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We report radium-223 treatment in a 59-year-old woman patient with metastatic breast cancer who progressed on multiple systemic cytotoxic treatments. This patient was first diagnosed with infiltrating ductal carcinoma of the right breast in 1998, treated with lumpectomy, radiotherapy, and 5 years of adjuvant tamoxifen. In 2004, a second homolateral breast cancer (infiltrating ductal carcinoma, grade 2, Estrogen Receptor (ER) 8/8, Progesterone Receptor (PgR) 2/8, HER2 0, Ki67 40%) was treated with mastectomy (as per the patient’s wish), chemotherapy (six cycles of 5-Fluorouracyl, Epirubicine, Cyclophosphamide) and 5 years of adjuvant letrozole. In 2016, an increase in CA15.3 level (62kU/L; normal range 15-30kU/L) led to the performance of a 18 Fluorodeoxyglucose (FDG)-Positron Emission Tomography Computed tomography (PET-CT) that detected an axillary adenopathy and multiple bone metastases. Lymph node biopsy identified a grade 2 infiltrating ductal carcinoma (ER 8/8, PgR 8/8, HER2 0, Ki67 26%) and anastrozole therapy led to a rapid decrease in CA15.3 levels (30kU/L), the disappearance of the axillary adenopathy and decrease in FDG metabolism of bone lesions. Denosumab was started on a monthly basis administrated (subcutaneously) in association with calcium and D-vitamin. Twelve months later, in 2017, based on a rise of CA15.3 (120kU/L) and an increase in FDG metabolic uptake of bone lesions on PET-CT, anastrozole was switched to letrozole in combination with the cyclin-dependent kinase (CDK) 4/6 inhibitor palbociclib, which resulted in stability in CA15.3 and bone metastases metabolism for 10 months. In 2018, the increase in serum biomarkers (CA15.3 180kU/L) and radiological progression led to the introduction of everolimus and exemestane, without any significant response after nine months. Chemotherapy was started (six cycles of weekly paclitaxel; 3 weeks/4) with a decrease in CA15.3 and in bone FDG uptake. Three months after the last paclitaxel administration, based on the progression of bone metastases on PET-CT and re-increase in CA15.3 (350kU/L), capecitabine was started for eight cycles (14 days/21) and was interrupted due to asthenia, diarrhea, and progressive grade 2 anemia. In March 2021, an increase in CA15.3 (500kU/L) and progression on PET-CT led to the initiation of eribulin; however, this treatment was rapidly stopped after 3 months as CA15.3 continued to increase (900kU/L) and as PET-CT showed significant progression in size, number, and FDG metabolism of bone lesions. There was no FDG avid extra-skeletal metastasis, particularly nodal disease. At this time, complete blood count showed a grade 1 anemia (10.7g/dl), Lactate Dehydrogenase (LDH), and Phosphatase alkaline levels were 264U/L (normal range <225U/L) and 101 U/L (<130U/L), respectively. The patient had moderate and diffuse dorso-lumbar pain (Visual Analogue Scale 3/10). A 99 mTc-Hydroxyethylene diphosphonate scintigraphy ( 99 mTc-HDP bone scan) showed increased radiotracer uptake in multiple bone lesions of the entire axial skeleton, suggesting osteoblastic lesions. We started radium-223 treatment (off-label clinical use) in August 2021 in association with letrozole and denosumab. Radium-223 was administered at the same dose as for prostate cancer (50 kBq/kg every 4 weeks for six cycles) with a repeated complete blood count before each administration. Clinically, pain disappeared after two cycles of radium-223. A thoraco-abdominal CT after three cycles confirmed the absence of any new bone (or visceral) metastases and radium-223 was continued for two cycles and was well tolerated. The sixth administration was not done due to asymptomatic low hemoglobin (8.7 g/dl). The FDG PET-CT performed one month after the fifth cycle showed the development of three liver metastases (19mm, 16mm, and 10mm) and right axillary adenopathy (14mm), reflecting an extra-skeletal progression. However, a decrease in FDG uptake was observed in all bone metastatic lesions that were previously described; for example, we observed a metabolic decrease of 59% in the 10th dorsal vertebra (with maximum standardized uptake value (max. SUV) of 12.4 before and 5.1 after radium-223) and of 63% in the sacrum (with max. SUV of 14.9 before and 5.4 after radium-223). The SUVmax in normal liver (reference) was 2.14 in pre- and 2.20 in post-radium-223 (+2.8%). Interestingly, the FDG uptake was increased in bilateral humerus, clavicules, and femur diaphysis, but this increased metabolism was homogenous and symmetrical, reflecting medullary regeneration. The 99 mTc-HDP bone scan showed a decrease in 99 Tc uptake in previously described bone lesions. There was a discrepancy between FDG metabolism decrease and 99 Tc uptake increase in the humeral head , which likely reflects reparative bone associated with treatment response. Bone CT of the column showed hyperdensities of bone metastases, reflecting increased bone formation on treatment . CA15.3 level increased from 941 kU/L at baseline to 1135 kU/L after radium-223 which is attributed to the progressive liver and nodal metastases. Alkaline phosphatase and LDH remained in the normal range during radium-223 treatment. Cisplatin (70mg/m 2 ) plus gemcitabine was started 5 weeks after the last administration of radium-223, with G-CSF support. Three cycles were administered with a CA 15.3 response (decrease to 900 kU/L) and a grade 2 thrombopenia that resolved spontaneously. The timeline is summarized in Figure 4 .
| 4.074219
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|
sec[1]/p[0]
|
en
| 0.999996
|
PMC9195502
|
https://doi.org/10.3389/fonc.2022.896301
|
[
"bone",
"radium",
"cycles",
"decrease",
"uptake",
"increase",
"metastases",
"lesions",
"grade",
"metabolism"
] |
[
{
"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": "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"
}
] |
=== 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
[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
=== 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--> [?] Nonorgan specific systemic autoimmune disorders
--- 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
--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--> [?] Nonorgan specific systemic autoimmune disorders",
"[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 --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
| |
A 74-year-old Japanese man was referred to our hospital with an elevated white blood cell (WBC) count and a pancreatic head tumor measuring 42 mm on computed tomography (CT). He complained of abdominal fullness and pain after eating; however, no jaundice or fever was observed. The patient had a medical history of hyperlipidemia and diabetes mellitus and received the required treatment. After admission, laboratory examination findings were as follows: WBC count, 23,770/μL (90.9% neutrophils, 5.6% lymphocytes, 2.8% monocytes, 0.3% eosinophils, and 0.4% basophils); hemoglobin, 13.6 g/dL; platelet count, 34.7 × 10 4 /mm 3 ; C-reactive protein, 7.19 mg/dL). Tumor marker levels were normal: carcinoembryonic antigen, 0.9 ng/mL; carbohydrate antigen 19–9, 17.3 U/mL; duke pancreatic monoclonal antigen type 2, 25 U/mL; and s-pancreas-1 antigen, 5.1 U/mL. The patient exhibited an increased inflammatory response without clinical signs, such as fever; however, antibiotics were administered owing to the possibility of cholangitis. A few days later, a blood test showed a persistently high inflammatory reaction level (WBC: 22,480/μL). G-CSF showed a high value of 251 pg/mL (normal < 39.0 pg/mL). Dynamic enhanced CT, conducted 2 weeks after the previous hospital CT scan, revealed a well-demarcated low-density mass measuring 60 mm in diameter with an enhancement of the peripheral portion of the lesion in the pancreatic head. The tumor involved the superior mesenteric vein (SMV) and gastroduodenal artery , but did not invade the nerve of the superior mesenteric artery, and there were no enlarged lymph nodes or distant metastases. Dynamic magnetic resonance imaging (MRI) with Gd-EOB-DPTA enhancement revealed a tumor in the pancreatic head with low intensity on T1-weighted images and slightly high intensity on T2-weighted images. MRI showed clear tumor borders and invasion within the SMV in the portal phase of dynamic enhancement . Diffusion-weighted imaging revealed the hyperintensity of the pancreatic head tumor . No liver metastases were observed in the hepatobiliary phase. Endoscopic ultrasonography revealed a low-echoic mass with a round shape and capsular-like structures . The pathological diagnosis based on ultrasound-guided fine-needle aspiration was anaplastic carcinoma. As there are no reports of effective chemotherapy for anaplastic pancreatic cancer and no clear distant metastasis or non-resectable factors, we decided to perform surgery for pancreatic head cancer without preoperative chemotherapy. Intraoperative findings showed that the tumor had invaded the SMV and transverse mesocolon. Intraoperative Sonazoid contrast-enhanced ultrasonography revealed no obvious liver metastases. Peritoneal dissemination was not observed. We performed a subtotal stomach-preserving pancreaticoduodenectomy (PD) with portal vein reconstruction, partial transverse colon resection, and the modified Child method. The operation time was 406 min, and the blood loss was 650 g. The resected specimen showed a gray and dark reddish brown solid mass with hemorrhage and necrosis measuring 65 mm in diameter in the pancreatic head . Histologically, the tumor showed a diffused proliferation with necrosis . The tumor comprised poorly cohesive, large, pleomorphic cells with abundant eosinophilic cytoplasm and a neutrophilic infiltration . The tumor showed venous invasion . Immunohistochemical analysis of the resected specimen revealed G-CSF expression on the plasma membrane of tumor cells . Pathological diagnosis was Ph, TS4 (65 mm), nodular type, anaplastic carcinoma, pleomorphic type, int, INFb, Ly1, V2, Pn2, mpd0, pT3, pCH0, pDU1, pS1, pRP0, pPV1 (PVsm), pA0, pPL0, pOO0, pPCM0, pBCM0, pDPM0, R0, pN1a (1/16) M0 pStage IIB, according to the JPS 8th classification. It was classified as T3, N1, M0, Stage IIB according to the UICC 8th TNM staging system. We finally diagnosed the case as G-CSF-producing pleomorphic ACP based on these pathological findings. The WBC level decreased from 21,180/μL on the day before the surgery to 8490/μL on the postoperative day (POD) 7. Dynamic CT on POD 7 showed no obvious intra-abdominal complications, but did reveal liver metastasis in hepatic segment IV, measuring 8 mm in diameter. The patient required rehabilitation to improve the quality of daily life before discharge. The patient progressed without any postoperative complications and was discharged on POD 21. Fig. 1 Preoperative images. A Abdominal CT in the coronal section revealed a well-demarcated cystic tumor with slight enhancement of the peripheral portion of the pancreatic head. B MRI revealed a pancreatic head tumor with SMV invasion. C Diffusion-weighted magnetic resonance imaging showing reduced tumor diffusion. D Diffusion-weighted images showing a pancreatic head mass with a high signal intensity Fig. 2 Macroscopic and microscopic findings of the tumor. A Macroscopic appearance of the resected specimen. A gray and dark reddish mass measuring 65 mm in diameter with hemorrhage and necrosis was found in the pancreatic head. B Histological findings of the tumor showed a diffuse proliferation with necrosis. C Tumor cells were poorly cohesive, large, pleomorphic with abundant eosinophilic cytoplasm. The tumor showed a neutrophilic infiltration. D Tumor showed a vascular invasion. E Immunohistochemical staining for anti-G-CSF antibody in formalin-fixed paraffin-embedded resected specimen. Anaplastic cancer cells were positive for G-CSF
| 4.125
| 0.963379
|
sec[1]/p[0]
|
en
| 0.999998
|
39231851
|
https://doi.org/10.1186/s40792-024-02008-3
|
[
"tumor",
"pancreatic",
"head",
"measuring",
"weighted",
"antigen",
"dynamic",
"diameter",
"enhancement",
"invasion"
] |
[
{
"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": "DC3Z",
"title": "Diseases of pancreas, unspecified"
},
{
"code": "DC3Y",
"title": "Other specified diseases of pancreas"
},
{
"code": "LB21.3",
"title": "Agenesis-aplasia of pancreas"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "DC35.0",
"title": "Atrophy of pancreas"
}
] |
=== ICD-11 CODES FOUND ===
[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
[DC3Z] Diseases of pancreas, unspecified
Also known as: Diseases of pancreas, unspecified
[DC3Y] Other specified diseases of pancreas
Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis
[LB21.3] Agenesis-aplasia of pancreas
Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.
Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[DC35.0] Atrophy of pancreas
Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs"
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 67-year-old man, who had worked in a quarry for decades and was diagnosed with silicosis at age of 54 years, visited a primary hospital due to fever and cough. The chest radiography revealed a new ground-glass shadow in the right middle and under lung fields, and the SpO 2 was 91%. The patient was diagnosed with bacterial pneumonia, and antibiotics were administered. Since his fever and cough persisted for 9 days, he was admitted to another hospital. Laboratory tests demonstrated an elevated serum creatinine (Cr) concentration of 2.87 mg/dL, which was 1.39 mg/dL a year before, and gradually increased thereafter. Laboratory tests also showed leukopenia (1.71 × 10 3 cells/μL) with lymphopenia (100 cells/μL), anemia (hemoglobin 9.7 g/dL), thrombocytopenia (115 × 10 3 cells/μL), elevated serum levels of anti-nuclear antibody (320×, homogeneous and speckled pattern), anti-double stranded DNA (dsDNA) antibody (99.2 IU/mL), and decreased serum level of C3 (31.1 mg/dL). A direct Coombs test result was positive, but the serum haptoglobin level did not decrease (315 mg/dL). Urine analysis revealed proteinuria (2.27 g/g Cr) and microscopic hematuria with dysmorphic red blood cells (RBCs) (30–49 /high-power field) and granular cylinders. Computed tomography (CT) of the chest revealed ground-glass shadows and infiltrative shadows in the right middle and under the lung lobes with right pleural effusion. Bronchoalveolar lavage fluid showed total cell count of 15.0 × 10 6 , in which the lymphocyte fraction was elevated (39.5% of lymphocytes, 1.0% of neutrophils, and 58.5% of macrophages). Ten days after admission, his respiratory condition worsened and he was referred to our hospital. On the first day of admission, his temperature was 38.0°C and SpO 2 was 90% under 3 L oxygen inhalation on nasal cannula. His serum Cr concentration was elevated to 3.20 mg/dL. Chest radiography showed consolidation of the bilateral lung fields, the right costophrenic angle was dull , and chest CT showed expanded ground-glass shadows, infiltrative shadows, and increased pleural effusion . Based on these observations, he was finally diagnosed with SLE with rapidly progressive glomerulonephritis and acute interstitial pneumonitis based on the criteria defined by the American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) : leukopenia, lymphopenia, renal disorder, serositis, anti-dsDNA antibody, anti-nuclear antibody, low C3, and direct Coombs test. Glucocorticoid therapy was initiated on the second day after admission (prednisolone, 50 mg/day for 15 days, after which the dosage was gradually tapered). Renal biopsy was conducted 10 days after admission; IgG, IgA, IgM, C3, and C1q granular depositions were observed on the capillary walls and partly in the mesangial region by immunofluorescence . In particular, IgM, C3, and C1q depositions showed fringe-like patterns . Fifteen glomeruli were confirmed by light microscopy, and 2 showed global sclerosis. Diffuse global wire loop lesions and endocapillary proliferation were observed with periodic acid-Schiff and periodic acid-methenamine silver staining . Fibrocellular crescents were also found in 2 of 15 glomeruli . Under electron microscopy, subepithelial, intramembrane, subendothelial, and paramesangial dense deposits were observed, some of which contained fingerprint-like structures . These findings were consistent with lupus nephritis class IV-G(A/C) + V, active and chronic lesions of diffuse global proliferative and sclerosing lupus nephritis, and membranous lupus nephritis, as defined by the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification. [ 6 – 8 ] Based on this pathological diagnosis, intravenous cyclophosphamide therapy (500 mg/body weight) was administered 24 and 53 days after admission. The patient's fever and respiratory condition gradually improved after the initiation of treatment, and the oxygen flow rate decreased to 1 L/min on the nasal cannula. Chest CT on 32 days after admission revealed diminishment of ground-glass shadows and infiltrative shadows in the lung and reduction of pleural effusion. On 41 days after admission, the cytomegalovirus antigenemia test was positive (10/50,000 cells) without any symptoms. Intravenous ganciclovir (2.5 mg/kg) was administered for 14 days, after which the cytomegalovirus antigenaemia test was negative. Laboratory tests on the 59 days after admission showed reduction of serum Cr concentration to 1.29 mg/dL and improvement of pancytopenia. In the urine analysis, proteinuria was reduced to 1.46 g/g Cr with RBCs 5-9/high-power field, and the granular cylinders disappeared. The patient remained asymptomatic under 1 L oxygen inhalation only when walking and was discharged from our hospital 62 days after admission. He had herpes zoster in his right abdominal skin 19 days after discharge from our hospital; therefore, the third intravenous cyclophosphamide therapy was discontinued. Although the serum Cr level was elevated to 1.45 mg/dL due to dehydration at that time, pancytopenia did not worsen (leukocyte 7.00 × 10 3 cells/μL, hemoglobin 10.3 g/dL, thrombocyte 18.2 × 10 3 cells/μL), proteinuria was reduced to 0.71 g/g Cr, and urinary RBCs disappeared. Chest CT showed further improvement in lung shadows and pleural effusion. His herpes zoster healed after amenamevir initiation, and he received outpatient care with slowly tapered prednisolone.
| 4.074219
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999999
|
35363197
|
https://doi.org/10.1097/MD.0000000000028872
|
[
"serum",
"cells",
"shadows",
"chest",
"lung",
"which",
"ground",
"glass",
"anti",
"antibody"
] |
[
{
"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": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
=== GRAPH WALKS ===
--- Walk 1 ---
[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 2 ---
[NE80.3] Other serum reactions
--RELATED_TO--> [?] Serum sickness vasculitis
Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large...
--PARENT--> [?] Adverse cutaneous reactions to parenteral administration of proteins
Def: Undesired effects with cutaneous manifestations resulting from parenteral administration of proteins. These include vasculitis, serum sickness reaction and anaphylaxis....
--- Walk 3 ---
[5D0Y] Other specified metabolic disorders
--PARENT--> [?] Other metabolic disorders
--CHILD--> [5D0Y] Other specified metabolic disorders
--- Walk 4 ---
[5D0Y] Other specified metabolic disorders
--PARENT--> [?] Other metabolic disorders
--CHILD--> [5D0Y] Other specified metabolic disorders
--- Walk 5 ---
[5B91.0] Hypercalcaemia
Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...
--RELATED_TO--> [?] Myopathy due to hypercalcaemia
--PARENT--> [?] Neurological disorders due to an excess of micro or macro nutrients
--- 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--> [?] Neurological disorders due to an excess of micro or macro nutrients
|
[
"[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",
"[NE80.3] Other serum reactions\n --RELATED_TO--> [?] Serum sickness vasculitis\n Def: An acute vasculitic illness typified by fever, arthralgia and urticarial vasculitis resulting from an immune complex-mediated (type III) immune reaction to foreign protein. Historically this was large...\n --PARENT--> [?] Adverse cutaneous reactions to parenteral administration of proteins\n Def: Undesired effects with cutaneous manifestations resulting from parenteral administration of proteins. These include vasculitis, serum sickness reaction and anaphylaxis....",
"[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D0Y] Other specified metabolic disorders",
"[5D0Y] Other specified metabolic disorders\n --PARENT--> [?] Other metabolic disorders\n --CHILD--> [5D0Y] Other specified metabolic disorders",
"[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Neurological disorders due to an excess of micro or macro nutrients",
"[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--> [?] Neurological disorders due to an excess of micro or macro nutrients"
] |
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": "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]"
}
] |
T880XXA
|
Infection following immunization, initial encounter
|
An 82-year-old African American female with history of hypertension, chronic active smoker for 60 years along with prior surgical history significant for a laparotomy more than 20 years previously for unknown reason who was initially admitted to the medical service after a fall. She had a long history of nonspecific lower abdominal pain. As per her family, she had not seen a doctor for 10 years and never had a colonoscopy. She reported unintentional weight loss. Vital signs at the time of presentation were stable. On physical examination, she appeared cachectic and dehydrated. Her abdomen was soft, non-tender with audible bowel sounds. Mild right lower quadrant tenderness was noted. Labs were significant for microcytic hypochromic anemia and urine analysis positive for leukocyte esterase. Liver function test was normal. Chest X-ray showed cardiomegaly. Abdominal US revealed mild ascites and dilated common bile duct to 1 cm. The patient was admitted to medical service with a diagnosis of dehydration, failure to thrive, and for work-up of an occult gastrointestinal malignancy. She was scheduled for EGD and colonoscopy by gastroenterology team. In addition to all of this, her CEA was 12.2 ng/ml (normal less than 3 ng/ml). While the patient was on the medical service, her hemoglobin dropped to 6.2 gm/dL requiring blood transfusions. During the second unit of blood transfusion, the patient became hypoxemic and tachypneic. She was transferred to Medical Intensive Care Unit (MICU) and subsequently intubated for acute respiratory failure. Chest X-ray at this point showed bilateral infiltrates, and the patient was started on IV antibiotics for possible pneumonia. The scheduled GI procedures were cancelled due to critical health status. She had echocardiography in MICU which revealed mitral stenosis and severe pulmonary hypertension, with normal ejection fraction. Her respiratory status improved, and she was transferred back to medical floor after staying four days in MICU. She also had urine culture which grew klebsiella. Three days later after being transferred from MICU, she developed abdominal distension. A CT scan of the abdomen without contrast was obtained which revealed gastric, small bowel, and colonic distension. There was copious amount of stool in the colon. She was transferred to the surgical service for management of possible ileus/stool impaction pending colonoscopy to rule out colonic lesion. She was managed with nil per os, nasogastric tube suction, intravenous fluid hydration, and enemas. Nasogastric tube output was minimal but the patient's abdomen remained distended while on surgical service. The patient became hypotensive and tachycardic and less responsive. After fluid resuscitation, another CT of the chest and abdomen with oral and intravenous contrast was performed one week from prior CT, which revealed persistent dilation of the stomach, small bowel, and large bowel, a left colonic mass, and large amount of retroperitoneal free fluid in the region of the duodenum and pancreas . She was taken to the operating room for exploratory laparotomy. A midline laparotomy was performed, and numerous adhesions from the previous laparotomy were seen. The patient had a high-grade small bowel obstruction with a transition point in the mid ileum caused by adhesions. Lysis of adhesions was performed. There was a large left descending colonic mass invading the lateral abdominal wall causing partial large bowel obstruction. The transverse colon was attached to the left colon mass with adhesions, creating a space through which there was herniation of dilated small bowel. However, this did not cause an obstruction. These dilated bowel loops were reduced. Because of the finding of free air in the retroperitoneum of the upper abdomen, we decided to explore that area. Generous kocherization of the duodenum was performed. The head of the pancreas and hepatic flexure were mobilized and found to be normal. With further mobilization of the duodenum, a perforated duodenal diverticulum was noticed in the third part of the duodenum. There was a leak of bile in the area. There was extensive retroperitoneal necrosis extending across the upper abdomen to the tail of the pancreas. The duodenal diverticulum was broad based, inflamed, and closely attached to the superior mesenteric artery. The diverticulum was dissected off, stapled, and sent for pathology . The third part of the duodenum became dusky, and we decided to resect it with a GIA. At this point, the patient was hypotensive and acidotic. A decision was made to perform damage control and a temporary abdominal closure and to transfer the patient to ICU for resuscitation. In the ICU, she was aggressively resuscitated with correction of her acidosis, coagulopathy, and hypothermia. She was brought back to the OR the following day. There were no signs of bowel ischemia, and the small bowel obstruction had resolved. An end to side duodenojejunostomy was performed using an EEA. The anastomosis was protected with a Stamm's gastrostomy through which a feeding jejunostomy was passed distal to the anastomosis. A drain was left in the right upper quadrant. We then performed a transverse colon loop colostomy to divert the colonic tumor. Blood cultures later grew pseudomonas and yeast. The patient subsequently developed multiorgan failure, and the family requested DNI/DNR. Their after family requested terminal extubation 12 days after the last operation.
| 3.654297
| 0.983887
|
sec[1]/p[0]
|
en
| 0.999995
|
30159194
|
https://doi.org/10.1155/2018/6197828
|
[
"bowel",
"abdomen",
"which",
"service",
"abdominal",
"small",
"colonic",
"duodenum",
"laparotomy",
"this"
] |
[
{
"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": "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 ===
[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
[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 ---
[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 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....
--RELATED_TO--> [?] Short bowel syndrome in neonate
Def: Short bowel syndrome in neonate is a condition originating in the perinatal period in which nutrients are not properly absorbed due to either surgical removal of a large portion of the small intestine...
--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....
--- 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....
--RELATED_TO--> [?] Short bowel syndrome in neonate
Def: Short bowel syndrome in neonate is a condition originating in the perinatal period in which nutrients are not properly absorbed due to either surgical removal of a large portion of the small intestine...
--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....
--- 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...
--PARENT--> [13] Diseases of the digestive system
--- 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...
--RELATED_TO--> [?] Angiodysplasia of colon
Def: Small dilated submucosal vessels of colonic mucosa with perforating vessels going through the muscularis mucosae....
|
[
"[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...",
"[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 --RELATED_TO--> [?] Short bowel syndrome in neonate\n Def: Short bowel syndrome in neonate is a condition originating in the perinatal period in which nutrients are not properly absorbed due to either surgical removal of a large portion of the small intestine...\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....",
"[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 --RELATED_TO--> [?] Short bowel syndrome in neonate\n Def: Short bowel syndrome in neonate is a condition originating in the perinatal period in which nutrients are not properly absorbed due to either surgical removal of a large portion of the small intestine...\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....",
"[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 --PARENT--> [13] Diseases of the digestive system",
"[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 --RELATED_TO--> [?] Angiodysplasia of colon\n Def: Small dilated submucosal vessels of colonic mucosa with perforating vessels going through the muscularis mucosae...."
] |
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
|
This report presents a rare case of a cranial cervical spinal glioma, confirmed by surgical histopathology, with postoperative improvement in a dog. Gliomas arise from glial cells in the brain or spinal cord and are grouped as astrocytic, oligodendroglial, and ependymal tumors. Canine gliomas typically affect older individuals, especially those of brachycephalic breeds, and occur mainly in the frontal, parietal, or temporal telencephalic lobes and less frequently in the brainstem and spinal cord ( 3 , 7 ). The most common type of canine spinal cord glioma is ependymoma, followed by astrocytoma, oligodendroglial tumors, gliomatosis cerebri, and unclassified glioma ( 3 , 8 ). In a recent report of seven canine spinal gliomas, the affected spinal cord segments were, in decreasing order of frequency, thoracic (three cases), lumbar (three cases), and cervical (one case); the most common spinal cord glioma was oligodendroglioma ( 3 ). In another canine report of 53 intramedullary spinal tumor cases, thoracolumbar segments were the most frequently affected, although primary intramedullary tumors were more common in the cervical spinal cord in young dogs. Furthermore, intramedullary masses were identified in all dogs in which MRI was performed ( 8 ). However, intramedullary spinal tumors can expand and infiltrate other sites, although intramedullary spinal lesions may initially be intraparenchymal ( 3 , 8 ). Clinical diagnosis and treatment of intramedullary neoplasms may be challenging because of the rapidly progressive clinical course and neuroanatomical location of these tumors. On MRI, both astrocytomas and oligodendrogliomas appear as ovoid-to-elliptical mass lesions that are well-marginated, located eccentrically in the spinal cord, and associated with variable degrees of spinal cord expansion. Astrocytomas and oligodendrogliomas are iso-to-hypointense on T1-weighted images and hyperintense on T2-weighted and short-tau inversion recovery images with moderate contrast enhancement. In contrast, ependymomas appear as focal to multi-segmental, fusiform, centrally located lesions that are heterogeneously iso-to-hypointense on T1-weighted images and hyperintense on T2-weighted images, with marked contrast enhancement ( 8 ). Nevertheless, there have been reports of one dog diagnosed with oligodendroglioma showing hyperintensity on T1-weighted images and another dog with diffuse leptomeningeal oligodendroglioma accompanied by the “dural tail sign” ( 15 , 16 ). In a recent study evaluating the MRI characteristics of inflammatory, neoplastic, and vascular diseases of the canine spinal cord, the diagnostic sensitivity was excellent for intradural spinal diseases but poor for intramedullary tumors. Published descriptions of the imaging features of intramedullary tumors are sparse, their predilection sites are poorly understood and variable, and their MRI features overlap with those of inflammatory and vascular diseases ( 9 ). Therefore, the present case, which included MRI and surgical resection with histopathological examination of the spinal mass, has significant clinical value. The MRI characteristics included a well-defined, homogenously marked contrast-enhancing, single-mass lesion with extensive, eccentric distribution throughout the spinal parenchyma. The origin of the lesion was difficult to establish because of the extensive involvement of the spinal cord parenchyma without broad-based dural contact and findings mimicking the “golf-tee” and “dural tail” signs, further complicating the evaluation. This case suggests that an intramedullary glioma should be considered when the lesion is widely distributed throughout the spinal parenchyma, even if it is located eccentrically rather than centrally. The authors considered the present case to be a glioma originating from the spinal cord parenchyma, exhibiting extensive expansion in the extramedullary space. Ultimately, the mass was relatively well removed, significantly contributing to the improvement of the neurological symptoms. Intraoperatively, the mass was observed in the extramedullary region, facilitating its identification and resection after durotomy. The left ventral area of the mass adhered to the meninges around the left intervertebral foramen. To date, such canine spinal gliomas attached to the meninges with a pedunculated pattern have not been reported. Additionally, the mass exhibited a well-circumscribed red-colored and elastic appearance, differing in characteristics from those in previously reported soft grayish masses in oligodendroglioma or oligodendrogliomatosis ( 14–16 ). Consequently, the surgeons suspected, even postoperatively, the extension of an intradural extramedullary tumor into the intramedullary parenchyma rather than an intramedullary origin. Considering the craniocervical location and elastic appearance of the mass, the surgeons suspected a meningioma ( 17 , 18 ). Following the histopathological results, a genomic tumor test was performed, which strongly supported the diagnosis of a spinal glioma. Indeed, it has been reported that the MYC gene is overexpressed in glioma, and the deletion of the CDKN gene is considered a clinically important molecular alteration in glioma ( 19 , 20 ). This case provided additional evidence against drawing a conclusion regarding a presumptive histologic diagnosis and making decisions based solely on MRI findings to classify the lesion location relative to the meninges ( 5 ).
| 4.441406
| 0.630371
|
sec[2]/p[0]
|
en
| 0.999998
|
38840642
|
https://doi.org/10.3389/fvets.2024.1400139
|
[
"spinal",
"cord",
"intramedullary",
"glioma",
"tumors",
"canine",
"weighted",
"parenchyma",
"gliomas",
"oligodendroglioma"
] |
[
{
"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": "JB08.5",
"title": "Labour or delivery complicated by other cord entanglement, with compression"
},
{
"code": "8A40.Z",
"title": "Multiple sclerosis, unspecified"
},
{
"code": "ND51.1",
"title": "Injury of unspecified nerve, spinal nerve root or plexus of trunk"
},
{
"code": "GB0Y",
"title": "Other specified diseases of the male genital system"
},
{
"code": "8B41",
"title": "Myelitis"
}
] |
=== 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
[JB08.5] Labour or delivery complicated by other cord entanglement, with compression
Also known as: Labour or delivery complicated by other cord entanglement, with compression | labour and delivery complicated by other cord entanglement | Compression of cord NOS | umbilical cord compression, complicating delivery | umbilical cord entanglement
[8A40.Z] Multiple sclerosis, unspecified
Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis
[ND51.1] Injury of unspecified nerve, spinal nerve root or plexus of trunk
Also known as: Injury of unspecified nerve, spinal nerve root or plexus of trunk | spinal nerve injury | injury of spinal nerve root | injury of spinal nerve plexus | injury of spinal cord plexus
[GB0Y] Other specified diseases of the male genital system
Also known as: Other specified diseases of the male genital system | Diseases of male genital organs | disease or disorder of male genitourinary system | Pain in scrotum | scrotal pain
[8B41] Myelitis
Also known as: Myelitis | spinal cord inflammation NOS | radiculomyelitis NOS | myeloradiculitis | Myelitis due to noninfectious, inflammatory or autoimmune disorders
=== 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--> [?] Neck syndrome
--- 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....
