmonary lymphangiectasia\n Def: Congenital pulmonary lymphangiectasia is a rare developmental disorder involving the lung and characterised by pulmonary subpleural, interlobar, perivascular, and peribronchial lymphatic dilatation....\n --CHILD--> [?] Primary pulmonary lymphangiectasia", "[CB04.1] Pulmonary lymphatic dysplasia syndromes\n --RELATED_TO--> [?] Congenital pulmonary lymphangiectasia\n Def: Congenital pulmonary lymphangiectasia is a rare developmental disorder involving the lung and characterised by pulmonary subpleural, interlobar, perivascular, and peribronchial lymphatic dilatation....\n --CHILD--> [?] Primary pulmonary lymphangiectasia", "[CB2Z] Pleural, diaphragm or mediastinal disorders, unspecified\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --CHILD--> [CB21] Pneumothorax\n Def: Pneumothorax is an abnormal collection of air or gas in the pleural space that separates the lung from the chest wall, and that may interfere with normal breathing....", "[CB2Z] Pleural, diaphragm or mediastinal disorders, unspecified\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --CHILD--> [CB22] Diseases of mediastinum, not elsewhere classified\n Def: This refers to diseases of the mediastinum where the mediastinum is an undelineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thora..." ]
CB24
Chylous effusion
[ { "from_icd11": "CB24", "icd10_code": "J940", "icd10_title": "Chylous effusion" }, { "from_icd11": "CB2Z", "icd10_code": "J948", "icd10_title": "Other specified pleural conditions" }, { "from_icd11": "CB2Z", "icd10_code": "J949", "icd10_title": "Pleural condition, unspecified" }, { "from_icd11": "CB2Z", "icd10_code": "J90-J94", "icd10_title": "" }, { "from_icd11": "CB2Z", "icd10_code": "J94", "icd10_title": "Other pleural conditions" }, { "from_icd11": "LA76", "icd10_code": "Q340", "icd10_title": "Anomaly of pleura" }, { "from_icd11": "MD31", "icd10_code": "R091", "icd10_title": "Pleurisy" }, { "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" } ]
J940
Chylous effusion
A 43-year-old white female (II:2) presented with reduced vision in her right eye, inadvertently noticed when closing her left eye. On examination visual acuities were 6/60 OD and 6/7.5 OS. Fundoscopy revealed bilateral central atrophy, seen clearly on autofluorescence imaging (AF) . Eight years later AF imaging showed a preserved small central spot of AF, surrounded by a reduced AF signal corresponding to the area of atrophy, which increased in size over time, with a ring of AF. . Optical coherence tomography (OCT) imaging, 10 years after initial presentation, showed loss of the ellipsoid zone (EZ) . These features were consistent with a macular dystrophy, with features of bullโ€™s eye maculopathy (BEM). Electrophysiology testing showed that the pattern electro-retinogram was significantly affected in both eyes; the rod electro-retinogram (ERG) showed slight increase in implicit times of both โ€˜aโ€™ and โ€˜bโ€™ waves with significant reduction of the โ€˜bโ€™ wave amplitude. The photopic and 30 Hz flicker stimuli were normal; the EOG light rise was borderline reduced in the right eye, and normal in the left . In view of the family history of Stargardt macular dystrophy (STGD1) and the BEM phenotype genetic testing for ABCA4 variants was undertaken. Sanger sequencing was used to screen all 50 exons and approximately 50 base pairs of flanking intronic regions (standard practice at the time) in the proband. This identified a single previously reported pathogenic variant c.4685 T > C, p. , in the proband , but a second variant was not identified; (at that time, 15โ€“30% of STGD patients were reported as having only one detectable mutation in ABCA4 [ 2 โ€“ 4 ]). A family survey was then performed including her sister (II:4) and father (I:2), who were consented and examined. Her sister (II:4), previously diagnosed with STGD1 aged 18 years old, was re-examined at 46 years. Visual acuities were 6/60 right and left, and fundoscopy showed marked central atrophy . The atrophy seen on AF and OCT imaging were similar to that seen in the proband, but were more advanced . Multimodal imaging at follow up 4 years later, aged 54 years, showed a further increase in central atrophy . Their father (I:2), aged 70 years old, was asymptomatic with visual acuities of 6/6 right, and left with a normal appearing fundus . However, his AF imaging showed abnormalities of central stippled reduction in signal, consistent with early macular atrophy , but less advanced than that seen in his daughters . Nine years after his diagnosis, aged 79, his visual acuities had deteriorated to 6/60 right, and left and he had developed central atrophic changes similar to his daughters . Electrophysiology results were not available for II:4, or I:II. None of the family had any co-existing systemic disorders. Fig. 1 Images of proband at different time points: a and b show AF at age of 51, 8 years after first presentation with a central preserved spot of AF, surrounded by atrophy, and a ring of AF external to the atrophy. c and d show wide field Optos images at age of 59 (16 years after presentation) with central atrophy; e and f show AF at the same time showing enlargement of the decreased AF signal; g and h OCT showing loss of the EZ between the yellow arrows Key: Autofluorescence AF, Optical coherence tomography (OCT), Ellipsoid Zone (EZ). Fig. 2 Electrophysiology testing results for the proband ( a ) Pattern ERG with the reduction in amplitude in both eyes ( b ) Scotopic ERG showing increased โ€˜ a โ€™ and โ€˜ b โ€™ wave implicit times, and reduction in โ€˜ b โ€ wave amplitude in both eyes ( c ) Photopic ERG showing normal โ€˜ a โ€™ and โ€˜ b โ€™ wave latencies and normal โ€˜ a โ€™ and โ€˜ b โ€™ wave amplitudes for both flash and 30 Hz flicker stimuli ( d ) electro-oculogram showing borderline Arden Index in the right eye and normal in the left eye Fig. 3 a Pedigree of the family. The black arrow indicates the proband II:2. The shaded boxes and circles indicate affected individuals ( b ). Fig. 4 Imaging of the probandโ€™s younger sister (II/4). Images ( a to f ) at review aged 56, at 38 years after diagnosis. Optos imaging showing atrophic maculae ( a and b ). Autofluorescence (AF) shows loss of signal centrally corresponding to atrophy with a surrounding band of increased AF within the arcades ( c and d . optical coherence tomography (OCT) imaging showing the temporal extent of the loss of the ellipsoid zone demarcated by yellow arrows. e and f . Images ( g to l ) showing increased atrophy after a 4-year interval. Optos imaging shows increased bilateral macular atrophy ( g and h ). AF imaging shows extension of patchy AF surrounding the central atrophy with a small preserved foveal remnant ( i and j ). OCT showing further extension of the loss of the ellipsoid zone demarcated by the yellow arrows Fig. 5 Imaging of probandโ€™s father (I/2) Images ( a to d ) at age 73 (asymptomatic. Colour images of both maculae which appeared normal ( a and b ). Autofluorescence (AF) revealed central patchy reduction in AF signal, consistent with early atrophy ( c and d ). Images E to J of I:2 9 years later. Optos imaging showing distinct macular atrophy in both eyes and a choroidal naevus at left superotemporal arcade ( e and f ). AF imaging showing further atrophy at the central macula with central foveal sparing ( g and h ). Optical coherence tomography (OCT) showing preservation of the ellipsoid zone in the foveal area demarcated by red arrows, and the extent of loss of the ellipsoid zone denoted by yellow arrows ( i and j )
4.167969
0.944824
sec[1]/p[0]
en
0.999998
33836713
https://doi.org/10.1186/s12886-021-01919-1
[ "atrophy", "imaging", "proband", "both", "loss", "ellipsoid", "zone", "signal", "time", "macular" ]
[ { "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": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "MB27.3", "title": "Disturbance of body image" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "ME21", "title": "Clinical findings on diagnostic imaging of liver or biliary tract" }, { "code": "ME91", "title": "Clinical findings on diagnostic imaging of limbs" } ]
=== ICD-11 CODES FOUND === [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 [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [MB27.3] Disturbance of body image Definition: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it. Also known as: Disturbance of body image [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [ME21] Clinical findings on diagnostic imaging of liver or biliary tract Also known as: Clinical findings on diagnostic imaging of liver or biliary tract | Abnormal diagnostic imaging of liver | Nonvisualisation of gallbladder [ME91] Clinical findings on diagnostic imaging of limbs Also known as: Clinical findings on diagnostic imaging of limbs | abnormal diagnostic imaging of limbs === GRAPH WALKS === --- Walk 1 --- [FB32.Y] Other specified disorders of muscles --PARENT--> [FB32] Certain specified disorders of muscle Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category.... --CHILD--> [FB32.0] Diastasis of muscle Def: This is a pathological separation or tearing of muscle fibres from other muscle fibres, tendons or fascia... --- 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--> [?] Alcoholic myopathy Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa... --- Walk 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... --CHILD--> [?] Hypotension --- Walk 4 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --EXCLUDES--> [?] Developmental anomalies Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period.... --- Walk 5 --- [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 6 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...
[ "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --CHILD--> [FB32.0] Diastasis of muscle\n Def: This is a pathological separation or tearing of muscle fibres from other muscle fibres, tendons or fascia...", "[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --EXCLUDES--> [?] Alcoholic myopathy\n Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa...", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --CHILD--> [?] Hypotension", "[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --EXCLUDES--> [?] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....", "[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--> [?] 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..." ]
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": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "ME21", "icd10_code": "R932", "icd10_title": "Abnormal findings on diagnostic imaging of liver and biliary tract" }, { "from_icd11": "ME91", "icd10_code": "R936", "icd10_title": "Abnormal findings on diagnostic imaging of limbs" } ]
M6281
Muscle weakness (generalized)
Therefore, diagnostic coronary angiography was performed rapidly, documenting epicardial coronaries free from stenosing lesions. On ventriculography, the cardiac chamber appeared undilated with moderate global contractile dysfunction (FE of approximately 40%), as per Takotsubo syndrome of the mid-ventricular wall. During the procedure, further worsening of haemodynamic conditions (due to a phase of bradycardisation and decreasing pulse oximetry) resulted in pulseless electrical activity (PEA), with a return of spontaneous circulation (ROSC), which was reached after five minutes of cardiopulmonary resuscitation (CPR). Considering the silent medical history of the patient and the abrupt onset of her hypertensive crisis, a total body CT scan was required in order to reach a diagnosis. The brain scan results were negative, while the lungs displayed bilateral pleural effusion (maximum thickness 11.5 mm on the right side and 10.7 mm on the left side), with associated atelectasis of the left lung parenchyma. Finally, we found an 8.5 cm adrenal mass which occupied the superior cap of the left kidney. This mass displaced the pancreas tail up and forward, compressing the left kidneyโ€™s upper pole. In addition, there was a blood-type flap in the left perirenal area, as seen from the recent bleeding shown in Figure 1 . The [123I]-MIBG scintigraphy was also performed, which showed intense emission from a left-sided adrenal mass. The patient was admitted to intensive care because of the persistent haemodynamic instability, despite volume filling with crystalloids and norepinephrine infusion. The echocardiogram performed in intensive care showed a further reduction in the ejection fraction to 25%. As a further complication caused by refractory haemodynamic instability, acute renal failure was superimposed (treated by continuous renal replacement therapy). Continuous infusion of levosimendan was added as per protocol for the treatment of cardiogenic shock. Blood chemistry results are shown in Table 4 . The dosage of catecholamines, vanillylmandelic, and homovanillic acid in the urine was not possible because it took 5โ€“7 days. Considering the clinical situation and laboratory results (which showed increased blood levels of metanephrine and normetanephrine), which strongly indicated pheochromocytoma, an alpha-blocking therapy (Phenoxybenzamine, from 10 up to 80 mg/die) was initiated. After four days, despite the pharmacological treatments, haemodynamic instability persisted, with phases of marked hypotension alternating with phases of refractory hypertension. For this reason, an MDT was assembled to manage the patient. Urologists, radiologists, and anaesthesiologists agreed on a course of action: an open surgery performed under general anaesthesia. Monitoring included radial and pulmonary artery catheters; as expected, during tumour isolation, the patient developed a hypertensive crisis which was managed with continuous infusion of sodium nitroprusside and esmolol. We chose an anterior transperitoneal approach through bilateral subcostal laparotomy according to Chevron, which provided the surgeons with optimal exposure and confirmed this surgical approachโ€™s usefulness in the excision of larger adrenal masses. Left kidney compression emerged during a direct inspection. After careful separation of surrounding structures and identification of the left renal vein, the adrenal vein was isolated and ligated in order to block the incretion of catecholamines, followed by the artery. The tumourโ€™s size and the inflammatory reaction complicated cleavage, but the removal of the large mass was completed in 30 min, with an estimated blood loss of 150 mL. Hydrocortisone was administered to manage the expected transient acute adrenal insufficiency in the first 48 h. Hypotension developed early when the renal vein was clamped, and its management required norepinephrine infusion, in addition to discontinuation of the previous short-acting vasoactive drugs. Norepinephrine was gradually discontinued within the first 18 h. Hydrocortisone was tapered to 100 mg/day (from 200 mg daily) and replaced with same-dose oral cortisone; total cortisol and ACTH levels were monitored to guide therapy and were maintained within normal ranges. Histopathology revealed an adrenal pheochromocytoma characterised by solid and alveolar growth, moderate nuclear pleomorphism with the presence of hyaline blood cells, and rare mitosis (immunohistochemical examination: CK-, VIM-, EMA-, CD56+, synaptophysin+, chromogranin+, neuron-specific enolase (NSE)+, Ki67 equal to 1%). The neoplasm appeared delimited by a fibrous pseudo-capsule and showed almost complete haemorrhagic infarction with blood extravasations in the surrounding adipose tissue. There were no images of angioinvasion or adrenal gland infiltration (PASS score: 3). Without any metastases or recurrent symptoms or signs, the MDT maintained a close follow-up and withheld further treatment. The intensive postoperative hospitalisation continued until the stabilisation of the patientโ€™s clinical condition and her transfer to the hospital ward. The patient also tested negative on genetic tests for familial syndromes that could cause the development of pheochromocytoma. Two years after diagnosis and surgery, she enjoys a disease-free life. The close follow-up includes urine catecholamine tests twice a year and magnetic resonance every two years. Metabolic tests were normalised since the first check-up visit, 6 months after surgery.
4.046875
0.967285
sec[1]/p[1]
en
0.999998
PMC9149903
https://doi.org/10.3390/diseases10020029
[ "which", "adrenal", "blood", "haemodynamic", "infusion", "renal", "kidney", "this", "intensive", "instability" ]
[ { "code": "BD50.41", "title": "Abdominal aortic aneurysm with rupture" }, { "code": "EK91", "title": "Dermatoses which may presage cutaneous lymphoma" }, { "code": "MH12.1", "title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained" }, { "code": "8A44.3", "title": "Certain specified leukodystrophies" }, { "code": "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": "3C0Z", "title": "Diseases of the blood or blood-forming organs, unspecified" } ]
=== ICD-11 CODES FOUND === [BD50.41] Abdominal aortic aneurysm with rupture Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA [EK91] Dermatoses which may presage cutaneous lymphoma Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature. Also known as: Dermatoses which may presage cutaneous lymphoma [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease [8A44.3] Certain specified leukodystrophies Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome [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 [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 === GRAPH WALKS === --- Walk 1 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --PARENT--> [BD50] Aortic aneurysm or dissection Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ... --- Walk 2 --- [BD50.41] Abdominal aortic aneurysm with rupture --PARENT--> [BD50.4] Abdominal aortic aneurysm --CHILD--> [BD50.4Z] Abdominal aortic aneurysm, without mention of perforation or rupture --- Walk 3 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.2] Primary cutaneous plasmacytosis Def: A skin disorder resulting from focal or multifocal dense infiltration of the skin by plasma cell aggregates. It may be associated with high levels of serum IgG4. It typically presents as widespread re... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 4 --- [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --CHILD--> [EK91.2] Primary cutaneous plasmacytosis Def: A skin disorder resulting from focal or multifocal dense infiltration of the skin by plasma cell aggregates. It may be associated with high levels of serum IgG4. It typically presents as widespread re... --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.... --- Walk 5 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --EXCLUDES--> [?] Sudden infant death syndrome Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance... --- Walk 6 --- [MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained --PARENT--> [MH12] Other sudden death, cause unknown --CHILD--> [MH12.0] Instantaneous death
[ "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --PARENT--> [BD50] Aortic aneurysm or dissection\n Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...", "[BD50.41] Abdominal aortic aneurysm with rupture\n --PARENT--> [BD50.4] Abdominal aortic aneurysm\n --CHILD--> [BD50.4Z] Abdominal aortic aneurysm, without mention of perforation or rupture", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.2] Primary cutaneous plasmacytosis\n Def: A skin disorder resulting from focal or multifocal dense infiltration of the skin by plasma cell aggregates. It may be associated with high levels of serum IgG4. It typically presents as widespread re...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....\n --CHILD--> [EK91.2] Primary cutaneous plasmacytosis\n Def: A skin disorder resulting from focal or multifocal dense infiltration of the skin by plasma cell aggregates. It may be associated with high levels of serum IgG4. It typically presents as widespread re...\n --PARENT--> [EK91] Dermatoses which may presage cutaneous lymphoma\n Def: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature....", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --EXCLUDES--> [?] Sudden infant death syndrome\n Def: Sudden infant death syndrome is the abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance...", "[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained\n --PARENT--> [MH12] Other sudden death, cause unknown\n --CHILD--> [MH12.0] Instantaneous death" ]
BD50.41
Abdominal aortic aneurysm with rupture
[ { "from_icd11": "BD50.41", "icd10_code": "I713", "icd10_title": "Abdominal aortic aneurysm, ruptured" }, { "from_icd11": "EK91", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MH12.1", "icd10_code": "R961", "icd10_title": "" }, { "from_icd11": "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": "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" } ]
I713
Abdominal aortic aneurysm, ruptured
At 9-month-old, she was admitted to our hospital for acute gastroenteritis caused by astrovirus infection. On physical examination, the girl presented with obvious chubby and flabby face , and the skin was hyperelastic. She also had muscular hypotonia and joint laxity. A microcephaly was notable, with a head circumference of 40 cm (โˆ’ 3.2SD). Abdominal examination demonstrated an enlarged liver with its lower edge 7 cm below the right costal margin, and an enlarged spleen with its lower edge 2.5 cm below the left costal margin. The textures of the liver and the spleen were median. Laboratory examination revealed severe liver and coagulation dysfunction. Vitamin D levels were slightly decreased (Table 1 ). The muscle enzyme, blood glucose, lactate level, and AFP levels were all normal. Hepatitis viruses, including hepatitis A, B, C, D, E, CMV, and EBV were all negative. The autoantibodies were negative. Ultrasound examination of the liver revealed hepatomegaly and hepatic cirrhosis, with compensatory enlargement of the hepatic artery . With liver failure triggered by infections and growth retardation, progressive deterioration of liver function, and muscle involvement, inherited metabolic liver disease was considered. The genetic test for medical exome sequencing was sent at 9 months and 22 days. The patient was given symptomatic and supportive treatment, including transfusion of fresh frozen plasma and prothrombin complex, albumin and fibrinogen, supplements of vitamin A, D, E, and K, and infusion of glutathione and S-adenosylmethionine. Her liver function recovered and was sustained for a period of time with supportive treatment. However, when she was 19-month-old, she developed severe pneumonia, and the liver function collapsed again (the biochemical changes are shown in Table 1 ). The blood zinc level was tested, with normal results. The CT scan of the brain indicated that the boundary between the gray matter and white matter was not clear, the sulci and cistern were slightly widened and deepened, and the left lateral ventricle was slightly widened, approximately 1.0 cm . Oxygen inhalation through nasal catheter was needed when she was admitted. Anti-infection and supportive treatments were no longer effective this time. The mechanical ventilation was needed at the final stage. The patient died of liver failure and severe infection at last. The clinical and genetic findings of this patient are summarized in Table 2 . Fig. 1 Clinical manifestations. a Face feature. This girl had abnormal fat, round face, and soft translucent skin. b Ultrasound examination. Conventional B-mode ultrasound (left) showed that the liver was significantly enlarged and the echo of the liver parenchyma was coarse, suggesting the possibility of cirrhosis. The B-mode ultrasound (middle) and color Doppler flow imaging (CDFI)(right) showed enlargement of hepatic artery (arrows). c CT scan of brain. The boundary between gray matter and white matter was not clear, the sulci and cistern were slightly widened and deepened, the left lateral ventricle was slightly widened, about 1.0 cm(arrows) Table 1 Biochemical change of the patient in different ages Biochemical item 9 months old 19 months old Normal range ALT 745 231 <49U/L AST 4372 1172 <40U/L TBIL 36.9 23.8 5~21ฮผmol/L DBIL 31.6 21.8 <6.8ฮผmol/L TBA 254.8 254.8 0~10ฮผmol/L ALB 21.0 24.8 38.0~54.0g/L PT 29.6 25.2 8.7~14.7sec APTT 123.6 212.0 17.5~37.5 sec INR 2.47 2.09 0.8~1.5 Fg 102 <50 200~400mg/dl VitD a 23.4 21.90 30~100ng/ml Zn a - 54.62 43.55~95.63ฮผmol/L NH 3 40.0 76.0 9~30ฮผmol/L Abbreviation : ALT Alanine aminotransferase, AST Aspartate Aminotransferase, TBIL Total bilirubin, DBIL Direct bilirubin, TBA Total bile acid, ALB Albumin, PT Prothrombin time, APTT Activated partial thromboplastin time, INR International Normalized Ratio, Fg Fibrogen, VitD Vitamin D, Zn Zinc a The patient received Vitamin AD drops and Calcium Zinc Gluconate Oral Solution daily based on the advice of pediatrician of child health care departement Table 2 Clinical and genetic findings of patients with IARS1 mutations No. Ethnic Sex ALV AO IARS1 mutations Clinical features cDNA;protein Growth Retardation Intellectual Disability Muscular Hypotonia Infantile Hepatopathy Other features P1 German M 18.7y Prenatal (IUGR) c.[1252C>T], [3521T>A]; p.[Arg418 a ],[lle117Asn] + + + + zinc deficiency, recurrent infections, esophagitis, microcephaly. P2 Japanese F 19y Prenatal (IUGR) c.[760C>T], [1310C>T]; p.[Arg254 a ], [Pro437Leu] + + โƒ + zinc deficiency, diabetes mellitus, sensoneurinal hearing loss, epilepsy. P3 Austrian M 3y Prenatal (IUGR) c.[1109T>G], [2974A>G]; p.[Val370Gly],[Asn992Asp] + + + + zinc deficiency, recurrent infections, recurrent liver crises triggered by infections, chubby cheeks, microcephaly. P4 Israeli Arab M 4y Prenatal (IUGR) c.[2215C>T], [1667T>C]; p.[Arg739Cys],[Phe556Ser] + + โƒ + zinc normal, hydronephrosis, joint hyperlaxity, hyperelastic, doughy-like and transparent skin, microcephaly. P5 Polish M 7y Prenatal (IUGR) c.[2011delC], [206C>T]; p.[Gln671fs],[Thr69lle] + + + + zinc deficiency, recurrent infections, drumstick fingers P6 a Chinese F 1.58y Prenatal (IUGR) c.[701T>C], c.[1555C>T]; p.[L234P], p.[R519C] + + + + zinc normal, recurrent infections, recurrent liver failure triggered by infections, microcephaly, chubby cheeks, hyperelastic skin, vitamin D deficiency Abbreviation : M Male, F female, ALV Age at last visit, AO Age of onset, IUGR Intrauterine growth retardation. a P6 is the present patient
4.015625
0.976074
sec[1]/sec[0]/p[2]
en
0.999997
PMC9172121
https://doi.org/10.1186/s12887-022-03371-6
[ "liver", "zinc", "infections", "iugr", "prenatal", "recurrent", "microcephaly", "vitamin", "slightly", "deficiency" ]
[ { "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": "5B5K.2", "title": "Zinc deficiency" }, { "code": "5B91.1", "title": "Zinc excess" }, { "code": "5C64.21", "title": "Zinc deficiency syndromes" }, { "code": "5C64.2Z", "title": "Disorders of zinc metabolism, unspecified" }, { "code": "5C64.2Y", "title": "Other specified disorders of zinc metabolism" } ]
=== 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 [5B5K.2] Zinc deficiency Definition: The clinical features of severe zinc deficiency in humans are growth retardation, delayed sexual and bone maturation, skin lesions, diarrhoea, alopecia, impaired appetite, increased susceptibility to infections mediated via defects in the immune system, and the appearance of behavioural changes. The effects of marginal or mild zinc deficiency are less clear. A reduced growth rate and impairments of immune defence are so far the only clearly demonstrated signs of mild zinc deficiency in humans. O Also known as: Zinc deficiency | dietary zinc deficiency | Hypozincaemia [5B91.1] Zinc excess Definition: Adverse effects associated with chronic intake of supplemental zinc include suppression of immune response, decrease in high-density lipoprotein (HDL) cholesterol and reduced copper status. Acute adverse effects of excess zinc include epigastric pain, nausea, vomiting, loss of appetite, abdominal cramps, diarrhoea, headaches and gastrointestinal distress. Also known as: Zinc excess | hyperzincaemia [5C64.21] Zinc deficiency syndromes Also known as: Zinc deficiency syndromes | Acquired zinc deficiency syndrome | Neonatal nutritional zinc deficiency [5C64.2Z] Disorders of zinc metabolism, unspecified Also known as: Disorders of zinc metabolism, unspecified | Disorders of zinc metabolism [5C64.2Y] Other specified disorders of zinc metabolism Also known as: Other specified disorders of zinc metabolism | Hyperzincaemia or hypercalprotectinaemia === GRAPH WALKS === --- Walk 1 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --EXCLUDES--> [?] Unspecified jaundice Def: A clinical manifestation of hyperbilirubinemia of unspecified origin, characterised by the yellowish staining of the skin; mucus membranes and sclera.... --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB91] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 3 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --EXCLUDES--> [?] Drug-induced or toxic liver disease Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent.... --- Walk 4 --- [DB97.Z] Inflammatory liver disease, unspecified --PARENT--> [DB97] Certain specified inflammatory liver diseases --EXCLUDES--> [?] Acute viral hepatitis Def: A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, wi... --- Walk 5 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --CHILD--> [DB99.0] Chronic liver disease --- Walk 6 --- [DB99.7] Hepatic failure without mention whether acute or chronic --PARENT--> [DB99] Certain specified diseases of liver Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere.... --CHILD--> [DB99.2] Hepatorenal syndrome
[ "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --EXCLUDES--> [?] Unspecified jaundice\n Def: A clinical manifestation of hyperbilirubinemia of unspecified origin, characterised by the yellowish staining of the skin; mucus membranes and sclera....", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --CHILD--> [DB91] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Drug-induced or toxic liver disease\n Def: Drug-induced or toxic liver disease is hepatotoxicity as injury to the liver that is associated with impaired liver function caused by exposure to a drug or another noninfectious agent....", "[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Acute viral hepatitis\n Def: A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, wi...", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.0] Chronic liver disease", "[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.2] Hepatorenal syndrome" ]
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 admitted to the room, and after administering general anaesthesia, the lower extremity of the affected side was routinely disinfected with Anerโ€™s iodine. A sterile surgical drape was laid, a balloon tourniquet was applied, the blood was removed, and the operation was timed. If the lesion was close to the medial side, a 5-cm arc-shaped incision was made at the anterior edge of the medial malleolus, and the skin, subcutaneous tissue, and fascia were separated layer by layer. Care should be taken to protect the saphenous vein and important nerves and extreme plantar flexion of the ankle joint. In cases of a bony obstruction at the lesion site, an oscillating saw was used to perform a tri-plane osteotomy on the medial malleolus. The medial malleolus was propped up distally to fully expose the lesioned area of the medial talus; if the lesion was close to the lateral side, the lateral malleolus was removed. An arc-shaped incision with an anterior edge of approximately 8 cm is used to separate the skin, subcutaneous tissue, and fascia layer by layer. Important blood vessels and superficial peroneal nerves were protected. The ankle was placed in extreme plantar flexion to fully expose the lesion. In cases of a bony obstruction, a pendulum saw a โ€œZโ€-shaped osteotomy was performed on the fibula. The exfoliated and necrotic cartilage of the articular surface was carefully cleaned, and the size of the lesion area was observed. A ring-shaped bone extractor with an appropriate diameter was used, and the ring-shaped bone extractor and the talus cartilage surface were maintained perpendicular to the subchondral bone. A cylindrical bone groove was drilled in the lesion area with a depth of 10โ€“12 mm, and the cystic necrotic tissue and surrounding areas in the lesion were cleaned. For sclerotic bone, a Kirschner target was used to polish the pericystic wall until fresh blood oozed. A 3-cm-long surgical incision was made on the medial side of the talus or the medial side of the knee joint, and the cartilage surface of the medial non-weight-bearing area of the talus or the cartilage surface of the non-weight-bearing area of the medial femoral condyle was exposed. A cylindrical cartilage of appropriate length was extracted from the non-weight-bearing area with an equal diameter annular bone extractor. One or two columns were reserved, and the adjacent two columns were separated by 1 mm to avoid intersection. Then, an appropriate amount of cancellous bone was collected from the osteotomy site to implant in the cleaned cystic area, and the removed cartilage column was placed in the gap under pressure to construct the grafted bone. The cartilage surface of the column was at the same level as the cartilage surface of the talus. The ankle joint was passively moved, and the osteotomy ends of the medial malleolus and lateral malleolus were reduced and fixed with screws or plates. After satisfactory results were confirmed by intraoperative C-arm X-ray fluoroscopy, the joint cavity was washed, and the surgical incision was sutured layer by layer. Sterile gauze and bandages were used for pressure dressing to avoid post-operative complications such as joint swelling and infection. The surgical procedure is shown in Fig. 1 ; the pre-operative X-ray and computed tomography (CT) results are shown in Fig. 2 ; the pre-operative and post-operative MRI images obtained at the last three follow-up visits are shown in Fig. 3 . Fig. 1 Flowchart of the surgical procedure. a After incision to expose the damaged area of the talus osteochondral lesion, the peeled and separated cartilage pieces can be seen locally. b Because the bony barrier affects the operation, a medial malleolus osteotomy was performed to fully expose the operative area. c After the medial malleolar osteotomy, the operative area was fully exposed, the exfoliated cartilage sheet can be seen lifted up locally, and the subchondral capsule becomes clearly visible. d The necrotic bone in the cystic degeneration area was cleaned and cured. e Microfracture was performed in the cystic degeneration area. f The talus from the non-weight-bearing area on the medial side of the talus was excised, with the bone column with cartilage for backup. g A bone column of the same size was collected from the anterior side of the distal end of the tibia. h The bone column was placed from the distal end of the tibia to the non-weight-bearing area on the medial side of the talus and flattened. i Osteotomy of the tibia was performed. An appropriate amount of cancellous bone was taken from the site and implanted into the cystic degeneration area, and the spare cartilage column was implanted and flattened. j Allogeneic bone granules were placed in the osteotomy site. k The osteotomy and tibia can be seen. The distal bone extraction sites were well filled. l The osteotomy block was reduced and fixed Fig. 2 Pre-operative X-ray and CT. a Pre-operative X-ray showing that the local bone density of the medial talus was reduced. b Pre-operative CT showing that the local sac of the talus fornix becomes obvious and a cavity was formed Fig. 3 MRI before and at the last follow-up after surgery. a Pre-operative MRI showing cystic degeneration of the medial talus with a local high signal. b MRI of the patient at the last follow-up (17 months after surgery), after talus osteochondral transplantation; there is no obvious change in the medial talus. Cystic degeneration and high signal intensity were significantly reduced
4.042969
0.739746
sec[1]/sec[1]/p[0]
en
0.999996
36574023
https://doi.org/10.1007/s00264-022-05673-x
[ "bone", "area", "talus", "cartilage", "osteotomy", "side", "lesion", "malleolus", "cystic", "layer" ]
[ { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "FB84.Z", "title": "Osteomyelitis or osteitis, unspecified" }, { "code": "FB80.Z", "title": "Disorder of bone density or structure, unspecified" }, { "code": "FB86.11", "title": "Hypertrophy of bone" }, { "code": "FB86.1Z", "title": "Bone hyperplasias, unspecified" }, { "code": "QF29", "title": "Difficulty or need for assistance with major areas of life" }, { "code": "EH40.1Y", "title": "Other specified infantile napkin dermatoses" }, { "code": "GA90", "title": "Hyperplasia of prostate" }, { "code": "2B66.Z", "title": "Malignant neoplasms of other or unspecified parts of mouth, unspecified" }, { "code": "EG63.Z", "title": "Sacrococcygeal pilonidal disease, unspecified" } ]
=== ICD-11 CODES FOUND === [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [FB84.Z] Osteomyelitis or osteitis, unspecified Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease [FB80.Z] Disorder of bone density or structure, unspecified Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification [FB86.1Z] Bone hyperplasias, unspecified Also known as: Bone hyperplasias, unspecified | Bone hyperplasias [QF29] Difficulty or need for assistance with major areas of life Also known as: Difficulty or need for assistance with major areas of life | difficulty with major areas of life | need for assistance with major areas of life | Difficulty or need for assistance with education | Difficulty or needs for assistance with work and economic life [EH40.1Y] Other specified infantile napkin dermatoses Also known as: Other specified infantile napkin dermatoses | Infections of the napkin area [GA90] Hyperplasia of prostate Definition: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urinary urgency, nocturia, weak urine stream, straining while urinating, incomplete bladder emptying during urination, or increased frequency of urinary tract infection. Also known as: Hyperplasia of prostate | Adenofibromatous hypertrophy of prostate | benign prostatic hyperplasia | prostate hyperplasia | prostatic area hypertrophy Includes: Adenofibromatous hypertrophy of prostate Excludes: Benign neoplasms of prostate [2B66.Z] Malignant neoplasms of other or unspecified parts of mouth, unspecified Also known as: Malignant neoplasms of other or unspecified parts of mouth, unspecified | Malignant neoplasms of other or unspecified parts of mouth | cancer of buccal mucosa | cancer of cheek mucosa | internal cheek cancer [EG63.Z] Sacrococcygeal pilonidal disease, unspecified Also known as: Sacrococcygeal pilonidal disease, unspecified | Sacrococcygeal pilonidal disease | pilonidal disease of sacrococcygeal area | sacrococcygeal pilonidal disease NOS === GRAPH WALKS === --- Walk 1 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system --- Walk 2 --- [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue.... --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system --- Walk 3 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] Infection of vertebra Def: A condition of the vertebrae, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, weight loss, or may be asympto... --- Walk 4 --- [FB84.Z] Osteomyelitis or osteitis, unspecified --PARENT--> [FB84] Osteomyelitis or osteitis --EXCLUDES--> [?] 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 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopenia --- Walk 6 --- [FB80.Z] Disorder of bone density or structure, unspecified --PARENT--> [FB80] Certain specified disorders of bone density or structure --EXCLUDES--> [?] Osteopetrosis Def: Osteopetrosis ('marble bone disease') is a descriptive term that refers to a group of rare, heritable disorders of the skeleton characterised by increased bone density on radiographs. Osteopetrotic co...