--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 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
--CHILD--> [FA71] Torticollis
--- 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--> [FA92] Inflammatory spondyloarthritis
Def: Inflammatory spondyloarthritis is a rheumatic disease referring to the group of inflammatory disorders affecting the lower limb, enthesitis, dactylitis, and uveitis. Clinical characteristics include t...
|
[
"[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--> [?] Neck syndrome",
"[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....",
"[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 --CHILD--> [FA71] Torticollis",
"[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--> [FA92] Inflammatory spondyloarthritis\n Def: Inflammatory spondyloarthritis is a rheumatic disease referring to the group of inflammatory disorders affecting the lower limb, enthesitis, dactylitis, and uveitis. Clinical characteristics include t..."
] |
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
|
Anti-NMDA receptor antibody encephalitis is increasingly identified as an etiology for noninfectious encephalitis in children and adults . A classic presentation of the condition would be acute onset psychosis/encephalopathy with associated orofacial dyskinesias, without clear precipitant or injury, leading to progressive decline and coma in some . Tumor as a substrate for a paraneoplastic etiology is not uncommon . As awareness of the condition has grown, a broadening of the phenotype has become evident, associated in some with seizures and gait disturbances . Importantly, a growing number of movement disorders have been identified as well [ 4 , 10 – 12 ]. Our patient's initial presentation with new-onset “tremor” in association with psychiatric decline is characteristic in that there was a clear association with movement phenomenon and neurobehavioral deterioration. However, to our knowledge, a unilateral presentation of ataxia has not been described to date. Movement phenomena in children and adults with psychiatric conditions are not uncommon and include tic, stereotypy, chorea, and drug induced dyskinesias . Depending on the etiologic substrate, these manifestations may be of variable degree and sometimes subtle in their presentation, with psychiatric signs outweighing manifestations of movement impairment . A detailed neurologic examination is therefore indicated in all individuals with unexplained neuropsychiatric presentations, especially if clinical signs indicate neurologic dysfunction beyond isolated psychiatric impairments . Our patient's manifestations of ataxia were initially ascribed to psychogenic tremor, and coordination disturbances can appear to be semirhythmic in character (as with tremor) as the patient attempts to reach a target in the environment. However, a variety of means can be used to identify the clear disturbance in amplitude modulation seen in ataxia/dysmetria, such as repetitive finger to object testing or testing of the ability to rhythmically and quickly modify hand position (finger, hand tapping, etc.). Ataxia is a common, nonspecific accompaniment of a number of congenital, posttraumatic, metabolic, and autoimmune conditions . Manifestations can be bilateral or unilateral and variably affect the appendicular or axial musculature. Signs are typically related to a dysfunction of amplitude of movement and coordination, often leading to gait disturbance and impairments of fine motor functioning. Although typically localized to the cerebellum, ataxia may occur resulting from injury to a variety of neuroanatomic regions. Because it may be semirhythmic as the patient attempts to correct the movement trajectory, it can be confused with tremor. The coarse and variable amplitude in some may also be reminiscent of a psychogenic manifestation . Formal neurologic examination at 8 months of symptoms demonstrated, however, a clear isolated dysmetria affecting the left upper extremity and mild left sided ataxia. In our case, the abnormal movements were initially attributed to a psychogenic etiology. Although psychogenic movement disorders are common, the manifestations of this patient upon formal neurologic evaluation were clearly attributable to a neurologic etiology. The combination of a unilateral movement abnormality in association with the psychiatric manifestations placed her case outside the realm of an isolated psychiatric condition and warranted further diagnostic evaluation. Our case emphasizes both the expanded spectrum of movement phenomenon that might be seen in cases of anti-NMDA receptor antibody encephalitis and the variability of the encephalopathy at presentation and throughout the course. Additionally, recent reports indicate a propensity for unilateral presentations of the movement phenomenon as was clearly demonstrated in our patient with more than 8 months of hemiataxia without contralateral findings . Testing for anti-NMDA antibody disorders has become readily available, with serum and spinal fluid analysis typically demonstrating positivity in affected individuals. The presence of the antibodies themselves is considered pathologic, and the autoimmune dysregulation that underlies this condition appears to be triggered by a number of precipitants, including paraneoplastic and infectious entities . Treatment for the autoimmune disorder is most effective when initiated early in the course, and, unfortunately, our patient was not diagnosed until approximately 8 months after disease onset. This may portend a more challenging prognosis, and a possible increased rate of disease recurrence and permanent neuropsychiatric deficits were discussed with the family as a result . Additionally, screening for a neoplastic substrate is important as early recognition and treatment of an underlying tumor may improve neurologic outcome. Treatment of these conditions typically involves a combination of immunosuppressive and immunomodulating agents in hopes of decreasing abnormal antibody production and eliminating the harmful effects of antibodies already circulating . Improvements are typically seen within days to weeks. However, a prolonged course refractory to medical therapy is possible, and multiple agents for immune suppression may be necessary. At present, formal recommendations regarding duration of therapy are unknown . A significant number of patients relapse, indicating that there may be justification for indefinite treatment in some individuals.
| 4.433594
| 0.512207
|
sec[2]/p[0]
|
en
| 0.999996
|
29333310
|
https://doi.org/10.1155/2017/1310465
|
[
"movement",
"psychiatric",
"ataxia",
"manifestations",
"neurologic",
"typically",
"antibody",
"etiology",
"clear",
"number"
] |
[
{
"code": "8A0Z",
"title": "Movement disorders, unspecified"
},
{
"code": "8A0Y",
"title": "Other specified movement disorders"
},
{
"code": "6B60.8Y",
"title": "Dissociative neurological symptom disorder, with other specified movement disturbance"
},
{
"code": "8A07",
"title": "Certain specified movement disorder"
},
{
"code": "8D43.4",
"title": "Movement disorders due to toxicity"
},
{
"code": "6E8Z",
"title": "Mental, behavioural or neurodevelopmental disorders, unspecified"
},
{
"code": "QA00.3",
"title": "General mental examination"
},
{
"code": "QC65",
"title": "Family history of mental or behavioural disorder"
},
{
"code": "QA04.6",
"title": "General mental examination, requested by authority"
},
{
"code": "FB83.1Y",
"title": "Other specified osteoporosis"
}
] |
=== ICD-11 CODES FOUND ===
[8A0Z] Movement disorders, unspecified
Also known as: Movement disorders, unspecified | extrapyramidal and movement disorders | abnormal movement NOS | disorder of basal ganglia | basal ganglia disease
[8A0Y] Other specified movement disorders
Also known as: Other specified movement disorders | Other movement disorders, not elsewhere classified | chorea NOS | Familial congenital mirror movements | Primary progressive freezing gait
[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
[8A07] Certain specified movement disorder
Definition: Neurologic motor disorders that present with slowness of movement (bradykinesia or hypokinesia) or abnormal involuntary movements (hyperkinesias) as a result of genetic, infectious, toxic, metabolic, inflammatory, or vascular abnormalities.
Also known as: Certain specified movement disorder
[8D43.4] Movement disorders due to toxicity
Definition: Movements of the body such as hyperkinesias, dyskinesias, myoclonus, chorea, tremor and tics produced by toxicity either by toxin or drug, e.g. toxicity by manganese, neuroleptic drugs, calcium channel blockers, gastrointestinal prokinetics, antiarrhythmics and antidepressants that may induce Parkinsonism.
Also known as: Movement disorders due to toxicity
[6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified
Also known as: Mental, behavioural or neurodevelopmental disorders, unspecified | Psychiatric disorder | mental disease NOS | mental disorder NOS | mental illness
[QA00.3] General mental examination
Also known as: General mental examination | mental health evaluation | general psychiatric examination
Excludes: examination requested for medicolegal reasons
[QC65] Family history of mental or behavioural disorder
Also known as: Family history of mental or behavioural disorder | family history of psychiatric disorder | Family history of intellectual development disorder | Family history of mental retardation | Family history of conditions classifiable as intellectual development disorder
[QA04.6] General mental examination, requested by authority
Also known as: General mental examination, requested by authority | evaluation of mental health requested by authority | psychiatric examination requested by authority | general psychiatric examination, requested by authority
[FB83.1Y] Other specified osteoporosis
Also known as: Other specified osteoporosis | Osteoporosis due to eating disorders | Osteoporosis due to anorexia | Osteoporosis due to bulimia | Osteoporosis due to pregnancy or lactation
=== GRAPH WALKS ===
--- Walk 1 ---
[8A0Z] Movement disorders, unspecified
--PARENT--> [?] Movement disorders
Def: This is a group of involuntary movement disorders....
--CHILD--> [8A01] Choreiform disorders
Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another....
--- Walk 2 ---
[8A0Z] Movement disorders, unspecified
--PARENT--> [?] Movement disorders
Def: This is a group of involuntary movement disorders....
--CHILD--> [8A00] Parkinsonism
Def: Parkinsonism is a clinical syndrome characterised by four cardinal features: rest tremor, muscular rigidity, akinesia or bradykinesia, and postural disturbances which include shuffling gait and flexed...
--- Walk 3 ---
[8A0Y] Other specified movement disorders
--PARENT--> [?] Movement disorders
Def: This is a group of involuntary movement disorders....
--CHILD--> [8A02] Dystonic disorders
--- Walk 4 ---
[8A0Y] Other specified movement disorders
--PARENT--> [?] Movement disorders
Def: This is a group of involuntary movement disorders....
--CHILD--> [8A00] Parkinsonism
Def: Parkinsonism is a clinical syndrome characterised by four cardinal features: rest tremor, muscular rigidity, akinesia or bradykinesia, and postural disturbances which include shuffling gait and flexed...
--- Walk 5 ---
[6B60.8Y] Dissociative neurological symptom disorder, with other specified movement disturbance
--PARENT--> [6B60.8] Dissociative neurological symptom disorder, with movement disturbance
Def: Dissociative neurological symptom disorder, with movement disturbance is characterised by symptoms such as chorea, myoclonus, tremor, dystonia, facial spasm, parkinsonism, or dyskinesia that are not c...
--PARENT--> [6B60] Dissociative neurological symptom disorder
Def: Dissociative neurological symptom disorder is characterised by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sen...
--- Walk 6 ---
[6B60.8Y] Dissociative neurological symptom disorder, with other specified movement disturbance
--PARENT--> [6B60.8] Dissociative neurological symptom disorder, with movement disturbance
Def: Dissociative neurological symptom disorder, with movement disturbance is characterised by symptoms such as chorea, myoclonus, tremor, dystonia, facial spasm, parkinsonism, or dyskinesia that are not c...
--CHILD--> [6B60.82] Dissociative neurological symptom disorder, with tremor
Def: Dissociative neurological symptom disorder, with tremor is characterised by involuntary oscillation of a body part that is not consistent with a recognised disease of the nervous system, other mental,...
|
[
"[8A0Z] Movement disorders, unspecified\n --PARENT--> [?] Movement disorders\n Def: This is a group of involuntary movement disorders....\n --CHILD--> [8A01] Choreiform disorders\n Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another....",
"[8A0Z] Movement disorders, unspecified\n --PARENT--> [?] Movement disorders\n Def: This is a group of involuntary movement disorders....\n --CHILD--> [8A00] Parkinsonism\n Def: Parkinsonism is a clinical syndrome characterised by four cardinal features: rest tremor, muscular rigidity, akinesia or bradykinesia, and postural disturbances which include shuffling gait and flexed...",
"[8A0Y] Other specified movement disorders\n --PARENT--> [?] Movement disorders\n Def: This is a group of involuntary movement disorders....\n --CHILD--> [8A02] Dystonic disorders",
"[8A0Y] Other specified movement disorders\n --PARENT--> [?] Movement disorders\n Def: This is a group of involuntary movement disorders....\n --CHILD--> [8A00] Parkinsonism\n Def: Parkinsonism is a clinical syndrome characterised by four cardinal features: rest tremor, muscular rigidity, akinesia or bradykinesia, and postural disturbances which include shuffling gait and flexed...",
"[6B60.8Y] Dissociative neurological symptom disorder, with other specified movement disturbance\n --PARENT--> [6B60.8] Dissociative neurological symptom disorder, with movement disturbance\n Def: Dissociative neurological symptom disorder, with movement disturbance is characterised by symptoms such as chorea, myoclonus, tremor, dystonia, facial spasm, parkinsonism, or dyskinesia that are not c...\n --PARENT--> [6B60] Dissociative neurological symptom disorder\n Def: Dissociative neurological symptom disorder is characterised by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sen...",
"[6B60.8Y] Dissociative neurological symptom disorder, with other specified movement disturbance\n --PARENT--> [6B60.8] Dissociative neurological symptom disorder, with movement disturbance\n Def: Dissociative neurological symptom disorder, with movement disturbance is characterised by symptoms such as chorea, myoclonus, tremor, dystonia, facial spasm, parkinsonism, or dyskinesia that are not c...\n --CHILD--> [6B60.82] Dissociative neurological symptom disorder, with tremor\n Def: Dissociative neurological symptom disorder, with tremor is characterised by involuntary oscillation of a body part that is not consistent with a recognised disease of the nervous system, other mental,..."
] |
8A0Z
|
Movement disorders, unspecified
|
[
{
"from_icd11": "8A0Z",
"icd10_code": "G2571",
"icd10_title": "Drug induced akathisia"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G2579",
"icd10_title": "Other drug induced movement disorders"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G2570",
"icd10_title": "Drug induced movement disorder, unspecified"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G2581",
"icd10_title": "Restless legs syndrome"
},
{
"from_icd11": "8A0Z",
"icd10_code": "R2681",
"icd10_title": "Unsteadiness on feet"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G3109",
"icd10_title": "Other frontotemporal dementia"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G2589",
"icd10_title": "Other specified extrapyramidal and movement disorders"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G3101",
"icd10_title": "Pick's disease"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G2582",
"icd10_title": "Stiff-man syndrome"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G20",
"icd10_title": "Parkinson's disease"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G255",
"icd10_title": "Other chorea"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G210",
"icd10_title": "Malignant neuroleptic syndrome"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G111",
"icd10_title": "Early-onset cerebellar ataxia"
},
{
"from_icd11": "8A0Z",
"icd10_code": "G259",
"icd10_title": "Extrapyramidal and movement disorder, unspecified"
},
{
"from_icd11": "8A0Z",
"icd10_code": "R268",
"icd10_title": "Other abnormalities of gait and mobility"
}
] |
G2571
|
Drug induced akathisia
|
All the clinicians had experience in treating severe adult and pediatric maxillofacial dimorphisms. Surgeons proposed the technique to the parents, and explained the complications of the maxillofacial surgery necessary to correct their child’s facial malformation. The expert anesthesiologists proposed general anesthesia, and explained potential risks of anesthesiology management according to the difficult airway management and metabolic implications of the syndrome. Also, the need for post-operative admission to Intensive Care for appropriate treatment was explained. The psychologist also took care of the whole family with their consent from the beginning of the hospital stay. The day before the surgery, the multidisciplinary team had a briefing to discuss the intraoperative management strategy. The difficult airway management was an important aspect for the expected difficulty to ventilate and to intubate, especially for the encumbrance of the lingual body . The expert anesthesiologist and the anesthesia nurses assessed the pediatric difficult airway algorithms and checked the difficult intubation trolley (face masks of different sizes, nasal cannulas, pediatric orotracheal cannulas, pediatric bronchoscope, laryngeal masks of different sizes, and emergency tracheostomy sets) available in operating room. On the day of the surgery, the patient, with her mother, after a negative nasal swab for SARS-CoV-2, was admitted to the maxillofacial surgery ward. The patient was re-evaluated by the anesthetist and the surgeon, and her vital parameters (SpO 2 , T°, NIBP and 3-lead ECG) were re-measured; all were within normal limits. Clonidine (4 µg/kg) was administered as premedication intranasally half an hour before the surgery through a nebulizer (MAD), which also helps with an antiscialogogue effect, under constant monitoring and two drops per nostril of a nasal vasoconstrictor to avoid potential bleeding during tube passage. She was accompanied to the operating block together with the parent and the psychologist, in order to reassure her. After the sign-in and timeout assessment and compilation of the Surgical Safety checklist, the general anesthesia induction was performed with an inhalatory technique by administering Sevoflurane in increasing doses up to a concentration of 8%. When loss of consciousness occurred, the mother was accompanied outside the operating block, and two peripheral venous accesses were inserted. Fentanyl (1 µg/kg ev) was given, and continuous intravenous Remifentanil administration started (0.05 µg/kg/min). The patient was pre-oxygenated with nasal cannulae and, as soon as she stopped breathing, she was manually ventilated, minimizing the period of hypo-oxygenation. In addition to the previous monitoring, electrodes were placed for the evaluation of entropy maintained until the end of the intervention, as well as the monitoring for the end tidal CO 2 with visualization of the capnographic curve and the temperature probe. Devices were used to warm the patient (a mattress with a heater and an infusion of hot liquids) in the recovery room (pre-warming) and throughout the surgery. Laryngoscopy with videolaryngoscope blade 2 was performed, with a match of grade II to the Cormack-Lehane classification; 40 mg of 2% lidocaine was administered to the vocal cords. After a few minutes, during which the patient continued to be manually ventilated with 100% O 2 , and after analgosedation, rhinotracheal intubation with a size 4.5 tube was carried out. The procedure was successful on the first attempt, and did not lead to problems of any kind. The patient maintained stable vital signs and, in particular, an SpO 2 of no less than 98% throughout the procedure. The tube was then fixed to the nasal choana through a point, to avoid accidental dislocations by the operators, given the area proximal to the operating field. Anti-decubitus devices (Liofoam) were placed on the skin where there could be contact with the tube. A bladder catheter and a gastric nose tube were placed, and a radial artery was cannulated with the Seldinger technique for invasive blood pressure monitoring. Finally, before starting the procedure, a block of the Lingual Nerve was performed with Levobupivacaine 0.5% 1 mL bilaterally. Analgosedation was maintained with 3% Sevoflurane in air and oxygen (FiO 2 of 40%), and Remifentanil in continuous intravenous infusion at a rate of 0.08–0.15 µg/kg/min. The vital parameters continued to remain stable throughout the procedure, blood losses were contained thanks above all to the experience of the operator, and the water balance was constantly monitored. An initial blood gas analysis was performed, then one after the first hour of surgery and one before leaving the operating block, and all three did not show any noteworthy changes. The procedure lasted 2 h and 32 min; the type of intervention performed consisted of a partial glossectomy according to the Egyedi/Obwegeser technique, in which the central portion of the lingual body is resected through a hourglass cut and the side flaps are sutured . The result will certainly be a reduction in the volume of the organ, with a slightly pointed final shape and a significant limitation of the encumbrance of the tongue within the oral cavity. At the end of the surgery, the patient was transferred to intensive care, analgosedated, and mechanically ventilated with a portable ventilator, always under monitoring of vital parameters.
| 3.921875
| 0.939941
|
sec[1]/sec[2]/p[0]
|
en
| 0.999996
|
PMC10529883
|
https://doi.org/10.3390/children10091467
|
[
"nasal",
"operating",
"monitoring",
"tube",
"pediatric",
"technique",
"difficult",
"vital",
"block",
"maxillofacial"
] |
[
{
"code": "MA82.2",
"title": "Nasality"
},
{
"code": "CA0Z",
"title": "Upper respiratory tract disorders, unspecified"
},
{
"code": "CA0Y",
"title": "Other specified upper respiratory tract disorders"
},
{
"code": "LA70.2",
"title": "Choanal atresia"
},
{
"code": "NA00.3&XJ1C6",
"title": "Haematoma of nose"
},
{
"code": "PL12.5",
"title": "Operator error, as mode of injury or harm"
},
{
"code": "PL11.5",
"title": "Procedure undertaken at wrong site or wrong side, as mode of injury or harm"
},
{
"code": "NE81.0Z",
"title": "Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified"
},
{
"code": "NE81.1",
"title": "Disruption of operation wound, not elsewhere classified"
},
{
"code": "NE81.3",
"title": "Postsurgical leak"
}
] |
=== ICD-11 CODES FOUND ===
[MA82.2] Nasality
Definition: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur when there is obstruction in one of the cavities, causing hyponasality, or when there is velopharyngeal dysfunction, causing hypernasality. This category should only be assigned when hyponasality or hypernasality is outside the limits of normal variation and results in reduced intelligibility and si
Also known as: Nasality | Hypernasality | Hyponasality
[CA0Z] Upper respiratory tract disorders, unspecified
Also known as: Upper respiratory tract disorders, unspecified | Disorder of the nose, unspecified | Disease of nose, unspecified | nasal disease | Lesion of nose, unspecified
[CA0Y] Other specified upper respiratory tract disorders
Also known as: Other specified upper respiratory tract disorders | Acute adenoiditis | adenoid infection | Pharyngotonsillitis | tonsillopharyngitis
[LA70.2] Choanal atresia
Definition: Any condition in neonates, caused by failure of the nose to correctly develop during the antenatal period. This condition is characterised by narrowing or blockage of the nasal airway by tissue. This condition may also present with chest retraction unless child is breathing through mouth or crying, difficulty breathing, cyanosis, and inability to nurse and breathe at same time.
Also known as: Choanal atresia | choanal fusion | atresia of nares | congenital stenosis of nares | congenital stenosis of choanae
[PL12.5] Operator error, as mode of injury or harm
Definition: Harm arising due to process or procedural issues associated with the use and/or maintenance of a device not related to device failure.
Also known as: Operator error, as mode of injury or harm | operator error due to poor training as mode of injury | operator error due to poor maintenance as mode of injury | operator error due to incorrect device installation as mode of injury | mistake by operator
Excludes: Combination or interaction of operator error and device failure, as mode of injury or harm | Operator error without injury or harm
[PL11.5] Procedure undertaken at wrong site or wrong side, as mode of injury or harm
Also known as: Procedure undertaken at wrong site or wrong side, as mode of injury or harm | operation performed on incorrect site | surgery undergone on incorrect body part | wrong surgery | Performance of inappropriate operation
Excludes: Patient received diagnostic test or treatment intended for another patient
[NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified
Also known as: Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | postoperative haemorrhage | postoperative bleeding | Haemorrhage at any site resulting from a procedure
[NE81.1] Disruption of operation wound, not elsewhere classified
Also known as: Disruption of operation wound, not elsewhere classified | burst stitches or sutures | Dehiscence of operation wound | dehiscence of operation wound nos | dehiscence of surgical wound
Includes: Dehiscence of operation wound | Rupture of operation wound
Excludes: Postsurgical anastomosis leak
[NE81.3] Postsurgical leak
Also known as: Postsurgical leak | postoperative leak | Postsurgical air leak | postoperative air leak | Postsurgical bile leak
Excludes: Malfunction or complication of external stoma of digestive organs | Tracheostomy malfunction
=== GRAPH WALKS ===
--- Walk 1 ---
[MA82.2] Nasality
Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...
--PARENT--> [MA82] Voice disturbances
Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances....
--CHILD--> [MA82.2] Nasality
Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...
--- Walk 2 ---
[MA82.2] Nasality
Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...
--PARENT--> [MA82] Voice disturbances
Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances....
--CHILD--> [MA82.2] Nasality
Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...
--- Walk 3 ---
[CA0Z] Upper respiratory tract disorders, unspecified
--PARENT--> [?] Upper respiratory tract disorders
Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...
--CHILD--> [CA02] Acute pharyngitis
Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o...
--- Walk 4 ---
[CA0Z] Upper respiratory tract disorders, unspecified
--PARENT--> [?] Upper respiratory tract disorders
Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...
--CHILD--> [CA02] Acute pharyngitis
Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o...
--- Walk 5 ---
[CA0Y] Other specified upper respiratory tract disorders
--PARENT--> [?] Upper respiratory tract disorders
Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...
--EXCLUDES--> [?] Chronic obstructive pulmonary disease with acute exacerbation, unspecified
Def: An acute unspecified exacerbation of COPD is an acute event characterised by a worsening of the patient’s respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medi...
--- Walk 6 ---
[CA0Y] Other specified upper respiratory tract disorders
--PARENT--> [?] Upper respiratory tract disorders
Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...
--EXCLUDES--> [?] Chronic obstructive pulmonary disease with acute exacerbation, unspecified
Def: An acute unspecified exacerbation of COPD is an acute event characterised by a worsening of the patient’s respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medi...
|
[
"[MA82.2] Nasality\n Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...\n --PARENT--> [MA82] Voice disturbances\n Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances....\n --CHILD--> [MA82.2] Nasality\n Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...",
"[MA82.2] Nasality\n Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...\n --PARENT--> [MA82] Voice disturbances\n Def: Voice disturbances include dysphonia, aphonia, hypernasality and hyponasality, and other voice disturbances....\n --CHILD--> [MA82.2] Nasality\n Def: Nasality (or resonance) refers to the quality of the voice that is determined by the balance of sound vibration in the oral, nasal, and pharyngeal cavities during speech. Abnormal resonance can occur ...",
"[CA0Z] Upper respiratory tract disorders, unspecified\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --CHILD--> [CA02] Acute pharyngitis\n Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o...",
"[CA0Z] Upper respiratory tract disorders, unspecified\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --CHILD--> [CA02] Acute pharyngitis\n Def: Acute pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils and is a part of the common cold symptoms. The etiology is usually infectious, with most cases being of viral o...",
"[CA0Y] Other specified upper respiratory tract disorders\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --EXCLUDES--> [?] Chronic obstructive pulmonary disease with acute exacerbation, unspecified\n Def: An acute unspecified exacerbation of COPD is an acute event characterised by a worsening of the patient’s respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medi...",
"[CA0Y] Other specified upper respiratory tract disorders\n --PARENT--> [?] Upper respiratory tract disorders\n Def: This group of disorders refers to diseases of the upper airways (upper respiratory tract). The upper airways anatomically are complicated structures which extend from the airway openings at the nares ...\n --EXCLUDES--> [?] Chronic obstructive pulmonary disease with acute exacerbation, unspecified\n Def: An acute unspecified exacerbation of COPD is an acute event characterised by a worsening of the patient’s respiratory symptoms that is beyond normal day-to-day variations and leads to a change in medi..."