[ "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system", "[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the musculoskeletal system", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] Infection of vertebra\n Def: A condition of the vertebrae, caused by an infection with a bacterial, viral, fungal, or parasitic source. This condition commonly presents with fever, chills, headache, weight loss, or may be asympto...", "[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --EXCLUDES--> [?] 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...", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopenia", "[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --EXCLUDES--> [?] Osteopetrosis\n Def: Osteopetrosis ('marble bone disease') is a descriptive term that refers to a group of rare, heritable disorders of the skeleton characterised by increased bone density on radiographs. Osteopetrotic co..." ]
FC0Z
Diseases of the musculoskeletal system or connective tissue, unspecified
[ { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "FB84.Z", "icd10_code": "M86672", "icd10_title": "Other chronic osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86172", "icd10_title": "Other acute osteomyelitis, left ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86171", "icd10_title": "Other acute osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M86671", "icd10_title": "Other chronic osteomyelitis, right ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X7", "icd10_title": "Other osteomyelitis, ankle and foot" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X8", "icd10_title": "Other osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X6", "icd10_title": "Other osteomyelitis, lower leg" }, { "from_icd11": "FB84.Z", "icd10_code": "M868X9", "icd10_title": "Other osteomyelitis, unspecified sites" }, { "from_icd11": "FB84.Z", "icd10_code": "M8668", "icd10_title": "Other chronic osteomyelitis, other site" }, { "from_icd11": "FB84.Z", "icd10_code": "M86662", "icd10_title": "Other chronic osteomyelitis, left tibia and fibula" }, { "from_icd11": "FB84.Z", "icd10_code": "M86151", "icd10_title": "Other acute osteomyelitis, right femur" }, { "from_icd11": "FB84.Z", "icd10_code": "M86141", "icd10_title": "Other acute osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M86641", "icd10_title": "Other chronic osteomyelitis, right hand" }, { "from_icd11": "FB84.Z", "icd10_code": "M8669", "icd10_title": "Other chronic osteomyelitis, multiple sites" } ]
XIII
In May 2021, the patient was admitted to the emergency department of a multispecialist hospital in Poznaล„ for suspected pulmonary tuberculosis and multiple abscesses in the right supraclavicular region. One of them, the largest in size, had a large cutaneous fistula. A CT scan of the chest revealed two abscesses in the subcutaneous tissue in the right supraclavicular area, size 70 ร— 38 mm and 60 ร— 26 mm; a thick-walled cavity in the first right segment, size 24 ร— 28 mm with a contrasting capsule; a nodule diam. 13 mm, with a cavity inside, located in the right third segment; disseminated interstitial nodules up to 5 mm in diameter; and numerous enlarged mediastinal lymph nodes with contrasting capsules filled with a necrotic mass . Medical interview with the patient revealed a history of pulmonary tuberculosis, treated in 2015, and HIV infection. The patient had taken antiretroviral drugs in the past. He also reported tobacco and alcohol dependence. The patient was transferred to the tuberculosis department. His status was stable, with a productive cough, and was afebrile. Levels of inflammatory markers measured in laboratory tests were as follows: ESR 82 mm/h and CRP 8.1 mg/L. Due to the suspected tuberculosis, a sputum sample and abscess swab were collected for microbiological tests. The microscopic analysis of smears stained with the Ziehlโ€“Neelsen (Z-N) technique revealed the presence of acid fast bacilli (AFB+++). MTBC DNA with a mutation in the rpoB gene was detected in both biological materials using the GeneXpert test (Cepheid, Synnyvale, CA, USA). According to the relevant protocol, the biological materials were cultured in Lรถwensteinโ€“Jensen (LJ) solid medium and liquid medium (Becton Dickinson Diagnostic Systems, Sparks, MD, USA). The growth of MTBC was observed in cultures of sputum incubated at 37 ยฐC for 5 days and in cultures of the abscess swab incubated for 8 days. The phenotypic method confirmed the resistance of isolates to antimycobacterial drugs: isoniazid (INH), rifampicin (RMP), ethambutol (EMB), streptomycin (SM), and rifabutin (RIF). In line with the recommendations for the treatment of multidrug-resistant tuberculosis (MDR-TB), defined as resistance to at least INH and RMP, the patient started therapy with second-line antituberculotic drugs in the following regimen: linezolid (LZD), cycloserine (CS), levofloxacin (LFX), ethionamide (ETO), clofazimine (CFZ), and pyrazinamide (PZA). The expanded antimicrobial susceptibility testing revealed that the isolated strains were sensitive to moxifloxacin (MFX), LZD, PZA, kanamycin (KM), amikacin (AM), capreomycin (CM), and CFZ. The strains were sent to the National Reference Laboratory for Tuberculosis (NRLT) in Warsaw for genotyping. Based on the spoligotyping technique (Ocimum Biosolutions, Hyderabad, India), both strains were classified to the Beijing type 541 family (spoligotype). The spoligotype and phylogenetic subtype were assigned according to the SITVIT WEB database , administered by the Institute Pasteur de Guadeloupe ( Table 1 ) . Additional tests confirmed HIV infection by detecting anti-HIV antibodies and HIV-RNA (2.78 ร— 10 6 IU/mL), but the test for the p24 antigen was negative. The count of CD4 + lymphocytes was 32 cells/mm 3 . After more than one month of antituberculotic therapy, three antiretroviral drugs were introduced: dolutegravir, emtricitabine, and tenofovir. The patient also received prophylactic treatment with azithromycin, sulfamethoxazole and trimethoprim. The treatment was well tolerated, and after one month the retest of a sputum smear collected from the patient was negative for Mycobacterium , and no MTBC were cultured. The chest X-ray performed after a two-month-long treatment showed an irregular infiltration in the upper right area of the lungs . There was a gradual improvement in the general health of the patient, with weight gain of about 4 kg, reduction in coughing, and resolution of the abscess with a significant reduction in the fistula size. In the antimycobacterial treatment regimen, ETO was discontinued after 2 months. Another follow-up chest X-ray performed during the fifth month of treatment showed a marked reduction in the size of the oval infiltration at the apex of the right lung . A CT scan of the chest revealed an oval nodular lesion with calcification, size 36 ร— 20 mm, in the right upper lobe, connected with the pleura via protrusions; enlarged cluster-like right mediastinal lymph nodes, with the involvement of the vessels and bronchi of the right hilum; enlarged left mediastinal nodes; nodular lesions (8 mm in the right upper lobeโ€”anterior segment, and 7 mm in the left lower lobe of the apical segment); and multiple small nodules up to 2 mm in diameter . Bronchofiberoscopy revealed a flat infiltration of the mucosa with superficial necrosis in the lower lobe bronchus. Biopsy specimens were collected for histopathological analysis which revealed squamous cell lung carcinoma (p40+, TTF1โˆ’, CK7โˆ’). In the follow-up test after 4 months, the count of CD4 + lymphocytes was 70 cells/mm 3 . Oncological treatment was postponed because the patient had no valid health insurance. During the 6-month hospitalization, the patient voluntarily left the tuberculosis department and discontinued the treatment. The patient was located and admitted to the internal medicine department at another hospital, where he completed antimycobacterial treatment, was discharged, and referred for further oncological treatment in Ukraine.
4.277344
0.918945
sec[1]/sec[0]/p[0]
en
0.999997
PMC9318939
https://doi.org/10.3390/diagnostics12071699
[ "tuberculosis", "department", "chest", "segment", "drugs", "lobe", "enlarged", "mediastinal", "nodes", "sputum" ]
[ { "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" }, { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" }, { "code": "CA44", "title": "Pyothorax" }, { "code": "MD30.Z", "title": "Chest pain, unspecified" }, { "code": "NA80.Y&XJ1C6", "title": "Thoracic haematoma" } ]
=== ICD-11 CODES FOUND === [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 [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy [CA44] Pyothorax Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection. Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula Includes: empyema | pyopneumothorax Excludes: due to tuberculosis [MD30.Z] Chest pain, unspecified Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure === GRAPH WALKS === --- Walk 1 --- [1B1Z] Tuberculosis, unspecified --PARENT--> [?] Tuberculosis Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation... --RELATED_TO--> [?] Congenital tuberculosis Def: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission.... --- Walk 2 --- [1B1Z] Tuberculosis, unspecified --PARENT--> [?] Tuberculosis Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation... --EXCLUDES--> [?] Pneumoconiosis associated with tuberculosis Def: This is an occupational lung disease and a restrictive lung disease caused by the inhalation of dust, often in mines, associated with a common, and in many cases lethal, infectious disease caused by v... --- Walk 3 --- [1B1Y] Other specified tuberculosis --PARENT--> [?] Tuberculosis Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation... --EXCLUDES--> [?] Pneumoconiosis associated with tuberculosis Def: This is an occupational lung disease and a restrictive lung disease caused by the inhalation of dust, often in mines, associated with a common, and in many cases lethal, infectious disease caused by v... --- Walk 4 --- [1B1Y] Other specified tuberculosis --PARENT--> [?] Tuberculosis Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation... --RELATED_TO--> [?] HIV disease clinical stage 1 associated with tuberculosis --- Walk 5 --- [KA61.0] Congenital tuberculosis Def: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission.... --PARENT--> [KA61] Other bacterial infections of the fetus or newborn --EXCLUDES--> [?] Neonatal meningitis --- Walk 6 --- [KA61.0] Congenital tuberculosis Def: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission.... --PARENT--> [KA61] Other bacterial infections of the fetus or newborn --RELATED_TO--> [?] Early congenital syphilis, symptomatic Def: A disease affecting newborns or children up to 2 years of age, caused by an infection with the gram-negative bacteria Treponema pallidum pallidum in utero. This disease is characterised by premature b...
[ "[1B1Z] Tuberculosis, unspecified\n --PARENT--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...\n --RELATED_TO--> [?] Congenital tuberculosis\n Def: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission....", "[1B1Z] Tuberculosis, unspecified\n --PARENT--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...\n --EXCLUDES--> [?] Pneumoconiosis associated with tuberculosis\n Def: This is an occupational lung disease and a restrictive lung disease caused by the inhalation of dust, often in mines, associated with a common, and in many cases lethal, infectious disease caused by v...", "[1B1Y] Other specified tuberculosis\n --PARENT--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...\n --EXCLUDES--> [?] Pneumoconiosis associated with tuberculosis\n Def: This is an occupational lung disease and a restrictive lung disease caused by the inhalation of dust, often in mines, associated with a common, and in many cases lethal, infectious disease caused by v...", "[1B1Y] Other specified tuberculosis\n --PARENT--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...\n --RELATED_TO--> [?] HIV disease clinical stage 1 associated with tuberculosis", "[KA61.0] Congenital tuberculosis\n Def: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission....\n --PARENT--> [KA61] Other bacterial infections of the fetus or newborn\n --EXCLUDES--> [?] Neonatal meningitis", "[KA61.0] Congenital tuberculosis\n Def: A disease affecting infants, caused by an infection with the bacteria Mycobacterium tuberculosis in utero. Transmission is by vertical transmission....\n --PARENT--> [KA61] Other bacterial infections of the fetus or newborn\n --RELATED_TO--> [?] Early congenital syphilis, symptomatic\n Def: A disease affecting newborns or children up to 2 years of age, caused by an infection with the gram-negative bacteria Treponema pallidum pallidum in utero. This disease is characterised by premature b..." ]
1B1Z
Tuberculosis, unspecified
[ { "from_icd11": "1B1Z", "icd10_code": "A15-A19", "icd10_title": "" }, { "from_icd11": "KA61.0", "icd10_code": "P370", "icd10_title": "Congenital tuberculosis" }, { "from_icd11": "1B12.40", "icd10_code": "A1801", "icd10_title": "Tuberculosis of spine" }, { "from_icd11": "1B12.40", "icd10_code": "A1802", "icd10_title": "Tuberculous arthritis of other joints" }, { "from_icd11": "1B12.40", "icd10_code": "A180", "icd10_title": "Tuberculosis of bones and joints" }, { "from_icd11": "1B12.40", "icd10_code": "M90", "icd10_title": "Osteopathies in diseases classified elsewhere" }, { "from_icd11": "1B12.40", "icd10_code": "M900", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A162", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A163", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A164", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A165", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A167", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A168", "icd10_title": "" }, { "from_icd11": "1B10.Z", "icd10_code": "A169", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" } ]
A15-A19
Clinical indications in oncology Fig. 26 68 Ga-PSMA, prostate cancer, staging. Clinical history : 56 y.o. man with prostate cancer. At presentation, Gleason score 4 + 5; PSA = 14 ng/ml, candidate to radical prostatectomy. PET/CT findings : multiple foci of increased uptake involving prostate, lymph nodes, and bones ( a MIP). Vertebral lesion seen on fused images ( c ) is not evident on CT ( b ) Fig. 27 68Ga-PSMA, prostate cancer, initial staging. Clinical history : 58 y.o. man with prostate cancer, Gleason score 3 + 4. Suspicious rib lesion on bone SPECT/CT. PET/CT findings : increased uptake in prostate tumour. No abnormal findings in the skeleton. Faint uptake in inguinal and external iliac nodes, with abnormal appearance on CT, corresponding to inflammation. a MIP; b , c fused images Fig. 28 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): sensitivity. Clinical history : 68 y.o. man with prostate cancer, Gleason score 4 + 3, radical prostatectomy as primary treatment; PSA 0.8 ng/ml, PSAdt 5 months, TTR 24 months, candidate for salvage radiation therapy to the prostatic fossa. PET/CT findings : single focus of faint uptake seen in the internal iliac chain, corresponding to a small right presacral nodule at CT image. a MIP. b PET, CT, and fused images Fig. 29 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR). Clinical history : 62 y.o. man with prostate cancer, radical prostatectomy as primary treatment Gleason score 4 + 4; PSA = 0.7 ng/ml, PSAdt 5 months, TTR 24 months, candidate to salvage radiation therapy to the prostatic fossa. PET/CT findings : single focus of increased uptake seen in the prostatic fossa consistent with local relapse after biopsy. a MIP; b CT and fused images Fig. 30 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): specificity. Clinical history : 68 y.o. man with prostate cancer, prostatectomy as primary treatment, Gleason score 4 + 5; pT3N0Mx + adjuvant radiotherapy. Three years later: PSA = 2.49 ng/ml, PSAdt 8 months. PET/CT findings : no evidence of recurrent disease, but urinary activity is evident in the prostatic fossa and the urethra. a MIP in a lateral view; b CT, PET, and fused images Fig. 31 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): sensitivity. Clinical history : 64 y.o. man with prostate cancer, radical prostatectomy as primary treatment Gleason score 4 + 4; PSA = 0.7 ng/ml, PSA dt 6 months, TTR 12 months, candidate for salvage radiation therapy in the prostatic fossa. PET/CT findings : single focus of increased uptake seen in a right external iliac lymph node (obturatory) measuring 8 mm in maximum diameter. a MIP; b CT and fused images Fig. 32 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): sensitivity. Clinical history : 72 y.o. man with prostate cancer, radical prostatectomy as primary treatment Gleason score 4 + 5; PSA = 0.4 ng/ml, PSA dt 6 months, TTR 10 months, candidate for salvage radiation therapy in the prostatic fossa. PET/CT findings : a focus of increased uptake is seen in the prostatic fossa and a right common iliac lymph node measuring 7 mm in maximum diameter. a MIP; b CT and fused images, local relapse; c CT and fused images, iliac lymph node Fig. 33 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): uncommon precarinal solitary metastasis Clinical history : 64 y.o. man with prostate cancer, radical prostatectomy as primary treatment Gleason score 4 + 5; PSA = 1.9 ng/ml, PSA dt 6 months, TTR 28 months. PET/CT findings : focus of increased uptake seen in an enlarged precarinal lymph node (24 mm). Transbronchial biopsy diagnosed prostate cancer relapse. a MIP images; b CT and fused images Fig. 34 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): 223Ra feasability. Clinical history : 72 y.o. man with prostate cancer, radical prostatectomy as primary treatment Gleason score 4 + 3; during abiraterone treatment, PSA increased up to 127 ng/ml, candidate to 223Ra chloride. PET/CT findings : multiple foci of increased uptake in the bones. No lymph node or visceral metastases. After 68 Ga-PSMA PET/CT, the patient has been referred to 223Ra chloride treatment. a MIP; b fused images Fig. 35 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): peritoneal invasion. Clinical history : 67 y.o. man with prostate cancer, radical prostatectomy as primary treatment Gleason score 4 + 3; during anti-androgen treatment, PSA increased up to PSA = 114 ng/ml. PET/CT findings : multiple foci of increased uptake in the peritoneum, liver capsule, and mediastinal lymph nodes. a MIP. b PET, fused, and CT images Fig. 36 68 Ga-PSMA, prostate cancer, biochemical recurrence (BCR): pulmonary metastasis. Clinical history : 66 y.o. man with prostate cancer (Gleason score 4 + 3, pT3N0Mx), radical prostatectomy, and adjuvant RT. Three years later PSA = 1.62 ng/ml, PSAdt < 6 months. Bone scan, abdominal CT, and pelvic MRI were all negative. PET/CT findings : mild tracer uptake in multiple pulmonary nodules visualised on CT, the largest nodule is 19 mm, in the lingula. a MIP; b , c CT, PET, and fused images Fig. 37 68 Ga-PSMA, prostate cancer, initial staging: lung lesion. Clinical history : 68 y.o. patient diagnosed with prostate cancer, treated with radical prostatectomy. First biochemical recurrence: PSA 0.39 ng/ml. PET/CT findings : increased uptake in a pulmonary nodule with irregular margins and spiculated edges in the left upper lobe. Biopsy diagnosed a primary lung adenocarcinoma. a MIP, b CT images, c fused images
3.986328
0.472412
sec[1]/sec[6]/p[8]
en
0.999995
34191163
https://doi.org/10.1186/s41824-019-0066-2
[ "prostate", "cancer", "psma", "fused", "uptake", "gleason", "score", "prostatectomy", "radical", "biochemical" ]
[ { "code": "GA90", "title": "Hyperplasia of prostate" }, { "code": "GA91.Z", "title": "Inflammatory or other diseases of prostate, unspecified" }, { "code": "GA91.Y", "title": "Other specified inflammatory or other diseases of prostate" }, { "code": "GA91.0", "title": "Chronic prostatitis" }, { "code": "MF40.1", "title": "Problems of the prostate" }, { "code": "2D4Z", "title": "Unspecified malignant neoplasms of unspecified sites" }, { "code": "2C0Z", "title": "Malignant neoplasms of intestine, unspecified" }, { "code": "2B5Z", "title": "Malignant mesenchymal neoplasm of unspecified type" }, { "code": "2E2Z", "title": "Malignant neoplasm metastasis, unspecified" }, { "code": "2D42", "title": "Malignant neoplasms of ill-defined sites" } ]
=== ICD-11 CODES FOUND === [GA90] Hyperplasia of prostate Definition: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urinary urgency, nocturia, weak urine stream, straining while urinating, incomplete bladder emptying during urination, or increased frequency of urinary tract infection. Also known as: Hyperplasia of prostate | Adenofibromatous hypertrophy of prostate | benign prostatic hyperplasia | prostate hyperplasia | prostatic area hypertrophy Includes: Adenofibromatous hypertrophy of prostate Excludes: Benign neoplasms of prostate [GA91.Z] Inflammatory or other diseases of prostate, unspecified Also known as: Inflammatory or other diseases of prostate, unspecified | Inflammatory or other diseases of prostate | inflammation of prostate NOS | prostatitis NOS | disease of prostate NOS [GA91.Y] Other specified inflammatory or other diseases of prostate Also known as: Other specified inflammatory or other diseases of prostate | Acute bacterial prostatitis | acute prostatitis | Prostatitis category I (NIH classification) | Prostatitis category I [GA91.0] Chronic prostatitis Definition: A condition caused by obstruction of the prostate glands. This condition is characterised by inflammation of the prostate gland, dysuria, pollakiuria, urinary urgency, genital pain, lower back pain, abdominal pain, and repeated bladder infections that last for at least three months. Also known as: Chronic prostatitis | Fibrous prostatitis | Hypertrophic prostatitis | Subacute prostatitis | Chronic bacterial prostatitis [MF40.1] Problems of the prostate Definition: A group of disorders associated with the prostate occurring in diseases more specifically classified elsewhere. Also known as: Problems of the prostate [2D4Z] Unspecified malignant neoplasms of unspecified sites Also known as: Unspecified malignant neoplasms of unspecified sites | malignancy of unspecified site | malignancy unspecified primary site | malignant growth of unspecified site | malignant mass of unspecified site [2C0Z] Malignant neoplasms of intestine, unspecified Also known as: Malignant neoplasms of intestine, unspecified | cancer of intestine | malignant neoplasm of intestine NOS | malignant tumour of intestine NOS | intestinal cancer NOS [2B5Z] Malignant mesenchymal neoplasm of unspecified type Also known as: Malignant mesenchymal neoplasm of unspecified type | calvarium cancer | ethmoid bone cancer | facial bone cancer | frontal bone cancer [2E2Z] Malignant neoplasm metastasis, unspecified Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases [2D42] Malignant neoplasms of ill-defined sites Definition: Malignant neoplasms of ill defined sites is used for cases where the documentation refers to a site that includes multiple organ systems and tissue types that should be coded separately. Also known as: Malignant neoplasms of ill-defined sites | Malignant neoplasm of ill-defined site of head, face or neck | Malignant neoplasm of nose NOS | Primary malignant neoplasm of cheek | malignant neoplasm of cheek NOS === GRAPH WALKS === --- Walk 1 --- [GA90] Hyperplasia of prostate Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina... --EXCLUDES--> [?] Benign neoplasm of male genital organs Def: A non-metastasizing neoplasm that arises from the male reproductive system. Representative examples include benign prostate phyllodes tumour, benign Sertoli cell tumour, seminal vesicle cystadenoma, a... --CHILD--> [?] Benign neoplasm of testis Def: A non-metastasizing neoplasm that arises from the testis. Representative examples include benign Sertoli cell tumour, thecoma, and fibroma.... --- Walk 2 --- [GA90] Hyperplasia of prostate Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina... --EXCLUDES--> [?] Benign neoplasm of male genital organs Def: A non-metastasizing neoplasm that arises from the male reproductive system. Representative examples include benign prostate phyllodes tumour, benign Sertoli cell tumour, seminal vesicle cystadenoma, a... --CHILD--> [?] Benign neoplasm of prostate Def: A non-metastasizing neoplasm that arises from the prostate. Representative examples include benign phyllodes tumour, leiomyoma, and fibroma.... --- Walk 3 --- [GA91.Z] Inflammatory or other diseases of prostate, unspecified --PARENT--> [GA91] Inflammatory or other diseases of prostate Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate.... --CHILD--> [GA91.1] Abscess of prostate Def: A condition caused by infection with the gram-negative bacteria Neisseria gonorrhoeae and Escherichia coli, or the gram-positive bacteria Staphylococcus aureus or Mycobacterium tuberculosis. This cond... --- Walk 4 --- [GA91.Z] Inflammatory or other diseases of prostate, unspecified --PARENT--> [GA91] Inflammatory or other diseases of prostate Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate.... --CHILD--> [GA91.0] Chronic prostatitis Def: A condition caused by obstruction of the prostate glands. This condition is characterised by inflammation of the prostate gland, dysuria, pollakiuria, urinary urgency, genital pain, lower back pain, a... --- Walk 5 --- [GA91.Y] Other specified inflammatory or other diseases of prostate --PARENT--> [GA91] Inflammatory or other diseases of prostate Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate.... --RELATED_TO--> [?] Gonococcal prostatitis --- Walk 6 --- [GA91.Y] Other specified inflammatory or other diseases of prostate --PARENT--> [GA91] Inflammatory or other diseases of prostate Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate.... --RELATED_TO--> [?] Gonococcal prostatitis
[ "[GA90] Hyperplasia of prostate\n Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...\n --EXCLUDES--> [?] Benign neoplasm of male genital organs\n Def: A non-metastasizing neoplasm that arises from the male reproductive system. Representative examples include benign prostate phyllodes tumour, benign Sertoli cell tumour, seminal vesicle cystadenoma, a...\n --CHILD--> [?] Benign neoplasm of testis\n Def: A non-metastasizing neoplasm that arises from the testis. Representative examples include benign Sertoli cell tumour, thecoma, and fibroma....", "[GA90] Hyperplasia of prostate\n Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...\n --EXCLUDES--> [?] Benign neoplasm of male genital organs\n Def: A non-metastasizing neoplasm that arises from the male reproductive system. Representative examples include benign prostate phyllodes tumour, benign Sertoli cell tumour, seminal vesicle cystadenoma, a...\n --CHILD--> [?] Benign neoplasm of prostate\n Def: A non-metastasizing neoplasm that arises from the prostate. Representative examples include benign phyllodes tumour, leiomyoma, and fibroma....", "[GA91.Z] Inflammatory or other diseases of prostate, unspecified\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --CHILD--> [GA91.1] Abscess of prostate\n Def: A condition caused by infection with the gram-negative bacteria Neisseria gonorrhoeae and Escherichia coli, or the gram-positive bacteria Staphylococcus aureus or Mycobacterium tuberculosis. This cond...", "[GA91.Z] Inflammatory or other diseases of prostate, unspecified\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --CHILD--> [GA91.0] Chronic prostatitis\n Def: A condition caused by obstruction of the prostate glands. This condition is characterised by inflammation of the prostate gland, dysuria, pollakiuria, urinary urgency, genital pain, lower back pain, a...", "[GA91.Y] Other specified inflammatory or other diseases of prostate\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --RELATED_TO--> [?] Gonococcal prostatitis", "[GA91.Y] Other specified inflammatory or other diseases of prostate\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --RELATED_TO--> [?] Gonococcal prostatitis" ]
GA90
Hyperplasia of prostate
[ { "from_icd11": "GA90", "icd10_code": "N402", "icd10_title": "Nodular prostate without lower urinary tract symptoms" }, { "from_icd11": "GA90", "icd10_code": "N403", "icd10_title": "Nodular prostate with lower urinary tract symptoms" }, { "from_icd11": "GA90", "icd10_code": "N400", "icd10_title": "Benign prostatic hyperplasia without lower urinary tract symptoms" }, { "from_icd11": "GA90", "icd10_code": "N401", "icd10_title": "Benign prostatic hyperplasia with lower urinary tract symptoms" }, { "from_icd11": "GA90", "icd10_code": "N40", "icd10_title": "Benign prostatic hyperplasia" }, { "from_icd11": "GA91.Z", "icd10_code": "N414", "icd10_title": "Granulomatous prostatitis" }, { "from_icd11": "GA91.Z", "icd10_code": "N4289", "icd10_title": "Other specified disorders of prostate" }, { "from_icd11": "GA91.Z", "icd10_code": "N4283", "icd10_title": "Cyst of prostate" }, { "from_icd11": "GA91.Z", "icd10_code": "N410", "icd10_title": "Acute prostatitis" }, { "from_icd11": "GA91.Z", "icd10_code": "N419", "icd10_title": "Inflammatory disease of prostate, unspecified" }, { "from_icd11": "GA91.Z", "icd10_code": "N429", "icd10_title": "Disorder of prostate, unspecified" }, { "from_icd11": "GA91.Z", "icd10_code": "N418", "icd10_title": "Other inflammatory diseases of prostate" }, { "from_icd11": "GA91.Z", "icd10_code": "N41", "icd10_title": "Inflammatory diseases of prostate" }, { "from_icd11": "GA91.Z", "icd10_code": "N42", "icd10_title": "Other and unspecified disorders of prostate" }, { "from_icd11": "GA91.Z", "icd10_code": "N428", "icd10_title": "Other specified disorders of prostate" } ]
N402
Nodular prostate without lower urinary tract symptoms
A 52-year-old man was referred to our institution in 2012, two years after a total thyroidectomy for an FTC. The histopathological analysis showed a 16 mm FTC, with vascular invasion and 50% of poorly differentiated areas (pT1b pNx Mx). Post-operative staging revealed a basal serum thyroglobulin (sTg) of 9 ng/mL, negative anti-Tg antibodies, and a micronodule in the left lung in a CT scan. He was asymptomatic and had a good performance status. The patient received 100 mCi of RAI in 2013, and a post-treatment whole-body scan revealed moderate cervical uptake , with no distant uptake foci. Stimulated sTg was 408 ng/mL. Sixteen months later , suppressed sTg raised up to 183 ng/mL , and disease progression in the lungs, as well as in the mediastinal and hilar lymph nodes, was observed . His disease was considered RAIR, and he was then commenced on sorafenib in May 2014, with 400 mg twice daily. He developed high blood pressure, which was well-controlled with losartan/hydrochlorothiazide, grade 2 asthenia, anorexia, and diarrhea. The dosage of sorafenib was reduced to 600 mg daily. Sorafenib was discontinued in February 2015 due to biochemical and structural progression of the disease . He was treated with second-line chemotherapy, with five cycles of docetaxel (60 mg/m 2 ) and doxorubicin (50 mg/m 2 ) from February to May 2015. Serum Tg at the end of treatment was 893 ng/mL , and a CT scan showed progression of metastatic disease in the mediastinal lymph nodes and lungs . In September 2015, significant disease progression in these tissues was observed and a new lytic lesion in the right iliac was demonstrated by FDG-PET/CT, accompanied by a significant rise in sTg up to 1881 ng/mL . In October 2015, the bone lesion was treated with 30 Gy of palliative external-beam radiation, and sunitinib 50 mg daily (4 weeks on, 2 weeks off) was started. However, just after one cycle, sunitinib was suspended for 2 months due to poor tolerability (grade 2 anorexia, fatigue, and hemoptoic sputum). Bronchoscopy showed a vascular endobronchial lesion in the right upper bronchus and in the apical bronchus of the right lower lobe. He resumed sunitinib at a lower dose (37.5 mg) once daily, continuously. Six months later, worsening of dyspnea, unresponsive to bronchodilators and corticosteroids, with a permanent requirement of oxygen supplementation, was observed. Serum Tg level increased to 4926 ng/mL , and marked structural progression was seen on chest CT scan . The patient was then considered for off-label therapy with gemcitabine 1000 mg/m 2 plus oxaliplatin 100 mg/m 2 (GEMOX), every two weeks ( 16 ). GEMOX was started in July 2016. After nine cycles, due to grade 3 feet sensory neuropathy, the interval between cycles was prolonged (every 3 weeks) and oxaliplatin dosage was reduced by 20%. He completed three additional cycles . A favorable clinical (improvement of dyspnea allowing discontinuation of oxygen supply), biochemical , and structural response was observed. The best objective response was a 46% partial response, which was obtained 6 months after starting GEMOX and was sustained for 7 months after GEMOX discontinuation in January 2017. He remained asymptomatic for approximately 12 months. In February 2018, due to worsening of respiratory symptoms, lenvatinib, at a daily dosage of 24 mg, was initiated but discontinued after 4 months because of disease progression . Once again, disease stability was only achieved with GEMOX, which was reinstituted in June 2018 for additional 27 cycles , with each cycle being administered every 2โ€“3 weeks (depending on blood counts). However, in December 2019, he presented with superior vena cava syndrome and stent implantation, and radiotherapy and enoxaparin were required. In January 2020, mutational profiling of the tumor was performed through Sanger sequencing for TERT promoter ( TERT p), and next-generation sequencing (NGS) for 52 solid tumorsโ€™ related genes. Briefly, NGS was performed with DNA and RNA from the patientโ€™s FTC, using the AmpliSeq TM for Illumina Focus Panel (Illumina, CA, USA), which allows the analysis of single nucleotide variants (SNVs), indels, copy number variations (CNVs), and gene fusions. The Variant Interpreter software (Illumina) was used for variant annotation. One variant in the TP53 gene was identified, showing a high variant allele frequency (VAF = 68.8%), suggesting possible hemizygosity due to loss of the wild-type allele. The Tyr amino acid residue is conserved in several species, including Musmusculus and Xenopustropicalis , and in silico characterization with Sift and PolyPhen showed that this change was predicted to be deleterious and probably damaging, respectively. Its clinical significance was described to be likely pathogenic in ClinVar and pathogenic in COSMIC . No additional genetic alterations were identified. Gene fusions could not be assessed due to poor RNA quality. Figure 1 (A) Whole-body scan after 131 I treatment revealed moderate cervical uptake. (B) Lung, mediastinal, and hilar lymph nodes metastasis after total thyroidectomy and radioiodine treatment. Figure 2 Pattern of serum Tg evolution during the course of the disease. Gemox induced a transient increase in serum thyroglobulin (sTg) levels, followed by a sustained decrease. C= cycle. Figure 3 CT findings in the chest during treatment. Evaluation after sorafenib (A), docetaxel/doxorubicin (B), sunitinib (C), 12 cycles with GEMOX (D), lenvantinib (E), and 19 additional cycles of GEMOX (F).