] |
MA82.2
|
Nasality
|
[
{
"from_icd11": "MA82.2",
"icd10_code": "R4921",
"icd10_title": "Hypernasality"
},
{
"from_icd11": "MA82.2",
"icd10_code": "R4922",
"icd10_title": "Hyponasality"
},
{
"from_icd11": "MA82.2",
"icd10_code": "R492",
"icd10_title": "Hypernasality and hyponasality"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J349",
"icd10_title": "Unspecified disorder of nose and nasal sinuses"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J3489",
"icd10_title": "Other specified disorders of nose and nasal sinuses"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J3481",
"icd10_title": "Nasal mucositis (ulcerative)"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J398",
"icd10_title": "Other specified diseases of upper respiratory tract"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J392",
"icd10_title": "Other diseases of pharynx"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J399",
"icd10_title": "Disease of upper respiratory tract, unspecified"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J00-J06",
"icd10_title": ""
},
{
"from_icd11": "CA0Z",
"icd10_code": "J30-J39",
"icd10_title": ""
},
{
"from_icd11": "CA0Z",
"icd10_code": "J34",
"icd10_title": "Other and unspecified disorders of nose and nasal sinuses"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J348",
"icd10_title": "Other specified disorders of nose and nasal sinuses"
},
{
"from_icd11": "CA0Z",
"icd10_code": "J39",
"icd10_title": "Other diseases of upper respiratory tract"
},
{
"from_icd11": "LA70.2",
"icd10_code": "Q300",
"icd10_title": "Choanal atresia"
}
] |
R4921
|
Hypernasality
|
All ablations were performed according to our local protocol. Briefly, LV and RV high-density voltage mapping was obtained followed by programmed ventricular stimulation when the patient was not in sustained VT at the beginning of the procedure. When VA was sustained, activation map was conducted, and critical isthmus sites were identified using entrainment mapping and novel mapping modules such as the Coherent Mapping algorithm (CARTO 3 ® , Biosense Webster, Inc., Diamond Bar, CA, USA). VT was defined as “cannula dependent” when the isthmus was in close proximity to the cannula insertion site and VA ablation was performed at the critical isthmus site with additional substrate modification as described below. . Fig. 1 This patient was a 53-year-old male (dilated cardiomyopathy; DCM, LVEF 15%) with previous endocardial ventricular arrhythmia (VA) ablation 2019. In January 2020, a left ventricular assist device (LVAD; HeartWare) was implanted due to recurrent ventricular tachycardia (VT) storm and protracted cardiogenic shock. He was then readmitted to our hospital in September 2020 due to incessant VT storm despite antiarrhythmic therapy. During the VT, the patient was hemodynamically compromised with recurrent low-flow notifications of the LVAD. The VTs were highly suggestive of originating from the epicardium. Taking into account the patients’ refusal to receive a heart transplantation, we decided to perform an open chest epicardial ablation. Following surgical guided epicardial access via left thoracotomy, the epicardium was comprehensively mapped revealing a large scar between the midventricular and posterolateral parts of the left ventricle (LV). After induction of the clinical VT (TCL 420 ms), earliest activation was located at the basolateral site. The VT terminated specifically during ablation and rendered non-inducible during programmed ventricular stimulation (PVS). The patient was then discharged 7 days after the procedure with no other episode during follow-up. A Epicardial activation map during ventricular tachycardia (VT). Earliest activation is at the basolateral LV. The epicardium was reached via minithoracotomy. B Epicardial HD-mapping using a high-density mapping catheter (PentaRay © , Biosense Webster © ). C Epicardial ablation using an irrigated radiofrequency catheter. D Specific termination during epicardial ablation at earliest activation site. The patient did not have any recurrence following this hybrid-approach Fig. 2 This 62-year-old male patient with ischemic cardiomyopathy and previous inferior infarction (ICM; LVEF 20%) presented in February 2020 due to a ventricular arrhythmia (VA) storm with multiple ATP and shock therapies. Left ventricular assist device (LVAD) therapy was established in 2017 (HeartMate3). Activation mapping showed the earliest activation of the clinical ventricular tachycardia (VT) within an inferior scar. Ablation in this area terminated the VT rendering non-inducible during programmed ventricular stimulation (PVS). After discharge, he suffered one relapse, but after re-establishing a dual antiarrhythmic therapy with Amiodarone and Mexiletine, no more episodes occurred. A Sustained ventricular tachycardia during ablation in a patient with HeartMate 3 device. Please note that the ECG-recordings only show slight artifacts. B Termination of the VT during ablation at the apicoinferior site. C and D The intracardiac recordings from the apicoinferior ablation site shows distinct pre-potentials finally leading to specific termination. E and F : Voltage map ( E ) and coherent map ( F ). Meanwhile the voltage map shows a low voltage scar zone at the apicoinferior site, the coherent map identifies slow conduction at the scar border zones. Green dots: local abnormal ventricular activation (LAVA) Fig. 3 This patient suffered of ischemic cardiomyopathy (ICM; LVEF 25%) with coronary artery bypass graft operation in 2015 in conjunction with mechanical mitral and aortic valve replacement. The mechanical aortic valve was later replaced by a bioprosthetic valve. The left ventricular assist device (LVAD; HeartMate 3) was implanted in 2017. In November 2020, he was admitted to our intensive care unit due to drug refractory ventricular arrhythmia (VA) storm with hemodynamic compromise. We then decided to perform a VA ablation. During the procedure, the left ventricle (LV) was not approachable via transseptal puncture due to the mechanical mitral valve. Further, the aortic valve was permanently closed during the LVAD pump. Hence, access was obtained retrogradely via the aorta by switching off the pump for the passage through the aortic valve. During the procedure and using the 3d-mapping software CARTO 3 (Biosense Webster © ), termination of the clinical VT (cycle length 280 ms) succeeded at its earliest endocardial activation at the anterior aspect of the left ventricle (LV). Without LVAD, the VT would most likely not have been tolerated. A Catheter location at which the VT was specifically terminated. Note the ECG recordings on the left side which shows some noise due the LVAD pump. B Coherent map during right ventricular pacing identifies a slow-conduction zone at the spot of successful termination. C Fluoroscopy image (RAO 30° view) of the procedure. Please note the mechanical mitral valve which only allowed retrograde access via the bioprosthetic aortic valve. Even in close proximity to the inflow cannula, the catheter was correctly displayed
| 4.125
| 0.916992
|
sec[1]/p[3]
|
en
| 0.999994
|
34709450
|
https://doi.org/10.1007/s00392-021-01958-0
|
[
"ventricular",
"ablation",
"activation",
"mapping",
"valve",
"site",
"lvad",
"epicardial",
"this",
"earliest"
] |
[
{
"code": "LA89.Z",
"title": "Functionally univentricular heart, unspecified"
},
{
"code": "BC45",
"title": "Cardiomegaly"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "BC46&XA7XU8",
"title": "Ventricular thrombosis"
},
{
"code": "BD1Z&XT5R",
"title": "Acute heart failure"
},
{
"code": "QF01.10",
"title": "Acquired absence of female genital organs"
},
{
"code": "9B73.3",
"title": "Serous retinal detachment"
},
{
"code": "JA8C.Z",
"title": "Maternal care related to premature separation of placenta, unspecified"
},
{
"code": "KA02.Y",
"title": "Fetus or newborn affected by other specified complication of placenta"
},
{
"code": "5D40.00",
"title": "Hypothyroidism postradioactive iodine ablation"
}
] |
=== ICD-11 CODES FOUND ===
[LA89.Z] Functionally univentricular heart, unspecified
Also known as: Functionally univentricular heart, unspecified | Functionally univentricular heart | Univentricular cardiopathy | Single ventricle | univentricular heart
[BC45] Cardiomegaly
Also known as: Cardiomegaly | enlargement of heart | hypertrophic heart | heart hypertrophy | Cardiac hypertrophy
Includes: Left ventricular hyperplasia
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[QF01.10] Acquired absence of female genital organs
Also known as: Acquired absence of female genital organs | Acquired absence of cervix | amputation of cervix | Acquired absence of the uterus | acquired uterine absence
[9B73.3] Serous retinal detachment
Definition: This occurs due to inflammation, injury or vascular abnormalities that results in fluid accumulating underneath the retina without the presence of a hole, tear, or break.
Also known as: Serous retinal detachment | serous retinal detachment, unspecified eye | sensory retinal detachment | Retinal detachment without retinal break | Retinal detachment NOS
Excludes: Central serous chorioretinopathy
[JA8C.Z] Maternal care related to premature separation of placenta, unspecified
Also known as: Maternal care related to premature separation of placenta, unspecified | Maternal care related to premature separation of placenta | ablatio placentae | detachment of placenta | placenta abruptio
[KA02.Y] Fetus or newborn affected by other specified complication of placenta
Also known as: Fetus or newborn affected by other specified complication of placenta | Fetus or newborn affected by other forms of placental separation | Ablatio placentae affecting fetus or newborn | placenta ablation affecting fetus or newborn | Abruptio placentae affecting fetus or newborn
[5D40.00] Hypothyroidism postradioactive iodine ablation
Also known as: Hypothyroidism postradioactive iodine ablation
=== GRAPH WALKS ===
--- Walk 1 ---
[LA89.Z] Functionally univentricular heart, unspecified
--PARENT--> [LA89] Functionally univentricular heart
Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...
--CHILD--> [LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--- Walk 2 ---
[LA89.Z] Functionally univentricular heart, unspecified
--PARENT--> [LA89] Functionally univentricular heart
Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...
--CHILD--> [LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--- Walk 3 ---
[BC45] Cardiomegaly
--PARENT--> [?] Diseases of the myocardium or cardiac chambers
Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...
--CHILD--> [BC40] Acquired atrial abnormality
Def: A postnatal pathological change in form or function of one or both atriums....
--- Walk 4 ---
[BC45] Cardiomegaly
--PARENT--> [?] Diseases of the myocardium or cardiac chambers
Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...
--CHILD--> [BC40] Acquired atrial abnormality
Def: A postnatal pathological change in form or function of one or both atriums....
--- 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...
--EXCLUDES--> [?] Dressler syndrome
Def: A condition of postmyocardial infarction (1 to 8 weeks), characterised by a set of associated symptom, including malaise, fever, pericardial discomfort, leukocytosis, an elevated sedimentation rate, a...
--- 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...
--PARENT--> [?] Acute ischaemic heart disease
|
[
"[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....",
"[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....",
"[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC40] Acquired atrial abnormality\n Def: A postnatal pathological change in form or function of one or both atriums....",
"[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC40] Acquired atrial abnormality\n Def: A postnatal pathological change in form or function of one or both atriums....",
"[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --EXCLUDES--> [?] Dressler syndrome\n Def: A condition of postmyocardial infarction (1 to 8 weeks), characterised by a set of associated symptom, including malaise, fever, pericardial discomfort, leukocytosis, an elevated sedimentation rate, a...",
"[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 --PARENT--> [?] Acute ischaemic heart disease"
] |
LA89.Z
|
Functionally univentricular heart, unspecified
|
[
{
"from_icd11": "LA89.Z",
"icd10_code": "Q209",
"icd10_title": "Congenital malformation of cardiac chambers and connections, unspecified"
},
{
"from_icd11": "BC45",
"icd10_code": "I517",
"icd10_title": "Cardiomegaly"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A1",
"icd10_title": "Myocardial infarction type 2"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A9",
"icd10_title": "Other myocardial infarction type"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2109",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2119",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2111",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2102",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2129",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2121",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2101",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I214",
"icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I213",
"icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I219",
"icd10_title": "Acute myocardial infarction, unspecified"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21",
"icd10_title": "Acute myocardial infarction"
}
] |
Q209
|
Congenital malformation of cardiac chambers and connections, unspecified
|
A 76 y/o women experienced frequent episodes of palpitations and consulted our hospital. The 12-lead ECG exhibited normal sinus rhythm with a PQ interval and QRS width of 100 and 66 ms, respectively. The QT and QTc intervals were 520 and 425ms, respectively. Two types of PVCs were documented on the 12-lead ECG, and the morphology of one PVC (PVC1) exhibited a left bundle branch block with an inferior axis, and the other (PVC2) was similar to PVC1 but its QRS morphology was slight different (PVC2) . Routine check-ups including a transthoracic echocardiogram revealed no structural abnormalities. Her Holter monitoring revealed 21,564 PVC beats over 24 hrs which coincided in time with her palpitations. She was admitted to our hospital and underwent an electrophysiologic study (EPS). In the baseline study, the atrio-His and His-to-ventricular intervals during sinus rhythm were 135 ms and 42ms, respectively. Based on the morphologies of those two types of PVCs, the sites from which the PVCs arose were thought to be located in the right ventricular outflow tract (RVOT) . The earliest activation site (EAS) during the PVCs was determined using an electroanatomical mapping system (CARTO XP, Biosense Webster, Diamond Bar, CA). Since PVC1 was more frequently documented than PVC2 during the EPS, mapping of PVC1 was performed first to try and cure PVC1. The EAS during PVC1 was located in the anteroseptal region of the RVOT , where the local excitation preceded the QRS onset by 32ms and a QS complex was recorded by the mapping catheter in the unipolar electrogram . The pace map from the EAS exhibited an excellent match to the QRS morphology during spontaneous PVC1 . RFCA was applied at the EAS and to sites within close proximity to the EAS determined by CARTO during PVC1, and are indicated by red tags in Figure 2A . Those RFCA applications eliminated PVC1, but another type of PVC (PVC3) with a different morphology from that of PVCs 1 and 2 appeared with a similar frequency to PVC1 . Therefore a new electro-anatomical map was created to define the EAS during PVC3 after the initial RFCA applications targeting PVC1. The mapping revealed that the EAS during PVC3, where the local excitation preceded the QRS onset by 24ms, was located in the septal region of the RVOT and around 15mm more posterior than the EAS during PVC1 . The pace map performed from the EAS during PVC3 also revealed a good match . Again the RFCA applications to the EAS and the area around the EAS during PVC3 as indicated by the asterisks in Figure 2B however, could not eliminate PVC3. Careful mapping around the EAS during PVC3 revealed a small potential preceding the local ventricular potential when PVC3 appeared, and is indicated by the arrows in Figure 4 . The region where such potentials could be recorded is indicated by the light blue tags in Figure 2B . Such potentials could be seen during the late phase of the QRS complex and might be superimposed by the local ventricular potential during sinus rhythm, as indicated by the arrowheads in Figure 4 . The sites where such pre-potentials could be recorded covered a relatively large area of the RVOT, and were observed mainly in the superior region, both anteriorly and posteriorly, to the EAS, and in particular beneath the pulmonic valve as indicated by the arrowheads in Figure 2B. Although this was not determined with ventriculography, the position of the pulmonic valve could be assumed from the cardiac silhouette. The spatio-temporal relationship between the antecedent timing of the pre-potential and the emergence of the onset of the QRS, and the location where the pre-potentials could be recorded is shown in Figure 2B and 4 . The pre-potentials appeared earlier in timing to the QRS onset as the recording site became further away from the EAS. To assess the electrophysiologic relationship between such pre-potentials and the emergence of PVC3, pacing from the sites demonstrating such potentials was performed. The selective capture of such pre-potentials without local ventricular capture by pacing however, was impossible. A few applications of RFCA targeting the sites exhibiting such potentials, as indicated by the asterisks in Figure 2B , were delivered to see if they had any influence on suppressing the incidence of PVC3, but the RFCA did not have any influence on either the frequency or morphology of PVC3. Based on the results of the failure to eliminate PVC3 by RFCA at a few points, we presumed that the origin of PVC3 was located at a site some distance away from the EAS and that the excitation was propagating from the PVC origin through several preferential pathways, resulting in a single phenotypic presentation of the PVC3 QRS morphology even though the course of the conduction differed. The strategy for the RFCA applications was changed to create RFCA regions that intersected an arbitrary line connecting points between the sites where the pre-potentials could be recorded. The linear but actually stepped linear RFCA applications between the posterior and anterior septum in the RVOT, as indicated by the red tags in Figure 2B , resulted in the complete elimination of PVC3. In the process of delivering those RFCA applications for PVC3, the frequency of the occurrence of PVC2 decreased. Since PVC2 never appeared again after the final RFCA application targeting PVC3, the session was completed. During 6 months of follow-up, no further occurrences of PVCs 1-3 have been documented.
| 4.28125
| 0.749512
|
sec[1]/p[0]
|
en
| 0.999999
|
23573064
|
N/A
|
[
"rfca",
"potentials",
"applications",
"pvcs",
"morphology",
"sites",
"ventricular",
"rvot",
"mapping",
"local"
] |
[
{
"code": "DA95",
"title": "Coeliac disease"
},
{
"code": "MC21.Y",
"title": "Other specified impairment of electrophysiological functions"
},
{
"code": "EK92",
"title": "Histiocytoses of uncertain malignant potential"
},
{
"code": "QA53",
"title": "Pressure as potential mode of injury without injury or harm"
},
{
"code": "MA12.Y",
"title": "Other specified clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system"
},
{
"code": "EH70",
"title": "Pigmentary abnormalities of skin due to drug"
},
{
"code": "PL11.Y",
"title": "Other specified mode of injury or harm associated with a surgical or other medical procedure"
},
{
"code": "PJ47",
"title": "Legal intervention involving application of physical force"
},
{
"code": "JB0D.7",
"title": "Failed application of vacuum extractor or forceps, unspecified"
},
{
"code": "8A83",
"title": "Other primary headache disorder"
}
] |
=== ICD-11 CODES FOUND ===
[DA95] Coeliac disease
Definition: Coeliac disease is a permanent intolerance to gluten proteins, present in wheat, rye, and barley. It is an autoimmune disorder, characterised by a chronic inflammatory state of the small intestinal mucosa and submucosa, which can impair digestion and absorption of nutrients, leading to malnutrition.
Also known as: Coeliac disease | Gluten-sensitive enteropathy | Nontropical sprue | coeliac rickets | Gee disease
Includes: Gluten-sensitive enteropathy | Nontropical sprue | Idiopathic steatorrhoea
[MC21.Y] Other specified impairment of electrophysiological functions
Also known as: Other specified impairment of electrophysiological functions | Normal electrooculogram | Normal EOG | Moderate impairment of electrooculogram | Moderate impairment of EOG
[EK92] Histiocytoses of uncertain malignant potential
Definition: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable.
Also known as: Histiocytoses of uncertain malignant potential | Systemic non-Langerhans cell histiocytosis | Faisalabad histiocytosis | Sea-blue histiocytosis | Sinus histiocytosis with massive lymphadenopathy
[QA53] Pressure as potential mode of injury without injury or harm
Definition: Pressure as a potential mode of injury, includes factors such as: body positioning, retractors, or other instruments with direct pressure, without documented injury or harm.
Also known as: Pressure as potential mode of injury without injury or harm | retractor usage too long or incorrect without documented injury or harm | patient kept in same position too long without documented injury or harm
Excludes: Pressure, as mode of injury or harm
[MA12.Y] Other specified clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
Also known as: Other specified clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system | Finding of other drugs of addictive potential in blood
[EH70] Pigmentary abnormalities of skin due to drug
Definition: Disturbances of skin colour due to an ingested or injected drug. These may result from a number of different mechanisms including the colour of the drug itself, disturbed melanisation of the skin or deposition of pigments by drug breakdown products.
Also known as: Pigmentary abnormalities of skin due to drug | drug application site discolouration | discolouration of skin due to drug | Drug-induced hypermelanosis | Drug-induced hypomelanosis
[PL11.Y] Other specified mode of injury or harm associated with a surgical or other medical procedure
Also known as: Other specified mode of injury or harm associated with a surgical or other medical procedure | Other specified mode, as mode of injury or harm | Overdose of radiation given during therapy | overdose of radiation | radiation overdose
[PJ47] Legal intervention involving application of physical force
Also known as: Legal intervention involving application of physical force
[JB0D.7] Failed application of vacuum extractor or forceps, unspecified
Also known as: Failed application of vacuum extractor or forceps, unspecified | Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively
Includes: Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively
[8A83] Other primary headache disorder
Definition: A group of clinically heterogeneous headache disorders, believed to be primary. Although largely unrelated, they fall into four categories: headaches associated with physical exertion; headaches attributed to direct physical but innocuous stimuli; epicranial headaches; and other miscellaneous primary headache disorders.
Also known as: Other primary headache disorder | Primary cough headache | Primary exercise headache | Primary headache associated with sexual activity | Preorgasmic headache
=== GRAPH WALKS ===
--- Walk 1 ---
[DA95] Coeliac disease
Def: Coeliac disease is a permanent intolerance to gluten proteins, present in wheat, rye, and barley. It is an autoimmune disorder, characterised by a chronic inflammatory state of the small intestinal mu...
--PARENT--> [?] Diseases of small intestine
Def: This is a group of conditions characterised as being in or associated with the small intestine....
--CHILD--> [DA90] Nonstructural developmental anomalies of small intestine
Def: Any congenital defect of small intestine that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary grea...
--- Walk 2 ---
[DA95] Coeliac disease
Def: Coeliac disease is a permanent intolerance to gluten proteins, present in wheat, rye, and barley. It is an autoimmune disorder, characterised by a chronic inflammatory state of the small intestinal mu...
--PARENT--> [?] Diseases of small intestine
Def: This is a group of conditions characterised as being in or associated with the small intestine....
--RELATED_TO--> [?] 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 3 ---
[MC21.Y] Other specified impairment of electrophysiological functions
--PARENT--> [MC21] Impairment of electrophysiological functions
--CHILD--> [MC21.1] Normal electroretinogram
Def: An Electro-Retinogram records retinal action potentials in response to various visual stimuli....
--- Walk 4 ---
[MC21.Y] Other specified impairment of electrophysiological functions
--PARENT--> [MC21] Impairment of electrophysiological functions
--CHILD--> [MC21.1] Normal electroretinogram
Def: An Electro-Retinogram records retinal action potentials in response to various visual stimuli....
--- Walk 5 ---
[EK92] Histiocytoses of uncertain malignant potential
Def: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable....
--RELATED_TO--> [?] 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...
--CHILD--> [?] Hand-Schüller-Christian disease
Def: This is associated with multifocal Langerhans cell histiocytosis and is associated with a triad of exophthalmos, lytic bone lesions (often in the skull), and diabetes insipidus (from pituitary stalk i...
--- Walk 6 ---
[EK92] Histiocytoses of uncertain malignant potential
Def: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable....
--RELATED_TO--> [?] 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...
--CHILD--> [?] Eosinophilic granuloma
|
[
"[DA95] Coeliac disease\n Def: Coeliac disease is a permanent intolerance to gluten proteins, present in wheat, rye, and barley. It is an autoimmune disorder, characterised by a chronic inflammatory state of the small intestinal mu...\n --PARENT--> [?] Diseases of small intestine\n Def: This is a group of conditions characterised as being in or associated with the small intestine....\n --CHILD--> [DA90] Nonstructural developmental anomalies of small intestine\n Def: Any congenital defect of small intestine that results from interference with the normal growth and differentiation of the fetus. Such defects can arise at any stage of embryonic development, vary grea...",
"[DA95] Coeliac disease\n Def: Coeliac disease is a permanent intolerance to gluten proteins, present in wheat, rye, and barley. It is an autoimmune disorder, characterised by a chronic inflammatory state of the small intestinal mu...\n --PARENT--> [?] Diseases of small intestine\n Def: This is a group of conditions characterised as being in or associated with the small intestine....\n --RELATED_TO--> [?] 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...",
"[MC21.Y] Other specified impairment of electrophysiological functions\n --PARENT--> [MC21] Impairment of electrophysiological functions\n --CHILD--> [MC21.1] Normal electroretinogram\n Def: An Electro-Retinogram records retinal action potentials in response to various visual stimuli....",
"[MC21.Y] Other specified impairment of electrophysiological functions\n --PARENT--> [MC21] Impairment of electrophysiological functions\n --CHILD--> [MC21.1] Normal electroretinogram\n Def: An Electro-Retinogram records retinal action potentials in response to various visual stimuli....",
"[EK92] Histiocytoses of uncertain malignant potential\n Def: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable....\n --RELATED_TO--> [?] 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...\n --CHILD--> [?] Hand-Schüller-Christian disease\n Def: This is associated with multifocal Langerhans cell histiocytosis and is associated with a triad of exophthalmos, lytic bone lesions (often in the skull), and diabetes insipidus (from pituitary stalk i...",
"[EK92] Histiocytoses of uncertain malignant potential\n Def: Disorders characterised by abnormal proliferation of dendritic cells and macrophages. The proliferation may or may not be clonal and the prognosis is unpredictable....\n --RELATED_TO--> [?] 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...\n --CHILD--> [?] Eosinophilic granuloma"
] |
DA95
|
Coeliac disease
|
[
{
"from_icd11": "DA95",
"icd10_code": "K900",
"icd10_title": "Celiac disease"
},
{
"from_icd11": "EK92",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "QA53",
"icd10_code": "XXI",
"icd10_title": ""
},
{
"from_icd11": "EH70",
"icd10_code": "T788XXA",
"icd10_title": "Other adverse effects, not elsewhere classified, initial encounter"
},
{
"from_icd11": "EH70",
"icd10_code": "T788XXS",
"icd10_title": "Other adverse effects, not elsewhere classified, sequela"
},
{
"from_icd11": "EH70",
"icd10_code": "T788",
"icd10_title": "Other adverse effects, not elsewhere classified"
},
{
"from_icd11": "JB0D.7",
"icd10_code": "O665",
"icd10_title": "Attempted application of vacuum extractor and forceps"
},
{
"from_icd11": "8A83",
"icd10_code": "G44209",
"icd10_title": "Tension-type headache, unspecified, not intractable"
},
{
"from_icd11": "8A83",
"icd10_code": "G44221",
"icd10_title": "Chronic tension-type headache, intractable"
},
{
"from_icd11": "8A83",
"icd10_code": "G44229",
"icd10_title": "Chronic tension-type headache, not intractable"
},
{
"from_icd11": "8A83",
"icd10_code": "G44201",
"icd10_title": "Tension-type headache, unspecified, intractable"
},
{
"from_icd11": "8A83",
"icd10_code": "G44219",
"icd10_title": "Episodic tension-type headache, not intractable"
},
{
"from_icd11": "8A83",
"icd10_code": "G442",
"icd10_title": "Tension-type headache"
}
] |
K900
|
Celiac disease
|
A 19-year-old healthy male, farmer and shepherd, native and resident in Northwest of Iran, was admitted to the Department of Infectious Diseases of Mazandaran University of Medical Sciences, Sari, Iran, and presented with atypical dermatosis and fever, with the right side of his face swollen. Though the patient had much contact with sheep and slaughtering the sheep, he could not remember any history of trauma or puncture at the site of the lesion. The symptoms started two weeks prior to the emergence of the lesion, initially as a painful vesicle after having contact with Venetian ceruse (Spirits of Saturn) which is traditionally made from sheep's spinal cord. Initially, the lesions were small, asymmetric, swollen, and painless but the size has increased gradually and itchy nodule developed afterwards as pruritic scaly erythema with small dark dots at the surface and serous discharge by firm pressure was noticed (Figures 1(a) and 1(b) ). Due to the atypical clinical signs and occupational history of the patient, the initial suspicion was soft tissue infection or deep venous thrombosis. Nevertheless, no significant regional lymphadenopathy was noticed. No underling diseases were found and he was considered as an immunocompetent person. The blood count, blood chemistry, and renal functions were normal. Serological test for human immunodeficiency virus (HIV) and hepatitis C antibodies was negative. Ceftriaxone (800 mg/day) and gentamicin (1.5–2 mg/kg/day) treatments were started for suspected bacterial infections; however, fungal infection and other disorders were still considered. The skin scarping and serous discharges obtained from the lesions on his face were used for mycological and bacteriological investigations at the reference laboratory center. Gram staining of the specimens revealed nonbranching Gram-positive bacilli growing in chains and Bacillus anthracis was confirmed in aerobic blood culture (Becton Dickinson, Heidelberg, Germany). On subcultures, the bacilli were sticky, rough, white-grey, nonhaemolytic, and lipase negative on egg yolk agar (HiMedia, India). Phase-contrast microscopy showed large nonmotile bacilli and pearl string test was positive. Catalase test was positive. Glucose, fructose, maltose, and sucrose tests were positive with production of acid. These findings confirmed that the organism was correctly identified as Bacillus anthracis . Antibacterial susceptibility testing was performed using disk diffusion test. The isolate was susceptible to ceftriaxone, meropenem, penicillin, clindamycin, vancomycin, tetracycline, ciprofloxacin, and moxifloxacin but resistant to rifampin. The MIC result showed that ceftriaxone and penicillin have the highest efficiency. In addition, direct examination (KOH 10%) revealed indistinct, hyaline septate fungal hyphae. Subsequently, the remaining samples were inoculated on Sabouraud dextrose agar (SDA, Difco) with and without chloramphenicol (50 mg/L) and incubated at 30°C in the dark for two weeks. Cultures became positive with a fungus and routine morphological identification revealed a species of Trichophyton as causative agent. Stock cultures were maintained on slants of 2% malt extract agar (MEA, Difco) at 24°C, and a voucher strain was deposited into the reference laboratory culture collection of Mazandaran University of Medical Sciences under accession number LCCM10. Slides from 3- to 4-week-old cultures were prepared in lactophenol cotton blue and examined with a Nikon Eclipse 80i microscope equipped with a Nikon digital sight DS-Fi1 camera. Colonies grew fairly rapidly and were flat, white to cream in colour, with a powdery-to-granular surface and yellow-brown color in reverse ( Figure 2(a) ). Numerous single-celled microconidia were formed, and hyaline, smooth-walled, and spherical-to-subspherical microconidia, occasionally clavate to pyriform, were observed. Spherical chlamydoconidia, spiral hyphae, and smooth, thin-walled, clavate shaped, multicelled macroconidia were present which indicated the identification of T. interdigitale (Figures 2(b) and 2(c) ). DNA was extracted using an Ultra Clean Microbial DNA Isolation Kit (Mobio, Carlsbad, CA, USA) according to the manufacturer's instructions . Molecular identification was performed based on ITS rDNA region . ITS rDNA was amplified using primers V9G (5′-TTACGTCCCTGCCCTTTGTA-3′) and LS266 (5′-GCATTCCCAAACAACTCGACTC-3′) and sequenced with the internal primers ITS1 (5′-TCCGTAGGTGAACCTGCGG-3′) and ITS4 (5′-TCCTCCGCTTATTGATATGC-3′). The final sequence was blasted and compared with GenBank database and was identified as T. interdigitale showing 99.5% sequence identity with the ex-type of the species. After final confirmation about the presence of both Gram-positive B. anthracis and fungus T. interdigitale , the ceftriaxone dose was increased to 1000 mg/day for two weeks, terbinafine to 200 mg/week for one month, and 1% clotrimazole cream two times for 5 weeks, which resulted in gradual improvement. However, surgical intervention was not considered due to the absence of any abscesses. During the following month, the condition of the patient slightly improved, no relapse in one-year follow-up was observed, and the patient was considered to have been successfully cured. The presentation of this case was approved by the ethics committee of Mazandaran University of Medical Sciences, and written informed consent was obtained from the patient for publication of this report.
| 4.164063
| 0.947266
|
sec[1]/p[0]
|
en
| 0.999997
|
26451148
|
https://doi.org/10.1155/2015/325093
|
[
"considered",
"ceftriaxone",
"mazandaran",
"university",
"sciences",
"sheep",
"which",
"blood",
"gram",
"bacilli"
] |
[
{
"code": "MG50.91",
"title": "Third generation cephalosporin resistant Salmonella"
},
{
"code": "MG50.A2",
"title": "Third-generation cephalosporins resistant Shigella"
},
{
"code": "MG51.12",
"title": "Third-generation cephalosporins resistant Streptococcus pneumoniae"
},
{
"code": "MG50.52",
"title": "Third-generation cephalosporin resistant Klebsiella pneumoniae"
},
{
"code": "MG50.22",
"title": "Third generation cephalosporin resistant Escherichia coli"
},
{
"code": "LB18",
"title": "Congenital anomalies of intestinal fixation"
},
{
"code": "EC23.Y",
"title": "Other specified genetic disorders of skin pigmentation"
},
{
"code": "ED63.0",
"title": "Vitiligo"
},
{
"code": "ED70.2Y",
"title": "Other specified forms of alopecia areata"
},
{
"code": "EK5Y",
"title": "Other specified skin disorders provoked by external factors"
}
] |
=== ICD-11 CODES FOUND ===
[MG50.91] Third generation cephalosporin resistant Salmonella
Also known as: Third generation cephalosporin resistant Salmonella | 3GC - [third generation cephalosporin] resistant Salmonella | Cefotaxime resistant Salmonella | Ceftazidime resistant Salmonella | Ceftriaxone-resistant Salmonella
[MG50.A2] Third-generation cephalosporins resistant Shigella
Also known as: Third-generation cephalosporins resistant Shigella | Cefotaxime resistant Shigella | Ceftazidime resistant Shigella | Ceftriaxone resistant Shigella
[MG51.12] Third-generation cephalosporins resistant Streptococcus pneumoniae
Also known as: Third-generation cephalosporins resistant Streptococcus pneumoniae | Cefotaxime resistant Streptococcus pneumoniae | Ceftriaxone resistant Streptococcus pneumoniae
[MG50.52] Third-generation cephalosporin resistant Klebsiella pneumoniae
Also known as: Third-generation cephalosporin resistant Klebsiella pneumoniae | 3GC - [third generation cephalosporin] resistant Klebsiella pneumoniae | Cefotaxime resistant Klebsiella pneumoniae | Ceftazidime resistant Klebsiella pneumoniae | Ceftriaxone-resistant Klebsiella pneumoniae
[MG50.22] Third generation cephalosporin resistant Escherichia coli
Also known as: Third generation cephalosporin resistant Escherichia coli | 3GC - [third generation cephalosporin] resistant Escherichia coli | Cefotaxime resistant Escherichia coli | Ceftazidime resistant Escherichia coli | Ceftriaxone-resistant Escherichia coli
[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
[EC23.Y] Other specified genetic disorders of skin pigmentation
Also known as: Other specified genetic disorders of skin pigmentation | Genetically-determined mixed hyper- and hypomelanotic disorders of skin pigmentation | Hereditary universal dyschromatosis | Dyschromatosis universalis hereditaria | DUH1 - [Dyschromatosis universalis hereditaria] (MIM 127500)
[ED63.0] Vitiligo
Definition: Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes where progressive destruction of melanocytes results in loss of skin pigmentation. Half of all cases first appear before the age of 20. The clinical course is unpredictable but gradual extension of the areas involved is the norm. The disease may have a devastating psychological impact, particularly in people with dark skin.