3.960938
0.974121
sec[3]/p[0]
en
0.999997
36976625
https://doi.org/10.1530/ETJ-22-0227
[ "gemox", "cycles", "progression", "serum", "scan", "daily", "sorafenib", "which", "sunitinib", "additional" ]
[ { "code": "6A80.5", "title": "Rapid cycling" }, { "code": "PA03", "title": "Unintentional land transport traffic event injuring a motor cyclist" }, { "code": "5C50.AZ", "title": "Disorders of urea cycle metabolism, unspecified" }, { "code": "PA23", "title": "Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist" }, { "code": "PA02", "title": "Unintentional land transport traffic event injuring a pedal cyclist" }, { "code": "8B60.Y", "title": "Other specified motor neuron disease" }, { "code": "8B60.3", "title": "Progressive muscular atrophy" }, { "code": "4A42.1", "title": "Diffuse systemic sclerosis" }, { "code": "4A42.Z", "title": "Systemic sclerosis, unspecified" }, { "code": "FB32.Y", "title": "Other specified disorders of muscles" } ]
=== ICD-11 CODES FOUND === [6A80.5] Rapid cycling Definition: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood to the other, or the mood episodes may be demarcated by a period of remission. In individuals with a high frequency of mood episodes, some may have a shorter duration than those usually observed in bipolar type I or bipolar type II disorder. In particular, depressive periods may only last several da Also known as: Rapid cycling [PA03] Unintentional land transport traffic event injuring a motor cyclist Also known as: Unintentional land transport traffic event injuring a motor cyclist | motorcycle rider injured in transport accident | unintentional land transport accident motorbike | motorbike accident | motorbike traffic accident Excludes: Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle [5C50.AZ] Disorders of urea cycle metabolism, unspecified Also known as: Disorders of urea cycle metabolism, unspecified | Disorders of urea cycle metabolism | disorder of urea cycle | disorders of metabolism of ornithine, citrulline, argininosuccinic acid, arginine and ammonia | ammonia metabolic disorder [PA23] Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist Also known as: Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist | unintentional off-road crash injuring a motor cyclist, unknown whether on road | motor bike crash NOS | motor cycle crash NOS | Motorcycle rider injured in collision with railway train or railway vehicle [PA02] Unintentional land transport traffic event injuring a pedal cyclist Also known as: Unintentional land transport traffic event injuring a pedal cyclist | Pedal cyclist injured in collision with pedestrian or animal | Pedal cyclist injured in collision with pedestrian or animal, person injured while boarding or alighting | Pedal cyclist injured in collision with pedestrian or animal, driver injured in traffic accident | Pedal cyclist injured in collision with pedestrian or animal, passenger injured in traffic accident [8B60.Y] Other specified motor neuron disease Also known as: Other specified motor neuron disease | Fazio-Londe syndrome | Progressive bulbar paralysis of childhood | Progressive bulbar palsy of childhood | Pseudopolyneuritic form of Amyotrophic lateral sclerosis [8B60.3] Progressive muscular atrophy Definition: In progressive muscular atrophy, lower motor neuron signs in limb and trunk muscles are present without upper motor neuron involvement. Over time, some patients may progress to develop upper motor neuron signs, of which pathological evidence is common even in patients who never displayed clinical upper motor neuron signs, suggesting that progressive muscular atrophy is a form of ALS. Also known as: Progressive muscular atrophy | hereditary spinal muscle atrophy | PMA - [progressive muscular atrophy] | progressive muscle atrophy | progressive spinal muscle atrophy Excludes: Fazio-Londe syndrome | Amyotrophic lateral sclerosis [4A42.1] Diffuse systemic sclerosis Definition: Diffuse cutaneous systemic sclerosis (dcSSc) is a subtype of Systemic Sclerosis (SSc) characterised by truncal and acral skin fibrosis with an early and significant incidence of diffuse involvement (interstitial lung disease, oliguric renal failure, diffuse gastrointestinal disease, and myocardial involvement). Also known as: Diffuse systemic sclerosis | Progressive systemic sclerosis [4A42.Z] Systemic sclerosis, unspecified Also known as: Systemic sclerosis, unspecified | Systemic sclerosis | Systemic scleroderma | progressive scleroderma | Acroscleriasis [FB32.Y] Other specified disorders of muscles Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia === GRAPH WALKS === --- Walk 1 --- [6A80.5] Rapid cycling Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ... --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di... --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, ... --- Walk 2 --- [6A80.5] Rapid cycling Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ... --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di... --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, most commonly depressive symptoms. Th... --- Walk 3 --- [PA03] Unintentional land transport traffic event injuring a motor cyclist --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle --- Walk 4 --- [PA03] Unintentional land transport traffic event injuring a motor cyclist --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle --- Walk 5 --- [5C50.AZ] Disorders of urea cycle metabolism, unspecified --PARENT--> [5C50.A] Disorders of urea cycle metabolism --EXCLUDES--> [?] Disorders of ornithine metabolism --- Walk 6 --- [5C50.AZ] Disorders of urea cycle metabolism, unspecified --PARENT--> [5C50.A] Disorders of urea cycle metabolism --CHILD--> [5C50.A1] Carbamoylphosphate synthetase deficiency Def: Carbamyl phosphate synthetase deficiency is an urea cycle disorder strictly limited to the liver and intestine that results in congenital hyperammonemia and defective citrulline synthesis....
[ "[6A80.5] Rapid cycling\n Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ...\n --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders\n Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di...\n --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms\n Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, ...", "[6A80.5] Rapid cycling\n Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ...\n --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders\n Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di...\n --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms\n Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, most commonly depressive symptoms. Th...", "[PA03] Unintentional land transport traffic event injuring a motor cyclist\n --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle\n --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle", "[PA03] Unintentional land transport traffic event injuring a motor cyclist\n --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle\n --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with two- or three-wheeled motor vehicle", "[5C50.AZ] Disorders of urea cycle metabolism, unspecified\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --EXCLUDES--> [?] Disorders of ornithine metabolism", "[5C50.AZ] Disorders of urea cycle metabolism, unspecified\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --CHILD--> [5C50.A1] Carbamoylphosphate synthetase deficiency\n Def: Carbamyl phosphate synthetase deficiency is an urea cycle disorder strictly limited to the liver and intestine that results in congenital hyperammonemia and defective citrulline synthesis...." ]
6A80.5
Rapid cycling
[ { "from_icd11": "PA03", "icd10_code": "V299XXD", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V234XXA", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V299XXA", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2940XA", "icd10_title": "Motorcycle driver injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V239XXD", "icd10_title": "Unspecified motorcycle rider injured in collision with car, pick-up truck or van in traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V299XXS", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V2988XA", "icd10_title": "Motorcycle rider (driver) (passenger) injured in other specified transport accidents, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2950XA", "icd10_title": "Motorcycle passenger injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2960XA", "icd10_title": "Unspecified motorcycle rider injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XS", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V234XXS", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V235XXA", "icd10_title": "Motorcycle passenger injured in collision with car, pick-up truck or van in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V234XXD", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XA", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XD", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, subsequent encounter" } ]
V299XXD
Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, subsequent encounter
A woman aged 68 years was admitted to our hospital due to progressive dyspnea in March 2008. She presented mild bilateral leg edema at physical examination. The ECG showed acute right ventricular strain (SI/QIII) and sinus tachycardia (heart rate = 120 beats/min). Blood tests evidenced elevated serum D-dimer (2.59 mg/L, that is, fivefold increase). Computed tomography (CT) revealed extensive bilateral thrombi in proximal and peripheral pulmonary arteries plus RV dilation and hypertrophy . Pulmonary function tests indicated GOLD II chronic obstructive pulmonary disease (COPD). Arterial blood gas analysis suggested hypocapnia and hypoxemia (pCO 2 30 mmHg; PO 2 64 mmHg; O 2 saturation 94%). Initial transthoracic echocardiography (TTE; Table 1 ) showed a significantly dilated RV with D-shaped left ventricle (LV) and a dilated right atrium (RA). LV and left atrium dimensions as well as LV ejection fraction were normal. Doppler-derived maximal systolic pulmonary artery pressure (SPAP) was 69 mmHg (maximum trans-tricuspid pressure gradient of 59 mmHg + estimated RA pressure of 10 mmHg). Diagnosis of CTEPH was established by above examinations and right heart catheterization examination. Other causes of PH were excluded. Initial therapy consisted of sildenafil (3 ร— 20 mg/day), oral anticoagulation, and diuretics. Therapy was sequentially escalated towards triple therapy including inhaled iloprost (6 ร— 2.5 ฮผg/day) and endothelin receptor blockade with ambrisentan (1 ร— 10 mg/day). The patient repeatedly refused evaluation for pulmonary endarterectomy (PEA) and remained clinically stable on WHO level III for 4 years. The N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) levels also remained stable initially, but increased during long-term follow-up . The patient presented with decompensated right heart failure in October 2012 and was evaluated for PEA and heart/lung transplantation; however, the evaluation results were negative. After a stable period of several months under standard medication, the patient presented again with decompensated right heart failure in August 2013 and died in hospital due to cardiogenic shock. Figure 1 Computed tomography scans at first clinical presentation and 3 months later. (A) Coronal contrast-enhanced CT scan at first clinical presentation shows a flattened eccentric thrombus in the main right pulmonary artery (black arrows). (Aโ€™) Repeat CT scan after 3 months of treatment shows the shrunken thrombus formation (black arrow). (B, Bโ€™) Coronal contrast-enhanced CT scans at the time of first diagnosis and 3 months later show multiple filling defects both at the bifurcation and in the left pulmonary arteries (white arrows). (C, Cโ€™) Axial contrast-enhanced CT scans show dilatation of the right ventricle (RV), dilatation of the right atrium, and thickening of the RV free wall both at initial presentation and 3 months later. LPA: left pulmonary artery; LV: left ventricle; RA: right atrium; RPA: right pulmonary artery; RV: right ventricle. Table 1 Echocardiographic , right heart catheterization and arterial blood gas analysis characteristics Oct - 07 Mar - 08 initiation Apr - 09 Apr - 12 Oct - 12 Aug - 13 Echocardiography LVEDD (mm) 39 38 39 37 39 39 IVSd (mm) 8 8 8 8 8 8 CI (L/min,Teich) 3.16 2.71 2.46 2.31 1.61 1.86 LAD (mm) 27 29 28 28 32 30 RVD (mm) 37 46 48 51 53 48 RVd (mm) 6 7 7 7 7 7 RAA (cm 2 ) 13 23 26 30 30 20 LV EF (%) 69 69 68 85 73 72 RV FAC (%) 46 24 20 18 18 21 MAPSE_septal (mm) 9 6 5 7 7 8 MAPSE_lateral (mm) 10 8 8 9 9 10 TAPSE (mm) 18 15 13 13 12 13 LV diastolic function abnormal relaxation abnormal relaxation - abnormal relaxation - abnormal relaxation TR maxV (m/s) 2.5 3.8 3.8 4.2 3.0 2.2 TR maxPG (mmHg) 25 59 58 71 36 19 VTI RVOT (cm) - - 9.1 12.0 - 10.7 Estimated PVR (Woods units) - - 4.02 3.34 - 1.90 RAP (mmHg) 5 10 15 15 15 10 SPAP (mmHg) 30 69 73 86 51 29 RVOT diameter (mm) - 37 39 41 - 40 Main PA diameter (mm) - 24 24 25 - 30 Pericardial effusion (mm) 0 5 3 0 4 3 Pleural effusion - yes - - yes - Right heart catheterization PA mean pressure (mmHg) - 38 42 - 45 - PA systolic pressure (mmHg) - 71 75 - 81 - RA mean pressure (mmHg) - 4 6 - 14 - RV systolic pressure (mmHg) - 67 75 - 84 - PA O 2 (%) - 47 53 - 51 - Arterial blood gas analysis PO 2 (mmHg) - 64 56 59 50 58 PCO 2 (mmHg) - 30 33 35 43 41 O 2 saturation (%) - 94 91 93 89 93 6MWD (m) - - 200 190 - 200 Initiation represents the first hospitalization of this patient in our hospital because of progressive dyspnea. LVEDD: end-diastolic left ventricular dimension; IVSd: end-diastolic interventricular septal thickness; LAD: end-systolic left atrial diameter; RVD: end-diastolic basal right ventricular dimension; RVd: end-diastolic right ventricular free wall thickness; RAA: end-systolic right atrial area; LV: left ventricle; EF: ejection fraction; RV: right ventricle; FAC: fractional area change; MAPSE: mitral annular plane systolic excursion; TAPSE: tricuspid annular plane systolic excursion; TR: tricuspid regurgitation; maxV: maximal velocity; maxPG: maximal pressure gradient; RVOT: right ventricular outflow tract; VTI: velocity-time integral; PVR: pulmonary vascular resistance, estimated PVR by echocardiography formula: 10 ร— (TR maxV/VTI RVOT ) โˆ’ 0.16; CI: cardiac output indexed to body surface area; Woods units: mmHgโ‹…min/L; RAP: estimated right atrial pressure; PA: pulmonary artery; RA: right atrium; 6MWD: 6-min walk distance test. Figure 2 Temporal changes of NT - proBNP measurements during follow - up.
4.050781
0.973633
sec[1]/p[0]
en
0.999997
25889390
https://doi.org/10.1186/s40001-015-0112-x
[ "mmhg", "pulmonary", "pressure", "heart", "systolic", "ventricle", "ventricular", "atrium", "artery", "diastolic" ]
[ { "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": "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 === [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 [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 personโ€™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 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --PARENT--> [12] Diseases of the respiratory system --- Walk 2 --- [CB40.Y] Other specified diseases of the respiratory system --PARENT--> [CB40] Certain diseases of the respiratory system --CHILD--> [CB40.0] Ciliary dyskinesia Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l... --- Walk 3 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 4 --- [LA75.1] Agenesis of lung Def: This refers to the absence or rudimentary residua of an undeveloped lung.... --PARENT--> [LA75] Structural developmental anomalies of lungs Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period.... --CHILD--> [LA75.0] Accessory lobe of lung Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left... --- Walk 5 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --RELATED_TO--> [?] Severe acute respiratory syndrome Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to... --- Walk 6 --- [CA40.Z] Pneumonia, organism unspecified --PARENT--> [CA40] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --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....
[ "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --PARENT--> [12] Diseases of the respiratory system", "[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.0] Ciliary dyskinesia\n Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...", "[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --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...." ]
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
Our case, a 48โ€yearโ€old man, presented in January 2011 after suffering a road traffic accident. This occurred following anaphylaxis with complete loss of consciousness while driving, 15 min after being stung by a bee. He had previously experienced large local reactions to bee stings but no anaphylaxis. Past medical history was of avocado oral food allergy, with no other significant history of allergies, and TIA secondary to the presence of a patent foramen ovale for which he was on aspirin. This episode was not associated with any focal neurology, rash or respiratory symptoms and responded rapidly to 500 ฮผg of intramuscular adrenaline. Baseline serum mast cell tryptase (MCT) was 19.2 ฮผg L โˆ’1 and serum immunoglobulin E 344 kU L โˆ’1 (normal < 111 kU L โˆ’1 ). Bee venomโ€specific IgE was 60.5 kU L โˆ’1 (very high > 17.5 kU L โˆ’1 ) and avocado 6.84 kU L โˆ’1 (high > 3.5โ€“17.5 kU L โˆ’1 ). He commenced bee venom subcutaneous allergen immunotherapy (BVโ€SCIT) in February. Six months into BVโ€SCIT on a maintenance dose of 100 ฮผg bee venom extract, he suffered an allergic reaction. Symptoms appeared within minutes of receiving the injection, including alteration in vision, generalised malaise, lightโ€headedness and the fear of impending collapse. The symptoms resolved with administration of 500 ฮผg of adrenaline intramuscularly. In September 2011, BVโ€SCIT was recommenced and continued at 100 ฮผg per month until the beginning of August 2013 when he suffered another reaction. He was pale and unwell with a sensation of lightโ€headedness and impending loss of consciousness. He was treated for anaphylaxis and improved after 500 ฮผg adrenaline injection; however, the reaction continued for 30 min despite a second adrenaline injection 20 min later. He was observed in the emergency department and further treated with 100 mg IV hydrocortisone and intravenous fluids and discharged after a fiveโ€hour period of observation. One week later, he was admitted to hospital for persistent symptoms of lightโ€headedness and impeding collapse. He was commenced on regular Prednisolone 25 mg daily and cetirizine 10 mg twice daily. During his admission, he was noted to have a significant postural blood pressure drop of 40 mmHg, which was followed by a 20โ€min episode of severe lower abdominal pain. MCT level was 18.0 ฮผg/L. Hypoglycaemia, myocardial infarction, pulmonary embolism and infection were excluded with normal serum blood glucose, troponin, CK, dโ€dimer and CRP on laboratory tests. Serum fractionated catecholamines and metanephrines testing for pheochromocytoma and urinary 5โ€HIAA testing for carcinoid were negative. Dermatological examination excluded cutaneous mastocytoma. Bone marrow aspirate revealed normal trilineage haematopoiesis with no increase in mast cell numbers. Molecular testing for cโ€KIT D816V in marrow and serum was negative. The bone marrow trephine staining for CD2 and CD117 did not demonstrate a significant mast cell population. Despite a persistently elevated kappa/lambda ratio of 2.44, serum protein electrophoresis was negative for monoclonal immunoglobulins and fullโ€body PET scan revealed no area of abnormal scintigraphic uptake. Notably, bone mineral density completed before the commencement of Prednisolone determined a T score of โˆ’1.5 at the spine which was low normal in comparison with the young adult reference population. Treatment montelukast 10 mg in combination with thriceโ€daily cetirizine 10 mg or fexofenadine 180 mg was commenced after discharge in addition to the Prednisolone. Prednisolone was then weaned over 6 months and ceased in April 2014. Despite treatment, his symptoms progressed. He further described mental clouding, poor concentration and early morning wakening. By July 2014, he reported daily symptoms of impending collapse especially with exercise and a reduced tolerance to red wine and caffeine. Consequently, he decided to resign from his employment as a Chief Executive Officer and seek management from a clinical psychiatrist to manage anxiety and depressive symptoms. The combination of symptoms, persistently elevated MCT and negative bone marrow testing led to the diagnosis of nonโ€clonal MCAS and advised to avoid food rich in tyramine and histamine and to limit any strenuous exercise. There was minimal symptomatic improvement. Omalizumab, rather than an alternate mast cell stabiliser, was commenced in October 2014 because of persistent and severe symptoms at 150 mg, two doses 1 week apart, to allow for the recommencement of BVโ€SCIT. Using a rapid upโ€dosing protocol, BVโ€SCIT was reโ€initiated 2 weeks later (Table 1 ). Since that time, he reports improved mental clarity, reduction in anxiety symptoms and overall general improvement in health, allowing him to return to his work. By choice, he continues a histamineโ€free diet but can freely complete any cardiovascular exercise. Omalizumab has been well tolerated, the only reaction occurring following the initial 150 mg injection where he reported preโ€syncopal symptoms and a recorded bradycardia of 40 bpm. He has been able to reduce his daily use of antihistamines to one tablet of fexofenadine (180 mg) in addition to 10 mg montelukast . He no longer requires Prednisolone. Triggers such as exercise, emotional stress and spicy foods which were initially major contributors to symptoms now do not cause exacerbations. He receives monthly doses of subcutaneous 150 mg omalizumab along with maintenance BVโ€SCIT at 100 ฮผg. Mast cell tryptase levels remain stable, albeit elevated .
3.929688
0.980469
sec[0]/p[0]
en
0.999998
31576204
https://doi.org/10.1002/cti2.1075
[ "serum", "scit", "mast", "cell", "prednisolone", "daily", "which", "adrenaline", "commenced", "reaction" ]
[ { "code": "NE80.3", "title": "Other serum reactions" }, { "code": "5D0Y", "title": "Other specified metabolic disorders" }, { "code": "5B91.0", "title": "Hypercalcaemia" }, { "code": "4A84.Y", "title": "Other specified anaphylaxis" }, { "code": "5C50.F2", "title": "Homocarnosinosis" }, { "code": "2A21.1Y", "title": "Other specified cutaneous mastocytosis" }, { "code": "2A21.0Z", "title": "Systemic mastocytosis, unspecified" }, { "code": "2A21.Z", "title": "Mastocytosis, unspecified" }, { "code": "2A21.2", "title": "Mast cell sarcoma" }, { "code": "2A21.00", "title": "Mast cell leukaemia" } ]
=== ICD-11 CODES FOUND === [NE80.3] Other serum reactions Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness Excludes: serum hepatitis [5D0Y] Other specified metabolic disorders Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood [5B91.0] Hypercalcaemia Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome [4A84.Y] Other specified anaphylaxis Also known as: Other specified anaphylaxis | Latex-induced anaphylaxis | Anaphylaxis due to latex | Latex anaphylaxis | Anaphylactic shock due to serum [5C50.F2] Homocarnosinosis Definition: Homocarnosinosis is a metabolic defect characterised by progressive spastic diplegia, intellectual deficit and retinitis pigmentosa. This extremely rare disorder has been reported in only one family, namely a woman and three of her children. The latter showed but their mother was symptom free. It is therefore uncertain whether there is a relationship between the biochemical defect and the clinical symptoms. Inheritance in the reported family seems to be autosomal dominant. Also known as: Homocarnosinosis | Homocarnosinase deficiency | Serum carnosinase deficiency [2A21.1Y] Other specified cutaneous mastocytosis Also known as: Other specified cutaneous mastocytosis | Cutaneous mastocytoma | mast cell neoplasm NOS | mast cell tumour NOS | mastocytoma NOS [2A21.0Z] Systemic mastocytosis, unspecified Also known as: Systemic mastocytosis, unspecified | Systemic mastocytosis | SMCD - [systemic mast cell disease] | systemic tissue mast cell disease [2A21.Z] Mastocytosis, unspecified Also known as: Mastocytosis, unspecified | Mastocytosis | malignant mastocytoma | malignant mast cell tumours | malignant mastocytosis [2A21.2] Mast cell sarcoma Definition: A rare entity characterised by localised but destructive growth of a tumour consisting of highly atypical, immature mast cells. Also known as: Mast cell sarcoma [2A21.00] Mast cell leukaemia Also known as: Mast cell leukaemia | mast cell leukaemia NOS | mast cell leukaemia without mention of remission | Aleukaemic mast cell leukaemia | Classic mast cell leukaemia === GRAPH WALKS === --- Walk 1 --- [NE80.3] Other serum reactions --RELATED_TO--> [?] Anaphylactic shock due to serum --PARENT--> [?] Other serum reactions --- Walk 2 --- [NE80.3] Other serum reactions --EXCLUDES--> [?] Acute hepatitis B without Hepatitis D virus co-infection Def: Acute liver injury related with hepatitis B virus (HBV). Acute hepatitis B is suspected based on positive HBsAg and high-titer IgM anti-HBc. However, other causes of acute viral hepatitis may not be f... --CHILD--> [?] Transfusion hepatitis --- Walk 3 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --CHILD--> [5D01] Tumour lysis syndrome Def: This is a group of metabolic complications that can occur after treatment of cancer, usually lymphomas and leukaemias, and sometimes even without treatment. These complications are caused by the break... --- Walk 4 --- [5D0Y] Other specified metabolic disorders --PARENT--> [?] Other metabolic disorders --EXCLUDES--> [?] Langerhans cell histiocytosis Def: A neoplastic proliferation of Langerhans cells which contain Birbeck granules by ultrastructural examination. Three major overlapping syndromes are recognised: eosinophilic granuloma, Letterer-Siwe di... --- Walk 5 --- [5B91.0] Hypercalcaemia Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ... --PARENT--> [5B91] Mineral excesses --RELATED_TO--> [?] Hyperkalaemia --- Walk 6 --- [5B91.0] Hypercalcaemia Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ... --RELATED_TO--> [?] Myopathy due to hypercalcaemia --PARENT--> [?] Hypercalcaemia Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...