Also known as: Vitiligo | Localised vitiligo | Generalised vitiligo | Universal vitiligo | Segmental vitiligo
[ED70.2Y] Other specified forms of alopecia areata
Also known as: Other specified forms of alopecia areata | Alopecia universalis | Universal alopecia areata | Ophiasis | Ophiasic alopecia areata
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[MG50.91] Third generation cephalosporin resistant Salmonella
--PARENT--> [MG50.9] Antibiotic resistant Salmonella
--CHILD--> [MG50.90] Fluoroquinolone resistant Salmonella
--- Walk 2 ---
[MG50.91] Third generation cephalosporin resistant Salmonella
--PARENT--> [MG50.9] Antibiotic resistant Salmonella
--CHILD--> [MG50.90] Fluoroquinolone resistant Salmonella
--- Walk 3 ---
[MG50.A2] Third-generation cephalosporins resistant Shigella
--PARENT--> [MG50.A] Antibiotic resistant Shigella
--CHILD--> [MG50.A1] Fluoroquinolone resistant Shigella
--- Walk 4 ---
[MG50.A2] Third-generation cephalosporins resistant Shigella
--PARENT--> [MG50.A] Antibiotic resistant Shigella
--CHILD--> [MG50.A0] Carbapenem resistant Shigella
--- Walk 5 ---
[MG51.12] Third-generation cephalosporins resistant Streptococcus pneumoniae
--PARENT--> [MG51.1] Antibiotic resistant Streptococcus pneumoniae
--PARENT--> [MG51] Finding of gram positive bacteria resistant to antimicrobial drugs
--- Walk 6 ---
[MG51.12] Third-generation cephalosporins resistant Streptococcus pneumoniae
--PARENT--> [MG51.1] Antibiotic resistant Streptococcus pneumoniae
--PARENT--> [MG51] Finding of gram positive bacteria resistant to antimicrobial drugs
|
[
"[MG50.91] Third generation cephalosporin resistant Salmonella\n --PARENT--> [MG50.9] Antibiotic resistant Salmonella\n --CHILD--> [MG50.90] Fluoroquinolone resistant Salmonella",
"[MG50.91] Third generation cephalosporin resistant Salmonella\n --PARENT--> [MG50.9] Antibiotic resistant Salmonella\n --CHILD--> [MG50.90] Fluoroquinolone resistant Salmonella",
"[MG50.A2] Third-generation cephalosporins resistant Shigella\n --PARENT--> [MG50.A] Antibiotic resistant Shigella\n --CHILD--> [MG50.A1] Fluoroquinolone resistant Shigella",
"[MG50.A2] Third-generation cephalosporins resistant Shigella\n --PARENT--> [MG50.A] Antibiotic resistant Shigella\n --CHILD--> [MG50.A0] Carbapenem resistant Shigella",
"[MG51.12] Third-generation cephalosporins resistant Streptococcus pneumoniae\n --PARENT--> [MG51.1] Antibiotic resistant Streptococcus pneumoniae\n --PARENT--> [MG51] Finding of gram positive bacteria resistant to antimicrobial drugs",
"[MG51.12] Third-generation cephalosporins resistant Streptococcus pneumoniae\n --PARENT--> [MG51.1] Antibiotic resistant Streptococcus pneumoniae\n --PARENT--> [MG51] Finding of gram positive bacteria resistant to antimicrobial drugs"
] |
MG50.91
|
Third generation cephalosporin resistant Salmonella
|
[
{
"from_icd11": "MG50.91",
"icd10_code": "U828",
"icd10_title": ""
},
{
"from_icd11": "LB18",
"icd10_code": "Q433",
"icd10_title": "Congenital malformations of intestinal fixation"
},
{
"from_icd11": "ED63.0",
"icd10_code": "L80",
"icd10_title": "Vitiligo"
},
{
"from_icd11": "ED63.0",
"icd10_code": "L80-L99",
"icd10_title": ""
},
{
"from_icd11": "EK5Y",
"icd10_code": "L259",
"icd10_title": "Unspecified contact dermatitis, unspecified cause"
}
] |
U828
| |
A Caucasian male patient, 72 years old, married, and retired, was taken in care in the Community Mental Health Center of Cagliari University (Italy) with a provisional diagnosis of “psychogenic pruritus” upon referral from his family physician. His medical history showed that he had been affected by a chronic nonobstructive pulmonary disease for an unspecified period of time, had manifested insulin-dependent diabetes mellitus type 2 in 1998 and onset of significant renal failure in 2004 (currently on dialysis), and had been diagnosed with hypertension and hypertensive heart disease in 2008. The patient had moreover undergone prostatectomy in 2004 and removal of a non-otherwise-specified “cyst” of the right breast in 2007. At the time of his first appointment, he was taking repaglinide, insulin, calcium acetate, sodium polystyrene, atorvastatin, doxazosin, amlodipine, and clonidine. The family and personal history of psychopathology was totally negative. The symptoms for which he was referred to our outpatient clinic had apparently started following a bout of influenza two years previously . In particular, the patient experienced an intense skin itching associated with the belief that an unspecified insect had laid eggs in various areas of the body, specifically in the skin and in various body cavities (nose, ears, and mouth). Furthermore, he maintained that he could see and feel small animals and pests everywhere although his wife denied ever having seen these animals. The patient was affected by skin lesions due to continuous scratching and manifested an obsessive search for “proof” of infestation, inspecting linens, clothing, and skin folds although he was somewhat upset at not having been ever able to catch the parasites to “show them to the doctors.” The patient was referred to our centre following repeated dermatologic examinations and skin tests, all of which were negative. Significant laboratory findings were mild anaemia (11.4 gr/dL), slight decrease in hematocrit (32.4%), phosphorus (4.8 mg/dL), potassium (5.5 mEq/L), gammaGT (66 U/L), and increases in TRF (193 mg/dL), urea (171 mg/dL), creatinine (6.5 mg/dL) triglycerides (242 mg/dL), ferritin (451.8 ng/mL), and PTH (216 pg/mL) and fasting glucose (212 mg/dL). Levels of folic acid and Vit.B12 were normal, and hepatitis markers were negative. Doppler ultrasound of the supra-aortic vessels showed an atherosclerotic plaque located on the proximal left common carotid causing a local stenosis of 35% and other nonstenosing plaques on the middle part of the left common carotid and carotid bifurcation bilaterally. The ECG was normal except for a slight left axis deviation (QRS axis <20). Echocardiogram revealed a slight thickening of the left ventricle, while aortic arch and ascending aorta were at the upper limit of normality, and a minimal tricuspid insufficiency and a mild aortic valve sclerosis were detected with a normal systolic function (EF 60%). Chest X-ray showed a small fibrotic nodule in the left lateral-basal area, and a flattening of the diaphragm. CT scan of the brain revealed the presence of residual signs of a left, nucleocapsular ischemic lesion, while MRI showed different areas of altered signal, hyperintense in FLAIR, and T2 and DP, in the periventricular white matter, in frontoparietal subcortical left and right areas and semioval centers due to chronic vascular hypoperfusion, in addition to expansion of the ventricular system and of cortical and cisternal spaces due to cerebral atrophy. Psychiatric evaluation confirmed the presence of a pervasive delusion of infestation associated with somatic and visual hallucinations. Nonsignificant cognitive impairment on Mini Mental State Examination (MMSE) was evidentiated (total score = 27). From the end of July 2010, the patient was treated with oral risperidone, 1 mg initially; after approximately a month, the dose was increased to 2 mg due to scarce efficacy. Approximately one month later, a slight improvement was observed (delusions were less pervasive and disturbing, and itching was reduced). However, after two months of treatment, risperidone was gradually withdrawn due to an increasing sedation and to the absence of further clinical improvement. As a replacement oral aripiprazole was gradually introduced, 10 mg daily initially, being increased after 2 weeks to 15 mg daily. After four weeks, the clinical picture was considerably improved, with disappearance of delusions, hallucinations, and itching, without recovery of insight. Probably due to this reason, for some months the patient made repeated requests to discontinue therapy, deeming it useless. He accepted, however, to continue, maintaining the same dosage as maintenance therapy. The only side effect attributable to the introduction of aripiprazole appeared after the first two weeks of treatment, in terms of a midterminal insomnia, which required additional treatment with quetiapine 12.5 mg for approximately a month; after this period, the drug was suspended, but sleep remained fairly good. Over the following months, no recurrence of psychotic symptoms was observed, but lack of retrospective insight remained. Accordingly, and given the fact that therapy was well tolerated (no significant side effects, modification of laboratory test, or ECG were detected), it was decided to continue maintenance treatment with aripiprazole 15 mg daily. After 10 months of treatment, the patient is in a stable condition.
| 4.039063
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999997
|
22174718
|
https://doi.org/10.1155/2011/103652
|
[
"skin",
"that",
"which",
"itching",
"areas",
"aortic",
"carotid",
"approximately",
"aripiprazole",
"daily"
] |
[
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "ME66.Y",
"title": "Other specified skin changes"
},
{
"code": "EM0Y",
"title": "Other specified diseases of the skin"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "ME66.1",
"title": "Changes in skin texture"
},
{
"code": "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 ===
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[ME66.Y] Other specified skin changes
Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta
[EM0Y] Other specified diseases of the skin
Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures
[ME60.Z] Skin lesion of unspecified nature
Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature
[ME66.1] Changes in skin texture
Definition: Alterations in skin texture of unspecified cause.
Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis
[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 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--- Walk 2 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [ME60] Skin lesion of uncertain or unspecified nature
Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...
--- Walk 3 ---
[ME66.Y] Other specified skin changes
--PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs
Def: Other specified skin changes which cannot be more precisely defined....
--RELATED_TO--> [?] Abnormal skin pigmentation
Def: Abnormal skin pigmentation without specification of type or cause....
--- Walk 4 ---
[ME66.Y] Other specified skin changes
--PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs
Def: Other specified skin changes which cannot be more precisely defined....
--RELATED_TO--> [?] Abnormal skin pigmentation
Def: Abnormal skin pigmentation without specification of type or cause....
--- Walk 5 ---
[EM0Y] Other specified diseases of the skin
--PARENT--> [14] Diseases of the skin
Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
--RELATED_TO--> [?] Haematoma of surgical wound of skin
Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...
--- Walk 6 ---
[EM0Y] Other specified diseases of the skin
--PARENT--> [14] Diseases of the skin
Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
--RELATED_TO--> [?] Haematoma of surgical wound of skin
Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...
|
[
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...",
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --RELATED_TO--> [?] Abnormal skin pigmentation\n Def: Abnormal skin pigmentation without specification of type or cause....",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --RELATED_TO--> [?] Abnormal skin pigmentation\n Def: Abnormal skin pigmentation without specification of type or cause....",
"[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...",
"[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis..."
] |
ME67
|
Skin disorder of uncertain or unspecified nature
|
[
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "ME66.Y",
"icd10_code": "L578",
"icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L918",
"icd10_title": "Other hypertrophic disorders of the skin"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L988",
"icd10_title": "Other specified disorders of the skin and subcutaneous tissue"
},
{
"from_icd11": "ME66.1",
"icd10_code": "R234",
"icd10_title": "Changes in skin texture"
},
{
"from_icd11": "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"
}
] |
L989
|
Disorder of the skin and subcutaneous tissue, unspecified
|
A 60-year-old female SLE patient was admitted to our hospital due to fever and paralysis of both of her lower legs. Four years before this admission, she had joint swelling on her fingers, wrists, right shoulder, knees, and non-palpable purpura on the forearms and thighs. Thrombocytopenia, elevated erythrocyte sedimentation rate, serum C-reactive protein (CRP), and total serum IgG; as well as reduced complement activity were reported. The patient presented antinuclear antibody (ANA) of 1:320 (homogeneous/speckled type), anti-dsDNA antibody (anti-DNA Ab) of 156 IU/ml, anti-SS-A Ab, circulating immune complex, and prolonged lupus anticoagulant. Based on the 2019 revised European Alliance of Associations for Rheumatology (EULAR) /American College of Rheumatology (ACR) classification criteria, she was diagnosed with SLE. Thrombocytopenia and anti-DNA Ab level were relieved and maintained by the treatment of prednisolone and tacrolimus for more than 4 years . Four days before the admission, however, she became acutely ill with a fever of 38°. Subsequently, the patient suffered from sudden laxative total paralysis in both lower limbs. Her bladder and rectum showed dysfunction with high intensity signal on the cervical cord of MRI . Pleocytosis, along with elevated protein, IgG and IL-6 levels in the cerebrospinal fluid (CSF) were detected. The patient presented mild leukocytosis with neutrophil predominance, moderate thrombocytopenia, elevated CRP and serum IgG amount, prolonged active prothrombin time, anti-DNA Ab, anti-ribosomal P antibody and marked reduction of complement activity (Table 1 ). The diagnosis of transverse myelitis due to the flare of SLE was made; then, standard pulse therapy of methylprednisolone was followed by high-dose of prednisolone, intravenous cyclophosphamide in combination with plasma exchange. In the following months, her refractory neurological and autoimmune symptoms continued to fluctuate, and failed to achieve remission with the appropriate treatments . The apparent histologically normal monocytes continued to cloud the clinical features of the patient whose monocytosis persisted. Flow cytometry analyses revealed an elevated ratio of CD14+CD16+ atypical monocytes, CD14+CD16+ atypical granulocytes as well as CD4+CD8+TCRαβ+ double positive T cells as compared to the healthy control . Increased atypical monocytes excluded chronic myelomonocytic leukemia ; and lupus-like symptoms with monocytosis together with these immune-phenotypes reminded us of previously-reported RALD cases, although these immunophenotypes can be seen in SLE cases. Therefore, we performed Sanger sequencing of KRAS and NRAS genes from the patients’ PBMC , magnetic-activated cell sorting (MACS)-sorted CD3+ lymphocytes and CD14+ monocytes, together with CSF . A point mutation in codon 12 of KRAS (c.G35A, p.G12D) was detected. Since the mutation was almost absent in the buccal mucosa sample of the patient , the mutation is likely to be somatic and not germline, as in RASopathies. A backtrack of the patient’s cell-free DNA obtained by the stocked serum samples showed that the mutation manifested at the time of encephalomyelitis diagnosis, and persisted for 5 years . This mutation seems to be involved in lupus flare of this case, as it was not detected when she was diagnosed of SLE , or in another SLE patient . Fig. 1 Graph depicts clinical course of the current case. Monocyte count, levels of anti-dsDNA antibody, anti-ssDNA-Ab, and serum C3 of the patient are shown in the graph. Diagnosis and the respective treatment measures are depicted on top of the graph Fig. 2 MRI images of the patient’s head and spine. Flair (left panel) and T2-weighed (middle and right panels) images of the patient at the onset of transverse myelitis are shown Table 1 Laboratory results at the admission for transverse myelitis (4 years after the onset of SLE) Fig. 3 Morphology and phenotypic profiles of blood of the patient. A Patient monocytes were sorted by flowcytometry and were Giemsa stained. No abnormalities were found. B Flow cytometric analyses of the blood from healthy donor (HC) and the patient. Top panels show the CD4 and CD8 expression profiles of lymphocyte-gated TCRαβ+ cells. CD4+CD8+TCRαβ+ lymphocyte percentage was higher in the patient than in the HC. Middle panels show the CD14 and CD16 expression profiles in the CD13+ cells (monocyte-gated). CD14+CD16+ monocyte percentage was elevated in the patient compared to the HC. Bottom panels show the CD14 and CD16 expression profiles of HLA-DR-negative cells in the large cells defined by Forward and Side scatter plots (granulocyte-gated). CD14+CD16+ granulocyte percentage was augmented in the patient using the HC as reference Fig. 4 Sanger sequence results of Kras. A T he chromatograms are showing wild type Kras DNA in the PBMC of healthy control (HC), and in another patient with systemic lupus erythematosus (SLE), whereas mutated Kras (c.G35A) DNA was detected from PBMC of the patient (P). The same mutation is not detected in mucosa of the patient of interest (P-mucosa). B The chromatograms are showing the same mutation site of Kras from sorted T cells, monocytes and cerebrospinal fluid (CSF). C Kras genomic sequence of the patient was wild type when she was diagnosed with SLE. However, Kras mutation (c.G35A) manifested spontaneously at the time when she developed encephalomyelitis, and persisted for 5 years after the encephalomyelitis diagnosis (ED)
| 4.277344
| 0.865234
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC8973904
|
https://doi.org/10.1186/s41232-022-00195-w
|
[
"anti",
"kras",
"mutation",
"monocytes",
"cells",
"serum",
"antibody",
"lupus",
"panels",
"profiles"
] |
[
{
"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": "4A01.22",
"title": "Immune dysregulation syndromes presenting primarily with lymphoproliferation"
},
{
"code": "GB90.4A",
"title": "Nephrogenic diabetes insipidus"
},
{
"code": "8A02.12",
"title": "Dystonia associated with heredodegenerative disorders"
},
{
"code": "4A01.21",
"title": "Immune dysregulation syndromes presenting primarily with autoimmunity"
},
{
"code": "8C73.Z",
"title": "Mitochondrial myopathies, unspecified"
}
] |
=== 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
[4A01.22] Immune dysregulation syndromes presenting primarily with lymphoproliferation
Also known as: Immune dysregulation syndromes presenting primarily with lymphoproliferation | Autosomal recessive lymphoproliferative disease | Autoimmune lymphoproliferative syndrome | autoimmune lymphoproliferative syndrome with recurrent infections | Canale-Smith syndrome
[GB90.4A] Nephrogenic diabetes insipidus
Definition: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. Polyuria with dilute urine and polydypsia (excessive thirst) are present. It can be congenital or acquired with many causes. The congenital forms may be attributed to vasopressin receptor or aquaporin-2 defects. They are characterised by polyuria with polydipsia, recurrent bouts of fever, constipatio
Also known as: Nephrogenic diabetes insipidus | renal diabetes insipidus | familial nephrogenic diabetes | antidiuretic-hormone-resistant diabetes insipidus | adiuretin-resistant diabetes insipidus
Excludes: Central diabetes insipidus
[8A02.12] Dystonia associated with heredodegenerative disorders
Definition: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen.
Also known as: Dystonia associated with heredodegenerative disorders | Dystonia due to autosomal dominant disorders | Rapid-onset dystonia-parkinsonism | Dystonia due to dentatorubropallidoluysian atrophy | Dystonia due to Huntington disease
[4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity
Also known as: Immune dysregulation syndromes presenting primarily with autoimmunity | Syndrome with autoimmunity | Immunodeficiency syndromes presenting primarily with autoimmunity | FADD-related immunodeficiency | X-linked immune dysregulation – polyendocrinopathy – enteropathy
[8C73.Z] Mitochondrial myopathies, unspecified
Also known as: Mitochondrial myopathies, unspecified | Mitochondrial myopathies | Myopathies in mitochondrial disorders
=== GRAPH WALKS ===
--- Walk 1 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--EXCLUDES--> [?] Labour or delivery complicated by fetal distress
--- Walk 2 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.0] Maternal care for red cell antibodies
Def: Maternal care for rhesus or other isoimmunization...
--- Walk 3 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--RELATED_TO--> [?] Speech dysfluency
Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...
--- Walk 4 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--CHILD--> [MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--- Walk 5 ---
[3B4Z] Coagulation defects, unspecified
--PARENT--> [?] Coagulation defects
--CHILD--> [3B4Z] Coagulation defects, unspecified
--- Walk 6 ---
[3B4Z] Coagulation defects, unspecified
--PARENT--> [?] Coagulation defects
--CHILD--> [?] Congenital or constitutional haemorrhagic condition
Def: A condition caused by determinants arising during the antenatal period or genetically inherited factors, leading to defects in clotting mechanisms or abnormalities causing structural flaws in the bloo...
|
[
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Labour or delivery complicated by fetal distress",
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.0] Maternal care for red cell antibodies\n Def: Maternal care for rhesus or other isoimmunization...",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --RELATED_TO--> [?] Speech dysfluency\n Def: Speech dysfluency is characterised by the frequent or pervasive disruption of the rhythmic flow of speech that arises subsequent to the developmental period (i.e., adult onset) and is outside the limi...",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --CHILD--> [MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....",
"[3B4Z] Coagulation defects, unspecified\n --PARENT--> [?] Coagulation defects\n --CHILD--> [3B4Z] Coagulation defects, unspecified",
"[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": "4A01.22",
"icd10_code": "D823",
"icd10_title": "Immunodeficiency following hereditary defective response to Epstein-Barr virus"
}
] |
O26841
| |
A 16-month-old Caucasian girl presented with prolonged, generalized, repetitive tonic-clonic seizures to our emergency department. She had watery diarrhea with a low-grade fever up to 38.4 °C and new types of seizures 4 days before. Two months earlier, she was admitted to our neuropediatric ward due to suspected generalized seizures. At that time, her psychomotor development and all clinical and laboratory findings, such as cerebrospinal fluid (CSF) status, electroencephalography as well as a cerebral magnetic resonance imaging (MRI) were normal. After a video documentation, a diagnosis of breath-holding spells was made. On admission day, she was unconscious with a generalized tonic-clonic seizure for approximately 20 minutes. At our emergency department, she received 5 mg midazolam buccal and the seizures subsided. She was then transferred to the general pediatric ward under the impression of a febrile seizure. However, during the following hours seizures reoccurred. She received levetiracetam intravenously up to a total dose of 50 mg/kg per day without a lasting effect. Full blood count, electrolytes, ammonia, blood gas analysis, inflammatory markers, and transaminases as well as ophthalmologic assessment were all repeatedly normal (Table 1 ). On day 2, she still had short generalized seizures and her consciousness deteriorated steadily so that a lumbar puncture was performed. Seizure control was only achieved after the application of phenobarbital (30 mg/kg) and she was then transferred to the pediatric intensive care unit. At that point, electroencephalography showed an encephalopathic picture with a generalized high amplitude theta and delta activity. Seizure activity was not noted. A CSF examination showed no abnormalities. Her glucose level was 60 mg/dl (reference range 40–70 mg/dl), protein level 12.6 mg/dl (reference range 15–45 mg/dl), lactate level 12.4 mg/dl (reference range < 20 mg/dl), and no cells were present. CSF was also negative for herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), enteroviruses, and Epstein–Barr virus. Isoelectric focusing showed no oligoclonal bands, but a Reibergram revealed an intrathecal production of immunoglobulin (IgM) and immunoglobulin (IgG) indicating an acute inflammatory process (Table 2 ). On day 3, she was still somnolent, so that a cerebral MRI was performed which showed no abnormalities. Electrolytes and glucose levels were repeatedly within normal limits (Table 1 ). On day 4, she gradually became awake, but was very agitated and not able to walk. Electroencephalography revealed a generalized high voltage theta activity, even though she had not received any sedative medication for 72 hours. The results of the stool samples, which were obtained on the third day of her hospitalization, were negative for Campylobacter , Salmonella , Shigella , Yersinia species, norovirus, enterovirus, Rotavirus , and adenovirus except for HAstV (Table 3 ). Table 1 Blood parameters Complete blood count Reference range Day of admission Day 3 Leukocytes 6.2–15 × 10 3 /μl 5.9 × 10 3 /μl 4.6 × 10 3 /μl Erythrocytes 4.1–5.0 × 10 12 /μl 4.3 × 10 12 /μl 4.17 × 10 12 /μl Hemoglobin 10.3–12.4 g/l 12.0 g/l 11.8 g/l Hematocrit 26–37% 36% 33% MCV 81–99 fl 82 fl 80 fl MCH 23–28 pg/cell 28 pg/cell 28 pg/cell MCHC 32–36 g/dl 33.8 g/dl 35.5 g/dl Thrombocytes 130–450 × 10 3 /μl 267 × 10 3 /μl 255 × 10 3 /μl Normoblasts % 0.1% Neutrophils % 21–67% 50% Lymphocytes % 20–64% 35% Monocytes % 5–11% 14% Eosinophils % 0–4% 1% Basophils % 0–1% 0% Chemistry panel Reference range Day of admission Day 3 Urea 17–43 mg/dl 33 mg/dl 11 mg/dl Creatinine 0.6–1.1 mg/dl 0.44 mg/dl 0.37 U/l CK < 247 U/l 75 U/l GOT < 82 U/l 75 U/l 49 U/l GPT < 30 U/l 17 U/l 15 U/l LDH < 300 U/l 241 U/l CRP < 0.5 mg/dl < 0.2 mg/dl < 0.2 mg/dl Ammonia 16–53 μmol/l 34.9 μmol/l 41.6 μmol/l Magnesium 0.77–1.03 mmol/l 0.77 mmol/l Potassium 3.4–4.5 mmol/l 4.0 mmol/l 4.3 mmol/l Sodium 136–146 mmol/l 143 mmol/l 141 mmol/l Calcium 1.15–1.29 mmol/l 1.27 mmol/l 1.22 mmol/l Glucose 70–105 mg/dl 74 mmol/l 87 mmol/l Chloride 98–106 mmol/l 108 mmol/l 104 mmol/l HbA1c% < 6% 4.8% Cortisol 6.7–22.6 μg/dl 22.3 μg/dl ACTH 4.7–48.8 pg/ml 15.8 pg/ml ACTH adrenocorticotropic hormone, CK creatine kinase, CRP C-reactive protein, GOT glutamic oxaloacetic transaminase, GPT glutamate-pyruvate transaminase, HbA1c glycated hemoglobin, LDH lactate dehydrogenase, MCH mean corpuscular hemoglobin, MCHC mean corpuscular hemoglobin concentration, MCV mean corpuscular volume Table 2 Cerebrospinal fluid parameters Cerebrospinal fluid results Cell count 1/3 /μl Glucose 60 mg/dl Protein 12.6 mg/dl Lactate 12.4 mg/dl Epstein–Barr virus DNA Negative Astrovirus PCR Positive Herpes virus 1 and 2 Negative Enteroviruses Negative Isoelectric focusing No sign of oligoclonal bands (serum and CSF) Reibergram Acute inflammatory process with intrathecally produced IgG and IgM, normal CSF barrier function CSF cerebrospinal fluid, IgG immunoglobulin G, IgM immunoglobulin M, PCR polymerase chain reaction Table 3 Stool parameters Stool results Campylobacter antigen (ELISA) Negative Astrovirus antigen (ELISA) Positive Adenovirus Antigen (ELISA) Negative Norovirus (PCR) Negative Rotavirus (PCR) Negative Salmonella (stool culture) Negative Shigella (stool culture) Negative Yersinia species (stool culture) Negative Clostridium difficile PCR (toxin A + B) Negative ELISA enzyme-linked immunosorbent assay, PCR polymerase chain reaction
| 4.039063
| 0.977051
|
sec[1]/p[0]
|
en
| 0.999997
|
31757225
|
https://doi.org/10.1186/s13256-019-2302-6
|
[
"mmol",
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"stool",
"reference",
"range",
"virus",
"that",
"cerebrospinal",
"fluid",
"seizure"
] |
[
{
"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": "8A68.Z",
"title": "Type of seizure, unspecified"
},
{
"code": "8A6Z",
"title": "Epilepsy or seizures, unspecified"
},
{
"code": "8A63.Y",
"title": "Seizure due to other acute cause"
},
{
"code": "8A67",
"title": "Acute repetitive seizures"
},
{
"code": "8A68.Y",
"title": "Other specified type of seizure"
},
{
"code": "ME0Y",
"title": "Other specified symptoms related to the lower gastrointestinal tract or abdomen"
},
{
"code": "ME24.A4",
"title": "Melaena"
}
] |
=== ICD-11 CODES FOUND ===
[GB42.1] Albuminuria, Grade A3
Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid.