[ "[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Anaphylactic shock due to serum\n --PARENT--> [?] Other serum reactions", "[NE80.3] Other serum reactions\n --EXCLUDES--> [?] Acute hepatitis B without Hepatitis D virus co-infection\n Def: Acute liver injury related with hepatitis B virus (HBV). Acute hepatitis B is suspected based on positive HBsAg and high-titer IgM anti-HBc. However, other causes of acute viral hepatitis may not be f...\n --CHILD--> [?] Transfusion hepatitis", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D01] Tumour lysis syndrome\n Def: This is a group of metabolic complications that can occur after treatment of cancer, usually lymphomas and leukaemias, and sometimes even without treatment. These complications are caused by the break...", "[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --EXCLUDES--> [?] Langerhans cell histiocytosis\n Def: A neoplastic proliferation of Langerhans cells which contain Birbeck granules by ultrastructural examination. Three major overlapping syndromes are recognised: eosinophilic granuloma, Letterer-Siwe di...", "[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --PARENT--> [5B91] Mineral excesses\n --RELATED_TO--> [?] Hyperkalaemia", "[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ..." ]
NE80.3
Other serum reactions
[ { "from_icd11": "NE80.3", "icd10_code": "T880XXA", "icd10_title": "Infection following immunization, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8061XA", "icd10_title": "Other serum reaction due to administration of blood and blood products, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8069XA", "icd10_title": "Other serum reaction due to other serum, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T8062XA", "icd10_title": "Other serum reaction due to vaccination, initial encounter" }, { "from_icd11": "NE80.3", "icd10_code": "T806", "icd10_title": "Other serum reactions" }, { "from_icd11": "NE80.3", "icd10_code": "T880", "icd10_title": "Infection following immunization" }, { "from_icd11": "5C50.F2", "icd10_code": "E7281", "icd10_title": "Disorders of gamma aminobutyric acid metabolism" }, { "from_icd11": "5C50.F2", "icd10_code": "E728", "icd10_title": "Other specified disorders of amino-acid metabolism" }, { "from_icd11": "2A21.Z", "icd10_code": "C9621", "icd10_title": "Aggressive systemic mastocytosis" }, { "from_icd11": "2A21.Z", "icd10_code": "Q822", "icd10_title": "Congenital cutaneous mastocytosis" }, { "from_icd11": "2A21.Z", "icd10_code": "C962", "icd10_title": "Malignant mast cell neoplasm" }, { "from_icd11": "2A21.00", "icd10_code": "C9430", "icd10_title": "Mast cell leukemia not having achieved remission" }, { "from_icd11": "2A21.00", "icd10_code": "C9431", "icd10_title": "Mast cell leukemia, in remission" }, { "from_icd11": "2A21.00", "icd10_code": "C9432", "icd10_title": "Mast cell leukemia, in relapse" }, { "from_icd11": "2A21.00", "icd10_code": "C943", "icd10_title": "Mast cell leukemia" } ]
T880XXA
Infection following immunization, initial encounter
A 90-year-old female was admitted to the chronic care hospital. The patient lived with her husband and was independent regarding cooking and feeding. She had a history of fracture of the right ankle for which she underwent an operation six years before. Though muscle of bilateral lower extremities was gradually getting weak since this episode, her indoor ambulation was sufficiently independent with the aid of a rehabilitation walker. However, she required support from either her husband or a wheelchair for ambulation at home due to the pain in the right knee related to gonarthrosis. She did not take any analgesic for the pain in the right knee. The patient had fallen while moving from a toilet to a wheelchair; thereafter, she was unable to transfer herself to the toilet due to anxiety about a repeated falling episode. As her ability to transfer to the toilet declined, incontinence recurred. She was, therefore, admitted to the hospital for rehabilitation therapy to regain independence regarding toileting and indoor ambulation. The patient had anemia, atrial fibrillation, and stomach cancer in the early stage. As the patient did not wish any treatment for the stomach cancer, the stomach cancer was under observation. She was taking iron supplementation, lansoprazole 15 mg, and verapamil 120 mg per day. On admission, the patient was examined by both occupational and physical therapists. Her height was 155 cm, and her body weight was 56 kg (body mass index = 23.3). She could not extend fully bilateral knees due to pain and muscle weakness and her back was kyphotic. However, the patient could stand still with that posture. She was able to walk only for approximately 6 m on parallel bars. After excretion in toilet, she could not lift up the slacks to the west. She had a score of 30 on the revised Hasegawaโ€™s Dementia Scale, while the initial functional independence measure (FIM), motor, and cognitive subtotal scores were 59, 32, and 27 respectively (Table 1 ); her Barthel Index (BI) on admission was 45. The scores regarding ambulation, grooming, and toilet activities were severely reduced (Table 2 ). Rehabilitation therapy for ambulation and independence of toileting was initiated. A physical therapist trained the patient 60 minutes a day and an occupational therapist trained her 40 minutes a day. Rehabilitation therapy was performed four to five days a week. During rehabilitation therapy, the patient needed rest due to irregular pulse, but the symptom disappeared within a few minutes. Three weeks after the initiation of rehabilitation therapy, the patient was able to walk for approximately 24 m on parallel bars. As the standing position of the patient started to be stable, the patient was able to walk for several meters with the aid of a rehabilitation walker. She started also to succeed to lift the slacks to the west after excretion in toilet. The vital signs of the patient were almost stable as systolic blood pressure of 95-110 mmHg and pulse of 70-80 per minute. However, a cluster of COVID-19 infections occurred at the hospital. All infected patients were transferred to other hospitals, and although the patient was not infected, rehabilitation therapy was ceased under the public health administration to avoid the risk of spreading COVID-19 through rehabilitation therapists. During the period of therapy suspension, the patient could only transfer to the toilet and dining hall with the aid of a wheelchair, while continuing herself to exercise by lifting bilateral legs while lying in the bed several times a day. During the cessation period of rehabilitation therapy, the patient started complaining of muscle weakness of the lower extremities. Thus, the patient required a flip-up wheelchair when she moved from the bed. Rehabilitation therapy was resumed two weeks after the last COVID-19-positive patient was identified; therefore, she did not receive rehabilitation therapy for a total of 25 days. The patient was re-evaluated when rehabilitation therapy was reinitiated and FIM and BI were assessed. The patient was not able to stand stably. The patient was able to walk for less than 6 m on parallel bars. The patient reported lethargy during therapy, and required additional support to get up from the sitting position; she also mentioned shortness of breath and an irregular pulse during toilet activities. When she complained of these symptoms, systolic blood pressure was 110-120 mmHg and pulse was 79-106 per minute. These symptoms did not disappear for more than 5 minutes even with suspension of rehabilitation therapy, which was not observed in the patient before the cluster of COVID-19 infections had occurred. However, the patient did not complain of lethargy outside of rehabilitation therapy. The FIM, and motor and cognitive subtotal scores were 54, 29, and 25, respectively (Table 1 ); the BI score was 40 (Table 2 ). The transfer scores decreased in both assessments, while the scores for comprehension and memory in the FIM also slightly decreased. At the time of writing, the patient continued to undergo rehabilitation therapy. The patient demonstrated recovery and was able to walk for 21 m with gait training on parallel bars, three weeks after reinitiating rehabilitation therapy. Shortness of breath or any irregular pulse did not last for more than 5 minutes as the patient's performance ameliorated with rehabilitation therapy. However, she did not achieve the goal of rehabilitation therapy to be independent of toileting.
3.845703
0.97998
sec[1]/p[0]
en
0.999998
34650855
https://doi.org/10.7759/cureus.17677
[ "rehabilitation", "toilet", "able", "ambulation", "however", "while", "walk", "scores", "minutes", "pulse" ]
[ { "code": "QB95.Z", "title": "Care involving use of rehabilitation procedures, unspecified" }, { "code": "QB95.3", "title": "Drug rehabilitation" }, { "code": "QC48.Y", "title": "Other specified personal history of medical treatment" }, { "code": "QB95.1", "title": "Physical rehabilitation" }, { "code": "QB95.8", "title": "Tobacco rehabilitation" }, { "code": "QB62.Z", "title": "Attention to artificial openings, unspecified" }, { "code": "5C81.1", "title": "Hypobetalipoproteinaemia" }, { "code": "QF27", "title": "Difficulty or need for assistance at home and no other household member able to render care" }, { "code": "2A20.0Z", "title": "Chronic myelogenous leukaemia, BCR-ABL1-positive, unspecified" }, { "code": "2A20.0Y", "title": "Other specified chronic myelogenous leukaemia, BCR-ABL1-positive" } ]
=== ICD-11 CODES FOUND === [QB95.Z] Care involving use of rehabilitation procedures, unspecified Also known as: Care involving use of rehabilitation procedures, unspecified | Care involving use of rehabilitation procedures | Rehabilitation NOS | care involving unspecified rehabilitation procedure | Admission for rehabilitation, not otherwise specified [QB95.3] Drug rehabilitation Definition: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the highest attainable level of health and well-being is reached. Also known as: Drug rehabilitation | drug abuse rehabilitation | rehabilitation measures for drug use | drug abuse detoxification therapy | drug abuse rehabilitation measures Excludes: Tobacco rehabilitation [QC48.Y] Other specified personal history of medical treatment Also known as: Other specified personal history of medical treatment | Personal history of contraception | history of contraception | Personal history of long-term use of medicaments other than anticoagulants | personal history of long term current use of medicaments [QB95.1] Physical rehabilitation Also known as: Physical rehabilitation | admission for physical rehabilitation | admission for physiotherapy | physio | Physical rehabilitation other than cardiac rehabilitation Excludes: Cardiac rehabilitation [QB95.8] Tobacco rehabilitation Also known as: Tobacco rehabilitation | rehabilitation for tobacco use | admission for tobacco rehabilitation [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 [5C81.1] Hypobetalipoproteinaemia Definition: Hypobetalipoproteinemia (HBL) constitutes a group of lipoprotein metabolism disorders that are characterised by permanently low levels (below the 5th percentile) of apolipoprotein B and LDL cholesterol. There are two types of HBL: familial hypobetalipoproteinemia and chylomicron retention disease (CMRD; see these terms). The familial form can be severe with early onset (abetalipoproteinemia/homozygous familial hypobetalipoproteinemia; see this term) or benign (benign familial hypobetalipoprotein Also known as: Hypobetalipoproteinaemia | Abetalipoproteinaemia | Homozygous familial hypobetalipoproteinaemia | Bassen-Kornzweig disease | Apolipoprotein B deficiency [QF27] Difficulty or need for assistance at home and no other household member able to render care Also known as: Difficulty or need for assistance at home and no other household member able to render care | lack of care in home | lack of person able to render necessary care | dependent on care provider and no other household member able to render care | caregiver burn out [2A20.0Z] Chronic myelogenous leukaemia, BCR-ABL1-positive, unspecified Also known as: Chronic myelogenous leukaemia, BCR-ABL1-positive, unspecified | Chronic myelogenous leukaemia, BCR-ABL1-positive | chronic myelosis | chronic myeloid leukaemia, BCR-ABL-positive without mention of remission [2A20.0Y] Other specified chronic myelogenous leukaemia, BCR-ABL1-positive Also known as: Other specified chronic myelogenous leukaemia, BCR-ABL1-positive | Chronic myelogenous leukaemia, BCR-ABL1-positive in complete remission | chronic myeloid leukaemia, BCR-ABL-positive in complete remission === GRAPH WALKS === --- Walk 1 --- [QB95.Z] Care involving use of rehabilitation procedures, unspecified --PARENT--> [QB95] Care involving use of rehabilitation procedures --CHILD--> [QB95.2] Alcohol rehabilitation Def: Alcohol rehabilitation is defined as the process that begins when alcohol users come into contact with a health provider or service, and continues through a succession of specific interventions until ... --- Walk 2 --- [QB95.Z] Care involving use of rehabilitation procedures, unspecified --PARENT--> [QB95] Care involving use of rehabilitation procedures --EXCLUDES--> [?] Contact with health services for counselling --- Walk 3 --- [QB95.3] Drug rehabilitation Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi... --EXCLUDES--> [?] Tobacco rehabilitation --PARENT--> [?] Care involving use of rehabilitation procedures --- Walk 4 --- [QB95.3] Drug rehabilitation Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi... --EXCLUDES--> [?] Tobacco rehabilitation --PARENT--> [?] Care involving use of rehabilitation procedures --- Walk 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.Z] Personal history of medical treatment, unspecified
[ "[QB95.Z] Care involving use of rehabilitation procedures, unspecified\n --PARENT--> [QB95] Care involving use of rehabilitation procedures\n --CHILD--> [QB95.2] Alcohol rehabilitation\n Def: Alcohol rehabilitation is defined as the process that begins when alcohol users come into contact with a health provider or service, and continues through a succession of specific interventions until ...", "[QB95.Z] Care involving use of rehabilitation procedures, unspecified\n --PARENT--> [QB95] Care involving use of rehabilitation procedures\n --EXCLUDES--> [?] Contact with health services for counselling", "[QB95.3] Drug rehabilitation\n Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi...\n --EXCLUDES--> [?] Tobacco rehabilitation\n --PARENT--> [?] Care involving use of rehabilitation procedures", "[QB95.3] Drug rehabilitation\n Def: Drug rehabilitation is defined as the process that begins when drug users come into contact with a health provider or service, and continues through a succession of specific interventions until the hi...\n --EXCLUDES--> [?] Tobacco rehabilitation\n --PARENT--> [?] Care involving use of rehabilitation procedures", "[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.Z] Personal history of medical treatment, unspecified" ]
QB95.Z
Care involving use of rehabilitation procedures, unspecified
[ { "from_icd11": "QB95.Z", "icd10_code": "Z50", "icd10_title": "" }, { "from_icd11": "QB95.Z", "icd10_code": "Z508", "icd10_title": "" }, { "from_icd11": "QB95.Z", "icd10_code": "Z509", "icd10_title": "" }, { "from_icd11": "QB95.3", "icd10_code": "Z503", "icd10_title": "" }, { "from_icd11": "QC48.Y", "icd10_code": "Z794", "icd10_title": "Long term (current) use of insulin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7902", "icd10_title": "Long term (current) use of antithrombotics/antiplatelets" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7982", "icd10_title": "Long term (current) use of aspirin" }, { "from_icd11": "QC48.Y", "icd10_code": "Z7984", "icd10_title": "Long term (current) use of oral hypoglycemic drugs" }, { "from_icd11": "QC48.Y", "icd10_code": "Z79899", "icd10_title": "Other long term (current) drug therapy" }, { "from_icd11": "QB95.1", "icd10_code": "Z501", "icd10_title": "" }, { "from_icd11": "QB62.Z", "icd10_code": "Z436", "icd10_title": "Encounter for attention to other artificial openings of urinary tract" }, { "from_icd11": "QB62.Z", "icd10_code": "Z434", "icd10_title": "Encounter for attention to other artificial openings of digestive tract" }, { "from_icd11": "QB62.Z", "icd10_code": "Z438", "icd10_title": "Encounter for attention to other artificial openings" }, { "from_icd11": "QB62.Z", "icd10_code": "Z439", "icd10_title": "Encounter for attention to unspecified artificial opening" }, { "from_icd11": "QB62.Z", "icd10_code": "Z43", "icd10_title": "Encounter for attention to artificial openings" } ]
Z50
The patient was a 53-year old female with multiple cardiovascular factors, including hypertension, hypercholesterolemia, diabetes mellitus, coronary artery disease, and history of heavy smoking (60 pack-years; quit 3 years ago), who presented with bilateral lower extremity intermittent claudication, right worse than left, forcing her to stop after 3 minutes of walking. On physical examination, her bilateral femoral, popliteal, dorsalis pedis and posterior tibialis pulses were not palpable. At rest, her ankle-brachial index (ABI) measured 0.57 on the right and 0.58 on the left. She underwent a computed tomographic angiography (CTA) that showed complete occlusion of the distal abdominal aorta, including the origin of the inferior mesenteric artery, as well as the bilateral common iliac arteries (CIAs), with reconstitution at the level of the iliac bifurcations. The diameter of the abdominal aorta was 12 mm at the proximal aspect of the occlusion and decreased to 9 mm at the level of the bifurcation, as seen on the preplanning CTA. The right external iliac artery (EIA) was 4 mm and the left EIA was 5 mm in diameter. The occluded right CIA was 6 mm and the occluded left CIA was 7 mm in diameter. The patient declined open surgery and opted for endovascular therapy. Left brachial arterial access was obtained under ultrasound guidance using a micropuncture access kit (Cook Medical, Bloomington, IN, USA). A 5 French sheath was placed and a 5 French pigtail flush catheter (Cook Medical, Bloomington, IN, USA) was advanced into the abdominal aorta. An aortogram was performed and showed complete occlusion of the distal infra-renal aorta and bilateral CIAs, with reconstitution at the iliac bifurcations . Bilateral retrograde common femoral artery (CFA) access was obtained using ultrasound guidance and a micropuncture access kit. Five French sheaths were inserted in the CFA bilaterally and upsized later to an 8 French sheath on the left and 7 French on the right. Unfractionated heparin was injected intravenously in boluses throughout the procedure to maintain the activated clotting time (ACT) >250 seconds. A 5 French Davis catheter (Cook, Bloomington, IN, USA) and 0.035โ€ฒโ€ฒ Glidewire (Terumo, Somerset, NJ, USA) were used to perform antegrade subintimal recanalization of the right CIA from a brachial approach. The Glidewire was retrieved from the right femoral sheath and then exchanged for a Rosen wire (Cook, Bloomington, IN, USA). Subintimal recanalization of the left CIA from a femoral approach was unsuccessful, with failure to reenter the true aortic lumen. Attempts to recanalize the left CIA from a brachial approach were also unsuccessful, as the wire and catheter continued to advance into the recanalized right CIA, following the path of the least resistance. To overcome this problem, the recanalized right CIA was occluded at its origin with a 5 mm ร— 40 mm UTD balloon catheter (Boston Scientific, Natick, MA, USA) inserted from the right femoral approach, sealing the origin of the right CIA. The 5 French Davis catheter was advanced from the brachial approach into the distal abdominal aorta to the level of the occluded left CIA. With the tip of the catheter pointed toward the occluded left CIA, the stiff back end of a 0.035โ€ฒโ€ฒ Glidewire was advanced to initiate a sharp recanalization of the occluded left CIA . The presence of the occlusion balloon prevented the Davis catheter from advancing into the recanalized right CIA and forced it in the direction of the occluded left CIA. The catheter was advanced over the wire into the occluded left CIA. At this point, the floppy end of the Glidewire was advanced through the catheter, and recanalization of the left CIA continued from a brachial approach. The wire reentered the true lumen of the left EIA and was retrieved from the left femoral sheath . The Glidewire was exchanged for a Rosen wire advanced into the abdominal aorta. From the left femoral approach, a 16 mm length Intrastent Doublestrut LD balloon expandable stent (EV3, Plymouth, MN, USA) mounted on 10 mm ร— 2 cm EverCross balloon catheter (EV3, Plymouth, MN, USA) was deployed in the proximal occluded aortic segment, and then further balloon dilated to 12 mm using a 12 mm ร— 2 cm EverCross balloon catheter (EV3, Plymouth, MN, USA) . More distally, the occluded aortoiliac bifurcation was reconstructed using a 6 mm ร— 59 mm iCAST balloon expandable covered stent (Atrium, Hudson, NH, USA) on the right and a 7 mm ร— 59 mm iCAST balloon expandable covered stent on the left, deployed simultaneously in a kissing fashion; the iliac stents were extended further to cover the entire length of the occluded common iliac arteries, ending just above the iliac bifurcations. Final arteriogram showed reestablishment of flow through the reconstructed aortoiliac bifurcation with no significant residual stenosis . The patient was discharged the next day on Clopidogrel 75 mg once a day for 3 months and aspirin 325 mg once a day for life. She noted significant clinical improvement with an ABI of 0.85 on the right and 1.01 on the left at her 2-week postprocedure followup. She was seen in followup at 6 months, with recurrence of intermittent claudication on the right after 15 minutes of walking. Her right ABI decreased to 0.69; her left ABI was stable and measured 1.05. A CTA showed severe stenosis at the proximal aspect of the right CIA stent. Her symptoms were subjectively described as mild and nondisabling and she declined any further intervention.
3.964844
0.975098
sec[1]/p[0]
en
0.999998
23762730
https://doi.org/10.1155/2013/647850
[ "occluded", "catheter", "balloon", "femoral", "iliac", "french", "approach", "brachial", "aorta", "advanced" ]
[ { "code": "BE2Y", "title": "Other specified diseases of the circulatory system" }, { "code": "DB30.Y", "title": "Other specified obstruction of large intestine" }, { "code": "DA0C.Y", "title": "Other specified periodontal disease" }, { "code": "BA41.Z", "title": "Acute myocardial infarction, unspecified" }, { "code": "GA16.Y", "title": "Other specified acquired abnormalities of uterus, except cervix" }, { "code": "QB62.Z", "title": "Attention to artificial openings, unspecified" }, { "code": "QB30.5", "title": "Fitting or adjustment of urinary device" }, { "code": "PK93.10", "title": "Gastroenterology or urology devices associated with injury or harm, urinary catheter" }, { "code": "PK90.1", "title": "Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices" }, { "code": "PK91.2Y", "title": "Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices" } ]
=== ICD-11 CODES FOUND === [BE2Y] Other specified diseases of the circulatory system Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart [DB30.Y] Other specified obstruction of large intestine Also known as: Other specified obstruction of large intestine | Obstruction of large intestine due to compression or stenosis | Acute bowel obstruction, not elsewhere classified | Subacute bowel obstruction, not elsewhere classified | subacute intestinal obstruction NOS [DA0C.Y] Other specified periodontal disease Also known as: Other specified periodontal disease | Chronic periodontitis | Adult periodontitis | adult-onset periodontitis | chronic pericementitis [BA41.Z] Acute myocardial infarction, unspecified Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction [GA16.Y] Other specified acquired abnormalities of uterus, except cervix Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus [QB62.Z] Attention to artificial openings, unspecified Also known as: Attention to artificial openings, unspecified | Attention to artificial openings | toilet or cleansing of artificial opening | removal of catheter | passage of sounds or bougies [QB30.5] Fitting or adjustment of urinary device Also known as: Fitting or adjustment of urinary device | change of indwelling catheter | Removal of indwelling urinary catheter | removal of urinary catheter | removal of indwelling catheter [PK93.10] Gastroenterology or urology devices associated with injury or harm, urinary catheter Also known as: Gastroenterology or urology devices associated with injury or harm, urinary catheter | Gastroenterology or urology devices associated with adverse incidents, Foley catheter | Gastroenterology or urology devices associated with adverse incidents, indwelling urinary catheter | Mechanical complication of urinary catheter | Mechanical complication of urinary indwelling catheter Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK90.1] Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices Definition: An anaesthesiology device was involved in an adverse incident that occurred in a therapeutic (nonsurgical) and rehabilitative task Also known as: Anaesthesiology devices associated with injury or harm, therapeutic, nonsurgical or rehabilitative devices | Anaesthesiology devices associated with injury or harm, spinal catheter | Mechanical complication of spinal catheter | Anaesthesiology devices associated with injury or harm, epidural catheter | Anaesthesiology devices associated with injury or harm, endotracheal tube Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm [PK91.2Y] Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices Also known as: Other specified cardiovascular devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Cardiovascular devices associated with injury or harm, conduits | Mechanical complication of other cardiac and vascular devices and implants | Mechanical complication of artificial heart | Mechanical complication of vascular balloon implant or device === GRAPH WALKS === --- Walk 1 --- [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 โ€œstrokeโ€, which includes the following entities: Intracerebral haemorrhage; Subarachnoi... --- Walk 2 --- [BE2Y] Other specified diseases of the circulatory system --PARENT--> [11] Diseases of the circulatory system Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases... --RELATED_TO--> [?] Functional vascular disorders of the skin Def: Skin disorders due to disturbances in vascular tone and skin blood flow.... --- Walk 3 --- [DB30.Y] Other specified obstruction of large intestine --PARENT--> [DB30] Obstruction of large intestine Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ... --CHILD--> [DB30.1] Volvulus of large intestine Def: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vess... --- Walk 4 --- [DB30.Y] Other specified obstruction of large intestine --PARENT--> [DB30] Obstruction of large intestine Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ... --EXCLUDES--> [?] Paralytic ileus of large intestine Def: Paralytic ileus of large intestine is a decreased motor activity of colon due to non-mechanical causes. The intestinal paralysis need not be complete, but it must be sufficient to prohibit the passage... --- Walk 5 --- [DA0C.Y] Other specified periodontal disease --PARENT--> [DA0C] Periodontal disease Def: Periodontal disease can refer to any pathological process involving the gum (GINGIVA), the alveolar bone (alveolar process), the dental cementum, and / or the periodontal ligament... --CHILD--> [DA0C.0] Acute periodontitis Def: This is an acute disease affecting the tooth-supporting structures, i.e. gingiva, alveolar bone and periodontal membrane.... --- Walk 6 --- [DA0C.Y] Other specified periodontal disease --PARENT--> [DA0C] Periodontal disease Def: Periodontal disease can refer to any pathological process involving the gum (GINGIVA), the alveolar bone (alveolar process), the dental cementum, and / or the periodontal ligament... --CHILD--> [DA0C.1] Aggressive periodontitis Def: A type of periodontal disease and includes localised aggressive periodontitis (LAP), and Generalised aggressive periodontitis (GAP)....
[ "[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 โ€œstrokeโ€, 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--> [?] Functional vascular disorders of the skin\n Def: Skin disorders due to disturbances in vascular tone and skin blood flow....", "[DB30.Y] Other specified obstruction of large intestine\n --PARENT--> [DB30] Obstruction of large intestine\n Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...\n --CHILD--> [DB30.1] Volvulus of large intestine\n Def: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vess...", "[DB30.Y] Other specified obstruction of large intestine\n --PARENT--> [DB30] Obstruction of large intestine\n Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...\n --EXCLUDES--> [?] Paralytic ileus of large intestine\n Def: Paralytic ileus of large intestine is a decreased motor activity of colon due to non-mechanical causes. The intestinal paralysis need not be complete, but it must be sufficient to prohibit the passage...", "[DA0C.Y] Other specified periodontal disease\n --PARENT--> [DA0C] Periodontal disease\n Def: Periodontal disease can refer to any pathological process involving the gum (GINGIVA), the alveolar bone (alveolar process), the dental cementum, and / or the periodontal ligament...\n --CHILD--> [DA0C.0] Acute periodontitis\n Def: This is an acute disease affecting the tooth-supporting structures, i.e. gingiva, alveolar bone and periodontal membrane....", "[DA0C.Y] Other specified periodontal disease\n --PARENT--> [DA0C] Periodontal disease\n Def: Periodontal disease can refer to any pathological process involving the gum (GINGIVA), the alveolar bone (alveolar process), the dental cementum, and / or the periodontal ligament...\n --CHILD--> [DA0C.1] Aggressive periodontitis\n Def: A type of periodontal disease and includes localised aggressive periodontitis (LAP), and Generalised aggressive periodontitis (GAP)...." ]
BE2Y
Other specified diseases of the circulatory system
[ { "from_icd11": "BA41.Z", "icd10_code": "I21A1", "icd10_title": "Myocardial infarction type 2" }, { "from_icd11": "BA41.Z", "icd10_code": "I21A9", "icd10_title": "Other myocardial infarction type" }, { "from_icd11": "BA41.Z", "icd10_code": "I2109", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2119", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall" }, { "from_icd11": "BA41.Z", "icd10_code": "I2111", "icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2102", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2129", "icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I2121", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I2101", "icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery" }, { "from_icd11": "BA41.Z", "icd10_code": "I214", "icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I213", "icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site" }, { "from_icd11": "BA41.Z", "icd10_code": "I219", "icd10_title": "Acute myocardial infarction, unspecified" }, { "from_icd11": "BA41.Z", "icd10_code": "I21", "icd10_title": "Acute myocardial infarction" }, { "from_icd11": "BA41.Z", "icd10_code": "I212", "icd10_title": "ST elevation (STEMI) myocardial infarction of other sites" }, { "from_icd11": "BA41.Z", "icd10_code": "I210", "icd10_title": "ST elevation (STEMI) myocardial infarction of anterior wall" } ]
I21A1
Myocardial infarction type 2
A 53-year-old man with previous history of alcohol-related liver cirrhosis presents to our department for routine follow-up. His comorbidities include hypertension managed with oral antihypertensive drugs and diabetes mellitus type 2. He has no significant allergies and never underwent any surgical procedure. He brings an ultrasound, which shows a 4 cm heterogenous mass in segment 8. His alfafetoprotein level is elevated to 76 ng/mL. He has no symptoms and looks in good performance status. We scheduled him for a triphasic CT scan, which shows a lesion of 4.3 cm with brisk arterial contrast and venous washout. According to the LIRADS classification, this lesion could be considered a class 5 with diagnostic features of hepatocellular carcinoma. The patient was discussed in our multidisciplinary tumor board including hepatobiliary and transplant surgeons, hepatologists, radiologists, pathologists, oncologists, and interventional radiologists. The plan was to submit the patient to curative intent treatments given his early presentation according to the Barcelona Clinic Liver Cancer Staging System (BCLC), namely surgical resection or liver transplantation; radiofrequency ablation was excluded given the tumorโ€™s dimensions. Given the good performance status, the position of the lesion (which was right below the Glissonian capsule) and the liver function of the patients, the MDT decided to schedule the patient for surgery. We therefore saw the patient in clinic and discussed the procedure. Informed consent was signed, and liver function was tested using ICG retention rate. We used 0.5 mg/Kg corresponding to 40 mg in this 80 kg patient. The DICOM data of the CT scan of the patient were then submitted to our radiologist who performed a 3D reconstruction of the patientโ€™s anatomy and the relationship of the lesion with the major vessels. Furthermore, the exact dimensions of the portal territories for segment 8 were reconstructed and showed on the model. We normally aim at the narrowest but still oncologically safe resection possible. The surgery is then planned on the model, identifying the borders of the resection and the exact location of the Glissonian pedicle to tackle and the hepatic veins to skeletonize and cut. Once the preoperative surgical plan is discussed between the surgeons and the radiologists, the patient can be scheduled for surgery. This generally happens 2 weeks from the administration of ICG to achieve a complete washout of the dye by the normal parenchyma and a retention by the tumor that will then be showed intraoperatively using the narrow band camera. The patient is scheduled for a laparoscopic anatomical segment 8 resection. In our experience, we use the so called โ€œFrench positionโ€ to operate laparoscopic cases, with the patient standing in between the legs of the patient and two assistants on each side. Two screens in the operating room are dedicated to the endoscopic vision, one screen is dedicated to the intraoperative ultrasound, while one dedicated screen allows to show the preoperative surgical planning and therefore guide the resection throughout the case. We use a five-trocar technique with 1 umbilical port and 4 ports on the subcostal line. One port is epigastric and is very important for the dissection of the hepatocaval confluence. An extra 5 mm access is used to perform an extracorporeal Pringle manuever. Open laparoscopy access is gained at the level of the umbilicus. After inserting all the trocars, the narrow band camera is used to identify the HCC on the hepatic dome on segment 8, which is shining green because of the ICG administered 2 weeks before. Intraoperative ultrasound and doppler are then performed to confirm the border of the resection. Pringle manuever is prepared. Dissection is started from the hepatocaval confluence to immediately identify the middle and right hepatic veins. For segment 8 resections, no extensive right lobe mobilization is necessary unless exposure is limited. We then start our parenchymal transection using a combination of energy-based device clamp-crushing technique, CUSA dissection and bipolar coagulation. We identify the middle hepatic vein at its origin, and we carry our parenchymal transection in a cranio-caudal fashion, sweeping the liver parenchyma from the vein. This avoids any tearing on small peripheral branches of the middle hepatic vein. Slowly progressing caudally, we encroach the Glissonian pedicle for segment 8, going to the lesion and vascularizing the tumor bearing area. We test the pedicle using a bulldog clamp and checking with the doppler the absence of flow in segment 8 and the presence of flow in the remnant liver. We then ask the anesthesiologist to inject 1 mL of ICG intravenously. We will then see all the liver shining green but not segment 8, which is our resection area. Guided by the ICG we will then carry out the anatomical resection. The Glissonian pedicle is stapled, and the resection is carried out dissecting the whole resection area from the middle and right hepatic veins. Once the resection is finished, the vascularization of the remnant liver is checked both with the ICG and the doppler. A drain is generally not placed unless there are specific issues during the procedure. The patient was placed on a fast-track protocol with early feeding and mobilization and was discharged home on postoperative day 4. Follow up is now more than 1 year and the patient is currently in good health status with no signs of recurrence.