Also known as: Albuminuria, Grade A3 | albuminuria >30 mg/mmol creatinine | macroalbuminuria | overt albuminuria | overt nephropathy
[GB42.0] Albuminuria, Grade A2
Definition: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted to the urine creatinine concentration to correct for variations in overall urine concentration. When persistent and of moderate or greater severity usually indicates overt glomerular disease such as caused by diabetic glomerulosclerosis, glomerulonephritis or amyloid.
Also known as: Albuminuria, Grade A2 | microalbuminuria | incipient nephropathy | mild to moderate albuminuria | albuminuria 3-30 mg/mmol creatinine
[MA18.0Y] Other specified elevated blood glucose level
Also known as: Other specified elevated blood glucose level | Blood glucose between 8.0 - 11.9 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L pre-meal or fasting | Blood glucose greater than or equal to 14.0 mmol/L pre-meal or fasting | Blood glucose between 12.0 - 13.9 mmol/L post-meal or not otherwise specified
[8A68.Z] Type of seizure, unspecified
Also known as: Type of seizure, unspecified | Types of seizures | uncontrolled seizures | Seizure NOS | fits NOS
[8A6Z] Epilepsy or seizures, unspecified
Also known as: Epilepsy or seizures, unspecified | Cerebral seizures | Seizure disorder | seizure disorder, so described | epilepsy NOS
[8A63.Y] Seizure due to other acute cause
Also known as: Seizure due to other acute cause | Seizures due to immune disorders | Seizures due to medications | Toxic syndrome with generalised seizures, drug related | Acute seizures due to central nervous system infections or infestations
[8A67] Acute repetitive seizures
Definition: Acute repetitive seizures are multiple seizures, with a distinct time of onset, with recovery between each seizure, occurring within 24 hours in adults, or 12 hours in children.
Also known as: Acute repetitive seizures | complex partial status epilepticus | Cluster seizures | Serial seizures | Recurrent seizures
[8A68.Y] Other specified type of seizure
Also known as: Other specified type of seizure | Absence episode | Absence seizure episode | Pseudotetanus | Clonic seizure disorder
[ME0Y] Other specified symptoms related to the lower gastrointestinal tract or abdomen
Also known as: Other specified symptoms related to the lower gastrointestinal tract or abdomen | Change in faeces or bowel movements | Diminished rectal sensation | Incomplete emptying of faeces | Other faecal abnormalities
[ME24.A4] Melaena
Definition: It is bloody stools that indicate bleeding from vascular system in the digestive tract. It is also described as black, tarry, and foul-smelling stools or red/maroon-coloured stools that contain degraded blood.
Also known as: Melaena | altered blood in stool | altered blood passed per rectum | tarry stools | black tarry stool
Excludes: occult blood in faeces
=== GRAPH WALKS ===
--- Walk 1 ---
[GB42.1] Albuminuria, Grade A3
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--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 “at risk” pat...
--EXCLUDES--> [?] Gestational proteinuria without hypertension
--- Walk 3 ---
[GB42.0] Albuminuria, Grade A2
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Gestational proteinuria without hypertension
--- Walk 4 ---
[GB42.0] Albuminuria, Grade A2
Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...
--PARENT--> [GB42] Persistent proteinuria or albuminuria
Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...
--EXCLUDES--> [?] Gestational proteinuria without hypertension
--- Walk 5 ---
[MA18.0Y] Other specified elevated blood glucose level
--PARENT--> [MA18.0] Elevated blood glucose level
--RELATED_TO--> [?] Neonatal hyperglycaemia
--- Walk 6 ---
[MA18.0Y] Other specified elevated blood glucose level
--PARENT--> [MA18.0] Elevated blood glucose level
--RELATED_TO--> [?] Neonatal hyperglycaemia
|
[
"[GB42.1] Albuminuria, Grade A3\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --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 “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension",
"[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension",
"[GB42.0] Albuminuria, Grade A2\n Def: Presence of excessive albumin in the urine, indicating abnormal permeability glomerular filtration. Can be quantitated by either timed collections or spot urine samples with the concentration adjusted...\n --PARENT--> [GB42] Persistent proteinuria or albuminuria\n Def: Persistent albuminuria >3mg/mmol creatinine or >30mg/day is regarded as abnormal, indicative and often the first manifestation of chronic kidney disease (CKD). In surveillance for CKD in “at risk” pat...\n --EXCLUDES--> [?] Gestational proteinuria without hypertension",
"[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --RELATED_TO--> [?] Neonatal hyperglycaemia",
"[MA18.0Y] Other specified elevated blood glucose level\n --PARENT--> [MA18.0] Elevated blood glucose level\n --RELATED_TO--> [?] Neonatal hyperglycaemia"
] |
GB42.1
|
Albuminuria, Grade A3
|
[
{
"from_icd11": "8A68.Z",
"icd10_code": "R561",
"icd10_title": "Post traumatic seizures"
},
{
"from_icd11": "8A68.Z",
"icd10_code": "R569",
"icd10_title": "Unspecified convulsions"
},
{
"from_icd11": "8A68.Z",
"icd10_code": "R56",
"icd10_title": "Convulsions, not elsewhere classified"
},
{
"from_icd11": "8A68.Z",
"icd10_code": "R568",
"icd10_title": ""
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40A09",
"icd10_title": "Absence epileptic syndrome, not intractable, without status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40B09",
"icd10_title": "Juvenile myoclonic epilepsy, not intractable, without status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40B19",
"icd10_title": "Juvenile myoclonic epilepsy, intractable, without status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40A19",
"icd10_title": "Absence epileptic syndrome, intractable, without status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40A11",
"icd10_title": "Absence epileptic syndrome, intractable, with status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40A01",
"icd10_title": "Absence epileptic syndrome, not intractable, with status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40409",
"icd10_title": "Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40802",
"icd10_title": "Other epilepsy, not intractable, without status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40801",
"icd10_title": "Other epilepsy, not intractable, with status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G40901",
"icd10_title": "Epilepsy, unspecified, not intractable, with status epilepticus"
},
{
"from_icd11": "8A6Z",
"icd10_code": "G4089",
"icd10_title": "Other seizures"
}
] |
R561
|
Post traumatic seizures
|
A Chinese boy was found to have short stature and poor performance at school when he was 7 years old. He was born at full term after an uncomplicated pregnancy. His parents were non-consanguineous. He was diagnosed with omphalitis 2 days after birth and recovered after being treated with antibiotics. The patient’s mother was not sure about his mental and physical development before 7 years of age. So he went to a local hospital, yet diagnosis and treatment were unknown, and no improvement was achieved. At the age of 14 years, he was found to have gynecomastia and was admitted to the West China Second University Hospital. He was 147 cm tall and 38.5 kg at that time. Further evaluations revealed that he had normal estradiol (27.6 pg/ml, reference range: 0–39.8), low testosterone (0.23 ng/ml, reference range: 2.41–8.27), low luteinizing hormone (LH; 1.4 IU/l, reference range: 1.5–9.3), and normal follicular stimulating hormone (FSH; 2.5 IU/L, reference range: 1.4–18.1). His growth hormone (GH) was 0.50 ng/ml, and the insulin-like growth factor was 297.0 ng/ml (reference range: 221–904 ng/ml for subjects aged 13–18 years). The GH stimulation test confirmed GH deficiency because the peak GH after stimulation was 2.40 ng/ml, yet we were not sure how the GH stimulation test was performed. He had normal thyroid and adrenocortical function. He was administered recombinant GH 4IU per day consecutively for 3 months, and later for the inconvenience of injection, he used recombinant GH irregularly. We were not sure about the dose and frequency of recombinant GH he used after the first 3 months. His height increased from 147 to 160 cm in 2 years, and there was no change in the recent 2 years. He was admitted to the West China Hospital complaining of gynecomastia and small penis at the age of 18 years. Physical examination showed that he was 160 cm tall and 54 kg, had a high-pitched voice, and hand span of 162 cm. Pubic hair and external genitalia development were both stage I in the Tanner stage. Bilateral breast enlargement was found without galactorrhea or overlying skin changes. His olfaction was normal. Complete blood count, biochemical profiles, and urinalysis showed nothing remarkable. Random measurement of sex hormone indicated very low testosterone and decreased LH and FSH. Prolactin level and thyroid function were normal. Adrenocorticotropic hormone (ACTH) was 21.10 ng/l, and morning cortisol was 291 nmol/l. Bone age was 14 years, which was considerably delayed. The gonadotropin-releasing hormone (GnRH) stimulation test using 100 μg gonadorelin intravenously showed that the peak LH was 11.3 mIU/ml at 60 min, compared with 1.0 mIU/ml at baseline. The repetitive GnRH loading test was performed in which 100 μg gonadorelin was administered intravenously for 7 consecutive days, and in day 7, another standard GnRH stimulation test was performed ( Table 1 ). The peak LH was 44.6 mIU/ml at 30 min. To further evaluate the pituitary adrenal axis and GH secretion, the GH stimulation test by insulin-induced hypoglycemia showed poor GH reserve (peak 1.87 ng/ml) and slightly blunted adrenocortical reserve, with the peak cortisol to be 487 nmol/l ( Table 2 ). Human chorionic gonadotropin (HCG) was administered 2,000 IU per day intravenously for 3 consecutive days, and fasting blood was drawn on the 4th day which indicated that testosterone increased from 0.06 to 2.06 ng/ml. Magnetic resonance imaging (MRI) demonstrated nothing abnormal in the sellar area, dysgenesis of the corpus callosum, and a small nodule in the septum pellucidum . Cognitive assessment using full-scale intelligence quotient showed a score of 72, which was borderline, very close to intellectual disability. Whole-exome sequencing indicated a hemizygous frame-shift mutation of SOX3 (c.287 delG, p.G96Afs*44) located in chromosome X, resulting in the change of 44 amino acid residues between codons 96 and 139 . The mutation was highly pathogenic, and this variant was not found in the Exome Aggregation Consortium, dbSNP, 1000 Genomes project, or in-house databases. A heterogeneous point mutation of SEMA3A was also identified by Sanger sequencing, which resulted in a missense mutation (p.R733H). His mother was confirmed to have the same mutation in SOX3 and SEMA3A , and one of his elder sisters had the same mutation in SEMA3A. Sanger sequencing of his father and the other elder sister turned negative. His mother had a history of schizophrenia and was well-controlled by antipsychotic medication. Otherwise, his mother was quite healthy. She reached her target height, had normal menstruation before menopause, and gave birth to two daughters and one son after natural conception. Although a cognitive assessment was not performed, she behaved normally and had no difficulty in working and taking care of her children. His father and two elder sisters were phenotypically normal. For the treatment of this patient, the short-term goal was to help him achieve puberty induction and sexual maturation, and the long-term goal was to achieve induction of fertility. Since testosterone replacement does not restore normal spermatogenesis in men with GnRH deficiency, and fertility was desired by the patient, he was prescribed 1,500 IU of HCG twice a week after discharge. He was not administered with GnRH since GnRH was very expensive. For the short follow-up time after administration of HCG, we were not sure whether he responded well to the treatment.
| 3.939453
| 0.983398
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC8918540
|
https://doi.org/10.3389/fendo.2022.810375
|
[
"hormone",
"stimulation",
"gnrh",
"mutation",
"that",
"reference",
"range",
"peak",
"which",
"mother"
] |
[
{
"code": "5B3Z",
"title": "Endocrine diseases, unspecified"
},
{
"code": "6C4H.1Z",
"title": "Harmful pattern of use of non-psychoactive substances, unspecified"
},
{
"code": "5A61.3",
"title": "Growth hormone deficiency"
},
{
"code": "5A61.0",
"title": "Hypopituitarism"
},
{
"code": "5A81.1",
"title": "Testicular hypofunction"
},
{
"code": "MB72",
"title": "Results of function studies of the nervous system"
},
{
"code": "4A01.0Y",
"title": "Other specified immunodeficiencies with predominantly antibody defects"
},
{
"code": "NE60",
"title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified"
},
{
"code": "8D85",
"title": "Autonomic nervous system disorder due to substances"
},
{
"code": "6C46.3",
"title": "Stimulant intoxication including amphetamines, methamphetamine or methcathinone"
}
] |
=== ICD-11 CODES FOUND ===
[5B3Z] Endocrine diseases, unspecified
Also known as: Endocrine diseases, unspecified | endocrine disorder NOS | disorder of endocrine gland | disease of endocrine gland | disorder of endocrine system
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies
[5A61.3] Growth hormone deficiency
Definition: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficiency. Includes idiopathic, inborn and acquired forms of growth hormone deficiency.
Also known as: Growth hormone deficiency
Excludes: Hypopituitarism
[5A61.0] Hypopituitarism
Definition: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/infarction.
Also known as: Hypopituitarism | subpituitarism | hypophyseal dystrophy | hypohypophysism | anterior pituitary insufficiency (in part)
Includes: pituitary cachexia | pituitary short stature
[5A81.1] Testicular hypofunction
Definition: In pre-puberty, a disorder characterised by atrophied testes and sterility, abnormal height and absence of secondary sex characteristics. In post-puberty, a disorder characterised by depressed sexual function, loss of sex drive and sterility, muscle weakness and osteoporosis (due to loss of the androgen anabolic effect).
Also known as: Testicular hypofunction | hypofunction testicle | gonadal insufficiency of testis | Testicular hypogonadism NOS | undeveloped testis
[MB72] Results of function studies of the nervous system
Also known as: Results of function studies of the nervous system | Abnormal results of function studies of central nervous system | abnormal central nervous system function studies | Abnormal brain function studies | Abnormal EEG - [electroencephalogram]
[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects
Also known as: Other specified immunodeficiencies with predominantly antibody defects | Common variable immunodeficiency | B-cell activating factor receptor deficiency | BAFF - [ B-cell activating factor] receptor deficiency | Cluster of differentiation 19 deficiency
[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS
Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug
[8D85] Autonomic nervous system disorder due to substances
Also known as: Autonomic nervous system disorder due to substances | Serotonin syndrome | Seritonergic syndrome | Autonomic disorder due to stimulant intoxication | Autonomic disorder due to Wernicke-Korsakoff syndrome
[6C46.3] Stimulant intoxication including amphetamines, methamphetamine or methcathinone
Definition: Stimulant intoxication including amphetamines, methamphetamine and methcathinone but excluding caffeine, cocaine and synthetic cathinones is a clinically significant transient condition that develops during or shortly after the consumption of amphetamine or other stimulants that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of amphetamine or other stimulants and thei
Also known as: Stimulant intoxication including amphetamines, methamphetamine or methcathinone | Amphetamine or certain specified stimulant intoxication | Amphetamine intoxication | Methamphetamine intoxication | Acute methamphetamine intoxication
Excludes: amphetamine poisoning | Caffeine intoxication | Cocaine intoxication
=== GRAPH WALKS ===
--- Walk 1 ---
[5B3Z] Endocrine diseases, unspecified
--PARENT--> [?] Endocrine diseases
--CHILD--> [?] Diabetes mellitus
Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...
--- Walk 2 ---
[5B3Z] Endocrine diseases, unspecified
--PARENT--> [?] Endocrine diseases
--CHILD--> [?] Diabetes mellitus
Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...
--- Walk 3 ---
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
--PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances
Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...
--PARENT--> [6C4H] Disorders due to use of non-psychoactive substances
Def: Disorders due to use of non-psychoactive substances are characterised by the pattern and consequences of non-medical use of non-psychoactive substances. Non-psychoactive substances include laxatives, ...
--- Walk 4 ---
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
--PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances
Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...
--EXCLUDES--> [?] Harmful pattern of use of other specified psychoactive substance
Def: A pattern of use of a specified psychoactive substance or medication that is not included in the other substance classes specifically identified under Disorders Due to Substance Use that has caused da...
--- 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...
--CHILD--> [?] Nonacquired hypopituitarism
Def: This refers to non-acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain....
--- Walk 6 ---
[5A61.3] Growth hormone deficiency
Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...
--EXCLUDES--> [?] Hypopituitarism
Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...
--CHILD--> [?] Argonz-del Castillo Syndrome
|
[
"[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --CHILD--> [?] Diabetes mellitus\n Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...",
"[5B3Z] Endocrine diseases, unspecified\n --PARENT--> [?] Endocrine diseases\n --CHILD--> [?] Diabetes mellitus\n Def: A metabolic disorder with heterogenous aetiologies which is characterised by chronic hyperglycaemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secre...",
"[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified\n --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances\n Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...\n --PARENT--> [6C4H] Disorders due to use of non-psychoactive substances\n Def: Disorders due to use of non-psychoactive substances are characterised by the pattern and consequences of non-medical use of non-psychoactive substances. Non-psychoactive substances include laxatives, ...",
"[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified\n --PARENT--> [6C4H.1] Harmful pattern of use of non-psychoactive substances\n Def: A pattern of use of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The pattern of use is evident over a period of at least 12 months i...\n --EXCLUDES--> [?] Harmful pattern of use of other specified psychoactive substance\n Def: A pattern of use of a specified psychoactive substance or medication that is not included in the other substance classes specifically identified under Disorders Due to Substance Use that has caused da...",
"[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Nonacquired hypopituitarism\n Def: This refers to non-acquired decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain....",
"[5A61.3] Growth hormone deficiency\n Def: Deficiency of growth hormone in children, adolescents and adults. Includes deficiency of growth hormone releasing hormone (GHRH) and excess of central somatostatin, leading to growth hormone deficienc...\n --EXCLUDES--> [?] Hypopituitarism\n Def: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/in...\n --CHILD--> [?] Argonz-del Castillo Syndrome"
] |
5B3Z
|
Endocrine diseases, unspecified
|
[
{
"from_icd11": "5B3Z",
"icd10_code": "E342",
"icd10_title": "Ectopic hormone secretion, not elsewhere classified"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E348",
"icd10_title": "Other specified endocrine disorders"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E349",
"icd10_title": "Endocrine disorder, unspecified"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E20-E35",
"icd10_title": ""
},
{
"from_icd11": "5B3Z",
"icd10_code": "E34",
"icd10_title": "Other endocrine disorders"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E351",
"icd10_title": ""
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F558",
"icd10_title": "Abuse of other non-psychoactive substances"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F552",
"icd10_title": "Abuse of laxatives"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F553",
"icd10_title": "Abuse of steroids or hormones"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F551",
"icd10_title": "Abuse of herbal or folk remedies"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F55",
"icd10_title": "Abuse of non-psychoactive substances"
},
{
"from_icd11": "5A61.0",
"icd10_code": "E230",
"icd10_title": "Hypopituitarism"
},
{
"from_icd11": "5A61.0",
"icd10_code": "Q044",
"icd10_title": "Septo-optic dysplasia of brain"
},
{
"from_icd11": "5A61.0",
"icd10_code": "E231",
"icd10_title": "Drug-induced hypopituitarism"
}
] |
E342
|
Ectopic hormone secretion, not elsewhere classified
|
A 19-year-old man with no significant medical history presented with a two-year history of nocturnal right lumbar paravertebral radicular and low back pain unresponsive to anti-inflammatory medications. The patient denied any history of trauma, deterioration in overall health, or associated neurological symptoms. Physical examination revealed the patient to be in good general condition, with stable gait and no limping observed during ambulation. A left-sided gibbosity was noted, with a positive Sonnette sign at the lumbar spine levels L3-L4 and L4-L5 on the right. Straight leg raising test was negative. No neurologic deficit was noticed. X-rays , requested six months prior to diagnosis, displayed a lytic image on the right inferior articular process (IAP) of L3 and a left convex scoliotic posture. The patient was provided with symptomatic treatment, and no further investigations were requested. Due to the lack of improvement, the patient sought our consultation, leading to an MRI showing an edematous signal abnormality in the right lateral and posterior arches of the L3 and L4 vertebrae. This anomaly exhibited hyperintensity on T2 and STIR sequences and hypointensity on T1, enhancing homogeneously following Gadolinium injection. These signal irregularities were focused on the ipsilateral posterior zygapophyseal joints, with enhancement of the right L4 zygapophyseal joint space. The signal abnormalities extended to the right lumbar psoas and paravertebral muscles without any distinguishable collection within them. A CT scan unveiled a well-defined lytic lesion centered on the right inferior articular process of L3, extending to the inferior articular surface of L3 and the adjacent superior articular process of L4. A calcified nidus causing cortical disruption was surrounded by osteocondensation with indistinct borders, confirming the diagnosis of spinal osteoblastoma. Under general anesthesia, the patient underwent en bloc resection of the right L3 IAP, with the surgical approach carefully planned to ensure adequate exposure and minimize risks. The procedure began with precise osteotomy at the level of the right lamina and isthmus of L3, following established anatomical landmarks for safe dissection. Intraoperative findings revealed more extensive tumor involvement than anticipated on preoperative imaging, with invasion into three critical areas: the joint space, the proximal part of the superior articular process, and the L3-L4 right foramen. This discovery required adaptation of the surgical plan, demonstrating the importance of having a complete array of surgical equipment available. A meticulous curettage was performed with particular attention to protecting the L3 nerve root, which was found to be in close proximity to the tumor. To address potential instability following the resection, unilateral fixation with pedicle screws at L3-L4 was performed . The procedure required careful consideration of both planned and unplanned morbidity risks, with particular attention to preventing complications. The surgery concluded with meticulous hemostasis and closure, recognizing that technical problems or complications could lead to persistent postoperative pain. The resection specimen was sent to the pathology laboratory for analysis. Histological examination confirmed the diagnosis of osteoblastoma . Fig. 1 (A, B): Anteroposterior (A) and lateral view (B) radiographs illustrating a distinctive lytic lesion positioned at the right inferior articular process of L3. Fig. 1 Fig. 2 (A, B): The MRI depicted edematous signal abnormalities in the right lateral and posterior arches of the L3 and L4 vertebrae, characterized by hyperintensity on T2 and STIR sequences and hypointensity on T1. Post Gadolinium injection, these signals exhibited homogeneous enhancement. The abnormalities were centered on the ipsilateral posterior zygapophyseal joints, notably enhancing the right L4 zygapophyseal joint space, and extended into the right lumbar psoas and paravertebral muscles, without evident collections. Fig. 2 Fig. 3 (A, B, C): CT scan showing a well-defined lytic lesion located at the right inferior articular process of L3, extending to the inferior articular surface of L3 and the adjacent superior articular process of L4. The lesion includes a calcified nidus causing cortical disruption, surrounded by osteocondensation with blurred borders. Fig. 3 Fig. 4 Specimen radiograph (A) and Postoperative X-rays depicting the extent of resection and successful placement of pedicle screws, as seen in the anteroposterior view (B) and lateral view (C). Fig. 4 Fig. 5 A. Low-power view of Osteoblastoma with a well-defined tumor border. The bony lesion is encircled by a sclerotic rim and consists of inter-anastomosing trabeculae of woven bone within a loose, edematous fibrovascular stroma. (Hematoxylin and eosin stain, magnification ×40). B. Bony lesion composed of inter-anastomosing trabeculae of woven bone, set within loose edematous fibrovascular stroma, with extravasated erythrocytes. ( Hematoxylin and eosin, magnification ×100 ) . C. High-power view of Osteoblastoma: Osseous trabeculae bordered by a single layer of activated osteoblasts within a loose, edematous fibrovascular stroma. (Hematoxylin and eosin stain, magnification ×400). D. High-power view of Osteoblastoma showing scattered osteoclast-type, multinucleated giant cells (black arrows). (Hematoxylin and eosin stain, magnification ×400). Fig. 5
| 4.078125
| 0.972168
|
sec[1]/p[0]
|
en
| 0.999997
|
39848079
|
https://doi.org/10.1016/j.ijscr.2025.110924
|
[
"articular",
"process",
"lesion",
"view",
"edematous",
"osteoblastoma",
"lumbar",
"lytic",
"signal",
"zygapophyseal"
] |
[
{
"code": "FA34.Y",
"title": "Other joint derangements"
},
{
"code": "ME82",
"title": "Pain in joint"
},
{
"code": "FA37.Y",
"title": "Other specified certain joint disorders, not elsewhere classified"
},
{
"code": "2F9B",
"title": "Neoplasms of unknown behaviour of bone or articular cartilage"
},
{
"code": "FA33.Y",
"title": "Other specified internal derangement of knee"
},
{
"code": "AB5Y",
"title": "Other specified disorders with hearing impairment"
},
{
"code": "GB41/MF8Y",
"title": "Minimal change glomerulonephritis"
},
{
"code": "1H0Z",
"title": "Infection, unspecified"
},
{
"code": "DA0A.Y",
"title": "Other specified disorders of teeth and supporting structures"
},
{
"code": "NA02.70",
"title": "Fracture of condylar process of mandible"
}
] |
=== ICD-11 CODES FOUND ===
[FA34.Y] Other joint derangements
Also known as: Other joint derangements | Other articular cartilage disorders | Other articular cartilage disorders, multiple sites | Other articular cartilage disorders, shoulder region | Other articular cartilage disorders, acromioclavicular joint
[ME82] Pain in joint
Definition: Arthralgia secondary to inflammation, cartilage degeneration, crystal deposition, infection, and trauma not detailed in or used in conjunction with other condition.
Also known as: Pain in joint | arthralgia | arthrodynia | articular pain | joint pain
Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain
[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
[2F9B] Neoplasms of unknown behaviour of bone or articular cartilage
Also known as: Neoplasms of unknown behaviour of bone or articular cartilage | Bone or articular cartilage tumour, not elsewhere classified | bone or articular cartilage tumour NOS | Ecchondrosis of unknown behaviour of unspecified site | Giant cell tumour of bone unknown behaviour of unspecified site
[FA33.Y] Other specified internal derangement of knee
Also known as: Other specified internal derangement of knee | Degeneration of meniscus | degenerate meniscus | Derangement of meniscus | Derangement of lateral meniscus
[AB5Y] Other specified disorders with hearing impairment
Also known as: Other specified disorders with hearing impairment | Certain specified hearing impairment | hypoacusis | Deaf mutism, not elsewhere classified | nonspeaking deafness
[1H0Z] Infection, unspecified
Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS
[DA0A.Y] Other specified disorders of teeth and supporting structures
Also known as: Other specified disorders of teeth and supporting structures | Alveolar process haemorrhage | alveolar haemorrhage | Barodontalgia | aerodontalgia
[NA02.70] Fracture of condylar process of mandible
Definition: Condylar process fractures are defined as fractures running above or posterior to a line confined by the sigmoid notch line and the masseteric notch line. The mandibular condylar process comprises three fracture levels and is subdivided into the head region, the condylar neck, and the condylar base. Fractures of the condylar head show typical fracture lines either within the lateral pole zone, which may lead to loss of vertical height, or medially to the pole zone, with the latter ones usually n
Also known as: Fracture of condylar process of mandible | Dislocation fracture of condylar process of mandible | Displaced fracture of condylar process of mandible | Undisplaced fracture of condylar process of mandible | articular process fracture of the mandible
Excludes: Fracture of ramus of mandible | Fracture of subcondylar process of mandible
=== GRAPH WALKS ===
--- Walk 1 ---
[FA34.Y] Other joint derangements
--PARENT--> [FA34] Certain specified joint derangements
--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 2 ---
[FA34.Y] Other joint derangements
--PARENT--> [FA34] Certain specified joint derangements
--EXCLUDES--> [?] Temporomandibular joint disorders
Def: This is an umbrella term covering acute or chronic pain, especially in the muscles of mastication and/or inflammation of the temporomandibular joint, which connects the mandible to the skull....
--- Walk 3 ---
[ME82] Pain in joint
Def: Arthralgia secondary to inflammation, cartilage degeneration, crystal deposition, infection, and trauma not detailed in or used in conjunction with other condition....
--EXCLUDES--> [?] Chronic primary musculoskeletal pain
Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...
--EXCLUDES--> [?] Acute pain
Def: Pain with a duration of less than 3 months.
This code should be used only when there is no further specification of site....
--- Walk 4 ---
[ME82] Pain in joint
Def: Arthralgia secondary to inflammation, cartilage degeneration, crystal deposition, infection, and trauma not detailed in or used in conjunction with other condition....
--EXCLUDES--> [?] Chronic secondary musculoskeletal pain
Def: Chronic secondary musculoskeletal pain is chronic pain arising from bone(s), joint(s), muscle(s), vertebral column, tendon(s) or related soft tissue(s). It is a heterogeneous group of chronic pain con...
--CHILD--> [?] Chronic secondary musculoskeletal pain due to disease of the nervous system
Def: Chronic secondary musculoskeletal pain due to diseases of the nervous system is chronic pain localized in joint(s), bone(s), tendon(s) or muscle(s) that is related to peripheral or central neurologica...