4
0.957031
sec[4]/p[1]
en
0.999997
34943406
https://doi.org/10.3390/diagnostics11122169
[ "resection", "liver", "segment", "hepatic", "which", "lesion", "this", "tumor", "glissonian", "using" ]
[ { "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": "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 === [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 [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 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --CHILD--> [DB91] Acute or subacute hepatic failure Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases.... --- Walk 2 --- [DB9Z] Diseases of liver, unspecified --PARENT--> [?] Diseases of liver --RELATED_TO--> [?] Structural developmental anomalies of liver --- 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 --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.... --CHILD--> [DB99.1] Hepatic cyst Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue. It may contain air, fluids, or semi-solid material of the liver.... --- 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--> [DB91] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....", "[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Structural developmental anomalies of liver", "[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 --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 --CHILD--> [DB99.1] Hepatic cyst\n Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue. It may contain air, fluids, or semi-solid material of the liver....", "[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
A 55 year-old Caucasian male was admitted to the hospital with complaints of worsening generalized weakness. He had a past medical history of tobacco abuse with a 60-pack-year smoking history without any other pertinent medical and family history. At initial presentation, the patient was seen at an urgent care with complaints of a new skin nodule on his right upper back. The patient was referred to dermatology via urgent care, but the patient was lost to follow up. Two months later, it grew and ulcerated, prompting a surgical consult by his PCP for biopsy and excision . The ulcerated skin lesion became painful and developed purulent drainage requiring antibiotics. During this time, he also noticed weight loss, loss of appetite, and worsening constipation. He denied coughing, hemoptysis, shortness of breath, or any other respiratory symptoms. On physical examination he had normal vital signs and was cachectic. He had a post excision wound on the right upper back measuring about 10 cm in greatest diameter surrounded by mild erythema with sutures in place . No drainage was noted. He had three palpable, non-tender and freely mobile right posterior cervical lymphadenopathy measuring 2 cm ร— 2 cm in size. On auscultation of lungs, he had equal air entry bilaterally and was without wheezes or crackles. Otherwise, he had a unremarkable physical exam including normal cardiac exam. Lab work revealed hypercalcemia of 16.3 mg/dL, which was corrected for his albumin. PTHrP was elevated with a low normal PTH. Renal function was normal (Table 1 ). Chest x-ray revealed a large cavitary lesion in the right upper lung lobe and right hilar adenopathy or a mass . CT chest with contrast showed extensive malignancy most significantly involving the mediastinum, right hilum, and right upper lobe with areas of interstitial thickening and nodularity in the right upper lobe and right middle lobe and Indeterminate partially exophytic mass in the posterior upper right chest measuring about 3.8 ร— 6.2 cm . He underwent bronchoscopy with endobronchial ultrasound which showed a large subcarinal mass and a small fixed, friable, irregular, oval and vascular lesion with less than 25% obstruction in the right main stem . The histopathology report of the skin lesion was consistent with metastatic poorly differentiated squamous cell carcinoma, mainly invading the dermis and subcutaneous tissue with no dysplastic changes in the epidermis. Smaller nodules were also invading the angiolymphatic vessels. The sections of surgical margins were free of tumor cells. Bronchial washings and FNA of hilar lymph node pathology results confirmed non-small cell carcinoma favoring squamous cell carcinoma. They stained positive for p40 and negative for TTF1. The tumor cells PD-L1 membranous positivity was 5%. Our patient had LSCC and nonkeratinizing SCC in his skin biopsy which made it more likely that it was Stage IV LSCC with metastasis to the skin than a primary cutaneous tumor in addition to the primary pulmonary tumor. Fig. 1 Skin lesion (blue arrow) on the infraspinous region of the right shoulder prior to excision Fig. 2 Wound after excision with sutures in place (blue arrow) Table 1 Laboratory values Laboratory test Value Reference range White blood cell count 9.99 10 (3)/mcl 4.00โ€“12.00 10 (3)/mcL Red blood cell count 4.32 10 (3)/mcl 4.40โ€“5.80 10 (6)/mcL Hematocrit 37.1% 38.0โ€“50.0% Hemoglobin 11.7 g/dL 13.0โ€“16.5 g/dL MCV 85.9 fL 82.0โ€“96.0 fL Platelet count 425 10(3)/mcl 140โ€“440 10(3)/mcL Neutrophils 59.0% 40.0โ€“68.0 % Lymphocytes 32.5% 19.0โ€“49.0 % Monocytes 6.2% 3.0โ€“13.0 % Eosinophils 1.3% 0.0โ€“8.0 % Basophils 0.5% 0.0โ€“1.0 % Absolute neutrophils 5.89 10 (3)/mcl 1.40โ€“5.3 10 (3)/mcL Absolute lymphocytes 3.25 10 (3)/mcl 0.90โ€“3.30 10 (3)/mcL Sodium 135 mmol/L 136โ€“145 mmol/L Potassium 4.3 mmol/L 3.5โ€“5.1 mmol/L Creatinine 1.14 mg/dL 0.70โ€“1.30 mg/dL Calcium 15.7 mg/dL 8.7โ€“10.5 mg/dL Albumin 3.3 g/dL 3.5โ€“5.0 g/dL PTH 11 pg/mL 13โ€“85 pg/mL PTH related peptide 32 pmol/L < or = 4.2 pmol/L White blood cell count 5.55 10 (3)/mcl 4.00โ€“12.00 10 (3)/mcL Red blood cell count 3.28 10 (3)/mcl 4.40โ€“5.80 10 (6)/mcL Hematocrit 28.6% 38.0โ€“50.0 % Hemoglobin 9.3 g/dL 13.0โ€“16.5 g/dL MCV 87.2 fL 82.0โ€“96.0 fL Platelet count 316 10 (3)/mcl 140โ€“440 10 (3)/mcL Neutrophils 60.5% 40.0โ€“68.0 % Lymphocytes 29.2% 19.0โ€“49.0 % Monocytes 6.7% 3.0โ€“13.0 % Eosinophils 3.1% 0.0โ€“8.0 % Basophils 0.5% 0.0โ€“1.0 % Absolute neutrophils 3.36 10 (3)/mcl 1.40โ€“5.3 10 (3)/mcL Absolute lymphocytes 1.62 10 (3)/mcl 0.90โ€“3.30 10 (3)/mcL Sodium 137 mmol/L 136โ€“145 mmol/L Potassium 3.1 mmol/L 3.5โ€“5.1 mmol/L Creatinine 0.6 mg/dL 0.70โ€“1.30 mg/dL Calcium 8.8 mg/dL 8.7โ€“10.5 mg/dL mcl microliters, MCV mean corpuscular volume, mmol millimoles per liter, mg milligram, L liters, dL deciliter, PTH parathyroid hormone, pg picogram, pmol picomoles per liter, fL femtoliter Fig. 3 Chest radiograph showing large cavitary lesion in the right upper lung with right hilar mass (blue arrows) Fig. 4 A Trans-axial computerized tomography (CT) Chest showing right upper lung mass (blue arrow). B Trans-axial computerized tomography (CT) Chest in lung window showing right upper lung mass (blue arrow). C Coronal view computerized tomography (CT) chest showing the right upper lobe lung mass (blue arrow). Findings worrisome for extensive malignancy involving the mediastinum, right hilum, and right upper lobe Fig. 5 Bronchoscopy shows single small fixed, friable, irregular, nodular and oval lesion (blue arrow) in the right main stem bronchus
3.974609
0.980469
sec[1]/p[0]
en
0.999996
PMC9040228
https://doi.org/10.1186/s13256-022-03352-4
[ "mmol", "lesion", "chest", "cell", "blue", "skin", "lung", "lobe", "arrow", "count" ]
[ { "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": "FA5Z", "title": "Arthropathies, unspecified" }, { "code": "FC0Z", "title": "Diseases of the musculoskeletal system or connective tissue, unspecified" }, { "code": "ME60.Z", "title": "Skin lesion of unspecified nature" }, { "code": "MD41", "title": "Clinical findings on diagnostic imaging of lung" }, { "code": "GC2Z&XA6KU8", "title": "Disease of kidney, not elsewhere classified" }, { "code": "CB7Z", "title": "Diseases of the respiratory system, unspecified" }, { "code": "CB27", "title": "Pleural effusion" } ]
=== 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 [FA5Z] Arthropathies, unspecified Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic [FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS [ME60.Z] Skin lesion of unspecified nature Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature [MD41] Clinical findings on diagnostic imaging of lung Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging. Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass [CB7Z] Diseases of the respiratory system, unspecified Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS [CB27] Pleural effusion Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate Includes: Pleurisy with effusion Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy === 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 โ€œat riskโ€ pat... --EXCLUDES--> [?] Orthostatic proteinuria Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.... --- Walk 2 --- [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 3 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat... --EXCLUDES--> [?] Gestational proteinuria without hypertension --- Walk 4 --- [GB42.0] Albuminuria, Grade A2 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --PARENT--> [GB42] Persistent proteinuria or albuminuria Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat... --CHILD--> [GB42.1] Albuminuria, Grade A3 Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted... --- Walk 5 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --CHILD--> [MA18.0Y] Other specified elevated blood glucose level --- Walk 6 --- [MA18.0Y] Other specified elevated blood glucose level --PARENT--> [MA18.0] Elevated blood glucose level --EXCLUDES--> [?] Postprocedural hypoinsulinaemia Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus....
[ "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Orthostatic proteinuria\n Def: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position....", "[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension", "[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in โ€œat riskโ€ pat...\n --CHILD--> [GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --CHILD--> [MA18.0Y] Other specified elevated blood glucose level", "[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --EXCLUDES--> [?] Postprocedural hypoinsulinaemia\n Def: This is a low level of insulin that can result after medical procedures, including radiation, and it carries a risk of developing diabetes mellitus...." ]
GB42.1
Albuminuria, Grade A3
[ { "from_icd11": "FA5Z", "icd10_code": "M00-M25", "icd10_title": "" }, { "from_icd11": "FC0Z", "icd10_code": "XIII", "icd10_title": "" }, { "from_icd11": "ME60.Z", "icd10_code": "L989", "icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified" }, { "from_icd11": "MD41", "icd10_code": "R911", "icd10_title": "Solitary pulmonary nodule" }, { "from_icd11": "MD41", "icd10_code": "R91", "icd10_title": "Abnormal findings on diagnostic imaging of lung" }, { "from_icd11": "CB7Z", "icd10_code": "J989", "icd10_title": "Respiratory disorder, unspecified" }, { "from_icd11": "CB7Z", "icd10_code": "X", "icd10_title": "" }, { "from_icd11": "CB7Z", "icd10_code": "J09-J18", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J910", "icd10_title": "Malignant pleural effusion" }, { "from_icd11": "CB27", "icd10_code": "J918", "icd10_title": "Pleural effusion in other conditions classified elsewhere" }, { "from_icd11": "CB27", "icd10_code": "J90", "icd10_title": "Pleural effusion, not elsewhere classified" }, { "from_icd11": "CB27", "icd10_code": "J90-J94", "icd10_title": "" }, { "from_icd11": "CB27", "icd10_code": "J91", "icd10_title": "Pleural effusion in conditions classified elsewhere" } ]
M00-M25
A 60-year-old Caucasian female had undergone right primary THA for end-stage osteoarthritis. Components utilized include a Smith and Nephew R3 50 mm acetabular shell, R3 cross-linked polyethylene liner, size 11 Synergy femoral stem, and 32 mm diameter + 4 mm neck length cobalt-chrome femoral head. The arthroplasty was performing well until a dislocation 8 years following implantation. She ultimately re-presented to the initial orthopedic surgeon (JP) 9 years, 7 months following the index surgery after sustaining a second dislocation. At this point the patient was essentially asymptomatic with no pain, and was still functioning well apart from hip instability. Examination revealed a fluctuant, nontender collection anterior to the hip joint, along with a painless range of motion (ROM) including 90ยฐ flexion, 30ยฐ internal rotation (IR), and 30ยฐ external rotation (ER). Radiographs suggested radiolucency in the greater trochanter, and soft tissue shadowing and mineralization anterior to the joint, and along the lateral proximal femur . Subsequent metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) revealed complex multiloculated fluid collections suggestive of extensive pseudotumor originating from the right total hip arthroplasty, extending laterally and superiorly into the hip abductors, anteriorly and superiorly along psoas musculature, and along the inner table of the pelvis to the level of the iliac crest. Inferior extension continued to the deep aspect of the hamstring tendon origins . The pseudotumor was in close contact with the external iliac artery and vein and was displacing the femoral nerve. Laboratory investigations including a C-reactive protein (CRP) level of 2.1 mg/L and erythrocyte sedimentation rate (ESR) of 12 mm/hour suggested a low likelihood of infection. Assessment of whole blood metal ion levels revealed a cobalt level of 57.5 nmol/L (approximately 3.39 ppb) and chromium level of 11.2 nmol/L. Six weeks following confirmation of the associated pseudotumor, the patient underwent a near-complete excision of the intra- and extrapelvic pseudotumor followed by revision total hip arthroplasty and abductor mechanism reconstruction through a multidisciplinary team approach. With the patient supine, general surgeon (FS) performed a laparotomy in the right lower abdominal quadrant . In conjunction with a vascular surgeon (RM), the pseudotumor was found to extend from the retroperitoneal space displacing the iliac vessels and femoral nerve. There were numerous extensions into the psoas muscle, and a small amount of pseudotumor tissue was left in this area to minimize morbidity. Extension posteriorly invading the iliac crest also resulted in some retained tissue. The pseudotumor extended inferiorly beneath the inguinal ligament into the anterior femoral compartment and was excised through a second incision in the groin longitudinally over the femoral artery . Following anterior pseudotumor excision, the patient was repositioned in the lateral decubitus position, and through the previous THA incision a posterolateral approach was performed. Pseudotumor was encountered on incising the deep fascia. The abductors were nearly completely destroyed by pseudotumor , which was carefully excised. Trunnion wear was noted with black deposits on the femoral neck and in the bore of the femoral head . The wear debris was cleaned off the neck of the femoral component, and the anteversion and fixation of the stem were confirmed to be appropriate before retention. Explantation of the fixed acetabular component revealed mild posterior bone loss, and press-fit fixation of a Smith and Nephew 52 mm R3 socket was augmented with two fixation screws superiorly and one posteroinferiorly . In view of the absent abductors, a constrained liner was utilized with a 32 mm diameter + 4 mm neck length Oxinium head. Abductor reconstruction with tendo-Achilles allograft was performed with the os calcis contoured and secured to the greater trochanter and tendon sutured to the gluteus medius fascia with the hip abducted . The patient was instructed on toe-touch weight-bearing for 6 weeks with an abductor orthosis. The histopathological report revealed a final diagnosis of โ€œfibroconnective tissue with granulomatous and giant cell reaction, with foreign bodies and calcifications, negative for malignancy.โ€ Final culture results all returned negative. At 6 weeks follow-up, abductor strength was 4/5 and the patient was recovering well. Fig. 1 Select preoperative images: A anteroposterior (AP) pelvis radiograph following index right THA; B AP pelvis radiograph prior to revision demonstrating soft-tissue shadowing and mineralization surrounding the right hip and proximal femur (arrow); C , D axial MRI slices revealing significant pseudotumor extension (arrows) Fig. 2 Intraoperative images demonstrating A anterior intrapelvic pseudotumor excision; B second incision in femoral compartment (asterisks indicate pseudotumor) Fig. 3 A Significant lateral pseudotumor with near-complete destruction of abductor musculature; B , C trunnionosis with wear and corrosion products involving the femoral neck trunnion and bore of the femoral head; D abductor mechanism reconstruction with tendo-Achilles allograft prior to proximal tensioning Fig. 4 Immediate anteroposterior ( A ) and lateral ( B ) postoperative radiographs of right revision total hip arthroplasty following excision of extensive pseudotumor through multiple approaches
4.042969
0.973633
sec[1]/p[0]
en
0.999997
PMC8941771
https://doi.org/10.1186/s13256-022-03336-4
[ "pseudotumor", "femoral", "abductor", "neck", "tissue", "head", "arthroplasty", "along", "iliac", "excision" ]
[ { "code": "9A22.Z", "title": "Orbital inflammation, unspecified" }, { "code": "8D60.Y", "title": "Other specified increased intracranial pressure" }, { "code": "DB99.Y", "title": "Other specified diseases of liver" }, { "code": "3B81.0", "title": "Tumour-like conditions of spleen" }, { "code": "LD2A.Y", "title": "Other specified malformative disorders of sex development" }, { "code": "LB9A.8", "title": "Femoral agenesis or hypoplasia" }, { "code": "FA31.8", "title": "Acquired unequal limb length" }, { "code": "FA31.Y", "title": "Other specified acquired deformities of limbs" }, { "code": "8C11.2", "title": "Lesion of femoral nerve" }, { "code": "FB86.11", "title": "Hypertrophy of bone" } ]
=== ICD-11 CODES FOUND === [9A22.Z] Orbital inflammation, unspecified Also known as: Orbital inflammation, unspecified | Orbital inflammation | inflammation of orbit | Acute inflammation of orbit | acute orbital inflammation [8D60.Y] Other specified increased intracranial pressure Also known as: Other specified increased intracranial pressure | Idiopathic intracranial hypertension | benign intracranial hypertension | intracranial hypertension | intracranial HTN - [hypertension] [DB99.Y] Other specified diseases of liver Also known as: Other specified diseases of liver | Inflammatory pseudotumour of liver | Solitary necrotic nodule of the liver | Pulmonary fibrosis - hepatic hyperplasia - bone marrow hypoplasia | Focal nodular hyperplasia of liver [3B81.0] Tumour-like conditions of spleen Definition: Any condition caused by determinants acquired after birth, in the antenatal period or genetically inherited factors, leading to tumour-like conditions of the spleen. Confirmation is through medical imaging. Also known as: Tumour-like conditions of spleen | Splenic hamartoma | Inflammatory pseudotumour of spleen | Sclerosing angiomatoid nodular transformation | SANT - [Sclerosing angiomatoid nodular transformation] [LD2A.Y] Other specified malformative disorders of sex development Also known as: Other specified malformative disorders of sex development | 45, X, 46, XY gonadal dysgenesis | Mixed gonadal dysgenesis | Streak testis | 46, XX disorders of sex development [LB9A.8] Femoral agenesis or hypoplasia Definition: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur. Also known as: Femoral agenesis or hypoplasia | absence of femur | absent femur | agenesis of femur | congenital absence of femur [FA31.8] Acquired unequal limb length Also known as: Acquired unequal limb length | unequal length of limbs | unequal limb length | Acquired unequal limb length, multiple sites | Acquired unequal limb length, shoulder region [FA31.Y] Other specified acquired deformities of limbs Also known as: Other specified acquired deformities of limbs | Acquired deformity of forearm | Deflection of radius | Bowing of the radius | Bowing of forearm [8C11.2] Lesion of femoral nerve Also known as: Lesion of femoral nerve | Femoral neuropathy | Lesion of saphenous nerve Excludes: Injury of femoral nerve at hip or thigh level [FB86.11] Hypertrophy of bone Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification === GRAPH WALKS === --- Walk 1 --- [9A22.Z] Orbital inflammation, unspecified --PARENT--> [9A22] Orbital inflammation --CHILD--> [9A22.2] Granulomatous orbital inflammation --- Walk 2 --- [9A22.Z] Orbital inflammation, unspecified --PARENT--> [9A22] Orbital inflammation --CHILD--> [9A22.1] Diffuse orbital inflammation --- Walk 3 --- [8D60.Y] Other specified increased intracranial pressure --PARENT--> [8D60] Increased intracranial pressure Def: An increase in pressure within the skull caused by changes in the volumes of the intracranial components, such as brain matter, CSF and blood, or by the presence of a pathological mass entity.... --CHILD--> [8D60.1] Cerebral oedema Def: Is an excess accumulation of fluid in the intracellular and/or extracellular spaces of the brain.... --- Walk 4 --- [8D60.Y] Other specified increased intracranial pressure --PARENT--> [8D60] Increased intracranial pressure Def: An increase in pressure within the skull caused by changes in the volumes of the intracranial components, such as brain matter, CSF and blood, or by the presence of a pathological mass entity.... --CHILD--> [8D60.Y] Other specified increased intracranial pressure --- Walk 5 --- [DB99.Y] Other specified diseases of liver --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.... --- Walk 6 --- [DB99.Y] Other specified diseases of liver --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...