--- Walk 5 ---
[FA37.Y] Other specified certain joint disorders, not elsewhere classified
--PARENT--> [FA37] Certain joint disorders, not elsewhere classified
--EXCLUDES--> [?] Difficulty in walking
--- Walk 6 ---
[FA37.Y] Other specified certain joint disorders, not elsewhere classified
--PARENT--> [FA37] Certain joint disorders, not elsewhere classified
--RELATED_TO--> [?] Stiffness of joint
Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....
|
[
"[FA34.Y] Other joint derangements\n --PARENT--> [FA34] Certain specified joint derangements\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...",
"[FA34.Y] Other joint derangements\n --PARENT--> [FA34] Certain specified joint derangements\n --EXCLUDES--> [?] Temporomandibular joint disorders\n Def: This is an umbrella term covering acute or chronic pain, especially in the muscles of mastication and/or inflammation of the temporomandibular joint, which connects the mandible to the skull....",
"[ME82] Pain in joint\n Def: Arthralgia secondary to inflammation, cartilage degeneration, crystal deposition, infection, and trauma not detailed in or used in conjunction with other condition....\n --EXCLUDES--> [?] Chronic primary musculoskeletal pain\n Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...\n --EXCLUDES--> [?] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....",
"[ME82] Pain in joint\n Def: Arthralgia secondary to inflammation, cartilage degeneration, crystal deposition, infection, and trauma not detailed in or used in conjunction with other condition....\n --EXCLUDES--> [?] Chronic secondary musculoskeletal pain\n Def: Chronic secondary musculoskeletal pain is chronic pain arising from bone(s), joint(s), muscle(s), vertebral column, tendon(s) or related soft tissue(s). It is a heterogeneous group of chronic pain con...\n --CHILD--> [?] Chronic secondary musculoskeletal pain due to disease of the nervous system\n Def: Chronic secondary musculoskeletal pain due to diseases of the nervous system is chronic pain localized in joint(s), bone(s), tendon(s) or muscle(s) that is related to peripheral or central neurologica...",
"[FA37.Y] Other specified certain joint disorders, not elsewhere classified\n --PARENT--> [FA37] Certain joint disorders, not elsewhere classified\n --EXCLUDES--> [?] Difficulty in walking",
"[FA37.Y] Other specified certain joint disorders, not elsewhere classified\n --PARENT--> [FA37] Certain joint disorders, not elsewhere classified\n --RELATED_TO--> [?] Stiffness of joint\n Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes...."
] |
FA34.Y
|
Other joint derangements
|
[
{
"from_icd11": "ME82",
"icd10_code": "M25519",
"icd10_title": "Pain in unspecified shoulder"
},
{
"from_icd11": "ME82",
"icd10_code": "M25531",
"icd10_title": "Pain in right wrist"
},
{
"from_icd11": "ME82",
"icd10_code": "M25571",
"icd10_title": "Pain in right ankle and joints of right foot"
},
{
"from_icd11": "ME82",
"icd10_code": "M25569",
"icd10_title": "Pain in unspecified knee"
},
{
"from_icd11": "ME82",
"icd10_code": "M25522",
"icd10_title": "Pain in left elbow"
},
{
"from_icd11": "ME82",
"icd10_code": "M25579",
"icd10_title": "Pain in unspecified ankle and joints of unspecified foot"
},
{
"from_icd11": "ME82",
"icd10_code": "M25541",
"icd10_title": "Pain in joints of right hand"
},
{
"from_icd11": "ME82",
"icd10_code": "M25521",
"icd10_title": "Pain in right elbow"
},
{
"from_icd11": "ME82",
"icd10_code": "M25572",
"icd10_title": "Pain in left ankle and joints of left foot"
},
{
"from_icd11": "ME82",
"icd10_code": "M25532",
"icd10_title": "Pain in left wrist"
},
{
"from_icd11": "ME82",
"icd10_code": "M25559",
"icd10_title": "Pain in unspecified hip"
},
{
"from_icd11": "ME82",
"icd10_code": "M25542",
"icd10_title": "Pain in joints of left hand"
},
{
"from_icd11": "ME82",
"icd10_code": "M25549",
"icd10_title": "Pain in joints of unspecified hand"
},
{
"from_icd11": "ME82",
"icd10_code": "M25529",
"icd10_title": "Pain in unspecified elbow"
},
{
"from_icd11": "ME82",
"icd10_code": "M25539",
"icd10_title": "Pain in unspecified wrist"
}
] |
M25519
|
Pain in unspecified shoulder
|
This clinical case describes a rare SHAA causing acute abdomen in a patient with MM. AA is the most common abdominal surgical emergency in the world with an annual incidence of 96.5–100 cases per 100,000 adults . SHAA accounts for 0.08% of all cases of AA and makes up an annual incidence of 0.09 per 100,000 adults . Sub-hepatic position of caecum and appendix may occur in association with MM or arrested caecal descent. MM is caused by nonrotation or incomplete rotation of the primitive intestinal loop around the axis of superior mesenteric artery during weeks 5–10 of fetal life and subsequent abnormal fixation to the peritoneal wall. MM can manifest itself generally in the first month of life with bowel dysfunction and bilious vomiting, but in most of the cases it remained asymptomatic. The incidence of MM anomalies varies from 0.03% to 0.5% in the live births . Arrested caecal descent occurs where the caecum lies in the subhepatic position but does not descend to the right iliac fossa. The position of the appendix is extremely variable: the most common location is retrocecal (74%) followed pelvic (21%), subcecal (1.5%), preileal (1%), and postileal (0.5%) . The appendix can also show atypical locations such as subhepatic, left-sided , intraherniary , lateral pouch, mesocolic and lumbar . The first case of SHAA, due to non-descent of caecum, was first described in 1955 by King . Since then, only a few isolated cases of SHAA have been described in the literature with more reports of MM rather than nondescent of the caecum as a cause of this anatomical variant . Diagnosis of AA is based on well-established clinical symptoms and signs, radiologic findings and surgeon experience. Knowledge of the variations in the position of the appendix is important because in AA its variable positions may produce variable symptoms and signs that mimic other diseases. Typical presentation (60% of cases) of AA begins with a vague abdominal discomfort around the epigastric region accompanied by nausea and vomiting; several hours later the pain migrates to the right iliac fossa near McBurney's point. Additionally fever, rebound tenderness, Rovsing's sign, psoas sign, diarrhea and anorexia may be observed. However one third of patients with AA complains abdominal pain in an unexpected location due to the various anatomical position of the appendix. Symptoms and signs of AA may be caused not only by the inflammation of the appendix but also by rare appendiceal neoplasms . The main differential diagnosis of typical AA includes Crohn ileitis, mesenteric adenitis, right-sided colitis, intestinal perforation or obstruction , , incarcerated or strangulated hernia, regional enteritis, Meckel's diverticulitis, epiploic appendagitis, abdominal aortic aneurysm, mesenteric ischemia, renal colic, psoas abscess, testicular or ovarian torsion, ruptured ovarian cyst, ectopic pregnancy and pelvic inflammatory disease. SHAA, generally presenting with right upper abdominal pain, may be clinically indistinguishable from acute cholecystitis, liver abscess, perforated duodenal ulcer. This may lead to a delayed diagnosis of SHAA which can result in complications such as perforation of appendix, abscess formation, peritonitis and sepsis. However in our case report SHAA presented with classic symptoms and signs of AA . Imaging may be helpful for determining the correct diagnosis of SHAA, as well as confirming MM or maldescent of the caecum. When abdominal ultrasound is the first radiological investigation, it has a high probability of misdiagnosis of SHAA. CECT is the best modality to identify SHAA with sensitivity of 88–100%, specificity of 92–98%, positive predictive value of 86–98%, negative predictive value of 95–100% . MRI, compared to CT, has comparable sensitivity and specificity for the diagnosis of AA, but it is not universally available in emergency . In our patient with RLQ abdominal pain and a negative echography for AA we conducted abdominal CECT to confirm the diagnosis: a SHAA was detected. Generally unusual location of the appendix may result in delay in appropriate diagnosis and treatment of AA , however in this case report there was no diagnostic delay. In many cases diagnosis of SHAA is made at laparoscopy especially if abdominal CECT is inconclusive. After establishing the diagnosis of SHAA, the surgical options are the same as for normal patients. Appendectomy represents the standard treatment of AA, although intravenous antibiotics may be considered first-line therapy in selected patients. After radiological diagnosis of SHAA we decided for laparoscopic appendectomy. In literature only few cases of laparoscopic approach in SHAA are reported. We believe that laparoscopic appendectomy in rare anatomical positions of appendix is a better option than the big incisions needed for adequate access and also it permits a better exploration of the abdominal cavity. Successful laparoscopic management requires a tailored approach altering standard port positions to allow optimal operative access : the laparoscopic technique used in our case report was with four ports. AA is still one of the most common surgical emergencies with low morbidity and mortality if surgical treatment is not delayed. Morbidity and mortality increase if surgical treatment is delayed, often caused by misdiagnosis of AA. The mortality rate of AA is reported to be less than 1%, but it can be increased up to 5% in delayed diagnosed AA .
| 4.28125
| 0.849121
|
sec[2]/p[0]
|
en
| 0.999998
|
PMC9160733
|
https://doi.org/10.1016/j.ijscr.2022.107249
|
[
"shaa",
"abdominal",
"appendix",
"cases",
"position",
"caecum",
"laparoscopic",
"this",
"pain",
"rare"
] |
[
{
"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": "DB1Z",
"title": "Diseases of appendix, unspecified"
},
{
"code": "DB10.Z",
"title": "Appendicitis, unspecified"
},
{
"code": "DB10.01",
"title": "Acute appendicitis with localised peritonitis"
},
{
"code": "DB1Y",
"title": "Other specified diseases of appendix"
},
{
"code": "DB11.4",
"title": "Fistula of appendix"
}
] |
=== 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
[DB1Z] Diseases of appendix, unspecified
Also known as: Diseases of appendix, unspecified
[DB10.Z] Appendicitis, unspecified
Also known as: Appendicitis, unspecified | Appendicitis | appendiceal inflammation | appendicitis, unqualified | Periappendicitis
[DB10.01] Acute appendicitis with localised peritonitis
Definition: This condition is characterised by acute inflammation of the vermiform appendix with peritonitis that is contained into an abscess or phlegmone. There is often an underlying covered perforation of appendix with leakage from the appendix lumen.
Also known as: Acute appendicitis with localised peritonitis | Perforated appendix with localised peritonitis | Acute appendicitis with contained perforation to a localised abscess | Acute appendicitis with localised peritonitis with rupture or perforation | Acute appendicitis with localised peritonitis without rupture or perforation
Includes: Acute appendicitis with contained perforation to a localised abscess
[DB1Y] Other specified diseases of appendix
Also known as: Other specified diseases of appendix | Appendiceal colic | appendicular colic | appendix colic | Adhesion of appendix
[DB11.4] Fistula of appendix
Definition: A condition of an abnormal passageway between the appendix and neighbour organs.
Also known as: Fistula of appendix | appendicular fistula | appendix fistula | appendiceal fistula
=== 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....
--PARENT--> [?] Symptoms or signs involving the digestive system or abdomen
--- 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--> [?] Delivery of viable fetus in abdominal pregnancy
Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the...
--PARENT--> [?] Other assisted single delivery
--- Walk 4 ---
[JA01.0] Abdominal pregnancy
Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....
--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.Z] Ascites, unspecified
--- Walk 6 ---
[ME04.Z] Ascites, unspecified
--PARENT--> [ME04] Ascites
Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...
--CHILD--> [ME04.0] Fluid in peritoneal cavity
|
[
"[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --PARENT--> [?] Symptoms or signs involving the digestive system 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--> [MD81.2] 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--> [?] Delivery of viable fetus in abdominal pregnancy\n Def: A condition caused by the development of a viable fetus to the culmination of the pregnancy period. This condition is characterised by parturition of a viable neonate from the abdominal cavity, at the...\n --PARENT--> [?] Other assisted single delivery",
"[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity during pregnancy....\n --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.Z] Ascites, unspecified",
"[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.0] Fluid in peritoneal cavity"
] |
MD81.3
|
Acute abdomen
|
[
{
"from_icd11": "MD81.3",
"icd10_code": "R100",
"icd10_title": "Acute abdomen"
},
{
"from_icd11": "JA01.0",
"icd10_code": "O0000",
"icd10_title": "Abdominal pregnancy without intrauterine pregnancy"
},
{
"from_icd11": "JA01.0",
"icd10_code": "O000",
"icd10_title": "Abdominal pregnancy"
},
{
"from_icd11": "ME04.Z",
"icd10_code": "R180",
"icd10_title": "Malignant ascites"
},
{
"from_icd11": "ME04.Z",
"icd10_code": "R18",
"icd10_title": "Ascites"
},
{
"from_icd11": "DB1Z",
"icd10_code": "K389",
"icd10_title": "Disease of appendix, unspecified"
},
{
"from_icd11": "DB1Z",
"icd10_code": "K35-K38",
"icd10_title": ""
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K3580",
"icd10_title": "Unspecified acute appendicitis"
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K3589",
"icd10_title": "Other acute appendicitis"
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K35891",
"icd10_title": "Other acute appendicitis without perforation, with gangrene"
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K35890",
"icd10_title": "Other acute appendicitis without perforation or gangrene"
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K36",
"icd10_title": "Other appendicitis"
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K37",
"icd10_title": "Unspecified appendicitis"
},
{
"from_icd11": "DB10.Z",
"icd10_code": "K358",
"icd10_title": "Other and unspecified acute appendicitis"
},
{
"from_icd11": "DB10.01",
"icd10_code": "K3532",
"icd10_title": "Acute appendicitis with perforation and localized peritonitis, without abscess"
}
] |
R100
|
Acute abdomen
|
Our case involved a 73-year-old man who was a former company employee. He had hypertension as a comorbidity but was otherwise healthy without any other notable medical history. He drinks alcohol around three times a week and had no history of smoking, drug or food allergies, or bird breeding. He had been suffering from a persistent cough since June 2022, which prompted him to visit his local doctor in early September. Given that no abnormalities were noted on chest X-ray, only antitussive medication was prescribed. However, his cough worsened and his oxygen saturation (SpO₂) fell below 90% at rest using an arterial blood oxygen saturation monitor at home. Hence, he was sent to our hospital on September 14, 2022 for a thorough examination of pneumonia. A chest high-resolution CT (HRCT) at admission showed bilateral lower lobe infiltration shadows, diffuse ground glass opacities predominantly in the upper lobes, and air trapping during exhalation CT . The several parameters of blood tests were elevated: white blood cells 10010 /μL , C-reactive protein (CRP) 8.96 mg/dL (reference range: 0–0.30 mg/dL), and surfactant protein D (SP-D), 244.8 ng/mL (reference range: 0–109.9 ng/mL). Specific Immunoglobulin G testing for avian antibody was negative. Aspergillus antibody and cytomegalovirus antigen tests came back were negative. We suspected HP based on the living environment , including the rotting walls and household items in his room, ground glass opacities predominantly in the upper lobes on chest HRCT, and elevated SP-D value. Transbronchial lung cryobiopsy from the right B⁹ a,b and bronchoalveolar lavage (BAL) from the right B⁴ were performed. Histopathology revealed a central airway infiltrate of lymphocytes and plasma cells, with small intraluminal organization in the alveolar space and some macrophage clusters. No obvious granuloma formation was observed . The leukocyte fraction in the BAL fluid was as follows: Mφ 17.0%, lymphocytes 80%, neutrophils 2.5%, and eosinophils 0.5%. According to the 2020 American Thoracic Society/ Japanese Respiratory Society/ The Latin American Thoracic Association HP guidelines, our patient was determined to be a definite non-fibrotic HP case. An antigen avoidance test was subsequently performed at our hospital. Although the patient required 4 L/min of oxygen at admission, oxygen administration was terminated on the 9th day after avoidance test. Moreover, his white blood count and CRP decreased from 10010 /μL to 9720 /μL and 8.96 to 2.64 mg/dL on 9 days after avoidance test, respectively ( Table 1 ). Chest HRCT findings performed 9 days after the antigen avoidance test showed a decrease in some of the ground glass opacities. Respiratory function tests performed on the 9th and 31st days after the antigen avoidance test showed improvement in his forced vital capacity (FVC) from 102% to 130%. 31st after the antigen avoidance test decreased in his serum CRP (0.10 mg/dL). On HRCT finding, ground glass opacities were mostly improved; however, some reticular shadows remained, suggesting a diagnosis of fibrotic HP caused by Paecilomyces . The inciting antigen was considered to have existed in his home environment. Given that the home environment of the patient was suspected to be antigenic, his family scraped off some of the rotting walls and furniture in his home and submitted them for culture, which led to the detection of Paecilomyces . The results of antibody precipitation reaction were negative for Trichosporon , Cephalosporium , Aspergillus , Penicillium , and Cladosporium . He was ultimately diagnosed with HP caused by Paecilomyces and was discharged from the hospital after the rotting interior walls and furniture in his home, which could have been the source of Paecilomyces , were removed and replaced. Respiratory function tests performed 2 months after discharge showed an improvement in his FVC to 135%, while chest HRCT performed 4 months after discharge showed a decrease in diffuse ground glass opacities and serum CRP (0.20 mg/dL). Fig. 1 HRCT on admission Chest HRCT image on admission. (A) Diffuse ground glass opacities predominantly in the upper lobes. (B) Infiltration shadows were seen in the bilateral lower lobes. (C) Air trapping was observed in expiratory CT. Fig. 1 Fig. 2 Image of patient's house Wood rot was observedon (A) floor and (B) wall. Fig. 2 Fig. 3 Pathologic findings Hematoxylin-Eosin Stain in right lower lobe B⁹b, showing lymphocyte and plasma cell infiltration in the airway center. (A) Weak magnification: 40×, (B) Strong magnification: 200×. Fig. 3 Table 1 Changes of laboratory data and pulmonary function test. Table 1 On admission 9 days after avoidance test 31 days after avoidance test 2 months after discharge 4 months after discharge WBC, μL 10010 9720 6720 8840 9160 LDH, U/L 194 200 185 173 167 CRP, mg/dL 8.96 2.64 0.10 0.33 0.20 KL-6, U/mL 376 650 827 491 320 FVC, % NA 102 130 135 NA DLco, % NA 75 91 NA NA SpO₂, % (Oxgen requirement, L/min) 96 (3) 94 (0) 97 (0) 98 (0) 97 (0) WBC, white blood cell; LDH, lactate dehydrogenase; CRP, C-reactive protein; KL-6, Krebs von den Lungen-6; FVC, forced vital capacity; DLco, diffusing capacity of the lung for carbon monoxide; SpO 2 , oxygen saturation; NA, not available. Fig. 4 HRCT after 31 days from antigen avoidance test (A) The ground glass opacities in the bilateral upper lobes were improved. (B) The ground glass opacities in bilateral lower lobes were also improved. Fig. 4
| 4.085938
| 0.974609
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC10975500
|
https://doi.org/10.1016/j.rmcr.2024.102013
|
[
"avoidance",
"hrct",
"ground",
"glass",
"opacities",
"antigen",
"chest",
"lobes",
"oxygen",
"blood"
] |
[
{
"code": "6D10.Z",
"title": "Personality disorder, severity unspecified"
},
{
"code": "MB23.2",
"title": "Avoidance behaviour"
},
{
"code": "PL14.B",
"title": "Delayed treatment"
},
{
"code": "MB29.0",
"title": "Avoidant or restrictive eating"
},
{
"code": "6B83",
"title": "Avoidant-restrictive food intake disorder"
},
{
"code": "1F68.2",
"title": "Cutaneous larva migrans"
},
{
"code": "1F68.1",
"title": "Necatoriasis"
},
{
"code": "1F6B",
"title": "Strongyloidiasis"
},
{
"code": "PA60",
"title": "Unintentional fall on the same level or from less than 1 metre"
},
{
"code": "PG50",
"title": "Fall or jump of undetermined intent on the same level or from less than 1 metre"
}
] |
=== ICD-11 CODES FOUND ===
[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
[MB23.2] Avoidance behaviour
Definition: The act of keeping away from circumstances, situations, or stimuli that cause anxiety or other negative emotions in the individual.
Also known as: Avoidance behaviour
[PL14.B] Delayed treatment
Also known as: Delayed treatment | avoidable delay in treatment | Problem associated with delayed administration of a needed medication | Problem associated with delayed surgery
Excludes: Incorrect timing of drug or medicament, as mode of injury | Non provision of necessary procedure
[MB29.0] Avoidant or restrictive eating
Definition: Acceptance of only a limited diet, which may be defined in terms of a specific dietary composition or sensory features of food, that is inconsistent with cultural or subcultural norms.
Also known as: Avoidant or restrictive eating
Excludes: Avoidant-restrictive food intake disorder
[6B83] Avoidant-restrictive food intake disorder
Definition: Avoidant-restrictive food intake disorder (ARFID) is characterised by avoidance or restriction of food intake that results in: 1) the intake of an insufficient quantity or variety of food to meet adequate energy or nutritional requirements that has resulted in significant weight loss, clinically significant nutritional deficiencies, dependence on oral nutritional supplements or tube feeding, or has otherwise negatively affected the physical health of the individual; or 2) significant impairment
Also known as: Avoidant-restrictive food intake disorder | ARFID - [Avoidant-restrictive food intake disorder]
Excludes: Anorexia Nervosa | Feeding problem of infant | Feeding problems of newborn
[1F68.2] Cutaneous larva migrans
Definition: A disease caused by an infection with the parasitic worm larvae, commonly Ancylostoma braziliense, A. caninum, or Uncinaria stenocephala. This disease is characterised by intense pruritus and erythematous, serpiginous lesions due to migration of parasitic larvae in the upper dermis where the larvae penetrate the skin. Transmission is by direct contact with larvae from soil or sand contaminated with dog or cat faeces (by percutaneous migration of larvae).
Also known as: Cutaneous larva migrans | Creeping eruption | Ground itch | Sand-worm eruption | ancylostomal cutaneous larva migrans
[1F68.1] Necatoriasis
Definition: A disease caused by an infection with the parasitic worm Necator americanus. This disease is characterised by pruritus at the site of larval penetration. In mild infections, this disease may be asymptomatic; in moderate to severe infections, this disease may present with cough, pharyngeal irritation during larval migration in airways, iron-deficiency anaemia, abdominal pain, nausea, arthralgia, or delayed development (mental or physical). Transmission is by direct contact with larvae from soil o
Also known as: Necatoriasis | miner's anaemia | negro cachexia | dochmiasis | ground itch disease
Includes: Infection due to Necator americanus
[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
[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
[PG50] Fall or jump of undetermined intent on the same level or from less than 1 metre
Also known as: Fall or jump of undetermined intent on the same level or from less than 1 metre | same level fall | complications of ground level fall | Fall or jump of undetermined intent on ice or snow | Fall or jump of undetermined intent from pedestrian conveyance
=== GRAPH WALKS ===
--- Walk 1 ---
[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--> [6D10.1] Moderate personality disorder
Def: All general diagnostic requirements for Personality Disorder are met. Disturbances affect multiple areas of personality functioning (e.g., identity or sense of self, ability to form intimate relations...
--- Walk 2 ---
[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--> [6D10.1] Moderate personality disorder
Def: All general diagnostic requirements for Personality Disorder are met. Disturbances affect multiple areas of personality functioning (e.g., identity or sense of self, ability to form intimate relations...
--- Walk 3 ---
[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....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings
--- Walk 4 ---
[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....
--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 ---
[PL14.B] Delayed treatment
--EXCLUDES--> [?] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--EXCLUDES--> [?] Overdose of substance without injury or harm
Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration...
--- Walk 6 ---
[PL14.B] Delayed treatment
--EXCLUDES--> [?] Non provision of necessary procedure
--CHILD--> [?] Failure to introduce or to remove other tube or instrument
|
[
"[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--> [6D10.1] Moderate personality disorder\n Def: All general diagnostic requirements for Personality Disorder are met. Disturbances affect multiple areas of personality functioning (e.g., identity or sense of self, ability to form intimate relations...",
"[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--> [6D10.1] Moderate personality disorder\n Def: All general diagnostic requirements for Personality Disorder are met. Disturbances affect multiple areas of personality functioning (e.g., identity or sense of self, ability to form intimate relations...",
"[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....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings",
"[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....\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....",
"[PL14.B] Delayed treatment\n --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...\n --EXCLUDES--> [?] Overdose of substance without injury or harm\n Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration...",
"[PL14.B] Delayed treatment\n --EXCLUDES--> [?] Non provision of necessary procedure\n --CHILD--> [?] Failure to introduce or to remove other tube or instrument"
] |
6D10.Z
|
Personality disorder, severity unspecified
|
[
{
"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
|
The patient was a 74-year-old female who underwent left lower lobectomy for lung cancer 2 years before presenting to our institution. The histological type was adenocarcinoma, with a pathological staging of T4N1M0 stage IIIA (Union for International Cancer Control: UICC 8th ed) . One year after lobectomy, cystic lesions appeared on the head and tail of the pancreas, diagnosed as IPMN. The cystic tumor on the pancreatic head gradually increased from 20 to 37 mm in 1 year and showed a contrasted solid nodule inside the cystic tumor . The patient was referred to our department for surgery because the tumor was considered IPMN with high-risk stigmata. Her blood test results were as follows: carcinoembryonic antigen, 2.4 ng/mL (normal range, < 5.0 ng/mL); carbohydrate antigen 19-9, 38 U/mL (normal range, < 15 U/mL); DUPAN-2, 39 U/mL (normal range, < 150 U/mL); and SPAN-1, 29.8 U/mL (normal range, < 30 U/mL). Abdominal computed tomography (CT) showed a 37-mm cystic tumor with a contrasted solid nodule at the pancreatic head and a 17-mm cystic tumor at the pancreatic tail. Endoscopic ultrasonography (EUS) revealed that the cystic tumor at the head was a 35-mm solitary cyst with a 24-mm mural nodule, and the cystic tumor at the tail was a 20-mm solitary cyst with a 10-mm mural nodule. The main pancreatic duct had no extension. Although we had confirmed that the cystic tumor and main pancreatic duct were close, we could not define the link between the main pancreatic duct and the cyst . 18 F-fluorodeoxyglucose positron-emission tomography (FDG-PET) showed FDG uptake (SUV max 1.9) at the lesion in the pancreatic head. No evidence of metastasis from other organs was observed . Magnetic resonance imaging (MRI) could not be performed because of a cardiac pacemaker. The patient developed jaundice because the pancreatic head tumor excluded the common bile duct. From these results, we diagnosed the tumors as IPMN with high-risk stigmata because of jaundice and a contrasted mural nodule. We performed a total pancreatectomy for the two lesions after bile duct drainage by endoscopic retrograde cholangiopancreatography (ERCP). Because we performed ERCP on emergency, we could not perform brushing cytology or pancreatic juice cytology for food residue in the stomach and duodenum. The tumors were solitary cysts with papillary lesions at the pancreatic head and tail. Histopathological findings showed that tumor cells had papillary components without mucus production . Moreover, a small tumor lesion was also microscopically detected at the pancreatic tail. Immunohistochemical analysis showed positive results for TTF-1, Napsin A, and CK7, but CK20 did not present significant staining , and these findings indicated this tumor to be lung cancer metastasis rather than IPMN. The histological findings were similar to those of the existing lung adenocarcinoma resected 2 years before now . According to these findings, we diagnosed the patient with metastatic pancreatic carcinoma from lung cancer. The postoperative course was good, and the patient was discharged 21 days after the operation. The patient did not received adjuvant therapy and had no recurrence for 6 months after pancreatectomy. Fig. 1 Enhanced computed tomography findings. a CT findings at 1 year after lobectomy for primary lung cancer. A 20-mm cystic tumor was detected on the pancreatic head, with no tumor on the pancreatic body. b CT findings at 2 year after lobectomy. The cystic tumor on the pancreatic head gradually increased from 20 mm to 37 mm and showed a contrasted solid nodule inside the cystic tumor. The cystic tumor was also indicated at the pancreatic body Fig. 2 Endoscopic ultrasonography (EUS) imaging findings. EUS revealed that the cystic tumor of the pancreatic head was a 35-mm solitary cyst with a 24-mm mural nodule, and the cystic tumor of the pancreatic tail was a 20-mm solitary cyst with a mural nodule Fig. 3 18 F-Fluorodeoxyglucose positron-emission tomography findings (FDG-PET). FDG-PET showed FDG uptake (SUV max 1.9) in the lesion at the pancreatic head. No evidence of metastasis from other organs was observed Fig. 4 Histopathological findings of pancreatic tumors. a Macroscopic findings showed that the tumor comprised of a cystic wall and mural nodule, which contained cystic fluid. b Hematoxylin-eosin staining (× 40). Papillary tumors were growing in large cysts. Tumor cells had no mucus in the cytoplasm and had different characteristics from intraductal papillary mucinous neoplasm. The papillary structure was similar to that of the previously resected lung cancer tissue. c Hematoxylin-eosin staining (× 200) showed the power field of a . d Multiplex immunohistochemical staining (× 400), using specific antibody cocktails of TTF-1 and Napsin A. Nuclear expression of TTF-1 and granular cytoplasmic expression of Napsin A were seen. e CK7 was positive by immunohistochemical staining. f CK20 did not present significant staining Fig. 5 Histopathological and computed tomography (CT) findings of lung adenocarcinoma that was resected 2 years before pancreatectomy. a Hematoxylin-eosin staining (× 40). This figure shows a part, including the boundary with the non-tumor part. Tumors formed papillary structures in some places, and there were also alveolar epithelial replacement growths. b Hematoxylin-eosin staining (× 200) showed the power field of a . c Lung cancer had been detected at the left lower lobe as a solid tumor by CT
| 4.003906
| 0.977051
|
sec[1]/p[0]
|
en
| 0.999997
|
32468270
|
https://doi.org/10.1186/s40792-020-00870-5
|
[
"tumor",
"pancreatic",
"cystic",
"head",
"nodule",
"lung",
"staining",
"cancer",
"that",
"tail"
] |
[
{
"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": "DC3Z",
"title": "Diseases of pancreas, unspecified"
},
{
"code": "DC3Y",
"title": "Other specified diseases of pancreas"
},
{
"code": "LB21.3",
"title": "Agenesis-aplasia of pancreas"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "DC35.0",
"title": "Atrophy of pancreas"
}
] |
=== ICD-11 CODES FOUND ===
[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
[DC3Z] Diseases of pancreas, unspecified
Also known as: Diseases of pancreas, unspecified
[DC3Y] Other specified diseases of pancreas
Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis
[LB21.3] Agenesis-aplasia of pancreas
Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.
Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[DC35.0] Atrophy of pancreas
Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] 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
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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 --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...."