[ "[9A22.Z] Orbital inflammation, unspecified\n --PARENT--> [9A22] Orbital inflammation\n --CHILD--> [9A22.2] Granulomatous orbital inflammation", "[9A22.Z] Orbital inflammation, unspecified\n --PARENT--> [9A22] Orbital inflammation\n --CHILD--> [9A22.1] Diffuse orbital inflammation", "[8D60.Y] Other specified increased intracranial pressure\n --PARENT--> [8D60] Increased intracranial pressure\n Def: An increase in pressure within the skull caused by changes in the volumes of the intracranial components, such as brain matter, CSF and blood, or by the presence of a pathological mass entity....\n --CHILD--> [8D60.1] Cerebral oedema\n Def: Is an excess accumulation of fluid in the intracellular and/or extracellular spaces of the brain....", "[8D60.Y] Other specified increased intracranial pressure\n --PARENT--> [8D60] Increased intracranial pressure\n Def: An increase in pressure within the skull caused by changes in the volumes of the intracranial components, such as brain matter, CSF and blood, or by the presence of a pathological mass entity....\n --CHILD--> [8D60.Y] Other specified increased intracranial pressure", "[DB99.Y] Other specified diseases of liver\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....", "[DB99.Y] Other specified diseases of liver\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..." ]
9A22.Z
Orbital inflammation, unspecified
[ { "from_icd11": "9A22.Z", "icd10_code": "H05012", "icd10_title": "Cellulitis of left orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H05011", "icd10_title": "Cellulitis of right orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H05022", "icd10_title": "Osteomyelitis of left orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H05111", "icd10_title": "Granuloma of right orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H05019", "icd10_title": "Cellulitis of unspecified orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H05119", "icd10_title": "Granuloma of unspecified orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H05129", "icd10_title": "Orbital myositis, unspecified orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H0510", "icd10_title": "Unspecified chronic inflammatory disorders of orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H050", "icd10_title": "Acute inflammation of orbit" }, { "from_icd11": "9A22.Z", "icd10_code": "H051", "icd10_title": "Chronic inflammatory disorders of orbit" }, { "from_icd11": "LB9A.8", "icd10_code": "Q724", "icd10_title": "Longitudinal reduction defect of femur" }, { "from_icd11": "FA31.8", "icd10_code": "M21761", "icd10_title": "Unequal limb length (acquired), right tibia" }, { "from_icd11": "FA31.8", "icd10_code": "M21762", "icd10_title": "Unequal limb length (acquired), left tibia" }, { "from_icd11": "FA31.8", "icd10_code": "M21764", "icd10_title": "Unequal limb length (acquired), left fibula" }, { "from_icd11": "FA31.8", "icd10_code": "M21752", "icd10_title": "Unequal limb length (acquired), left femur" } ]
H05012
Cellulitis of left orbit
She exhibited SRS-compatible clinical features satisfying the Netchine-Harbison criteria in infancy to early childhood . She also exhibited overt hypotonia and borderline developmental delay: she controlled her head at six months of age, sat without support at nine months of age, walked without support at 23 months of age, and spoke single words at two years of age. She received growth hormone therapy for short stature from 6 to 12 years of age, and gonadotropin releasing hormone analog therapy for central precocious puberty with menarche at 7.5 years of age (the menarchial age in Japanese girls, 12.25 ยฑ 1.25 years) from 7 to 12 years of age. She also had hypersomnia from childhood and truncal obesity and oligomenorrhea from late teens. Table 1 Clinical findings in six cases with parthenogenetic mosaicism Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 < Parthenogenetic mosaicism > Karyotype 46,XX/46,XY 46,XX/46,XY/69,XXY 46,XX/46,XY 45,X/46,XX 46,XX/47,XXX 46,XX Parthenogenetic cells 46,XX 46,XX 46,XX 46,XX 46,XX 46,XX Non-parthenogenetic cells 46,XY 46,XY & 69,XXY 46,XY 45,X 47,XXX 46,XX Frequency of parthenogenetic cells > 98% (L) ~ 100% (L) 0% (L) 84% (L) 42% (Amniocytes) 70% (L) < 5% (SF) ~ 0% (SF) 45% (SF) 56% (Saliva) 67% (Saliva) Generation mechanism PA and ER Unknown PA and ER PA and ER PA and ER PB-2 retention and ER < Clinical features > Present age 1.2 years Unknown Unknown 34 years 18 weeks of gestation 28 years Phenotypic/social sex Male Male Male Female Unknown Female Prenatal growth failure โ€“ + Unknown + + + Birth length โ€” cm Unknown Unknown Unknown 44.0 (โˆ’ 3.1 SD) โ€ฆ (Fetus) 42.0 (โˆ’ 4.6 SD) Birth weight โ€” kg 3.36 (โˆ’ 0.5 SD) < 3rd percentile Unknown 2.10 (โˆ’ 2.9 SD) โ€ฆ (Fetus) 2.41 (โˆ’ 3.0 SD) Birth OFC โ€” cm Unknown 50th percentile Unknown 30.5 (โˆ’ 2.3 SD) โ€ฆ (Fetus) Unknown Postnatal growth failure Unknown โ€“ Unknown + โ€ฆ (Fetus) + Present height โ€” cm Unknown 25 percentile Unknown 125.0 (โˆ’ 6.2 SD) โ€ฆ (Fetus) 146.9 (โˆ’ 2.1 SD) Present weight โ€” kg Unknown Unknown Unknown 37.5 (โˆ’ 2.0 SD) โ€ฆ (Fetus) 60.4 (+ 0.9 SD) Present OFC โ€” cm Unknown Unknown Unknown 51.2 (โˆ’ 2.8 SD) โ€ฆ (Fetus) 55.6 (โˆ’ 0.1 SD) Intellectual disability + (Mild) + (Moderate) + + (DQ 56) โ€ฆ (Fetus) ยฑ Hypotonia Unknown Unknown Unknown + โ€ฆ (Fetus) + Disorder of sex development + (46,XX DSD) + (Genital anomalies) Unknown โ€“ โ€ฆ (Fetus) โ€“ < SRS: Netchine-Harbison scoring system features > Birth length and/or weight โ‰ค โˆ’ 2 SDS โ€“ + (probably) Unknown + โ€ฆ (Fetus) + Relative macrocephaly at birth a Unknown + (probably) Unknown + โ€ฆ (Fetus) Unknown Postnatal height (at ~ 2 years) โ‰ค โˆ’ 2 SDS Unknown โ€“ Unknown + โ€ฆ (Fetus) + Prominent forehead (1โ€“3 years) Unknown + (probably) Unknown + โ€ฆ (Fetus) + Body asymmetry + + + + โ€ฆ (Fetus) + Feeding difficulties and/or low BMI Unknown Unknown Unknown Unknown โ€ฆ (Fetus) + Other features Footnote-1 Footnote-2 Footnote-3 Footnote-4 Footnote-5 Footnote-6 References (Patient 11) (Patient 30) This patient Footnote-1: Bifid uvula and submucous cleft palate. Footnote-2: Clinodactyly, syndactyly of toes, and down-turned mouth. Footnote-3: Skin pigmentation, hearing loss, and childhood obesity. Footnote-4: Triangular face, 5th finger clinodactyly, and horseshoe kidney. Footnote-5: Short nasal bone, single umbilical artery, and diaphragmatic hernia (left). Footnote-6: Bilateral myopia, left hearing loss, hypoplastic and low-set ears, micrognathia, irregular teeth, small hands and feet, 5th finger shortening and clinodactyly, big and laterally deviated toes, cafรฉ au lait spots, truncal obesity, precocious puberty, and hypersomnia OFC, occipitofrontal circumference; SDS, standard deviation score; BMI, body mass index; L, leukocytes; SF, skin fibroblasts; PA, parthenogenetic activation; ER, endoreplication; PB-2, second polar body; and DQ, developmental quotient a Birth OFC SDS โ‰ฅ 1.5 above birth length or weight SDS Fig. 1 Clinical and molecular findings of this patient. a Photographs of this patient at one and 28 years of age. b Methylation indices for imprinting disease-related DMRs, obtained by pyrosequencing. Normally, the H19 / IGF2 :IG-DMR, MEG3 / DLK1 :IG-DMR, and MEG3 :TSS-DMR are methylated after paternal transmission, and the remaining DMRs are methylated after maternal transmission. The physical positions of examined DMRs are described in Table S3. Gray vertical bars indicate the reference ranges (minimum โ€“ maximum) in 50 control subjects. c Array-based genomewide copy-number and BAF analyses using CytoScan HD, and violin plot for the BAFs. d Microsatellite analysis using leukocyte (L) and saliva cells (S). In addition to single major peaks consistent with maternal isodisomy, minor peaks of non-maternal (paternal) origin are detected for three loci on four BAF band regions (written in blue), and those of maternal and non-maternal (paternal) origin are identified for the remaining three loci on six BAF band regions (written in red). Minor peaks of maternal and non-maternal (paternal) origin are indicated with red and blue asterisks, respectively. e Schematic representation of the generation of the parthenogenetic 46,XX cell lineage and the biparental 46,XX cell lineage. For simplicity, the behavior of single homologous chromosomes is shown, and all homologous chromosomes act similarly. The red and orange bars indicate homologous chromosomes in the oocyte, and the blue bar denotes a homologous chromosome in the sperm. M1, meiosis 1; M2, meiosis 2; PB-1, first polar body; PB-2, second polar body; and ER, endoreplication
4.164063
0.729004
sec[1]/sec[0]/p[1]
en
0.999996
33827678
https://doi.org/10.1186/s13148-021-01062-0
[ "unknown", "fetus", "footnote", "parthenogenetic", "birth", "maternal", "body", "features", "single", "cells" ]
[ { "code": "MG48", "title": "Unknown or unspecified causes of morbidity" }, { "code": "1H0Z", "title": "Infection, unspecified" }, { "code": "EC90.6", "title": "Pruritus of unknown cause" }, { "code": "MH14", "title": "Other ill-defined or unspecified causes of mortality" }, { "code": "2F9C", "title": "Neoplasms of unknown behaviour of connective or other soft tissue" }, { "code": "LD9Z", "title": "Developmental anomalies, unspecified" }, { "code": "KB20.Z", "title": "Intrauterine hypoxia, unspecified" }, { "code": "3A50.4", "title": "Hereditary persistence of fetal haemoglobin" }, { "code": "KB42", "title": "Persistent pulmonary hypertension of the newborn" }, { "code": "LD2Z", "title": "Multiple developmental anomalies or syndromes, unspecified" } ]
=== ICD-11 CODES FOUND === [MG48] Unknown or unspecified causes of morbidity Also known as: Unknown or unspecified causes of morbidity | undetermined cause | unknown cause of disease | illness | Illness NOS Includes: Undiagnosed disease, not specified as to the site or system involved [1H0Z] Infection, unspecified Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS [EC90.6] Pruritus of unknown cause Definition: Pruritus without identifiable cause despite thorough investigation. Also known as: Pruritus of unknown cause | Pruritus sine materia | Itch of unknown cause [MH14] Other ill-defined or unspecified causes of mortality Also known as: Other ill-defined or unspecified causes of mortality | death NOS | cause of mortality not stated | death of unknown cause | unknown cause of mortality Includes: unknown cause of mortality [2F9C] Neoplasms of unknown behaviour of connective or other soft tissue Also known as: Neoplasms of unknown behaviour of connective or other soft tissue | connective or other soft tissue tumour NOS | Abdominal desmoid of unknown behaviour of unspecified site | Mixed mesenchymal tumour of unspecified site | Muscular neoplasm of unknown behaviour Includes: Muscular neoplasm of unknown behaviour [LD9Z] Developmental anomalies, unspecified Also known as: Developmental anomalies, unspecified | congenital malformations, deformations and chromosomal abnormalities | congenital malformation NOS | developmental abnormality NOS | fetal abnormality NOS [KB20.Z] Intrauterine hypoxia, unspecified Also known as: Intrauterine hypoxia, unspecified | Intrauterine hypoxia | fetal distress | fetal distress syndrome | intrauterine distress [3A50.4] Hereditary persistence of fetal haemoglobin Definition: Hereditary persistence of fetal haemoglobin (HPFH) associated with beta-thalassaemia is a haemoglobinopathy characterised by high haemoglobin (Hb)F levels and an increased number of fetal-Hb-containing cells. The association of HPFH with beta-thalassaemia mitigates the clinical manifestations which vary from a normal state to beta-thalassaemia intermedia. Also known as: Hereditary persistence of fetal haemoglobin | HPFH - [Hereditary persistence of fetal haemoglobin] | fetal haemoglobin | persistence of fetal haemoglobin | persistent haemoglobin F [KB42] Persistent pulmonary hypertension of the newborn Definition: Persistent pulmonary hypertension of the newborn is a cardiopulmonary disorder characterised by systemic arterial hypoxemia secondary to pulmonary hypertension and extrapulmonary right-to-left shunting across the foramen ovale and ductus arteriosus. Also known as: Persistent pulmonary hypertension of the newborn | persistent fetal circulation syndrome | fetal circulation | PFC - [persistent fetal circulation] syndrome | PPHN - [Persistent pulmonary hypertension of the newborn] [LD2Z] Multiple developmental anomalies or syndromes, unspecified Also known as: Multiple developmental anomalies or syndromes, unspecified | multiple congenital birth defects NOS | multiple congenital birth deformities NOS | multiple fetal abnormalities NOS | severe birth deformities NOS === GRAPH WALKS === --- Walk 1 --- [MG48] Unknown or unspecified causes of morbidity --PARENT--> [?] General symptoms --CHILD--> [MG22] Fatigue Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu... --- Walk 2 --- [MG48] Unknown or unspecified causes of morbidity --PARENT--> [?] General symptoms --PARENT--> [?] General symptoms, signs or clinical findings --- Walk 3 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --CHILD--> [?] Mycobacterial diseases --- Walk 4 --- [1H0Z] Infection, unspecified --PARENT--> [01] Certain infectious or parasitic diseases Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi.... --RELATED_TO--> [?] Pneumonia Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ... --- Walk 5 --- [EC90.6] Pruritus of unknown cause Def: Pruritus without identifiable cause despite thorough investigation.... --PARENT--> [EC90] Pruritus Def: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.... --CHILD--> [EC90.0] Pruritus due to skin disorder Def: Pruritus due to skin disorder, especially those such as xerosis cutis or psoriasis where itch may occur but is not an inherent component of the disorder.... --- Walk 6 --- [EC90.6] Pruritus of unknown cause Def: Pruritus without identifiable cause despite thorough investigation.... --PARENT--> [EC90] Pruritus Def: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.... --CHILD--> [EC90.0] Pruritus due to skin disorder Def: Pruritus due to skin disorder, especially those such as xerosis cutis or psoriasis where itch may occur but is not an inherent component of the disorder....
[ "[MG48] Unknown or unspecified causes of morbidity\n --PARENT--> [?] General symptoms\n --CHILD--> [MG22] Fatigue\n Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...", "[MG48] Unknown or unspecified causes of morbidity\n --PARENT--> [?] General symptoms\n --PARENT--> [?] General symptoms, signs or clinical findings", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --CHILD--> [?] Mycobacterial diseases", "[1H0Z] Infection, unspecified\n --PARENT--> [01] Certain infectious or parasitic diseases\n Def: This chapter includes certain conditions caused by pathogenic organisms or microorganisms, such as bacteria, viruses, parasites or fungi....\n --RELATED_TO--> [?] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...", "[EC90.6] Pruritus of unknown cause\n Def: Pruritus without identifiable cause despite thorough investigation....\n --PARENT--> [EC90] Pruritus\n Def: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief....\n --CHILD--> [EC90.0] Pruritus due to skin disorder\n Def: Pruritus due to skin disorder, especially those such as xerosis cutis or psoriasis where itch may occur but is not an inherent component of the disorder....", "[EC90.6] Pruritus of unknown cause\n Def: Pruritus without identifiable cause despite thorough investigation....\n --PARENT--> [EC90] Pruritus\n Def: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief....\n --CHILD--> [EC90.0] Pruritus due to skin disorder\n Def: Pruritus due to skin disorder, especially those such as xerosis cutis or psoriasis where itch may occur but is not an inherent component of the disorder...." ]
MG48
Unknown or unspecified causes of morbidity
[ { "from_icd11": "MG48", "icd10_code": "R69", "icd10_title": "Illness, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B999", "icd10_title": "Unspecified infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A312", "icd10_title": "Disseminated mycobacterium avium-intracellulare complex (DMAC)" }, { "from_icd11": "1H0Z", "icd10_code": "B998", "icd10_title": "Other infectious disease" }, { "from_icd11": "1H0Z", "icd10_code": "A249", "icd10_title": "Melioidosis, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "R6511", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "R6510", "icd10_title": "Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction" }, { "from_icd11": "1H0Z", "icd10_code": "A318", "icd10_title": "Other mycobacterial infections" }, { "from_icd11": "1H0Z", "icd10_code": "A319", "icd10_title": "Mycobacterial infection, unspecified" }, { "from_icd11": "1H0Z", "icd10_code": "B948", "icd10_title": "Sequelae of other specified infectious and parasitic diseases" }, { "from_icd11": "1H0Z", "icd10_code": "B949", "icd10_title": "Sequelae of unspecified infectious and parasitic disease" }, { "from_icd11": "1H0Z", "icd10_code": "K77", "icd10_title": "Liver disorders in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "N771", "icd10_title": "Vaginitis, vulvitis and vulvovaginitis in diseases classified elsewhere" }, { "from_icd11": "1H0Z", "icd10_code": "I", "icd10_title": "" }, { "from_icd11": "1H0Z", "icd10_code": "B90-B94", "icd10_title": "" } ]
R69
Illness, unspecified
After 11 ECT sessions, she started to show signs of improvement. She started to walk around the ward and engage in various group activities. She started to accept her medications with less prompting. Her food and drink intake improved significantly, and she could eat independently. Her engagement with staff gradually improved, from making appropriate facial expressions to starting verbal communication. By the end of her ECT course, she could spontaneously engage in conversations and reported to us that โ€˜I am back.โ€™ She was able to reflect on how severely unwell she was and felt ready to be discharged home. In view of her clinical improvement, ECT treatment was stopped. Extracts of clinical documentation on her progress have been summarized in Table 4 . Table 4 Patient progress on the ward as documented in the electronic note system ECT Session Prior to ECT Post ECT in recovery Progress on the ward 1 Settled, anxious at times, joined in with activities. Able to hold a conversation Consented to ECT. Quiet on arrival, but did answer 4/5 orientation questions correctly Anxious, quiet, but pleasant on approach. Compliant with medications Reported to be highly anxious, kept saying โ€˜noโ€™ or โ€˜I donโ€™t knowโ€™ โ€“ unable to give capacitous consent. Moderate evidence of psychomotor retardation and evolving mutism. Did not appear to be responding to unseen external stimuli. She required full support for her personal care 2 Unable to consent On return to the ward, she refused medications, spitted them out and had her mouth closed Poor oral and fluid intake, received IV fluid treatment due to dehydration and deteriorating renal function 3 4 Very anxious and unable to answer any of the orientation questions Able to drink full cup of squash and ate 2 biscuits. Completed 4/5 orientation questions Upon returning to the ward, she became very anxious and hardly communicative. She was visibly shaking and humming 5 Very anxious and unable to answer any of the orientation questions Intermittent compliance with prescribed oral medication 6 Remained anxious and reluctant. Unable to answer any questions Had half a beaker of squash and IV Hartmannโ€™s. Unable to obtain MMSE Minimally interactive, and will respond with single words (no, no, no) 7 Had to be brought on a trolley due to high level of anxiety, distress and agitation Had some tea and biscuits โ€“ couldnโ€™t answer orientation questions afterwards She was having minimal conversation and continued to say โ€˜no, no, no.โ€™ 8 Very anxious and was reluctant. Unable to answer any of the orientation questions Had a mug of tea 280mls as well as 500 ml of Hartmannโ€™s Fluid IV She has been keeping tablets in her mouth at times. Staff had to escort her to the toilet using a wheelchair 9 After the session, had tea, toast and biscuit. Conversed with staff about dieting, exercise and dogs She returned to the ward with a smile. Then in the afternoon, she returned to the anxious state. She did manage all her meal 10 She had been variable in presentation. When she is less anxious, she could feed herself. Other times, she refused to eat and drink She had been sat in the communal area post-ECT. She was reasonably settled but gradually got anxious and had been repetitive and making sounds 11 SOAD applied for 6 further ECT sessions She was very calm, however did not interact with staff other than with short answers. She accepted a mug of tea and one and half slices of toast and marmalade. She was unable to answer any of the orientation questions She has been out in the garden for a walk. She joined in the colouring group and participated well. Accepted medication with less prompting 12 After the treatment, she was much calmer, however appeared confused at times. She had tea, cheddars and toast She engaged well in physiotherapy strength and balance sessions 13 Calm. Did not answer any of the orientation questions. The only thing she said was โ€˜what is my name.โ€™ She walked calmly back to the ward with staff Eating and drinking well. Taking food in the canteen now, despite eating slowly. Minimal assistance required with personal care 14 Accepted tea and toast. She was able to answer 2/5 of the orientation questions, however did say โ€˜my name used to be โ€ฆโ€™ She had been settled and calm, spent time in communal area with others. She engaged well when spoken to and has not been making any noise. 15 She was able to tell us her name, date of birth, however followed each answer by โ€˜well it used to beโ€™ When staff talked to her, she would always respond back with talking to staff. At times, she did smile to staff 16 She was able to walk to the clinic with a member of staff and answered 3/5 of the orientation questions. She became increasingly anxious when being prepared for ECT, however remained cooperative throughout She was able to tell us her name and date of birth, but responded โ€˜I have no ideaโ€™ when asked where she currently is Walked back to the ward with no concerns 17 She was able to answer 3/5 of the orientation questions She had cheddars and tea after the treatment. She completed 4/5 orientation questions and initiated the conversation briefly She joined drama therapy group for the first time. Although she appeared quiet throughout the session, she contributed vocally and artistically to group exercises 18 ECT cancelled due to temperature of 37.7 ยฐC She was bright in mood, smiling more, playing dominoes with other service users. Eating and drinking well. She could reflect on how severely unwell she was
3.535156
0.96875
sec[1]/p[12]
en
0.999997
33478427
https://doi.org/10.1186/s12888-021-03053-0
[ "questions", "anxious", "orientation", "answer", "staff", "ward", "able", "unable", "well", "times" ]
[ { "code": "2E66.Y", "title": "Other specified carcinoma in situ of cervix uteri" }, { "code": "6D10.Z", "title": "Personality disorder, severity unspecified" }, { "code": "6A73", "title": "Mixed depressive and anxiety disorder" }, { "code": "9D93", "title": "Complex vision-related dysfunctions" }, { "code": "1F85", "title": "Paragonimiasis" }, { "code": "1F80", "title": "Clonorchiasis" }, { "code": "QA00.6Y", "title": "Other specified examination of eyes or vision" }, { "code": "LA80.Z", "title": "Anomalous position-orientation of heart, unspecified" }, { "code": "9C83.12", "title": "Downward gaze deviation" }, { "code": "GA18.Y", "title": "Other specified acquired abnormalities of ovary" } ]
=== ICD-11 CODES FOUND === [2E66.Y] Other specified carcinoma in situ of cervix uteri Also known as: Other specified carcinoma in situ of cervix uteri | Epidermoid carcinoma in situ with questionable stromal invasion of unspecified site | Squamous cell carcinoma in situ with questionable stromal invasion of unspecified site [6D10.Z] Personality disorder, severity unspecified Also known as: Personality disorder, severity unspecified | Personality disorder | Specific personality disorders | Enduring personality change after psychiatric illness (deprecated) | Anankastic personality disorder [6A73] Mixed depressive and anxiety disorder Definition: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or markedly diminished interest or pleasure in activities. There are multiple anxiety symptoms, which may include feeling nervous, anxious, or on edge, not being able to control worrying thoughts, fear that something awful will happen, having trouble relaxing, muscle tension, or sympathetic autonomic sym Also known as: Mixed depressive and anxiety disorder | anxious depression | depression with anxiety | anxiety disorder mixed with depression | anxiety disorder mixed with mild depression [9D93] Complex vision-related dysfunctions Definition: Complex Vision-Related Dysfunctions involve interactions with other sensory and motor systems. They reflect the combined effects at all stages of processing. Also known as: Complex vision-related dysfunctions | Dysfunction of visual reading ability | Moderate limitation in reading ability | Profound limitation in reading ability | Dysfunctions of orientation or mobility [1F85] Paragonimiasis Definition: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depending on the site where the parasite migrates to. Transmission is commonly by ingestion of undercooked contaminated crustaceans (crab or crayfish). Confirmation is commonly by identification of Paragonimus eggs in a sputum or faecal sample. Also known as: Paragonimiasis | Pulmonary distomiasis | Parasitic haemoptysis | Oriental lung fluke disease | Endemic haemoptysis Includes: lung fluke disease | infection due to paragonimus species | Infestation due to Paragonimus species [1F80] Clonorchiasis Definition: A condition caused by an infection with the parasitic worm Clonorchis sinensis. This condition commonly presents with inflammation and obstruction of the biliary ducts. This condition may also present with abdominal pain, nausea, or diarrhoea. Transmission is commonly by ingestion of undercooked fish infected with parasitic cysts. Confirmation is by identification of Clonorchis sinensis eggs in a faecal sample. Also known as: Clonorchiasis | Clonorchis liver infection | clonorchiosis | Chinese liver fluke disease | Oriental liver fluke disease Includes: Chinese liver fluke disease | Oriental liver fluke disease | Infection due to Clonorchis sinensis [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 [LA80.Z] Anomalous position-orientation of heart, unspecified Also known as: Anomalous position-orientation of heart, unspecified | Anomalous position-orientation of heart | malposition of heart | abnormal position of heart | congenital abnormality of cardiac position [9C83.12] Downward gaze deviation Also known as: Downward gaze deviation | Sustained downward gaze deviation | Sustained tonic downward gaze deviation | Setting sun sign | Intermittent downward gaze deviation [GA18.Y] Other specified acquired abnormalities of ovary Also known as: Other specified acquired abnormalities of ovary | Prolapse or hernia of ovary or fallopian tube | displacement of ovary into hernial sac | displacement of oviduct | downward displacement of fallopian tube === GRAPH WALKS === --- Walk 1 --- [2E66.Y] Other specified carcinoma in situ of cervix uteri --PARENT--> [2E66] Carcinoma in situ of cervix uteri --EXCLUDES--> [?] Melanoma in situ neoplasms Def: Stage 0 includes: Tis, N0, M0. Tis: Melanoma in situ. N0: No regional lymph node metastases. M0: No detectable evidence of distant metastases.... --- Walk 2 --- [2E66.Y] Other specified carcinoma in situ of cervix uteri --PARENT--> [2E66] Carcinoma in situ of cervix uteri --CHILD--> [2E66.Z] Carcinoma in situ of cervix uteri, unspecified --- Walk 3 --- [6D10.Z] Personality disorder, severity unspecified --PARENT--> [6D10] Personality disorder Def: Personality disorder is characterised by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., abi... --PARENT--> [?] Personality disorders and related traits --- Walk 4 --- [6D10.Z] Personality disorder, severity unspecified --PARENT--> [6D10] Personality disorder Def: Personality disorder is characterised by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., abi... --CHILD--> [6D10.2] Severe personality disorder Def: All general diagnostic requirements for Personality Disorder are met. There are severe disturbances in functioning of the self (e.g., sense of self may be so unstable that individuals report not havin... --- Walk 5 --- [6A73] Mixed depressive and anxiety disorder Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma... --PARENT--> [?] Depressive disorders Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ... --RELATED_TO--> [?] Premenstrual dysphoric disorder Def: During a majority of menstrual cycles within the past year, a pattern of mood symptoms (depressed mood, irritability), somatic symptoms (lethargy, joint pain, overeating), or cognitive symptoms (conce... --- Walk 6 --- [6A73] Mixed depressive and anxiety disorder Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma... --PARENT--> [?] Depressive disorders Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ... --RELATED_TO--> [?] Premenstrual dysphoric disorder Def: During a majority of menstrual cycles within the past year, a pattern of mood symptoms (depressed mood, irritability), somatic symptoms (lethargy, joint pain, overeating), or cognitive symptoms (conce...
[ "[2E66.Y] Other specified carcinoma in situ of cervix uteri\n --PARENT--> [2E66] Carcinoma in situ of cervix uteri\n --EXCLUDES--> [?] Melanoma in situ neoplasms\n Def: Stage 0 includes: Tis, N0, M0. Tis: Melanoma in situ. N0: No regional lymph node metastases. M0: No detectable evidence of distant metastases....", "[2E66.Y] Other specified carcinoma in situ of cervix uteri\n --PARENT--> [2E66] Carcinoma in situ of cervix uteri\n --CHILD--> [2E66.Z] Carcinoma in situ of cervix uteri, unspecified", "[6D10.Z] Personality disorder, severity unspecified\n --PARENT--> [6D10] Personality disorder\n Def: Personality disorder is characterised by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., abi...\n --PARENT--> [?] Personality disorders and related traits", "[6D10.Z] Personality disorder, severity unspecified\n --PARENT--> [6D10] Personality disorder\n Def: Personality disorder is characterised by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., abi...\n --CHILD--> [6D10.2] Severe personality disorder\n Def: All general diagnostic requirements for Personality Disorder are met. There are severe disturbances in functioning of the self (e.g., sense of self may be so unstable that individuals report not havin...", "[6A73] Mixed depressive and anxiety disorder\n Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma...\n --PARENT--> [?] Depressive disorders\n Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ...\n --RELATED_TO--> [?] Premenstrual dysphoric disorder\n Def: During a majority of menstrual cycles within the past year, a pattern of mood symptoms (depressed mood, irritability), somatic symptoms (lethargy, joint pain, overeating), or cognitive symptoms (conce...", "[6A73] Mixed depressive and anxiety disorder\n Def: Mixed depressive and anxiety disorder is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or ma...\n --PARENT--> [?] Depressive disorders\n Def: Depressive disorders are characterised by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly ...\n --RELATED_TO--> [?] Premenstrual dysphoric disorder\n Def: During a majority of menstrual cycles within the past year, a pattern of mood symptoms (depressed mood, irritability), somatic symptoms (lethargy, joint pain, overeating), or cognitive symptoms (conce..." ]
2E66.Y
Other specified carcinoma in situ of cervix uteri
[ { "from_icd11": "6D10.Z", "icd10_code": "F6089", "icd10_title": "Other specific personality disorders" }, { "from_icd11": "6D10.Z", "icd10_code": "F6081", "icd10_title": "Narcissistic personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F603", "icd10_title": "Borderline personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F602", "icd10_title": "Antisocial personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F609", "icd10_title": "Personality disorder, unspecified" }, { "from_icd11": "6D10.Z", "icd10_code": "F600", "icd10_title": "Paranoid personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F606", "icd10_title": "Avoidant personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F601", "icd10_title": "Schizoid personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F69", "icd10_title": "Unspecified disorder of adult personality and behavior" }, { "from_icd11": "6D10.Z", "icd10_code": "F607", "icd10_title": "Dependent personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F604", "icd10_title": "Histrionic personality disorder" }, { "from_icd11": "6D10.Z", "icd10_code": "F60-F69", "icd10_title": "" }, { "from_icd11": "6D10.Z", "icd10_code": "F60", "icd10_title": "Specific personality disorders" }, { "from_icd11": "6D10.Z", "icd10_code": "F608", "icd10_title": "Other specific personality disorders" }, { "from_icd11": "6D10.Z", "icd10_code": "F61", "icd10_title": "" } ]
F6089
Other specific personality disorders
A 32-year-old woman, primigravida, who was 12 weeksโ€™ pregnant, initially consulted a practitioner with awareness of right abdominal discomfort. She was pointed out bilateral adrenal tumor by abdominal ultrasonography. She was diagnosed with pheochromocytoma by blood examination and consulted our hospital. There were no signs of preeclampsia. Her other past history were unremarkable. A physical examination showed a temperature of 35.7ยฐC and a respiratory rate of 16 breaths/min. Her blood pressure was 129/90 mmHg and pulse rate was 86 beats/min. Her heart and breath sounds were normal. The size of her uterus was consistent with 12 weeks of gestation and fetal heart rate was 148 beats/min. There were no palpable masses in the thyroid, no uterine contractions, and no edema was detected. Major laboratory findings included a hematocrit of 38.8% and white blood cell count of 8,100/mm 3 , with 72.0% neutrophils and the platelet count was 391,000/mm 3 . The blood sugar level in the fasting was 87mg/dl. Serum free T3, free T4, and TSH levels were 3.07 pg/ml (normal, 2.30โ€“4.00), 1.22 ng/dl (normal, 0.90โ€“1.70), and 3.940 ฮผunit/ml (normal, 0.500โ€“5.000), respectively. Urinary albumin was negative. A 24-h urine sample demonstrated elevated metanephrine (14 mg/24 h; normal, 0.005โ€“0.20 mg/24 h) and normetanephrine levels (12 mg/24 h; normal, 0.10โ€“0.28 mg/24 h). An ultrasonogram showed a normal fetus, which was compatible with 12 weeks of gestation and solid masses. The crown-rump length was 59 mm and the biparietal diameter was 22 mm. Magnetic resonance imaging (MRI) confirmed bilateral adrenal masses with central necrosis (right, 4.9 ร— 4.4 ร— 4.2 cm; left, 7.3 ร— 6.1 ร— 7.5 cm), which were compatible with bilateral pheochromocytoma . A tumor exhibiting relative non-uniform low signals on T1 MRI was observed in both adrenal glands. Alpha-adrenergic blockade with doxazosin mesylate 2 mg daily was initiated and blood pressure was maintained under 140/90 mmHg. Hydration was also started at 14 weeks of pregnancy. At 15 weeksโ€™ gestation, exploratory laparotomy and bilateral adrenalectomy were performed. Noradrenaline was used by an anesthesiologist during an operation and maintained blood pressure. With regard to surgical findings, no hemorrhage or abnormal adhesions were observed in the abdominal cavity. A soft elastic tumor measuring 9 cm was palpable in the retroperitoneum at the inferior border of the pancreatic body . The tumor was removed en bloc without leaving any remnants. After left adrenalectomy, right adrenal adrenalectomy was then performed . The operative time was 167 minutes and the amount of bleeding was approximately 215 ml. The patient recovered uneventfully. The right tumor measured 5.5 ร— 4.5 ร— 3.5 cm, with a weight of 60 g . The left tumor measured 9.0 ร— 8.5 ร— 5.5 cm, with a weight of 350 g . The cut surface was a yellowish solid tumor, and areas of bleeding accompanied by necrosis in a branched pattern were observed. Histology of the masses confirmed pheochromocytoma of bilateral adrenal glands . The postoperative course was uneventful but the patient also received daily prednisolone. Urinary metanephrine and normetanephrine levels were normalized on the 3rd day postoperation. Vital signs, the height of the uterus, fetal heart sounds, and urine protein levels were monitored accordingly. Postoperatively, the patientโ€™s blood pressure was not controlled with any antihypertensive agents, with normalization of urinary catecholamine levels over time. The patient and her fetus were in good health. She did not show any signs of intrauterine growth retardation or pregnancy-induced hypertension. Therefore, she continued pregnancy as an outpatient. At 39 weeks and 1 day of gestation, a healthy male neonate weighing 2810 g was delivered by vaginal birth with Apgar scores of 8 and 9 at 1 and 5 min, respectively. She was discharged on the 4th postpartum day and was followed up. Her neonate was also discharged with a body weight of 2718 g on the 4th postpartum day. All date reported in the manuscript have been visualized and then approved by our University Hospital Ethics Committee and all procedures carried out on the patients were in compliance with the Helsinki Declaration. Moreover, the patient has given written explicit, express and unequivocal consent to publish her sensible date on our manuscript. Figure 1 MRI findings: MRI shows bilateral adrenal masses with central necrosis. The right mass was 4.9 ร— 4.4 ร— 4.2 cm and the left mass was 7.3 ร— 6.1 ร— 7.5 cm, which were compatible with bilateral pheochromocytoma. A tumor exhibiting relative non-uniform low signals on T1 MRI was observed in both adrenal glands. Transverse plane (a) . Coronal plane (b) . Figure 2 Surgical findings: Soft elastic tumor measuring 9 cm was palpable in the retroperitoneum at the inferior border of the pancreatic body. The tumor was removed en bloc without leaving any remnants (a) . After the left adrenalectomy, right adrenal adrenalectomy was then performed (b) . Figure 3 Resected specimen: The right tumor measured 5.5 ร— 4.5 ร— 3.5 cm, with a weight of 60 g (a) . The left tumor measured 9.0 ร— 8.5 ร— 5.5 cm, with a weight of 350 g (b) . The cut surface was a yellowish solid tumor, and areas of bleeding accompanied by necrosis in a branched pattern were observed. Figure 4 Histopathological findings. Histology of the masses confirmed pheochromocytoma of bilateral adrenal glands. Hematoxylin and eosin staining (x100), Right (a) , Left (b) .