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 56-year-old female patient presented with severe headache, tetraparesis, hemiplegia and hypoglossal paralysis on the right side and somnolence. The medical history was essentially unremarkable. Shortly after admission to the referring hospital, she became comatose. Cranial non-contrast computed tomography (NCCT) showed a hematoma in the medulla oblongata and thrombus in the fourth ventricle. Magnetic resonance imaging (MRI) revealed edema and hematoma of the medulla oblongata and the cervical spinal cord extending to the level of the 6th cervical vertebral body . The hematoma had ruptured through the floor of the fourth ventricle. At the C1 and C2 levels, a spherical structure was visible within the hematoma. A DSA was carried out on the same day and this showed an intradural arteriovenous fistula at the C2 level on the right side. Supply of this intradural fistula was from the right vertebral artery (VA) at the atlas loop as well as from the anterior spinal artery (ASA) . A very small aneurysm was visible on a sulco-commissural artery adjacent to the ASA, located at the level of C1 and C2. The intention of the treatment was to prevent another intramedullary and/or subarachnoid hemorrhage arising from a re-rupture of the sulco-commissural artery aneurysm. During the acute posthemorrhagic phase, treatment was postponed to facilitate neurological recovery. The treatment options were discussed 5 months later when, after rehabilitation treatment, the clinical condition of the patient had considerably stabilized. The first choice was to attempt endovascular treatment. Entering via the right VA, the artery originating from the right V3 segment and supplying the intradural fistula was catheterized and injected. Embolization was not performed for two reasons: 1) there was a possibility of cervical spinal cord supply via this vessel and 2) a partial embolization with interruption of the dural supply only might have recruited pial feeding arteries and could have increased the hemodynamic stress on the aneurysm. The right V4 segment and the ASA were then carefully catheterized with three different microcatheters (Magic 1.2, Balt Extrusion, Montmorency, France; Marathon, Medtronic, Dublin, Ireland; Excelsior SL10, Stryker, Kalamazoo, MI, USA). Injecting contrast medium into the ASA illuminated the hypertrophic right-sided sulco-commissural artery and the aneurysm. From this position a part of the intradural fistula was also opacified . The use of DynaCT (Siemens, Erlangen, Germany) with contrast medium injection of the right VA confirmed the location of the aneurysm within the spinal cord. Wire access was gained along the ASA to the sulco-commissural artery in a controlled fashion. Several attempts were made to introduce a microcatheter into the aneurysm sac. Various combinations of Magic 1.2, Marathon and Excelsior SL10 with Mirage (Medtronic, Dublin, Ireland) and Hybrid (Balt Extrusion, Montmorency, France) wires were used but the small caliber of the sulco-commissural artery did not allow safe microcatheter access to the aneurysm . The failed endovascular procedure was tolerated with no new neurological deficits. The right-sided hemiplegia improved slowly over the following few weeks, which motivated the patient to undergo open surgery. The potential risks of both conservative management and surgery were explained to the patient and her family and she eventually accepted the proposed operation. Fig. 1 Diagnostic imaging and treatment in a patient with cervical hematomyelia due to an aneurysm of a sulco-commissural artery, associated with a cervical intradural arteriovenous fistula. T2*weighted image showing the hematoma in the cervical spinal cord and the surrounding edema ( a ). DSA at this time revealed an intradural arteriovenous fistula with dominant radiculomeningeal supply via the right VA ( b ). Injection of the left vertebral artery shows the pial supply of the intradural arteriovenous fistula via the anterior spinal artery ( c ). Selective injection of the anterior spinal artery 5 months later shows the connection between the anterior spinal artery and the aneurysm via a sulco-commissural artery ( d ). Meanwhile the aneurysm had considerably increased. While the guidewire could be introduced into the sulco-commissural artery, the vessel’s small caliber did not allow passage of the microcatheter ( e ). Via a small microsurgical approach to the cervical spinal cord from the right side and after dissection of the spinal cord tissue, the wall of the aneurysm became visible ( f ). Thermocoagulation of the wall of the aneurysm resulted in shrinkage of the lesion, providing additional space for further dissection of the whole aneurysm. After mobilization of the aneurysm, the afferent sulco-commissural artery was identified and the borders of the adjacent spinal cord were visible. The feeding artery was divided with microscissors. Postoperative follow-up MRI on the first day after the microsurgical aneurysm resection shows the hemosiderin remnants (T2-weighted image g ) while the previous contrast enhancing aneurysm wall is no longer visible on contrast enhanced T1WI ( h ). DSA of the right ( i ) and left ( j ) vertebral artery 3 weeks after the microsurgical resection of the sulco-commissural artery aneurysm. The previous aneurysm is no longer visible, the continuity of the anterior spinal artery is preserved and a small remnant of the intradural AV-fistula remains perfused
| 4.082031
| 0.972168
|
sec[1]/p[0]
|
en
| 0.999996
|
30874845
|
https://doi.org/10.1007/s00062-019-00772-6
|
[
"artery",
"aneurysm",
"spinal",
"sulco",
"commissural",
"intradural",
"fistula",
"cervical",
"cord",
"visible"
] |
[
{
"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": "BD51.Z",
"title": "Aneurysm and dissection of unspecified artery"
},
{
"code": "BD75.Y",
"title": "Venous varicosities of other specified sites"
},
{
"code": "BA81",
"title": "Coronary artery aneurysm"
},
{
"code": "BB02.1Z",
"title": "Aneurysm of pulmonary artery, unspecified"
},
{
"code": "BD51.4",
"title": "Aneurysm or dissection of renal artery"
}
] |
=== ICD-11 CODES FOUND ===
[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
[BD51.Z] Aneurysm and dissection of unspecified artery
Also known as: Aneurysm and dissection of unspecified artery | Arterial aneurysm or dissection, excluding aorta | cirsoid aneurysm NOS | false aneurysm NOS | ruptured aneurysm NOS
[BD75.Y] Venous varicosities of other specified sites
Also known as: Venous varicosities of other specified sites | Caput medusae | Jugular venous aneurysm | jugular vein aneurysm | Orbital varices
[BA81] Coronary artery aneurysm
Definition: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times.
Also known as: Coronary artery aneurysm | aneurysm of coronary vessels | aneurysmal lesion of coronary artery | arteriovenous aneurysm of coronary vessels | coronary aneurysm
Excludes: Congenital coronary arterial aneurysm | Mucocutaneous lymph node syndrome
[BB02.1Z] Aneurysm of pulmonary artery, unspecified
Also known as: Aneurysm of pulmonary artery, unspecified | Aneurysm of pulmonary artery | pulmonary artery aneurysm | PA - [pulmonary artery aneurysm] | pulmonary aneurysm
[BD51.4] Aneurysm or dissection of renal artery
Also known as: Aneurysm or dissection of renal artery | aneurysm of renal artery | renal artery aneurysm | renal aneurysm
=== GRAPH WALKS ===
--- Walk 1 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--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 2 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--CHILD--> [?] Chronic arterial occlusive disease
--- Walk 3 ---
[BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Nonorgan specific systemic autoimmune disorders
--CHILD--> [?] Idiopathic inflammatory myopathy
Def: These comprise a diverse group of syndromes that have in common persistent muscle inflammation of unknown pathophysiology, resulting in damage that affects muscle function. The inflammatory muscle dis...
--- Walk 4 ---
[BD52] Certain specified disorders of arteries or arterioles
--CHILD--> [BD52.1] Arteriovenous fistula, acquired
--EXCLUDES--> [?] Cerebral aneurysm, nonruptured
--- 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...
--PARENT--> [?] ICD Category
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\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...",
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease",
"[BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Nonorgan specific systemic autoimmune disorders\n --CHILD--> [?] Idiopathic inflammatory myopathy\n Def: These comprise a diverse group of syndromes that have in common persistent muscle inflammation of unknown pathophysiology, resulting in damage that affects muscle function. The inflammatory muscle dis...",
"[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.1] Arteriovenous fistula, acquired\n --EXCLUDES--> [?] Cerebral aneurysm, nonruptured",
"[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 --PARENT--> [?] ICD Category"
] |
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 70-year-old man was admitted for further examination and treatment after abdominal ultrasonography at a clinic revealed a 48-mm tumor in the gallbladder. Laboratory data showed an elevated aspartate transaminase level of 64 U/L, alanine transaminase level of 67 U/L, ICG R15 level of 20%, and normal levels of carcinoembryonic antigen and cancer antigen 19–9 (Table 1 ). Abdominal ultrasonography revealed a 50-mm hypoechoic mass in the cervix of the gallbladder with no obvious blood flow. Abdominal contrast-enhanced computed tomography (CT) revealed a mass measuring 48 mm in diameter on the right side of the common bile duct . The border of the mass was clear, with no obvious invasion, and the mass appeared to push out the bile duct from the outside. Abdominal magnetic resonance imaging (MRI) revealed a mass with a clear border that included hyperintense cystic and reticulated structures on T2-weighted images. Diffusion-weighted imaging revealed a hyperintense region of the mass . 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) confirmed high-level FDG uptake in the gallbladder tumor in the early phase without increasing FDG uptake in the later phase . With suspected malignancy, the patient underwent open cholecystectomy with wedge resection of the gallbladder bed. We found that the mass was elastic, soft, and slightly poorly mobilized . Based on the pathological diagnosis during surgery, the bile duct margin was negative; however, the tumor was strongly suspected to be mucinous carcinoma . Hence, the patient underwent radical cholecystectomy for gallbladder cancer in addition to extrahepatic bile duct resection, including common bile duct resection, lymphadenectomy of the liver hilum, and choledochojejunostomy. The total amount of bleeding was 1190 mL, and the surgery lasted for 8 h and 19 min because we had to perform an extended surgery. Pathologically, there was no invasion of the common bile duct or gallbladder bed despite the tumor extending into the subserosal fatty tissue surrounding the gallbladder. There was no lymph node metastasis. The tumor showed patternless growth, with vitrified oval- to spindle-shaped tumor cells in the stroma containing both low- and high-density areas of cells. We also observed irregularly dilated vasculature, known as “staghorn pattern”. It was positive for STAT6, CD34, BCL-2, and CD99 but negative for CK(AE1/AE3), C-Kit, ASMA, S100, D2-40, Factor VIII, HMB-45, melan A, and synaptophysin. Ki-67 was 10–15%, and p53 was 5–7% . Postoperatively, the patient developed an intraperitoneal abscess that was treated using percutaneous drainage. The patient recovered satisfactorily and was discharged on postoperative day 20. The patient was in good general condition without any recurrence at 24 months postoperatively. Table 1 Laboratory data Blood markers Index Normal range WBC (× 10 3 /μL) 4.26 3.3 – 8.6 RBC (× 10 4 /μL) 465 435 – 555 Hemoglobin (g/dL) 15.2 13.7 – 16.8 Platelets (× 10 4 /μL) 23.2 15.8 – 34.8 ALT (U/L) 64 13 – 30 AST (U/L) 67 10 – 42 ALP (U/L) 220 106 – 322 LDH (U/L) 254 124 – 222 ChE (U/L) 420 240 – 486 γ-GTP (U/L) 60 13 – 64 T-Bil (mg/dL) 0.7 0.4 – 1.5 D-Bil (mg/dL) 0.1 ≦0.3 TP (g/dL) 7.5 6.6 – 8.1 ALB (g/dL) 4.5 4.1 – 5.1 BUN (mg/dL) 16.3 8 – 20 CRE (mg/dL) 0.77 0.65 – 1.07 Na (mmol/L) 140 138 – 145 K (mmol/L) 4.6 3.6 – 4.8 Cl (mmol/L) 101 101 – 108 Ca (mg/dL) 10.6 8.8 – 10.1 CRP (mg/dL) 0.1 ≦0.14 PT % 116 70 – 140 PT-INR 0.93 0.80 – 1.20 APTT 24.5 23 – 40 ICG R15 (%) 20 ≦10 CEA 3.3 ≦5 CA19-9 2 ≦37 WBC white blood cell count, RBC red blood cell count, AST aspartate aminotransferase, ALT alanine aminotransferase, ALP aspartate aminotransferase, LDH lactate dehydrogenase, ChE cholinesterase, γ-GTP γ-glutamyl transpeptidase, T-Bil total bilirubin, D-Bil direct bilirubin, TP total protein, ALB albumin, BUN , urea nitrogen; CRE , creatinine; CRP , c-peptide immunoreactivity, PT prothrombin time, PT-INR prothrombin time-international normalized ratio, APTT activated partial thromboplastin time, CEA carcinoembryonic antigen, CA19-9 carbohydrate antigen 19–9, ICG indocyanine green Fig. 1 Abdominal contrast-enhanced computed tomography imaging. A A mass measuring 48 mm in diameter on the right side of the common bile duct (arrow). B The border of the mass was clear with no obvious invasion (arrow) Fig. 2 Abdominal magnetic resonance imaging. A A mass with a clear border, including hyperintense cystic and reticulated structures on T2-weighted imaging (arrow). B A mass with a hyperintense region on diffusion-weighted imaging (arrow) Fig. 3 18F-Fluorodeoxyglucose positron emission tomography confirmed high-level FDG uptake in the gallbladder tumor in the early phase ( A ) without increasing FDG uptake in the later phase ( B ) Fig. 4 A Intraoperative findings showed that the mass was elastic, soft, and slightly poorly mobilized (red arrow). The patient underwent open cholecystectomy with wedge resection (marking line, yellow arrow). B In the gallbladder, there was clear-bordered white and elastic soft tumor originating from the gallbladder mucosa (red arrow) Fig. 5 The intraoperative pathological findings show the pools of the mucinous component and variable amount of tumor cells Fig. 6 A , B Resected specimens. C Staghorn vessels observed on hematoxylin and eosin (HE) staining (× 40). D Patternless growth observed on HE staining (× 200). E Immunohistochemical staining for STAT6. F Immunohistochemical staining for CD34
| 4.140625
| 0.967285
|
sec[1]/p[0]
|
en
| 0.999997
|
39551910
|
https://doi.org/10.1186/s40792-024-02057-8
|
[
"gallbladder",
"tumor",
"bile",
"duct",
"arrow",
"abdominal",
"imaging",
"clear",
"antigen",
"blood"
] |
[
{
"code": "DC12.Z",
"title": "Cholecystitis, unspecified"
},
{
"code": "DC10.01",
"title": "Obstruction of gall bladder"
},
{
"code": "QF01.Y",
"title": "Other specified acquired absence of organs"
},
{
"code": "ME24.35&XA8KL9",
"title": "Perforation of gallbladder"
},
{
"code": "DC10.2",
"title": "Fistula of gallbladder or bile duct"
},
{
"code": "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 ===
[DC12.Z] Cholecystitis, unspecified
Also known as: Cholecystitis, unspecified | Cholecystitis | gallbladder inflammation
[DC10.01] Obstruction of gall bladder
Also known as: Obstruction of gall bladder | obstruction of gallbladder | gallbladder obstruction | Constriction of gallbladder | gallbladder constriction
[QF01.Y] Other specified acquired absence of organs
Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball
[DC10.2] Fistula of gallbladder or bile duct
Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.
Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula
[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 ---
[DC12.Z] Cholecystitis, unspecified
--PARENT--> [DC12] Cholecystitis
Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--- Walk 2 ---
[DC12.Z] Cholecystitis, unspecified
--PARENT--> [DC12] Cholecystitis
Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....
--CHILD--> [DC12.1] Chronic cholecystitis
Def: Chronic inflammation of the gall bladder wall resulted from repeated acute cholecystitis or from mechanical irritation of the gall bladder wall by unspecified disorders...
--- Walk 3 ---
[DC10.01] Obstruction of gall bladder
--PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts
Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--- Walk 4 ---
[DC10.01] Obstruction of gall bladder
--PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts
Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....
--CHILD--> [DC10.02] Obstruction of bile duct
--- Walk 5 ---
[QF01.Y] Other specified acquired absence of organs
--PARENT--> [QF01] Acquired absence of organs
--CHILD--> [QF01.0] Acquired absence of breast
--- Walk 6 ---
[QF01.Y] Other specified acquired absence of organs
--PARENT--> [QF01] Acquired absence of organs
--EXCLUDES--> [?] Postsurgical asplenia
Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept...
|
[
"[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...",
"[DC12.Z] Cholecystitis, unspecified\n --PARENT--> [DC12] Cholecystitis\n Def: Inflammation of gallbladder wall by infection of various organism and/or unspecified disorders....\n --CHILD--> [DC12.1] Chronic cholecystitis\n Def: Chronic inflammation of the gall bladder wall resulted from repeated acute cholecystitis or from mechanical irritation of the gall bladder wall by unspecified disorders...",
"[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...",
"[DC10.01] Obstruction of gall bladder\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --CHILD--> [DC10.02] Obstruction of bile duct",
"[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --CHILD--> [QF01.0] Acquired absence of breast",
"[QF01.Y] Other specified acquired absence of organs\n --PARENT--> [QF01] Acquired absence of organs\n --EXCLUDES--> [?] Postsurgical asplenia\n Def: A disease caused by underlying diseases, splenectomy or splenic rupture from trauma. This disease is characterised by absence of normal spleen function. This disease may present with increased suscept..."
] |
DC12.Z
|
Cholecystitis, unspecified
|
[
{
"from_icd11": "DC12.Z",
"icd10_code": "K812",
"icd10_title": "Acute cholecystitis with chronic cholecystitis"
},
{
"from_icd11": "DC12.Z",
"icd10_code": "K819",
"icd10_title": "Cholecystitis, unspecified"
},
{
"from_icd11": "DC12.Z",
"icd10_code": "K81",
"icd10_title": "Cholecystitis"
},
{
"from_icd11": "DC12.Z",
"icd10_code": "K818",
"icd10_title": ""
},
{
"from_icd11": "DC10.01",
"icd10_code": "K820",
"icd10_title": "Obstruction of gallbladder"
},
{
"from_icd11": "QF01.Y",
"icd10_code": "Z9049",
"icd10_title": "Acquired absence of other specified parts of digestive tract"
},
{
"from_icd11": "DC10.2",
"icd10_code": "K833",
"icd10_title": "Fistula of bile duct"
},
{
"from_icd11": "DC10.2",
"icd10_code": "K823",
"icd10_title": "Fistula of gallbladder"
},
{
"from_icd11": "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"
}
] |
K812
|
Acute cholecystitis with chronic cholecystitis
|
A 63-year-old Caucasian male subject presented to GI clinic in May 2009 with complaints of bloating, constipation, and 30 pounds weight loss for the past 6 months. He denied any abdominal pain, nausea, vomiting, dysphagia, diarrhea, hematochezia, or rash. Past medical history includes allergic rhinitis, chronic sinusitis, hearing loss, psychotic, and paranoid personality disorder. He had an appendectomy before. He denied smoking, alcohol, or any illicit drug use. Physical examination revealed nasal polyps, but the rest of the examination was unremarkable. Complete blood count showed peripheral blood eosinophilia of 53.1% (0.1–8), elevated erythrocyte sedimentation rate (ESR) of 31 mm/hour (0–20), and C-reactive protein (CRP) of 22.7 mg/L (0.0–4.0). Liver function tests (LFTs) showed elevated alkaline phosphatase of 285 U/L (40–140) and elevated gamma-glutamyl transferase (GGT) of 135 U/L (10–75). Antinuclear antibody (ANA), complements, cytoplasmic antineutrophilic antibodies (c-ANCA), proteinase3 (PR3) antibody, and myeloperoxidase (MPO) antibody were all normal. However, perinuclear antineutrophil cytoplasmic antibody (p-ANCA) was positive in low titer: 1 : 80. Stools for ova and parasites were negative but had a positive toxocara antibody. He was treated with ivermectin without any improvement in symptoms. Subsequently, a bone marrow biopsy was done and was negative for any myeloproliferative disorders. Biphasic liver CT showed diffuse portal fibrosis concerning biliary cirrhosis. A duodenal biopsy revealed areas with profound eosinophilic infiltrate (>100 eosinophils/HPF) suggestive of eosinophilic enteritis. A liver biopsy showed multiple hepatic granulomas with central necrosis and extensive eosinophilia. Based on the constellation of symptoms and biopsy findings, he was diagnosed with EGPA. Treatment with high-dose steroids was recommended, but the patient declined immunosuppressive medications due to concern for side effects. He continued to follow with allergy/immunology and rheumatology service and had multiple hospitalizations for asthma flare. He was receiving treatment with on and off corticosteroids for asthma flare and inhalers for asthma. In January 2020, he presented to the emergency department (ED) with a 2-week history of sudden onset sharp and right-sided lumbar back pain, which started after moving a large spare tire. He also reported pain in the umbilical region aggravated by meals and associated with nausea and loose stools. Vital signs were as follows: Blood pressure 129/77 mm of hg, pulse was 79/minute, RR was 12/minute, and temperature was 36.6°C. Physical examination was significant only for periumbilical tenderness. Laboratory tests showed white blood cell count of 14,240/ul and differentials of eosinophils 2% (0.1–8), polymorphonuclear cells 82% (38–72), and lymphocytes 8.3% (15–45). Hemoglobin and platelet counts were normal. CRP was 104 mg/L (0.0–5.0) and procalcitonin was 7.4 ng/mL (0.0–0.25). Renal function and urinalysis were normal. The liver function test showed normal transaminases, but alkaline phosphatase was elevated at 217 U/L (40–150). ANCA panel and ANA were negative. IgG4 was minimally elevated at 125 mg/dl (2–96). Blood cultures were negative. CT abdomen and pelvis with and without contrast showed asymmetric fusiform sac measuring 3.6 × 3.2 cm along the right lateral and anterior margin of the abdominal aorta at the level of L4. There was aortic wall calcification along the right lateral margin and hazy wall thickening of the aneurysm sac with surrounding stranding and haziness. These are suggestive of mycotic aneurysms (Figures 1(a) and 1(b) ). He was admitted to vascular surgery service. Infectious disease and rheumatology services were consulted. He was started on broad spectrum IV antibiotics, but he refused any surgical intervention for the aneurysm. The following day, the patient had worsening abdominal pain and a repeat CT abdomen with contrast showed localized areas of contrast bulging in the right side of the infrarenal abdominal aorta, projecting into the periaortic soft tissue thickening. These contrast projections extended beyond the calcified wall of the aorta and were contained within the soft tissue thickening; findings were consistent with confined aortic rupture associated with periaortic inflammatory thickening. He was taken to the operating room for an emergent exploratory laparotomy. The infrarenal aorta was resected and a right axillobifemoral bypass was performed with an 8 mm polytetrafluoroethylene (PTFE) graft. Aortic wall tissue was sent for histopathology analysis. Aortic wall pathology showed markedly inflamed, hemorrhagic, and partially necrotic periaortic and scant aortic tissue infiltration of plasma cells, lymphocytes, and neutrophils and histiocytes with occasional eosinophils within the vessel wall. It also showed eosinophilic vasculitis of mostly small and rarely medium vessels with rare fibrinoid necrosis (Figures 2(a) and 2(b) ). No granuloma was identified. Gram stain and Periodic Acid Schiff Stain (PAS) stain for fungus were negative. The final pathologic diagnosis was aortitis, periaortitis, and necrotizing vasculitis suggestive of EGPA. After multiple other postsurgical complications, he had a prolonged and difficult recovery in the surgical intensive care unit. After a month-long recovery period, he was offered further immunosuppressive therapy, which he continues to decline.
| 3.957031
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999996
|
34552804
|
https://doi.org/10.1155/2021/7093607
|
[
"wall",
"blood",
"antibody",
"aortic",
"abdominal",
"pain",
"liver",
"biopsy",
"contrast",
"aorta"
] |
[
{
"code": "LB0Y",
"title": "Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord"
},
{
"code": "PA82",
"title": "Unintentional striking against stationary object"
},
{
"code": "NB50.Y&XA3KX0&XJ1C6",
"title": "Haematoma of abdominal wall"
},
{
"code": "DC51.1",
"title": "Peritoneal adhesions"
},
{
"code": "LB73.1Z",
"title": "Structural developmental anomalies of chest wall, unspecified"
},
{
"code": "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 ===
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Also known as: Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord | Congenital deformity of abdominal wall | abdominal wall defect NOS
[PA82] Unintentional striking against stationary object
Also known as: Unintentional striking against stationary object | striking against stationary object | striking against or struck by other objects | Walked into wall
[DC51.1] Peritoneal adhesions
Definition: Disorders of peritoneum sticking by scar tissue or fibrosis
Also known as: Peritoneal adhesions | abdominal adhesion | adhesive peritoneal band | peritoneal adhesion | peritoneal band
Excludes: Adhesions of large intestine with obstruction | Postprocedural pelvic peritoneal adhesions | Intestinal adhesions or bands of small intestine with obstruction
[LB73.1Z] Structural developmental anomalies of chest wall, unspecified
Also known as: Structural developmental anomalies of chest wall, unspecified | Structural developmental anomalies of chest wall | Malformations of chest wall
[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 ---
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
--PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....
--CHILD--> [LB01] Omphalocele
Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce...
--- Walk 2 ---
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
--PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....
--CHILD--> [LB02] Gastroschisis
Def: Gastroschisis is a congenital abdominal wall defect characterised by viscera protruding, without a covering sac, from the fetal abdomen on the right lateral base of the umbilicus....
--- Walk 3 ---
[PA82] Unintentional striking against stationary object
--PARENT--> [?] Unintentional exposure to object, not elsewhere classified
--CHILD--> [PA81] Unintentionally struck by moving object
--- Walk 4 ---
[PA82] Unintentional striking against stationary object
--PARENT--> [?] Unintentional exposure to object, not elsewhere classified
--CHILD--> [PA80] Unintentionally struck by projectile from firearm
--- Walk 5 ---
[DC51.1] Peritoneal adhesions
Def: Disorders of peritoneum sticking by scar tissue or fibrosis...
--EXCLUDES--> [?] Intestinal adhesions or bands of small intestine with obstruction
Def: Small bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....
--CHILD--> [?] Postoperative obstruction of the small intestine
--- Walk 6 ---
[DC51.1] Peritoneal adhesions
Def: Disorders of peritoneum sticking by scar tissue or fibrosis...
--EXCLUDES--> [?] Postprocedural pelvic peritoneal adhesions
Def: A condition caused by or subsequent to any pelvic intervention leading to damage and inflammation of the peritoneum. This condition is characterised by fibrous bands of scar tissue and abnormal connec...
--EXCLUDES--> [?] Endometriosis
Def: A condition of the uterus that is frequently idiopathic. This condition is characterised by ectopic growth and function of endometrial tissue outside the uterine cavity. This condition may be associat...
|
[
"[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB01] Omphalocele\n Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce...",
"[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB02] Gastroschisis\n Def: Gastroschisis is a congenital abdominal wall defect characterised by viscera protruding, without a covering sac, from the fetal abdomen on the right lateral base of the umbilicus....",
"[PA82] Unintentional striking against stationary object\n --PARENT--> [?] Unintentional exposure to object, not elsewhere classified\n --CHILD--> [PA81] Unintentionally struck by moving object",
"[PA82] Unintentional striking against stationary object\n --PARENT--> [?] Unintentional exposure to object, not elsewhere classified\n --CHILD--> [PA80] Unintentionally struck by projectile from firearm",
"[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Intestinal adhesions or bands of small intestine with obstruction\n Def: Small bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....\n --CHILD--> [?] Postoperative obstruction of the small intestine",
"[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Postprocedural pelvic peritoneal adhesions\n Def: A condition caused by or subsequent to any pelvic intervention leading to damage and inflammation of the peritoneum. This condition is characterised by fibrous bands of scar tissue and abnormal connec...\n --EXCLUDES--> [?] Endometriosis\n Def: A condition of the uterus that is frequently idiopathic. This condition is characterised by ectopic growth and function of endometrial tissue outside the uterine cavity. This condition may be associat..."