4.011719
0.978027
sec[1]/p[0]
en
0.999997
25935403
https://doi.org/10.1186/s12893-015-0041-1
[ "tumor", "adrenal", "blood", "masses", "pheochromocytoma", "adrenalectomy", "weight", "pressure", "gestation", "necrosis" ]
[ { "code": "2F9Z", "title": "Neoplasms of unknown behaviour of unspecified site" }, { "code": "ME61", "title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature" }, { "code": "2E6Z", "title": "Carcinoma in situ of unspecified site" }, { "code": "2F91.1", "title": "Neoplasms of unknown behaviour of trachea, bronchus or lung" }, { "code": "2F92", "title": "Neoplasms of unknown behaviour of skin" }, { "code": "5A76.Y", "title": "Other specified disorders of adrenal gland" }, { "code": "5A7Z", "title": "Disorders of the adrenal glands or adrenal hormone system, unspecified" }, { "code": "5A74.Z", "title": "Adrenocortical insufficiency, unspecified" }, { "code": "5A74.Y", "title": "Other specified adrenocortical insufficiency" }, { "code": "LC8Z", "title": "Structural developmental anomalies of the adrenal glands, unspecified" } ]
=== ICD-11 CODES FOUND === [2F9Z] Neoplasms of unknown behaviour of unspecified site Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes [2E6Z] Carcinoma in situ of unspecified site Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm [2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site [2F92] Neoplasms of unknown behaviour of skin Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS [5A76.Y] Other specified disorders of adrenal gland Also known as: Other specified disorders of adrenal gland | Suprarenal gland abscess | Suprarenal abscess | Adrenal gland inflammation | adrenal glandular inflammation [5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified Also known as: Disorders of the adrenal glands or adrenal hormone system, unspecified | Adrenal gland disease, not elsewhere classified | adrenal cortex disease | adrenal cortical disease | adrenal glandular disease [5A74.Z] Adrenocortical insufficiency, unspecified Also known as: Adrenocortical insufficiency, unspecified | Adrenocortical insufficiency | adrenal failure NOS | Hypoadrenocorticism | adrenocortical hypofunction [5A74.Y] Other specified adrenocortical insufficiency Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism [LC8Z] Structural developmental anomalies of the adrenal glands, unspecified Also known as: Structural developmental anomalies of the adrenal glands, unspecified | adrenal anomaly | adrenal gland anomaly | congenital anomaly of adrenal gland | congenital malformation of adrenal gland === GRAPH WALKS === --- Walk 1 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs --- Walk 2 --- [2F9Z] Neoplasms of unknown behaviour of unspecified site --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour --- Walk 3 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Enlarged lymph nodes Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes.... --EXCLUDES--> [?] Chronic lymphadenitis --- Walk 4 --- [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature... --EXCLUDES--> [?] Localised adiposity Def: A condition characterised by accumulation of adipose tissue in specific regions of the body.... --CHILD--> [?] Fat pad Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied.... --- Walk 5 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system --- Walk 6 --- [2E6Z] Carcinoma in situ of unspecified site --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
[ "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs", "[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --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 --EXCLUDES--> [?] Chronic lymphadenitis", "[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --CHILD--> [?] Fat pad\n Def: A condition characterised by a mass of closely packed adipose cells surrounded by fibrous tissue septa. When localised in the heel this condition may present with dull pain when pressure is applied....", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system", "[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs" ]
2F9Z
Neoplasms of unknown behaviour of unspecified site
[ { "from_icd11": "2F9Z", "icd10_code": "D487", "icd10_title": "Neoplasm of uncertain behavior of other specified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D482", "icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system" }, { "from_icd11": "2F9Z", "icd10_code": "D37-D48", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D377", "icd10_title": "" }, { "from_icd11": "2F9Z", "icd10_code": "D48", "icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites" }, { "from_icd11": "2F9Z", "icd10_code": "D489", "icd10_title": "Neoplasm of uncertain behavior, unspecified" }, { "from_icd11": "ME61", "icd10_code": "R2240", "icd10_title": "Localized swelling, mass and lump, unspecified lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2232", "icd10_title": "Localized swelling, mass and lump, left upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2242", "icd10_title": "Localized swelling, mass and lump, left lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2231", "icd10_title": "Localized swelling, mass and lump, right upper limb" }, { "from_icd11": "ME61", "icd10_code": "R2241", "icd10_title": "Localized swelling, mass and lump, right lower limb" }, { "from_icd11": "ME61", "icd10_code": "R2233", "icd10_title": "Localized swelling, mass and lump, upper limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2243", "icd10_title": "Localized swelling, mass and lump, lower limb, bilateral" }, { "from_icd11": "ME61", "icd10_code": "R2230", "icd10_title": "Localized swelling, mass and lump, unspecified upper limb" }, { "from_icd11": "ME61", "icd10_code": "R220", "icd10_title": "Localized swelling, mass and lump, head" } ]
D487
Neoplasm of uncertain behavior of other specified sites
Subject 1 is a 29-year-old non-Hispanic white male with familial syndromic PBS (PBS + OPDSD) (RUBACE score 22). At 12 weeks gestation, he manifested bilateral severe hydronephrosis with renal dysplasia progressing to severe oligohydramnios which was treated with multiple fetal bladder aspirations. Born prematurely at 32 weeks gestation, he was initially ventilator dependent and had gastroesophageal reflux disease (GERD) requiring Nissen and gastrostomy tube. His urinary tract malformations included bilateral grade 4 VUR, urachal diverticulum, large capacity bladder, and urethral obstruction requiring genitourinary surgeries including neonatal vesicostomy, bilateral ureteral reimplantation, and urethral dilation. As an adult, he developed end stage renal disease and received a renal transplant. As he cannot urinate to completion, he empties his bladder by clean intermittent catheterization. His OPDSD features include distinct craniofacial and skeletal abnormalities including craniosynostosis with hydrocephalus requiring ventricular-atrial shunt, prominent supraorbital ridge, hypodontia, bilateral flaring of the anterior ribs, lumbar levoscoliosis, and bilateral genu valgum treated with distal femoral osteostomies . Table 1 Clinical features of Prune Belly Syndrome Subjects with FLNA mutations PBS Subject Subject 1 Subject 2 Subject 3 Subject 4 Current Age, years 29 yrs 25 yrs 51 yrs 7 yrs Prenatal History (Gestational age at birth, weeks) Oligohydramnios, multiple fetal bladder aspirations performed Oligohydramnios N/A (born at 40 weeks) Oligohydramnios Stage of Life Pediatric Adult Pediatric Adult Pediatric Adult Pediatric Adult PBS RUBACE Phenotype R enal Renal dysplasia ESRD b s/p c renal transplant Renal dysplasia requiring peritoneal dialysis ESRD s/p cadaveric renal transplant Obstructive uropathy requiring cutaneous ureterostomy CKD a stage 3 Normal renal function U reteral Bilateral VUR with bilateral ureteral reimplantation, urethral obstruction requiring dilation Right VUR treated with bilateral tapered ureteral reimplantation Bilateral ureterovesical junction obstruction necessitating bilateral ureterostomies and bilateral ureteral reimplantation ร— 3, no VUR d present Bilateral VUR with spontaneous resolution B ladder Large bladder capacity with urachal diverticulum, vesicostomy and clean intermittent catheterization Large capacity bladder, cutaneous continent vesicostomy, clean intermittent catheterization Small capacity bladder (40-50 cc at 4.5 years of age) necessitating conduit diversion at age 6 Ileal conduit Large capacity bladder s/p urachal diverticulectomy and clean intermittent catheterization A bdominal Musculature Severe laxity and wrinkling Laxity Mesh abdominal closure after Transplantation Laxity Right large direct and indirect inguinal hernia repair Laxity C ryptorchidism Bilateral intraabdominal non-palpable testes (bilateral orchiopexy) Bilateral inguinal testes (left orchiopexy and right orchiectomy) Bilateral undescended testes (bilateral orchiopexy) Right orchiopexy; recurrent large hydroceles Bilateral non-palpable testes (bilateral orchiopexy) E xtra-genitourinary: Gastrointestinal Nissen and Gastrostomy tube for GERD e , Constipation Malrotation, duodenal perforation, Nissen and gastrostomy tube for GERD, Constipation Constipation Constipation E xtra-genitourinary: Respiratory Ventilator dependent at birth Reactive airway disease Ventilator dependent in infancy Right Upper lobe pneumonia in first month of life Normal Normal PBS RUBACE Severity Score (range 0โ€“31) and PBS category 22, Syndromic PBS 24, Syndromic PBS 14, Isolated PBS 13, Isolated PBS OPDSD Phenotypes Craniofacial Craniosynostosis, Skull base sclerosis, Prominent supraorbital ridge, full cheeks, hypodontia, micrognathia Prominent supraorbital ridge, down slanting palpebral fissures, proptosis, ocular hypertelorism, hypodontia, micrognathia and facial asymmetry (Pierre Robin Sequence) Normal Normal Deafness Absent Congenital hearing loss bilaterally (hearing aids), recurrent otitis media and PET Absent Absent Cleft Palate Absent Yes, Bilaterally surgically corrected High arched palate Absent Thorax Pectus carinum, Irregular ribs (flaring of the anterior ribs bilaterally) Pectus carinum, Irregular ribs (absent T12 ribs bilaterally) Normal Normal Heart Atrial Septal Defect Atrial Septal Defect Normal Normal Omphalocele Absent Absent Absent Absent Scoliosis Lumbar Levoscoliosis, non-surgical T5-L4 Kyphoscoliosis s/p Posterior Spinal Fusion and L3-pelvis fusion (residual 38ยฐ thoracic levoscoliosis and 88ยฐ thoracolumbar kyphosis) Mild, non-surgical Not present Limbs/Digits Bilateral genu vaigum S/P bilateral distal femoral osteostomies, Short Achilles tendon, Broad thumbs, 2 nails on right 3rd toe, Hammer shaped toe, wide spaced toes, Hypoplastic distal phalanges Short proximally placed thumbs, hypoplastic distal phalanges, Short Achilles tendon, hypoplasia of the great toe, long second toe Hypoplastic distal phalanges, hypoplasia of the great toe Hypoplastic distal phalanges, hypoplasia of the great toe CNS Hydrocephalus S/P shunt X 2, Seizures Normal Normal Normal Mentation ADHD f treated with concerta Moderate Developmental Delay Normal Developmental Delay Other Anomalies Hypotonia, thrombocytopenia None None a CKD (Chronic kidney disease) b ESRD (End stage renal disease) c S/P (status post) d VUR (vesicoureteral reflux) e GERD (gastroesophageal reflux) f ADHD (attention-deficit/hyperactivity disorder)
4.164063
0.951172
sec[2]/sec[0]/p[1]
en
0.999997
32085749
https://doi.org/10.1186/s12881-020-0973-x
[ "absent", "renal", "bladder", "subject", "requiring", "large", "capacity", "ribs", "orchiopexy", "oligohydramnios" ]
[ { "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": "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 === [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 [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 --- [8A68.Y] Other specified type of seizure --PARENT--> [8A68] Types of seizures --EXCLUDES--> [?] Dissociative neurological symptom disorder, with non-epileptic seizures Def: Dissociative neurological symptom disorder, with non-epileptic seizures is characterised by a symptomatic presentation of seizures or convulsions that are not consistent with a recognised disease of t... --- Walk 2 --- [8A68.Y] Other specified type of seizure --PARENT--> [8A68] Types of seizures --PARENT--> [?] Epilepsy or seizures Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart.... --- 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 --- [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--> [8A66.1Z] Non-convulsive status epilepticus, unspecified --- 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--> [8A66.10] Absence status epilepticus Def: An absence seizure (see absence seizures, typical and atypical) lasting >10 min (on average 10-15 min)....
[ "[8A68.Y] Other specified type of seizure\n --PARENT--> [8A68] Types of seizures\n --EXCLUDES--> [?] Dissociative neurological symptom disorder, with non-epileptic seizures\n Def: Dissociative neurological symptom disorder, with non-epileptic seizures is characterised by a symptomatic presentation of seizures or convulsions that are not consistent with a recognised disease of t...", "[8A68.Y] Other specified type of seizure\n --PARENT--> [8A68] Types of seizures\n --PARENT--> [?] Epilepsy or seizures\n Def: At least 2 unprovoked (or reflex) seizures occurring more than 24 hours apart....", "[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....", "[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--> [8A66.1Z] Non-convulsive status epilepticus, unspecified", "[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)...." ]
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": "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" } ]
Q333
Agenesis of lung
A 64-year-old Persian man presented with abdominal pain. He was confused and affected by hypersomnia and fatigue. The patient also had retrosternal chest pain, exertional dyspnea, nausea, vomiting, and constipation. He was previously diagnosed with right adrenocortical carcinoma and had undergone right adrenalectomy with regional lymph nodes resection 5 months previously; the histopathology revealed adrenal cortical carcinoma with a score of 6 based on Weiss criteria, and immunohistochemistry was positive for synaptophysin, inhibin, and CKAE1/AE3 . He had a history of hypertension, and amlodipine was his only hypertensive medication. For constipation he had received lactulose, and oxycodone was prescribed for pain relief. The patient was a heavy cigarette smoker and had been using opium for more than 20 years. At admission, the patient had a blood pressure of 120/76 mmHg and a heart rate of 107 bpm. His respiratory rate was 20 breaths per minute. A body temperature of 36.7 ยฐC and SPO 2 of 93% were also recorded. On physical examination, the patient had abdominal distension and mild tenderness at the right upper quadrant. Pitting edema was detected bilaterally in the lower extremities. Other physical examinations were insignificant. Chest pain and dyspnea prompted echocardiography (ECG), which was unremarkable with estimated ejection fraction of 55% and no pericardial effusion. In addition to abdominal pain, nausea, and vomiting, the patient did not have defecation and gas passage for two consecutive days. To evaluate possible gastrointestinal obstruction, consultation with the surgery department and abdominopelvic x-ray were performed. Accordingly, the possibility of obstruction was ruled out. Abdominopelvic computed tomography (CT) revealed multiple and large lesions suggestive of liver metastases. In initial laboratory results, hyperkalemia (potassium 6 mg/dl), hyperuricemia (uric acid 16.4 mg/dl), hyperphosphatemia (phosphorus 6.9 mg/dl), and hypocalcemia (calcium 7.8 mg/dl), with elevated serum creatinine level (creatinine 3.8 mg/dl), were detected. White blood cell count of 26.58 ร— 10 9 /L, C-reactive protein (CRP) of 45 mg/L, and alkaline phosphatase (ALP) of 1144 IU/L were indicative of an inflammatory process (Table 1 ). In urine analysis, significant amounts of blood and protein were found. Due to these electrolyte disturbances (hyperkalemia, hyperuricemia, and hyperphosphatemia), which fulfilled Cairoโ€“Bishop criteria, tumor lysis syndrome was considered as an etiology of acute kidney injury for this patient, and since he had not ever received chemotherapy or radiotherapy, the patient was diagnosed as having spontaneous tumor lysis syndrome (TLS) and treated accordingly. Hydration with crystalloid intravenous fluids such as normal saline at a rate of 200 ml/hour was started as initial management to expand the intracellular volume and increase renal excretion of uric acid and other metabolites. A loop diuretic was used as add-on therapy to prevent volume overload and to wash out obstructing uric acid crystals. After ensuring a sufficient level of G6PD in the patient, rasburicase was administered to convert uric acid to more soluble and easily excreted compounds. Hyperkalemia, a life-threatening abnormality in TLS, was managed with sodium polystyrene sulfonate as a potassium-lowering agent. Insulin plus hypertonic glucose was also prescribed as a temporizing measure. In addition to massive hydration and hypouricemic agents, we considered restriction of dietary phosphate intake and administration of a phosphate binder such as sevelamer carbonate, to treat hyperphosphatemia. Blood and urine cultures were drawn, and piperacillinโ€“tazobactam was administrated to treat possible sepsis. Due to volume overload signs (i.e., pulmonary congestion and peripheral edema), severe oliguria, and blunted consciousness during hospitalization, the patient underwent renal replacement therapy with hemodialysis on three consecutive days. Despite immediate and intensive care with hydration, treatment with a hypouricemic agent, and renal replacement therapy, the patient ultimately passed away from cardiopulmonary failure. Table 1 Patientโ€™s laboratory data during hospitalization On admission Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Na (mEq/l) 136 139 133 132 131 132 137 137 K (mEq/l) 6.0 5.3 3.7 3.2 3.1 4.5 5.1 6.0 BS (mg/dl) 55 71 - - 57 - 55 42 Urea (mg/dl) 189 243 188 196 207 202 207 182 Cr (mg/dl) 3.8 4.0 3.6 3.7 4.4 4.4 4.3 4.6 Ca (mg/dl) 7.8 7.2 6.7 6.3 7.1 7.1 7.2 7.2 P (mg/dl) 6.9 8.5 7.2 7.9 8.6 5.7 8.5 โ€“ Mg (mg/dl) 3.1 3.5 3.0 2.3 2.6 2.7 2.8 2.6 Uric acid (mg/dl) 16.4โ€“ 4.0 7.1 2.5 2.0 1.2 โ€“ 2.7 CPK (mg/dl) โ€“ 174 โ€“ โ€“ โ€“ โ€“ 2.6 โ€“ LDH (mg/dl) โ€“ 8223 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ WBC (count) 26,580 โ€“ โ€“ โ€“ 23,500 25,960 โ€“ 20,800 Hb (%) 9.8 โ€“ โ€“ โ€“ 10.7 9.7 โ€“ 10 Platelet (count) 486,000 โ€“ โ€“ โ€“ 385,000 403,000 โ€“ 341,000 PT (seconds) 15.3 โ€“ 17 โ€“ โ€“ โ€“ โ€“ โ€“ PTT (seconds) 32 โ€“ 37 โ€“ โ€“ โ€“ โ€“ โ€“ INR 1.17 โ€“ 1.3 โ€“ โ€“ โ€“ โ€“ โ€“ AST (mg/dl) 360 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ ALT (mg/dl) 44 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ ALP (mg/dl) 1144 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ Bilirubin total (mg/dl) 0.8 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ CRP (mg/dl) 45 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ Albumin (g/dl) โ€“ โ€“ 2.6 โ€“ โ€“ 2.1 โ€“ โ€“ WBC, white blood cells; Hb, hemoglobin; CRP, C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; LDH, lactate dehydrogenase; CPK, creatine phosphokinase; BS, blood sugar; Cr, creatinine; PT, prothrombin time; PTT, partial thromboplastin time; INR, international normalized ratio
4.082031
0.972168
sec[1]/p[0]
en
0.999996
35139902
https://doi.org/10.1186/s13256-022-03263-4
[ "blood", "pain", "uric", "acid", "abdominal", "hyperkalemia", "hyperphosphatemia", "creatinine", "count", "protein" ]
[ { "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": "MG3Z", "title": "Pain, unspecified" }, { "code": "8E43.Z", "title": "Pain disorders, unspecified" }, { "code": "MG31.Z", "title": "Acute pain, unspecified" }, { "code": "MG30.Z", "title": "Chronic pain, unspecified" }, { "code": "FB56.2", "title": "Myalgia" } ]
=== ICD-11 CODES FOUND === [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 [MG3Z] Pain, unspecified Also known as: Pain, unspecified | pain observations | pain NOS | generalised pain | generalised pain, NOS [8E43.Z] Pain disorders, unspecified Also known as: Pain disorders, unspecified | Pain disorders [MG31.Z] Acute pain, unspecified Also known as: Acute pain, unspecified | Acute pain [MG30.Z] Chronic pain, unspecified Also known as: Chronic pain, unspecified | Chronic pain [FB56.2] Myalgia Definition: This is a disorder characterised by pain in a muscle or group of muscles. Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain === GRAPH WALKS === --- Walk 1 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Certain conditions originating in the perinatal period Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later.... --- Walk 2 --- [3C0Z] Diseases of the blood or blood-forming organs, unspecified --PARENT--> [03] Diseases of the blood or blood-forming organs Def: This chapter includes diseases of the blood as well as diseases of blood forming organs.... --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ... --- Walk 3 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --CHILD--> [MF50.41] Microscopic haematuria --- Walk 4 --- [MF50.4Z] Haematuria, unspecified --PARENT--> [MF50.4] Haematuria Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th... --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC... --- Walk 5 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.1] Finding of cocaine in blood --- Walk 6 --- [MA12.1] Finding of cocaine in blood --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system --CHILD--> [MA12.0] Finding of opiate drug in blood
[ "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....", "[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria", "[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood", "[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood" ]
3C0Z
Diseases of the blood or blood-forming organs, unspecified
[ { "from_icd11": "3C0Z", "icd10_code": "D75A", "icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia" }, { "from_icd11": "3C0Z", "icd10_code": "D7581", "icd10_title": "Myelofibrosis" }, { "from_icd11": "3C0Z", "icd10_code": "D7582", "icd10_title": "Heparin induced thrombocytopenia (HIT)" }, { "from_icd11": "3C0Z", "icd10_code": "D7589", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D759", "icd10_title": "Disease of blood and blood-forming organs, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "D763", "icd10_title": "Other histiocytosis syndromes" }, { "from_icd11": "3C0Z", "icd10_code": "Q899", "icd10_title": "Congenital malformation, unspecified" }, { "from_icd11": "3C0Z", "icd10_code": "III", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D70-D77", "icd10_title": "" }, { "from_icd11": "3C0Z", "icd10_code": "D75", "icd10_title": "Other and unspecified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D77", "icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere" }, { "from_icd11": "3C0Z", "icd10_code": "D758", "icd10_title": "Other specified diseases of blood and blood-forming organs" }, { "from_icd11": "3C0Z", "icd10_code": "D76", "icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue" }, { "from_icd11": "MF50.4Z", "icd10_code": "R310", "icd10_title": "Gross hematuria" }, { "from_icd11": "MF50.4Z", "icd10_code": "R312", "icd10_title": "Other microscopic hematuria" } ]
D75A
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
A 68-year-old man was admitted to our hospital with persistent colic in the lower abdomen which radiated to the back that had persisted for more than 10 days. He ate fish two weeks ago. There was no history of gastrointestinal bleeding or jaundice. Surgery for acute appendicitis and appendectomy was performed 6 years ago. The abdominal wall is palpated as slightly tense, with tenderness in the whole abdomen, significantly in the lower abdomen, no rebound pain and muscle tension. He visited the emergency department of our hospital and his emergency abdominal computed tomography (CT) scan showed high density streaks along the anterior lower edges of the 3rd part of duodenum with peripheral exudation and localized peritonitis . X-ray examination results showed no free gas under the diaphragm. Blood tests showed WBC 10.03 ร— 10 9 /L (normal range 3.5 ร— 10 9 /L โ€“9.5 ร— 10 9 /L), N 0.68 (normal range 0.4โ€“0.75), CRP 35.80 mg/L (normal range 0.068โ€“8.2). The patient was diagnosed as โ€œForeign bodies in the duodenumโ€ and hospitalized in department of Gastroenterology. Esophagogastroduodenoscopy (EGD) showed gastric body ulcer (locally with high-grade intraepithelial neoplasia); chronic atrophic gastritis with erosion (c-3) bile reflux; duodenal bulbous polyp. In order to observe the changes in the position of the foreign body, we recheck the abdominal CT. His second abdominal computed tomography (CT) scan showed foreign body in the 3rd part of duodenum with peritonitis, local inclusional effusion or abscess; Larger portion of the foreign body was located outside the intestine . The patient was transferred to gastrointestinal surgery for suspected duodenal foreign body and perforation. We gave conservative treatment measures such as fasting, drinking, and acid suppression. After one days of conservative treatment, the patient felt that the abdominal pain was relieved. On the second day of admission, we believed that the foreign body was clearly present and moving. Although the symptoms and signs were alleviated, the remained foreign body may cause perforation of the digestive tract or even shock and death, so we decided to operate. Then laparoscopy was made to detect and remove foreign body. The observation hole was located 5 cm below the umbilicus and was about 1 cm long. The main operation hole was 3 cm below the left midclavicular line and about 1.2 cm long. The remaining three operation holes were located 3 cm below the right midclavicular line and the intersection of the lateral third of the line connecting the bilateral anterior superior iliac spine and the umbilical cord, about 0.5 cm long. During the surgery, the retroperitoneum was opened to expose the 3rd and 4th part of the duodenum on both sides of the superior mesenteric vessels. No obvious inflammatory reaction was observed around the duodenum, and the location of foreign body penetration could not be determined. Considering colonoscopy is longer than gastroduodenoscopy, intraoperative colonoscopy were used and showed the perforation site between the 3rd and 4th part of the duodenum . Laparoscopy could not find the perforation site, and did not detect the abnormal area. So, we switched to open surgery. The median incision in the abdomen is about 20 cm long. Cut into the abdomen layer by layer, and continue to free the duodenum behind the upper mesenteric vessel on the right side. The lower wall of the intestine and the underside of the 3rd and 4th part of the duodenum showed heavy inflammation and tissue edema. The junction of 3rd and 4th part of the duodenum was partially perforated to a size of 0.5 cm. A fishbone-like foreign body about 3 cm long was found in the inflamed tissue below the perforation (in front of the right spine of the abdominal aorta) . We took out the foreign body and flushed the operation area. The duodenal decompression tube with a diameter of 4 mm is placed above the perforated part of the duodenum level and the jejunal nutrition tube were placed proximally and distally at 15 cm and 25 cm from the ligament of flexion, and two drainage tubes with a diameter of 7 mm were placed at the duodenal perforation. The operation lasts 6 h. Intraoperative vital signs were normal, with T 36.5 โ„ƒ, P 85 beats/min, R 20 times/min, BP 130/75 mmHg, SPO2 98 %. The bone was like a knife . Postoperative recovery is smooth, and the patient resumed normal diet and was discharged without any complication. The patient was hospitalized for 30 days. Enteral nutrition was started on the fifth day after the operation. The drainage tube and jejunal nutrition tube were removed after 3 weeks from the operation. The frequency of follow-up after discharge was once every two weeks. The last follow-up was one month after discharge, with normal nutritional status. Fig. 1 Migration of fish bones into abdominal para-aortic tissue from the duodenum after leading to duodenal perforation a Emergency abdominal computed tomography (CT) scan showed High density streaks along the horizontal anterior and lower edges of the duodenum. b Second abdominal computed tomography (CT) scan showed duodenal horizontal foreign body with peritonitis, local inclusional effusion or abscess. c Intraoperative endoscopy showed the foreign body had penetrated the intestinal wall at the junction between the horizontal and ascending parts of the duodenum. d A fishbone-like foreign body about 3 cm long was found in the inflamed tissue below the perforation. e The fishbone was like a knife
3.818359
0.98291
sec[1]/p[0]
en
0.999996
33622248
https://doi.org/10.1186/s12876-021-01662-3
[ "foreign", "body", "duodenum", "abdominal", "perforation", "part", "duodenal", "about", "long", "abdomen" ]
[ { "code": "PB07", "title": "Unintentional threat to breathing by inhalation or ingestion of other objects or materials" }, { "code": "FB56.0", "title": "Foreign body granuloma of soft tissue, not elsewhere classified" }, { "code": "ND73.Z", "title": "Foreign body in alimentary tract, unspecified" }, { "code": "ND74.1", "title": "Foreign body in bladder" }, { "code": "ND73.1", "title": "Foreign body in oesophagus" }, { "code": "ND51.Y", "title": "Other specified injuries of spine or trunk, level unspecified" }, { "code": "MG20.Z", "title": "Cachexia, unspecified" }, { "code": "ND56.Z", "title": "Unspecified injury to unspecified part of trunk, limb or body region" }, { "code": "8A22", "title": "Lewy body disease" }, { "code": "ME86.Z", "title": "Problem of unspecified body part" } ]
=== ICD-11 CODES FOUND === [PB07] Unintentional threat to breathing by inhalation or ingestion of other objects or materials Also known as: Unintentional threat to breathing by inhalation or ingestion of other objects or materials | inhalation and ingestion of other objects causing obstruction of respiratory tract | asphyxia by any object, except food or vomitus, entering by nose or mouth | aspiration and inhalation of foreign body, except food or vomitus into respiratory tract, NOS | choked on any object, except food or vomitus, entering by nose or mouth [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified Also known as: Foreign body granuloma of soft tissue, not elsewhere classified | foreign body granuloma | Foreign body granuloma of soft tissue, not elsewhere classified, multiple sites | Foreign body granuloma of soft tissue, not elsewhere classified, shoulder region | Foreign body granuloma of soft tissue, not elsewhere classified, acromioclavicular joint Excludes: Foreign body granuloma of skin [ND73.Z] Foreign body in alimentary tract, unspecified Also known as: Foreign body in alimentary tract, unspecified | Foreign body in alimentary tract | foreign body in digestive tract | foreign body of digestive structure | ingestion of foreign body [ND74.1] Foreign body in bladder Also known as: Foreign body in bladder [ND73.1] Foreign body in oesophagus Definition: Mechanical impaction or retention of foreign body in the oesophagus Also known as: Foreign body in oesophagus [ND51.Y] Other specified injuries of spine or trunk, level unspecified Also known as: Other specified injuries of spine or trunk, level unspecified | Superficial injury of trunk, level unspecified | multiple superficial injuries of trunk | Abrasion of trunk, level unspecified | Contusion of trunk, level unspecified [MG20.Z] Cachexia, unspecified Also known as: Cachexia, unspecified | Cachexia | cachectic | general body deterioration | inanition [ND56.Z] Unspecified injury to unspecified part of trunk, limb or body region Also known as: Unspecified injury to unspecified part of trunk, limb or body region | Injury of unspecified body region | injury NOS | trauma NOS | traumatic injury NOS [8A22] Lewy body disease Definition: Lewy body disease is a neurodegenerative disorder and the second most common form of dementia in the elderly after Alzheimer disease. Lewy bodies are histologically defined as intracytoplasmic eosinophilic neuronal inclusions in the cortex or brainstem. Also known as: Lewy body disease | Lewy body | DLBD - [diffuse Lewy body disease] | diffuse Lewy body disease | CLBD - [cortical Lewy body disease] [ME86.Z] Problem of unspecified body part Also known as: Problem of unspecified body part | Symptom or complaint of a body part === GRAPH WALKS === --- Walk 1 --- [PB07] Unintentional threat to breathing by inhalation or ingestion of other objects or materials --PARENT--> [?] Unintentional threat to breathing --CHILD--> [PB00] Unintentional threat to breathing by suffocation from object covering mouth or nose --- Walk 2 --- [PB07] Unintentional threat to breathing by inhalation or ingestion of other objects or materials --PARENT--> [?] Unintentional threat to breathing --CHILD--> [PB02] Unintentional threat to breathing by strangulation --- Walk 3 --- [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified --EXCLUDES--> [?] Foreign body granuloma of skin --PARENT--> [?] Dermatoses due to foreign bodies --- Walk 4 --- [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified --EXCLUDES--> [?] Foreign body granuloma of skin --PARENT--> [?] Dermatoses due to foreign bodies --- Walk 5 --- [ND73.Z] Foreign body in alimentary tract, unspecified --PARENT--> [ND73] Foreign body in alimentary tract --EXCLUDES--> [?] Foreign body in pharynx Def: Objects that inadvertently enter the pharynx from the environment.... --- Walk 6 --- [ND73.Z] Foreign body in alimentary tract, unspecified --PARENT--> [ND73] Foreign body in alimentary tract --CHILD--> [ND73.0] Foreign body in mouth
[ "[PB07] Unintentional threat to breathing by inhalation or ingestion of other objects or materials\n --PARENT--> [?] Unintentional threat to breathing\n --CHILD--> [PB00] Unintentional threat to breathing by suffocation from object covering mouth or nose", "[PB07] Unintentional threat to breathing by inhalation or ingestion of other objects or materials\n --PARENT--> [?] Unintentional threat to breathing\n --CHILD--> [PB02] Unintentional threat to breathing by strangulation", "[FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified\n --EXCLUDES--> [?] Foreign body granuloma of skin\n --PARENT--> [?] Dermatoses due to foreign bodies", "[FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified\n --EXCLUDES--> [?] Foreign body granuloma of skin\n --PARENT--> [?] Dermatoses due to foreign bodies", "[ND73.Z] Foreign body in alimentary tract, unspecified\n --PARENT--> [ND73] Foreign body in alimentary tract\n --EXCLUDES--> [?] Foreign body in pharynx\n Def: Objects that inadvertently enter the pharynx from the environment....", "[ND73.Z] Foreign body in alimentary tract, unspecified\n --PARENT--> [ND73] Foreign body in alimentary tract\n --CHILD--> [ND73.0] Foreign body in mouth" ]
PB07
Unintentional threat to breathing by inhalation or ingestion of other objects or materials
[ { "from_icd11": "PB07", "icd10_code": "W80", "icd10_title": "" }, { "from_icd11": "FB56.0", "icd10_code": "M6020", "icd10_title": "Foreign body granuloma of soft tissue, not elsewhere classified, unspecified site" }, { "from_icd11": "FB56.0", "icd10_code": "M60", "icd10_title": "Myositis" }, { "from_icd11": "FB56.0", "icd10_code": "M602", "icd10_title": "Foreign body granuloma of soft tissue, not elsewhere classified" }, { "from_icd11": "ND73.Z", "icd10_code": "T189XXA", "icd10_title": "Foreign body of alimentary tract, part unspecified, initial encounter" }, { "from_icd11": "ND73.Z", "icd10_code": "T188XXA", "icd10_title": "Foreign body in other parts of alimentary tract, initial encounter" }, { "from_icd11": "ND73.Z", "icd10_code": "T18", "icd10_title": "Foreign body in alimentary tract" }, { "from_icd11": "ND73.Z", "icd10_code": "T188", "icd10_title": "Foreign body in other parts of alimentary tract" }, { "from_icd11": "ND73.Z", "icd10_code": "T189", "icd10_title": "Foreign body of alimentary tract, part unspecified" }, { "from_icd11": "ND74.1", "icd10_code": "T191XXA", "icd10_title": "Foreign body in bladder, initial encounter" }, { "from_icd11": "ND74.1", "icd10_code": "T191", "icd10_title": "Foreign body in bladder" }, { "from_icd11": "ND73.1", "icd10_code": "T18198A", "icd10_title": "Other foreign object in esophagus causing other injury, initial encounter" }, { "from_icd11": "ND73.1", "icd10_code": "T18120A", "icd10_title": "Food in esophagus causing compression of trachea, initial encounter" }, { "from_icd11": "ND73.1", "icd10_code": "T18190A", "icd10_title": "Other foreign object in esophagus causing compression of trachea, initial encounter" }, { "from_icd11": "ND73.1", "icd10_code": "T18100A", "icd10_title": "Unspecified foreign body in esophagus causing compression of trachea, initial encounter" } ]
W80
An 84-year-old woman, with a history of a thyroid fine-needle aspiration biopsy for left-sided neck swelling one year ago (specific details undisclosed), was admitted for the first time three years ago . Her admission was prompted by a six-month history of coughing, with bloody sputum for one month, alongside chest pain, shortness of breath and a single episode of fever. Physical examination on admission revealed a temperature of 36.8ยฐC, heart rate of 107 beats per minute, respiratory rate of 24 breaths/min, blood pressure of 138/70 mmHg, and oxygen saturation of 97%. Decreased tactile vocal fremitus, dullness on percussion, and decreased breath sounds were noted over the right lung, without crackles or wheezes bilaterally. Complete blood count revealed RBC 3.16 ร— 10^9/L (reference: 3.8-5.1) and Hemoglobin 90 g/L (reference: 115-150). Inflammatory markers showed C-reactive protein (CRP) at 154.24 mg/L (reference: 0-10) and serum amyloid A(SAA) above 320 mg/L (reference: 0-10), while procalcitonin (PCT) was normal. NT-proBNP was 1489.9 pg/mL (reference: 0-250). Tumor markers were negative. Thyroid function showed TSH at 11.881 mIU/L (reference: 0.55-4.78). Liver function tests showed albumin at 28.2 g/L (reference: 40-55) and globulin at 45.1 g/L (reference: 20-40). D-dimer was 2.04 mg/L (reference: 0-1). Coagulation function, renal function, electrolytes, blood lipids, routine stool and urine tests, cardiac enzymes, and cardiac markers were all normal. Immunological tests for HIV, HBsAg, and HCV were negative. Serum ( 1 , 3 )-ฮฒ-D-glucan test (G test) and galactomannan test (GM test), nine respiratory pathogen IgM antibodies, sputum for acid-fast bacilli, and sputum culture were all negative. The ECG was unremarkable. Cardiac ultrasound showed moderate tricuspid regurgitation, mild mitral and aortic regurgitation, increased pulmonary artery pressure (SPAP 46 mmHg), decreased left ventricular diastolic function, and trace pericardial effusion. Chest ultrasound revealed small bilateral pleural effusions. Thyroid ultrasound revealed cystic masses in both lobes of the thyroid (TI-RADS category 2), isoechoic and mixed-echoic nodules in the right thyroid lobe (TI-RADS category 3), hyperechoic lesions in the left lobe (possibly calcifications). Other ultrasound, including abdominal, lower extremity venous, and cervical vascular ultrasounds, showed no abnormalities. The CT chest showed patchy density shadows, thickened bronchovascular bundles, pleural effusion, and pleural thickening . Initial diagnoses upon admission were pneumonia and possible malignant tumor in the right middle lobe. The patient was treated with antibiotics and underwent percutaneous lung biopsy of the right middle lobe. Pathology revealed no tumor cells . The lung tissue showed lymphocyte and plasma cell infiltration, with fibrous tissue proliferation in the alveolar septa. The patient experienced no further hemoptysis and opted for discharge after improvement of the cough. One month after discharge, the patient experienced recurrent hemoptysis, with a total of approximately 500 ml of fresh blood in 24 hours, prompting the second admission . Blood tests indicated a further decline in hemoglobin levels: RBC 2.75 ร— 10^9/L (reference: 3.8-5.1), Hemoglobin 80 g/L (reference: 115-150). CRP was 81.6 mg/L (reference: 0-10), SAA was 262.42 mg/L (reference: 0-10), erythrocyte sedimentation rate (ESR) was 57 mm/h (reference: 0-20), and liver function showed albumin 34.7 g/L (reference: 40-55), prealbumin 68 mg/L (reference: 180-350), and globulin 43 g/L (reference: 20-40). D-dimer was 1.8 mg/L (reference: 0-1). Extractable nuclear antigen (ENA) and anti-neutrophil cytoplasmic antibodies (ANCA) were negative. Other tests showed no significant changes compared to previous results. Imaging was consistent with previous findings. After treatment with antibiotics and hemostatic drugs, the patient had no further hemoptysis and requested discharge. However, eight days after discharge, the patient experienced two episodes of hemoptysis, with approximately 2-3 ml of fresh blood each time, accompanied by fatigue and dizziness, prompting a third admission on May 4, 2021. Laboratory tests revealed a complete blood count within normal limits except for a slightly decreased hemoglobin level 93g/L (reference: 115-150). ESR was 66 mm/h(reference: 0-20), CRP and PCT were normal. Liver function tests were normal except for an elevated globulin level 44.5g/L (reference: 20-40) and decreased albumin/globulin ratio 0.88(reference: 1.2-2.4). Cardiac ultrasound revealed moderate tricuspid regurgitation, elevated pulmonary arterial systolic pressure (SPAP: 36 mmHg), and decreased left ventricular diastolic function (E/F 70%, E/A <0.8). Chest CT findings are depicted in the accompanying image . We conducted a comprehensive immunoglobulin analysis that revealed elevated levels of IgG at 28.49 g/L (reference: 8.6-17.4) and IgG4 at 3114 mg/L (reference: 39.2-864.0). Complement C3 and C4 levels were normal, along with rheumatoid factor, T-cell subpopulations, and antibodies against SSA, SSB, double-stranded DNA, RNP, Sm, Jo-1, Scl-70, and phospholipase A2 receptor. All of these autoimmune antibodies tested negative. Immunohistochemical staining revealed infiltration of CD38-positive plasma cells, CD138-positive plasma cells and IgG4-positive plasma cells. Immunohistochemical staining (ร—400) showed that IgG4-positive plasma cells were above 10 per high power field .
4.046875
0.977051
sec[1]/p[0]
en
0.999995
PMC11695412
https://doi.org/10.3389/fimmu.2024.1432508
[ "reference", "function", "blood", "thyroid", "ultrasound", "cells", "plasma", "chest", "hemoglobin", "globulin" ]
[ { "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": "DD91.Z", "title": "Irritable bowel syndrome or functional bowel disorders, unspecified" }, { "code": "9E1Z", "title": "Diseases of the visual system, unspecified" }, { "code": "6B60.Z", "title": "Dissociative neurological symptom disorder, with unspecified symptoms" }, { "code": "6B60.8Y", "title": "Dissociative neurological symptom disorder, with other specified movement disturbance" }, { "code": "6B60.3", "title": "Dissociative neurological symptom disorder, with other sensory disturbance" } ]
=== 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 [DD91.Z] Irritable bowel syndrome or functional bowel disorders, unspecified Also known as: Irritable bowel syndrome or functional bowel disorders, unspecified | Irritable bowel syndrome or certain specified functional bowel disorders | Functional intestinal disorders NOS [9E1Z] Diseases of the visual system, unspecified Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder [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 [6B60.8Y] Dissociative neurological symptom disorder, with other specified movement disturbance Also known as: Dissociative neurological symptom disorder, with other specified movement disturbance | Functional movement disorder | Other functional hyperkinetic movements [6B60.3] Dissociative neurological symptom disorder, with other sensory disturbance Definition: Dissociative neurological symptom disorder, with other sensory disturbance is characterised by sensory symptoms not identified in other specific categories in this grouping such as numbness, tightness, tingling, burning, pain, or other symptoms related to touch, smell, taste, balance, proprioception, kinesthesia, or thermoception. The symptoms are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition a Also known as: Dissociative neurological symptom disorder, with other sensory disturbance | Functional neurological symptom disorder, with alteration of sensation | Functional sensory disorder | Functional neurological symptom disorder, with other sensory disturbance === 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... --PARENT--> [?] Obsessive-compulsive or related disorders Def: Obsessive-compulsive and related disorders is a group of disorders characterised by repetitive thoughts and behaviours that are believed to share similarities in aetiology and key diagnostic validator... --- 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--> [6B22.1] 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... --- 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--> [MB26.00] Bizarre delusion Def: A delusion that involves a phenomenon that would be regarded as physically impossible within the person's cultural context.... --- 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... --CHILD--> [MB26.00] Bizarre delusion Def: A delusion that involves a phenomenon that would be regarded as physically impossible within the person's cultural context.... --- 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--> [6B22.1] 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... --- 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 --PARENT--> [?] Obsessive-compulsive or related disorders\n Def: Obsessive-compulsive and related disorders is a group of disorders characterised by repetitive thoughts and behaviours that are believed to share similarities in aetiology and key diagnostic validator...", "[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--> [6B22.1] 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...", "[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--> [MB26.00] Bizarre delusion\n Def: A delusion that involves a phenomenon that would be regarded as physically impossible within the person's cultural context....", "[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--> [MB26.00] Bizarre delusion\n Def: A delusion that involves a phenomenon that would be regarded as physically impossible within the person's cultural context....", "[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--> [6B22.1] 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...", "[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": "DD91.Z", "icd10_code": "K598", "icd10_title": "Other specified functional intestinal disorders" }, { "from_icd11": "DD91.Z", "icd10_code": "K599", "icd10_title": "Functional intestinal disorder, unspecified" }, { "from_icd11": "DD91.Z", "icd10_code": "K592", "icd10_title": "Neurogenic bowel, not elsewhere classified" }, { "from_icd11": "DD91.Z", "icd10_code": "K55-K64", "icd10_title": "" }, { "from_icd11": "DD91.Z", "icd10_code": "K59", "icd10_title": "Other functional intestinal disorders" }, { "from_icd11": "9E1Z", "icd10_code": "H5500", "icd10_title": "Unspecified nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5509", "icd10_title": "Other forms of nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5581", "icd10_title": "Saccadic eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5501", "icd10_title": "Congenital nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5502", "icd10_title": "Latent nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5589", "icd10_title": "Other irregular eye movements" }, { "from_icd11": "9E1Z", "icd10_code": "H5503", "icd10_title": "Visual deprivation nystagmus" }, { "from_icd11": "9E1Z", "icd10_code": "H5504", "icd10_title": "Dissociated nystagmus" } ]
F428
Other obsessive-compulsive disorder
We included in the analysis a new, so far unpublished case described in detail in the Appendix of this article. A summary can be found in Table 1 . ITPR1-IgG/anti-Sj was associated with progressive cognitive decline in this patient, affecting mainly short-term memory, executive dysfunction, attention deficits, a sleep disorder, and psychotic symptoms. Immunotherapy with high-dose intravenous methylprednisolone (IVMP) given during periods of acute deterioration, either alone or with plasma exchange (PLEX) and intravenous immunoglobulins (IVIG), repeatedly resulted in significant recovery. Long-term therapy with cyclophosphamide led to some stabilization. However, several relapse-like end-of-dose episodes occurred, characterized by either worsening of pre-existing symptoms or occurrence of new symptoms. Clinical and paraclinical data covering a period of more than 2 years, including serological, CSF, magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (PET) findings as well as neuropsychological test results, are provided in the Appendix . Table 1 Clinical symptoms, laboratory and radiological findings and treatment in an illustrative case of ITPR1-IgG-positive encephalitis over a period of 2 years Augโ€“Sep 19 End Oct 19 Mid-Jan 20 Feb 20 Mar 20 End Mar 20 Beg-May 20 Jul 20 Sep 20 Oct 20 Nov 20 Jan 21 Apr 21 Jun 21 Mid-Jul 21 Aug 21 Clinical course 1st symptoms Aug 19 (incr. forgetfulness), rapid decline in short-term memory, confused actions, personal. changes Sep 19 Hosp. admiss.: dysdiad..; flat affect, irritab., persever., sev. cogn. impairm. (conc./attent.; short + long-term + working mem., process. speed, action plann., probl./error recogn.)โ†’ โ€œdysexec. dementiaโ€ โ†’ rapid deteror. with disor., impair. impulse contr., behav. abnorm Sust. marked improvem. (normal. affect and exec. funct. with restored probl. recogn. + solution capac.) but mild resid. attent. deficit Relapse with marked decline in cognitive function (see Appendix for details) Marked improvem. of impulse contr., reduct. in psychomot. restlessn., but resid. impair. attent. + proc. speed Newly emerging ataxia and mild tetraparesis 1st dose of CYCLโ†’ further im- prov. of cogn. test results, but residually impaired attent., mem., and proc. speed - - Relapse-like epis. ~ 1 mo after 3rd CYCL cycle, attent. + mem. defic., disorient., psychomot. restlessn. and formal thought disorder Signific. neurocogn. improvem., compl. psychiatr. recovery Nov 20; followed by relat. stability Dec 20-Aug 21, but mild increase in symptom severity shortly before each CYCL cycle; episode of blurred vision in both eyes June 21 (lasting for 6โ€“8 weeks, followed by complete recov.); re-admitted mid-Jul 21 with mild depress. disorder plus mild subj. decline in short-term mem. and exec. functions (prompt resolution after IVMP) At last follow-up: resid. cogn.def.; gait instab. and limb ataxia mostly resolved but still uses rollator for resid. parapar ITPR1-IgG CBA, serum โ€“ 1:1000 1:1000 1:1000 โ€“ โ€“ 1:100 โ€“ โ€“ โ€“ 1:320 โ€“ โ€“ โ€“ โ€“ 1:1000 ITPR1-IgG CBA, CSF โ€“ 1:1 โ€“ 1:4 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ ITPR1-IgG CBA, PLEX-E โ€“ โ€“ 1:320 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ ITPR1-IgG TBA, serum - 1:320 1:1000 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ Other anti-neural Abs โ€“ Neg Neg (serum + CSF) Neg โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ CTD-ass. auto-Abs โ€“ Neg โ€“ Neg โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ CSF โ€“ Normal Normal Normal โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ QAlb โ†‘ โ€“ CRP (mg/l; < 5) โ€“ 7 โ†’ 7.7 โ†’ 9.3 13 Normal โ€“ โ€“ โ€“ โ€“ โ€“ 13 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ BSR (mm/h; < 20) โ€“ 22 โ€“ Normal โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ CA125 (U/ml; < 35) โ€“ โ€“ 111 88 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ 35 MMSE โ€“ 27/30 โ†’ 23/30 โ†’ 29/30 at discharge end of Nov 29/30 24/30 28/30 โ€“ 30/30 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ Clock-drawing test โ€“ 3/7 7/7 1/7 3/7 โ€“ 7/7 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ DemTect โ€“ 9/18 16/18 8/16 14/18 โ€“ 15/18 โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ EEG โ€“ 2 ร— ri frontopar. delta activ Ri par.-occ. theta activ Ri par.-occ. theta activ Normal โ€“ โ€“ โ€“ โ€“ Intermittent ri-temp. slowing Normal โ€“ โ€“ โ€“ โ€“ โ€“ cMRI โ€“ 2 ร— normal (1 ร— with Gd) Normal Normal - โ€“ โ€“ โ€“ โ€“ Normal โ€“ โ€“ โ€“ โ€“ Normal โ€“ sMRI โ€“ โ€“ โ€“ Normal - โ€“ โ€“ โ€“ โ€“ - โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ FDG-PET, head โ€“ โ€“ โ€“ Glucose metabol. โ†‘ ri med. temp lobe (amygd., parahipp.) + ri striatum, esp. putamen - โ€“ โ€“ โ€“ โ€“ - โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ FDG-PET, body โ€“ โ€“ โ€“ Normal - โ€“ โ€“ โ€“ โ€“ - โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ CT abd/thor/pelv โ€“ Bilat. small nodular abnormal. in the lung (< 6 mm), cystic structures at isthmus uteri - Normal (pelv.) - โ€“ โ€“ โ€“ โ€“ - โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ Acute treatment IVMP (5 ร— 1 g) IVMP (3 ร— 1 g) a , oral tapering IVMP (5 ร— 1 g), 5 ร— PLEX, IVIG (4 ร— 35 g/day) โ€“ โ€“ โ€“ โ€“ โ€“ IVMP (5 ร— 1 g) b , oral tapering โ€“ โ€“ โ€“ โ€“ IVMP (3 ร— 1 g) โ€“ Outcome from acute therapy โ€“ Almost complete resolution Substantial improvement Significant improvement โ€“ โ€“ โ€“ โ€“ โ€“ Significant improvement โ€“ โ€“ โ€“ โ€“ Prompt resolution โ€“ Cyclophosphamide โ€“ โ€“ โ€“ โ€“ โ€“ โ€“ CYCL (350 mg/ m 2 /d for 3 d) CYCL CYCL - CYCL CYCL CYCL CYCL - CYCL CBA, cell-based assay; cMRI, cranial MRI; BSR, blood sedimentation rate; CA125, cancer antigen 125; CSF, cerebrospinal fluid; CRP, C-reactive peptide; CT, computed tomography; CTD, connective tissue disorders; CYCL, cyclophosphamide; EEG, electroencephalography; FDG-PET, 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography; Gd, gadolinium; IVIG, intravenous immunoglobulins; IVMP, intravenous methylprednisolone; MMSE, mini mental status examination; MRI, magnetic resonance imaging; PLEX, plasma exchange; PLEX-E, PLEX eluate; QAlb, albumin CSF/serum ratio; sMRI, spinal MRI a Plus risperidone, pipamperone, lorazepam b Plus risperidone, lorazepam
4.160156
0.538086
sec[2]/sec[0]/p[0]
en
0.999997
PMC9338677
https://doi.org/10.1186/s12974-022-02545-4
[ "cycl", "ivmp", "plex", "term", "attent", "decline", "short", "intravenous", "resid", "serum" ]
[ { "code": "6A80.5", "title": "Rapid cycling" }, { "code": "PA03", "title": "Unintentional land transport traffic event injuring a motor cyclist" }, { "code": "5C50.AZ", "title": "Disorders of urea cycle metabolism, unspecified" }, { "code": "PA23", "title": "Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist" }, { "code": "PA02", "title": "Unintentional land transport traffic event injuring a pedal cyclist" }, { "code": "8C7Y", "title": "Other specified primary disorders of muscles" }, { "code": "7A01", "title": "Short-term insomnia" }, { "code": "JA8E", "title": "Maternal care related to prolonged pregnancy" }, { "code": "2A8Z", "title": "Mature B-cell neoplasms, unspecified" }, { "code": "KA21.4Z", "title": "Preterm newborn, unspecified" } ]
=== ICD-11 CODES FOUND === [6A80.5] Rapid cycling Definition: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood to the other, or the mood episodes may be demarcated by a period of remission. In individuals with a high frequency of mood episodes, some may have a shorter duration than those usually observed in bipolar type I or bipolar type II disorder. In particular, depressive periods may only last several da Also known as: Rapid cycling [PA03] Unintentional land transport traffic event injuring a motor cyclist Also known as: Unintentional land transport traffic event injuring a motor cyclist | motorcycle rider injured in transport accident | unintentional land transport accident motorbike | motorbike accident | motorbike traffic accident Excludes: Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle [5C50.AZ] Disorders of urea cycle metabolism, unspecified Also known as: Disorders of urea cycle metabolism, unspecified | Disorders of urea cycle metabolism | disorder of urea cycle | disorders of metabolism of ornithine, citrulline, argininosuccinic acid, arginine and ammonia | ammonia metabolic disorder [PA23] Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist Also known as: Unintentional land transport event unknown whether traffic or nontraffic injuring a motor cyclist | unintentional off-road crash injuring a motor cyclist, unknown whether on road | motor bike crash NOS | motor cycle crash NOS | Motorcycle rider injured in collision with railway train or railway vehicle [PA02] Unintentional land transport traffic event injuring a pedal cyclist Also known as: Unintentional land transport traffic event injuring a pedal cyclist | Pedal cyclist injured in collision with pedestrian or animal | Pedal cyclist injured in collision with pedestrian or animal, person injured while boarding or alighting | Pedal cyclist injured in collision with pedestrian or animal, driver injured in traffic accident | Pedal cyclist injured in collision with pedestrian or animal, passenger injured in traffic accident [8C7Y] Other specified primary disorders of muscles Also known as: Other specified primary disorders of muscles | Certain specified primary disorders of muscles | Myopathy due to calsequestrin or SERCA1 protein overload | Delayed muscle maturation | delayed muscle growth [7A01] Short-term insomnia Definition: Short-term insomnia is characterised by difficulty initiating or maintaining sleep of less than 3 months duration that occurs despite adequate opportunity and circumstances for sleep and results in general sleep dissatisfaction and some form of daytime impairment. Daytime symptoms typically include fatigue, depressed mood or irritability, general malaise, and cognitive impairment. Individuals who report sleep related symptoms in the absence of daytime impairment are not regarded as having an ins Also known as: Short-term insomnia | Acute insomnia [JA8E] Maternal care related to prolonged pregnancy Definition: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period. Also known as: Maternal care related to prolonged pregnancy | post-term pregnancy | pregnancy beyond 42 weeks of gestation | prolonged gestation | postmature pregnancy Includes: Post-term [2A8Z] Mature B-cell neoplasms, unspecified Also known as: Mature B-cell neoplasms, unspecified | Primary central nervous system lymphoma [KA21.4Z] Preterm newborn, unspecified Also known as: Preterm newborn, unspecified | Preterm newborn | immaturity | other preterm infants, unspecified | other preterm infants, unspecified weight === GRAPH WALKS === --- Walk 1 --- [6A80.5] Rapid cycling Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ... --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di... --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, ... --- Walk 2 --- [6A80.5] Rapid cycling Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ... --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di... --CHILD--> [6A80.2] Current depressive episode persistent Def: The diagnostic requirements for a depressive episode are currently met and have been met continuously for at least the past 2 years.... --- Walk 3 --- [PA03] Unintentional land transport traffic event injuring a motor cyclist --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal --- Walk 4 --- [PA03] Unintentional land transport traffic event injuring a motor cyclist --PARENT--> [?] Unintentional land transport road traffic injury event --CHILD--> [PA01] Unintentional land transport traffic event injuring the user of a pedestrian conveyance --- Walk 5 --- [5C50.AZ] Disorders of urea cycle metabolism, unspecified --PARENT--> [5C50.A] Disorders of urea cycle metabolism --EXCLUDES--> [?] Lysinuric protein intolerance Def: Lysinuric protein intolerance is a very rare inherited multisystem condition caused by disturbance in amino acid metabolism. Affected patients may present with vomiting, diarrhea, failure to thrive, h... --- Walk 6 --- [5C50.AZ] Disorders of urea cycle metabolism, unspecified --PARENT--> [5C50.A] Disorders of urea cycle metabolism --EXCLUDES--> [?] Disorders of ornithine metabolism
[ "[6A80.5] Rapid cycling\n Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ...\n --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders\n Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di...\n --RELATED_TO--> [?] Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms\n Def: A syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, ...", "[6A80.5] Rapid cycling\n Def: In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood ...\n --PARENT--> [6A80] Symptomatic and course presentations for mood episodes in mood disorders\n Def: These categories may be applied to describe the presentation and characteristics of mood episodes in the context of single episode depressive disorder, recurrent depressive disorder, bipolar type I di...\n --CHILD--> [6A80.2] Current depressive episode persistent\n Def: The diagnostic requirements for a depressive episode are currently met and have been met continuously for at least the past 2 years....", "[PA03] Unintentional land transport traffic event injuring a motor cyclist\n --EXCLUDES--> [?] Unintentional land transport traffic event injuring an occupant of a low powered passenger vehicle\n --CHILD--> [?] Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal", "[PA03] Unintentional land transport traffic event injuring a motor cyclist\n --PARENT--> [?] Unintentional land transport road traffic injury event\n --CHILD--> [PA01] Unintentional land transport traffic event injuring the user of a pedestrian conveyance", "[5C50.AZ] Disorders of urea cycle metabolism, unspecified\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --EXCLUDES--> [?] Lysinuric protein intolerance\n Def: Lysinuric protein intolerance is a very rare inherited multisystem condition caused by disturbance in amino acid metabolism. Affected patients may present with vomiting, diarrhea, failure to thrive, h...", "[5C50.AZ] Disorders of urea cycle metabolism, unspecified\n --PARENT--> [5C50.A] Disorders of urea cycle metabolism\n --EXCLUDES--> [?] Disorders of ornithine metabolism" ]
6A80.5
Rapid cycling
[ { "from_icd11": "PA03", "icd10_code": "V299XXD", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V234XXA", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V299XXA", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2940XA", "icd10_title": "Motorcycle driver injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V239XXD", "icd10_title": "Unspecified motorcycle rider injured in collision with car, pick-up truck or van in traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V299XXS", "icd10_title": "Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V2988XA", "icd10_title": "Motorcycle rider (driver) (passenger) injured in other specified transport accidents, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2950XA", "icd10_title": "Motorcycle passenger injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2960XA", "icd10_title": "Unspecified motorcycle rider injured in collision with unspecified motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XS", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V234XXS", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, sequela" }, { "from_icd11": "PA03", "icd10_code": "V235XXA", "icd10_title": "Motorcycle passenger injured in collision with car, pick-up truck or van in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V234XXD", "icd10_title": "Motorcycle driver injured in collision with car, pick-up truck or van in traffic accident, subsequent encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XA", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, initial encounter" }, { "from_icd11": "PA03", "icd10_code": "V2949XD", "icd10_title": "Motorcycle driver injured in collision with other motor vehicles in traffic accident, subsequent encounter" } ]
V299XXD
Motorcycle rider (driver) (passenger) injured in unspecified traffic accident, subsequent encounter