] |
LB0Y
|
Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
|
[
{
"from_icd11": "PA82",
"icd10_code": "W2209XA",
"icd10_title": "Striking against other stationary object, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2201XA",
"icd10_title": "Walked into wall, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2211XA",
"icd10_title": "Striking against or struck by driver side automobile airbag, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W228XXS",
"icd10_title": "Striking against or struck by other objects, sequela"
},
{
"from_icd11": "PA82",
"icd10_code": "W2203XD",
"icd10_title": "Walked into furniture, subsequent encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2203XA",
"icd10_title": "Walked into furniture, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W228XXD",
"icd10_title": "Striking against or struck by other objects, subsequent encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2212XA",
"icd10_title": "Striking against or struck by front passenger side automobile airbag, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2209XS",
"icd10_title": "Striking against other stationary object, sequela"
},
{
"from_icd11": "PA82",
"icd10_code": "W228XXA",
"icd10_title": "Striking against or struck by other objects, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W22",
"icd10_title": "Striking against or struck by other objects"
},
{
"from_icd11": "DC51.1",
"icd10_code": "K660",
"icd10_title": "Peritoneal adhesions (postprocedural) (postinfection)"
},
{
"from_icd11": "LB73.1Z",
"icd10_code": "Q766",
"icd10_title": "Other congenital malformations of ribs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
}
] |
W2209XA
|
Striking against other stationary object, initial encounter
|
The patient was an asymptomatic 65-year-old man with a recent history of pneumonia. A follow-up computed tomography (CT) scan incidentally revealed a large tumor on his left upper abdomen. The patient did not have a reported family history of pancreatic cancer. Laboratory examinations showed elevated serum C-reactive protein (CRP) levels (2.76 mg/dl). His serum albumin and hemoglobin levels slightly decreased to 3.9 g/dl (normal range 4.1–5.1 g/dl) and 13.5 g/dl (normal range 13.7–16.8), respectively. His serum transaminase, pancreatic enzymes (amylase and lipase), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), total bilirubin, blood glucose, and HbA1c levels were within normal limits. His serum elastase-1 level elevated to 3250 (normal range 0–300), while his carcinoembryonic antigen (CEA), cancer antigen 19–9 (CA19-9), duke pancreatic monoclonal antigen type 2 (DUPAN-2), and s-pancreas antigen-1 (Span-1) levels were within their normal ranges. A contrast-enhanced CT revealed a hypoenhancing 12-cm tumor in the pancreas body and tail, suggesting a primary pancreatic cancer. The tumor was close to the celiac artery (CA), superior mesenteric artery (SMA) and vein (SMV), and common hepatic artery . Notably, the splenic artery was patent despite circumferential involvement by the tumor , which indicated the expansive-growth pattern of the tumor. The magnetic resonance imaging (MRI) showed that the tumor had a low intensity on the T1-weighted imaging, a high intensity on the T2-weighted imaging, and a marked restricted diffusion on the diffusion-weighted imaging. Neither CT nor MRI scans indicated any distant metastases. The patient underwent an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the mass. This revealed the presence of tumor cells with round nuclei and eosinophilic to amphophilic granular cytoplasm. An immunohistochemical examinations showed that the tumor was positive for BCL-10, trypsin, chymotrypsin, chromogranin A (80% positive), and synaptophysin (20% positive). We diagnosed the tumor as a pancreatic ACC or MANEC. The patient underwent a complete surgical resection by distal pancreatectomy with combined resection of the spleen, left adrenal gland, transverse colon, small bowel, and stomach . The intraoperative findings showed that the tumor was capsular and was in contact with the SMA, SMV, and CA; however, obvious infiltration of these vessels was not observed. The pathological examination indicated an MANEC with positivity for BCL-10, trypsin, chymotrypsin, and chromogranin A . The MIB-1 as per the Ki-67 expression was 80% positive in the immunochemical staining (UICC TNM classification 8 th edition: pT3, pN2, pMX StageIII) . The tumor tissue DNA was analyzed for genomic abnormalities, and the resected specimen indicated that the tumor was MSI-high and negative for RAS/BRAF mutation. Immunohistochemically, The mismatch repair (MMR) gene protein PMS2 was lost and MLH1, MSH2, and MSH6 were retained . The patient did not receive any adjuvant therapy because of fatigue and loss of appetite. The progress after the surgery is shown in Fig. 5 . Three months after the surgery, there was no recurrence of the tumor. However, five months after surgery, a CT scan revealed multiple liver, lung, and lymph node metastases and peritoneal dissemination. Chemotherapy with gemcitabine plus nab-paclitaxel was administered as the first-line treatment. Due to the side effects (leukopenia and severe malaise) and poor efficacy (tumors enlarged < 20%), the patient stopped receiving the treatment after two courses. Considering MSI-high of the tumor, pembrolizumab was administered as the second-line treatment. Although the patient tolerated this regimen, a CT scan revealed the tumor´s progression. The patient's general condition gradually deteriorated, and he died 8 months following the surgery. Fig. 1 Preoperative contrast-enhanced computed tomography. The tumor was close to the celiac artery (CA), superior mesenteric artery (SMA) and vein (SMV), and common hepatic artery (CHA, A – D ) The splenic artery was patent despite circumferential involvement by the tumor ( A – C ) Fig. 2 Macroscopic view of the resected specimen. Distal pancreatectomy with combined resection of the spleen, left adrenal gland, transverse colon, small bowel, and stomach ( A ). The tumor was encapsulated ( B ) Fig. 3 Histopathological findings. Hematoxylin and eosin staining at a magnification of A × 40 and B × 400; C BCL-10 staining, magnification, × 400; D trypsin staining, magnification, × 400; E chromogranin A staining, magnification, × 400; F MIB-1 staining, magnification, × 400). A , B Hematoxylin and eosin staining revealed an acinar growth of tumor cells with round nuclei and eosinophilic vesicles. Immunohistochemistry revealed positive BCL-10 ( C ), trypsin ( D ), and chromogranin A staining ( E ). The MIB-1 as Ki-67 expression was 80% positive ( F ) Fig. 4 Immunohistochemistry for mismatch repair gene proteins revealed negative PMS2 ( A ) and positive MLH1 ( B ), MSH2 ( C ), and MSH6 staining ( D ) Fig. 5 Summary of the treatments. Five months after surgery, a CT scan revealed the presence of multiple liver, lung, and lymph node metastases and peritoneal dissemination. Chemotherapy with gemcitabine (GEM) plus nab-paclitaxel (nabPTX) was administered. Subsequently, pembrolizumab was administered as the second-line treatment, however, did not show a good response
| 4.035156
| 0.976074
|
sec[1]/p[0]
|
en
| 0.999998
|
37386324
|
https://doi.org/10.1186/s40792-023-01709-5
|
[
"tumor",
"staining",
"artery",
"pancreatic",
"magnification",
"scan",
"serum",
"antigen",
"imaging",
"that"
] |
[
{
"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": "KD38",
"title": "Meconium staining"
},
{
"code": "9A78.1",
"title": "Corneal pigmentations or deposits"
},
{
"code": "MD22",
"title": "Haemoptysis"
},
{
"code": "ME24.A4",
"title": "Melaena"
},
{
"code": "DA08.4",
"title": "Deposits on teeth"
}
] |
=== 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
[KD38] Meconium staining
Definition: Green or yellowish appearing amniotic fluid, indicating presence of meconium. The newborn’s skin, nail beds or the umbilical cord may be stained.
Also known as: Meconium staining | meconium amniotic fluid | meconium staining of amniotic fluid
Excludes: Neonatal aspiration of meconium | Meconium passage during delivery
[9A78.1] Corneal pigmentations or deposits
Also known as: Corneal pigmentations or deposits | Haematocornea | corneal blood staining | keratohaemia | Kayser-Fleischer ring
Includes: Haematocornea | Kayser-Fleischer ring | Krukenberg spindle
[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
[ME24.A4] Melaena
Definition: It is bloody stools that indicate bleeding from vascular system in the digestive tract. It is also described as black, tarry, and foul-smelling stools or red/maroon-coloured stools that contain degraded blood.
Also known as: Melaena | altered blood in stool | altered blood passed per rectum | tarry stools | black tarry stool
Excludes: occult blood in faeces
[DA08.4] Deposits on teeth
Definition: In dentistry, calculus or tartar is a form of hardened dental plaque.
Also known as: Deposits on teeth | Accretions on teeth | Extrinsic staining of teeth NOS | staining of teeth NOS | Betel deposits on teeth
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F92] Neoplasms of unknown behaviour of skin
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --EXCLUDES--> [?] Nonspecific mesenteric lymphadenitis",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system"
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 44-year-old Chinese male living in Yunnan province was admitted to the emergency department in our hospital on NaN Invalid Date with an intermittent high fever for two months. The patient had worked in Kenya for two years and he started fever after four months back from Kenya. He received empiric treatment with antibiotics at the local hospital for two months, however, fever persisted, while the number of blood platelets reduced to the critical value (<20 × 10 9 /L). Therefore, the patient came to our hospital for further treatment. He denied any medical history. He had experience of eating wild animals (including paguma larvata, pheasant, etc.) during his stay in Kenya. A physical examination at the time of admission revealed a high fever (39.8 °C), hepatosplenomegaly, scleral yellow staining. The patient was suffering from fatigue, progressive weightless >6 kg within two months. His white blood cell (WBC) count was 13.21 × 10 9 /L (83% neutrophils), red blood cell count (RBC) 2.83 × 10 12 /L, haemoglobin (Hb) level 83 g/L and platelet (PLT) count 1 × 10 9 /L. Albumin 17.8 g/L, total bilirubin 55.4 μmol/L, direct bilirubin 40.8 μmol/L. Aspartate and alanine aminotransferase levels were normal. Activated partial thromboplastin time (APTT) and prothrombin time (PT) were prolonged (42.6 seconds and 14.5 seconds, respectively). The serum procalcitonin (PCT) and C-reactive protein (CRP) were elevated (3.342 ng/mL and 71.89 mg/L, respectively). Serologic tests for syphilis, human immunodeficiency virus, hepatitis B and C, and T -spot test for tuberculosis were negative. A CT scan of chest and abdomen showed mild inflammation in the lower lobes of bilateral lungs, and the liver was slightly enlarged . The sputum culture showed no positive result. However, Wright-stained bone marrow aspirates revealed intracellular oval or spherical yeast-like cells, which was highly suggestive of H. capsulatum , with normal number and classification of megakaryocytes. Although the culturing with bone marrow sample was negative for fungal and bacteria in 5 days incubation, disseminated histoplasmosis was diagnosed based on clinical presentation and visible intracellular yeast-like cells in bone marrow smear. Amphotericin B (30 mg, Qd, i.e.) was administered against fungal infection, meanwhile, cryoprecipitation and platelet transfusion were given to improve the coagulation function. Nevertheless, after 7 days of treatment, the fever persisted, and blood tests showed pancytopenia, WBC 2.22 × 10 9 /L, Hb 63 g/L, PLT 4 × 10 9 /L. APTT and PT prolonged more to 48.6 seconds and 17.2 seconds, respectively. His serum ferritin and sCD25 were elevated to 2,545 μg/L and 35,854 pg/mL, respectively. Then, a second bone marrow puncture was performed, and a bone marrow examination revealed lots of histiocytes phagocytosing red blood cells, erythroblasts, and platelets along with many intrahistiocytic, and extracellular H. capsulatum which indicated HLH secondary to histoplasmosis. HLH was diagnosed. However, the culture of the bone marrow aspirate provided negative results after 16 days of incubation. We did a routine check by smear with a negative culture specimen. Interestingly, yeast-like cells and hyphae were seen in the smears . which were compatible with Histoplasma spp., then we inoculated the culture specimen on the Sabouraud Dextrose Agar (SDA), incubated at 28 °C and 37 °C, respectively, in 9 days later, it appeared cottony white colonies under culture condition at 28 °C and a yeast-like colony at 37 °C . Microscopic examination showed tuberculate macroconidia and the septated hyphae, and budding cells and pseudohyphae under microscopic . The isolate was identified using PCR by amplifying the ITS1–4 gene, and four sets of specific primers (ARF, H-antigen, OLE, M-antigen) as described previously , the sequences were blasted in NCBI ( https://www.ncbi.nlm.nih.gov/ ). The isolate was identified as H. capsulatum . The sequences were deposited in the GenBank under the accession number ON244035 (ITS), ON478356 (ARF), ON478359 (H-antigen), ON478358 (OLE), ON478357 (M-antigen), which had 99% identity with the Ajellomyces capsulatum isolate UAMH 7141. The patient completed the 4-week course of AMB (30 mg, Qd, i.v) and changed to oral itraconazole (200 mg, Bid), which led to the rapid disappearance of fever, with the normal blood test indicators. He was discharged with a prescription of itraconazole 200 mg twice daily for 12 months, and followed up for 1 year, no evidence of relapse was noted. Figure 1. A CT scan of chest and abdomen on the day of admission. A mild inflammation was seen in the lower lobes of bilateral lungs, and the liver was slightly enlarged. Figure 2. Histoplasma capsulatum (numerous, capsulated yeast cells) of phagocyte cells (arrow) in bone marrow smear (Wright’s staining, magnification 1,000×). Figure 3. (a, b) Yeast-like spores and hyphae (with an arrow, gram staining, magnification 1,000×) under microscopy with bone marrow cultured at 37 °C in 16 days. (c, d) Colonies grown at 28 °C and 37 °C with bone marrow bone cultured in 16 days; (c) White, short villous and filamentous colonies; (d) Yeast-like colonies. (e, f) Fungal morphology under microscopy by taking colonies, respectively; (e) A filamentous form with tuberculate macroconidia on the septate hyphae (lactic acid phenol cotton blue staining); (f) Yeast-like fungus, budding cells with pseudohyphae (gram staining).
| 4.027344
| 0.977539
|
sec[2]/sec[0]/p[0]
|
en
| 0.999996
|
PMC10976997
|
https://doi.org/10.1080/21501203.2023.2259934
|
[
"bone",
"marrow",
"yeast",
"cells",
"like",
"fever",
"blood",
"respectively",
"staining",
"culture"
] |
[
{
"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....
--CHILD--> [?] Soft tissue disorders
--- Walk 2 ---
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--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
--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
--CHILD--> [FB80.1] Skeletal fluorosis
--- Walk 6 ---
[FB80.Z] Disorder of bone density or structure, unspecified
--PARENT--> [FB80] Certain specified disorders of bone density or structure
--CHILD--> [FB80.0] Fibrous dysplasia of bone
Def: Fibrous dysplasia of bone is a congenital non-hereditary benign bone disease, where normal bone is replaced by a fibrous-like tissue with immature osteogenesis. Bone lesions are mono- or polyostotic a...
|
[
"[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--> [?] Soft tissue disorders",
"[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --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 --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 --CHILD--> [FB80.1] Skeletal fluorosis",
"[FB80.Z] Disorder of bone density or structure, unspecified\n --PARENT--> [FB80] Certain specified disorders of bone density or structure\n --CHILD--> [FB80.0] Fibrous dysplasia of bone\n Def: Fibrous dysplasia of bone is a congenital non-hereditary benign bone disease, where normal bone is replaced by a fibrous-like tissue with immature osteogenesis. Bone lesions are mono- or polyostotic a..."
] |
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
| |
ITP is present in 0.01-0.02% of women during pregnancy. The decreased platelet count is due to binding of autoantibodies directed against target antigens on platelets, specifically the glycoprotein IIb-IIIa complex or glycoprotein Ib. These antibodies serve as opsonins accelerating platelet clearance by phagocytic cells in the reticuloendothelial system . Management of a pregnant woman with ITP is based on the assessment of the risk of significant hemorrhage. The platelet count usually falls as pregnancy progresses with the greatest rate of decline occurring in the 3rd trimester . Frequent monitoring of platelet count is required to ensure a safe platelet count at the time of delivery. In our patient platelets remained normal throughout the pregnancy and the first episode of thrombocytopenia was at the time of admission. Severe preeclampsia was diagnosed as the patient had hypertension with epigastric pain (stretching of liver capsule) and headache (sign of cerebral edema) and urine albumin was +2 by dip stick test. Elevated liver enzymes and S. Bilirubin and raised LDH correspond to the diagnosis of HELLP syndrome. As a part of preanaesthetic evaluation strategic planning is essential for anticipating difficulties like hemorrhage in the respiratory tract, aspiration of gastric contents, uncontrolled hypertension, convulsion, and fetal hypoxia and controlling these problems promptly. ITP itself is not an indication for caesarean delivery or general anesthesia. Mode of delivery and anesthesia in a pregnant patient with ITP is based on obstetric indication with avoidance of procedures associated with increased hemorrhagic risk. Maternal anesthesia must be based on safety of the mother. The HELLP syndrome affects 10–20% of women with severe preeclampsia but 15–20% of women do not have antecedent hypertension or proteinuria and symptoms may be absent . However, since our patient was already symptomatic and signs of haemolysis were present (increased LDH) we decided to give her general anesthesia (GA). In addition to the usual precautions of GA in pregnancy there are special problems that increase the anesthetic risk associated with such concomitant conditions. These include edema of upper airway, severe hypertensive response to laryngoscopy, interaction of magnesium with muscle relaxants, and risk of haemorrhage. Preoperative medication, Sellicks manoeuvre, and rapid sequence induction were used to avoid Mendelson's syndrome. Another therapeutic dilemma was the issue of platelet transfusion. Patients with ITP are generally refractory to platelet transfusion because of platelet alloantibodies. Conventionally a platelet count of ≥50 × 10 9 /L should target transfusion count and unnecessary transfusion of platelet concentrates in the absence of haemostatic failure may stimulate more autoantibodies and worsen maternal thrombocytopenia . Low platelets in our patient were more likely due to HELLP and not ITP as she was in remission; however, we did not transfuse any platelets as her preoperative platelet count was 60 × 10 9 /L and there was no problem with haemostasis. Risk of hemorrhage in respiratory tract due to thrombocytopenia and compromised airway was avoided by treatment with smooth, rapid, and atraumatic intubation with the help of small endotracheal tube, adequate expertise, and better muscle relaxation with succinylcholine. Hypertensive response to laryngoscopy was attenuated with IV lignocaine. Intensive postpartum monitoring is necessary in women with HELLP because laboratory parameters frequently worsen 24–48 hours after delivery with peak rise in LDH and platelet nadir and platelet count begins to rise by 4th day postpartum as was the case in our patient where parameters started improving by day 3. ITP is characterized by a reduced platelet count and increased peripheral destruction of platelets and augmented platelet production was evidenced by increased circulating megathrombocytes and higher number of megakaryocytes in bone marrow. Preeclamptic individuals have similar antiplatelet antibody profiles. The disorder differs in that the neonatal platelet counts are not depressed in preeclampsia whereas in ITP neonatal thrombocytopenia results from placentally transmitted maternal antibody . Therefore platelet count of the neonate should be obtained at delivery to determine the need for immediate therapy. In neonates with thrombocytopenia platelet count is obtained daily because its nadir is frequently seen in 2–5 days after birth. A spontaneous rise of platelet count is usually seen by day 7. There was no evidence of neonatal thrombocytopenia in our patient. Another rare differential diagnosis to HELLP is TTP (thrombotic thrombocytopenic purpura). TTP represents a rare complication mainly in the second trimester and mimics HELLP syndrome in its early stage. Patients with HELLP syndrome completely recover following delivery. In contrast TTP does not usually improve dramatically following delivery or monotherapy with corticosteroids. Also, if LDH to AST ratio exceeds 25 : 1, especially in association with severe haematuria with failure of the platelet count and LDH to respond to therapy, a presumptive diagnosis of TTP can be considered and emergent plasma exchange (PEX) needs to be initiated . However, since the patient improved after caesarean section and LDH to AST ratio was low it further corresponded to a diagnosis of PIH with HELLP in a patient of ITP.
| 4.328125
| 0.703125
|
sec[2]/p[0]
|
en
| 0.999995
|
25548684
|
https://doi.org/10.1155/2014/139694
|
[
"platelet",
"count",
"hellp",
"delivery",
"thrombocytopenia",
"platelets",
"risk",
"women",
"pregnancy",
"anesthesia"
] |
[
{
"code": "3B62.Z",
"title": "Qualitative platelet defects, unspecified"
},
{
"code": "3B63.1Z",
"title": "Acquired thrombocytosis, unspecified"
},
{
"code": "3B64.Z",
"title": "Thrombocytopenia, unspecified"
},
{
"code": "BD5Y",
"title": "Other specified diseases of arteries or arterioles"
},
{
"code": "3B62.00",
"title": "Alpha-granule diseases"
},
{
"code": "4B0Z",
"title": "Immune system disorders involving white cell lineages, unspecified"
},
{
"code": "4B03.Z",
"title": "Eosinophilia, unspecified"
},
{
"code": "4B00.1Z",
"title": "Neutrophilia, unspecified"
},
{
"code": "JA24.2",
"title": "HELLP syndrome"
},
{
"code": "KA02.0",
"title": "Fetus or newborn affected by placenta praevia"
}
] |
=== ICD-11 CODES FOUND ===
[3B62.Z] Qualitative platelet defects, unspecified
Also known as: Qualitative platelet defects, unspecified | Qualitative platelet defects | Thrombocytopathy | platelet defect | platelet disorder
[3B63.1Z] Acquired thrombocytosis, unspecified
Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia
[3B64.Z] Thrombocytopenia, unspecified
Also known as: Thrombocytopenia, unspecified | Thrombocytopenia | low platelet count | low platelets | decreased platelets
[BD5Y] Other specified diseases of arteries or arterioles
Also known as: Other specified diseases of arteries or arterioles | Arterial or microvascular embolism classified by source | Cardiac embolism | heart embolism | Thrombotic cardiac embolism
[3B62.00] Alpha-granule diseases
Definition: A condition caused by determinants arising after birth, in the antenatal period. This condition is characterised by defects in the alpha granules in platelets leading to abnormalities in coagulation mechanisms. This condition may present with prolonged bleeding, epistaxis, menorrhagia, easy bruising, anaemia, fatigue or shortness of breath. Confirmation is by identification of platelet defects in a blood sample.
Also known as: Alpha-granule diseases | Quebec platelet disorder | Factor V Quebec | Gray platelet syndrome
[4B0Z] Immune system disorders involving white cell lineages, unspecified
Also known as: Immune system disorders involving white cell lineages, unspecified
[4B03.Z] Eosinophilia, unspecified
Also known as: Eosinophilia, unspecified | Eosinophilia | Disorders with increased eosinophil counts | Idiopathic hypereosinophilic syndrome
[4B00.1Z] Neutrophilia, unspecified
Also known as: Neutrophilia, unspecified | Neutrophilia | Disorders with increased neutrophil counts
[JA24.2] HELLP syndrome
Definition: Severe preeclampsia associated with haemolysis, elevated liver enzymes, or low platelets
Also known as: HELLP syndrome | HELLP - [haemolysis, elevated liver enzymes and low platelet] syndrome | haemolysis-elevated liver enzymes-low platelet count syndrome | syndrome of haemolysis, elevated liver enzymes and low platelet [HELLP] | Haemolysis - elevated liver enzymes - low platelets
[KA02.0] Fetus or newborn affected by placenta praevia
Definition: Placenta praevia exists when the placenta lies wholly or in part in the lower segment of the uterus. Diagnosis has evolved from the clinical I-IV grading system, and is determined by ultrasonic imaging techniques relating the leading edge of the placenta to the cervical os. Grade I is a low lying placenta, Grade II is a placenta that meets the edge of the cervical os, Grade III is a placenta that partially covers the os, and Grade IV is a placenta that completely covers the os.
Also known as: Fetus or newborn affected by placenta praevia | fetus or neonate affected by placenta praevia | Transient neonatal neutropaenia due to placental insufficiency, including maternal HELLP syndrome
=== GRAPH WALKS ===
--- Walk 1 ---
[3B62.Z] Qualitative platelet defects, unspecified
--PARENT--> [3B62] Qualitative platelet defects
Def: A disease caused by determinants arising after birth, during the antenatal period or genetically inherited factors. This disease is characterised by abnormalities in coagulation of the blood due to de...
--CHILD--> [3B62.2] Isolated thrombocytopenia
--- Walk 2 ---
[3B62.Z] Qualitative platelet defects, unspecified
--PARENT--> [3B62] Qualitative platelet defects
Def: A disease caused by determinants arising after birth, during the antenatal period or genetically inherited factors. This disease is characterised by abnormalities in coagulation of the blood due to de...
--CHILD--> [3B62.2] Isolated thrombocytopenia
--- Walk 3 ---
[3B63.1Z] Acquired thrombocytosis, unspecified
--PARENT--> [3B63.1] Acquired thrombocytosis
Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...
--PARENT--> [3B63] Thrombocytosis
Def: A disease caused by essential thrombocytosis or other myelo-proliferative disorders such as chronic myelogenous leukaemia, polycythaemia, myelofibrosis. This disease can also have secondary causes suc...
--- Walk 4 ---
[3B63.1Z] Acquired thrombocytosis, unspecified
--PARENT--> [3B63.1] Acquired thrombocytosis
Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...
--CHILD--> [3B63.1Y] Other specified acquired thrombocytosis
--- Walk 5 ---
[3B64.Z] Thrombocytopenia, unspecified
--PARENT--> [3B64] Thrombocytopenia
Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...
--CHILD--> [3B64.0] Congenital thrombocytopenia
Def: A disease caused by determinants arising during the antenatal period leading to low platelet count. This disease is characterised by decreased levels of platelets within the blood. This disease may pr...
--- Walk 6 ---
[3B64.Z] Thrombocytopenia, unspecified
--PARENT--> [3B64] Thrombocytopenia
Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...
--CHILD--> [3B64.1] Acquired thrombocytopenia
Def: A disease caused by determinants arising after birth, leading to low platelet count. This disease is characterised by low levels of platelets within the blood. This disease may present with increased ...
|
[
"[3B62.Z] Qualitative platelet defects, unspecified\n --PARENT--> [3B62] Qualitative platelet defects\n Def: A disease caused by determinants arising after birth, during the antenatal period or genetically inherited factors. This disease is characterised by abnormalities in coagulation of the blood due to de...\n --CHILD--> [3B62.2] Isolated thrombocytopenia",
"[3B62.Z] Qualitative platelet defects, unspecified\n --PARENT--> [3B62] Qualitative platelet defects\n Def: A disease caused by determinants arising after birth, during the antenatal period or genetically inherited factors. This disease is characterised by abnormalities in coagulation of the blood due to de...\n --CHILD--> [3B62.2] Isolated thrombocytopenia",
"[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --PARENT--> [3B63] Thrombocytosis\n Def: A disease caused by essential thrombocytosis or other myelo-proliferative disorders such as chronic myelogenous leukaemia, polycythaemia, myelofibrosis. This disease can also have secondary causes suc...",
"[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.1Y] Other specified acquired thrombocytosis",
"[3B64.Z] Thrombocytopenia, unspecified\n --PARENT--> [3B64] Thrombocytopenia\n Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...\n --CHILD--> [3B64.0] Congenital thrombocytopenia\n Def: A disease caused by determinants arising during the antenatal period leading to low platelet count. This disease is characterised by decreased levels of platelets within the blood. This disease may pr...",
"[3B64.Z] Thrombocytopenia, unspecified\n --PARENT--> [3B64] Thrombocytopenia\n Def: This disease is characterised by decreased levels of platelets within the blood. This disease may present with increased bruising or haemorrhaging. Confirmation is by identification of decreased plate...\n --CHILD--> [3B64.1] Acquired thrombocytopenia\n Def: A disease caused by determinants arising after birth, leading to low platelet count. This disease is characterised by low levels of platelets within the blood. This disease may present with increased ..."
] |
3B62.Z
|
Qualitative platelet defects, unspecified
|
[
{
"from_icd11": "3B62.Z",
"icd10_code": "D691",
"icd10_title": "Qualitative platelet defects"
},
{
"from_icd11": "3B62.Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3B62.Z",
"icd10_code": "D69",
"icd10_title": "Purpura and other hemorrhagic conditions"
},
{
"from_icd11": "3B63.1Z",
"icd10_code": "D473",
"icd10_title": "Essential (hemorrhagic) thrombocythemia"
},
{
"from_icd11": "3B64.Z",
"icd10_code": "D6942",
"icd10_title": "Congenital and hereditary thrombocytopenia purpura"
},
{
"from_icd11": "3B64.Z",
"icd10_code": "D6941",
"icd10_title": "Evans syndrome"
},
{
"from_icd11": "3B64.Z",
"icd10_code": "D6949",
"icd10_title": "Other primary thrombocytopenia"
},
{
"from_icd11": "3B64.Z",
"icd10_code": "D696",
"icd10_title": "Thrombocytopenia, unspecified"
},
{
"from_icd11": "3B64.Z",
"icd10_code": "D694",
"icd10_title": "Other primary thrombocytopenia"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72829",
"icd10_title": "Elevated white blood cell count, unspecified"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72819",
"icd10_title": "Decreased white blood cell count, unspecified"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72818",
"icd10_title": "Other decreased white blood cell count"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72828",
"icd10_title": "Other elevated white blood cell count"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72823",
"icd10_title": "Leukemoid reaction"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72821",
"icd10_title": "Monocytosis (symptomatic)"
}
] |
D691
|
Qualitative platelet defects
|
The patient was treated with oxygen support, low-dose norepinephrine, and high-dose furosemide infusion. The initial patient response was satisfactory, and she was transferred to the cardiology ward in stable clinical conditions. Nevertheless, soon the patient became refractory to diuretics and after 48 h she was again in severe respiratory distress, hypotensive, with a rapid increase of the lactate levels (12 mmol/L). An urgent admission to the Intensive Cardiac Care Unit was required. Non-invasive ventilation, inotropic, and vasopressor support were started. TTE showed a significant worsening of MR with a prominent coaptation gap (5 mm) between leaflets; LV systolic function was depressed (EF 30%, with diffuse hypokinesia; estimated anterograde stroke volume index 15 mL/mq; estimated cardiac index 1.05 L/m 2 ). RV function was still preserved and estimated systolic pulmonary arterial pressure was 60 mmHg. Laboratory findings showed a picture of multi-organ failure (see Supplementary material online , Table S1 ). The patient was refractory to the medical treatment and, following a heart team discussion, the decision for a temporary mechanical cardiac support with IMPELLA CP® (Abiomed) was established. IMPELLA CP® is a microaxial pump draining blood from LV and ejecting it into ascending aorta, therefore providing unloading of LV and support to cardiac output (up to 4.3 L/min). It can be set to 9 levels, from P1 to P9, corresponding to increasing rotational velocity of the turbine and, accordingly, increasing levels of anterograde flow and LV unloading. After the implantation, through right femoral artery, the patient had a prompt and dramatic improvement (blood pressure 110/60 mmHg, satisfactory urine output, and reduction of dyspnoea). TTE immediately after implantation revealed a significant reduction in MR entity that was still severe, but without an evident coaptation gap between leaflets. LV systolic function gradually improved, no worsening of AR for the interaction of the catheter with cusps was observed. Estimated systolic pulmonary arterial pressure was 30 mmHg. After weaning the patient from inotropic and vasopressor support, a transesophageal echocardiography (TEE) was performed, with evidence of severe degenerative AR with a wide central jet (vena contracta width 9 mm) in a tricuspid valve with normal systolic leaflets opening, marked cusps fibrosis, and nodular calcification of commissures. Aortic root and ascending aorta were not significantly dilated (respectively, 36 and 35 mm) and sino-tubular junction was preserved (26 mm). Functional moderate MR (biplane vena contracta 0.45 cm) was detected during LV assistance with Impella CP® at P6 flow level, which increased to severe (biplane vena contracta 0.95 cm) when preload was increased by reducing, for a very short time interval, LV unloading at flow-level P1, the lowest allowed by the device . Central jet originating from A2-P2 was evident; leaflets were fibrotic with normal length, preserved diastolic motion, and systolic apical tethering; anulus was dilated (antero-posterior diameter 36 mm, inter-commissural diameter 38 mm). The surgical risk was judged prohibitive (EUROSCORE 22.7%). Therefore, a total percutaneous strategy was planned. An attempt to wean the patient from Impella assistance failed due to haemodynamic and clinical destabilization; therefore, we decided to treat mitral valve for first, keeping Impella on site during the procedure. The patient was judged suitable for transcatheter edge-to-edge repair (TEER) with MitraClip® (Abbot) system and G4 XTW clip was chosen due to favourable anatomical features (posterior leaflet length was 12 mm, planimetric mitral valve area was 4.5 cm 2 , anterograde pressure gradient 2 mmHg, trans-septal puncture height was 46 mm). Consequently, one clip was implanted between A2 and P2 . Residual regurgitation was trivial and anterograde transvalvular mean pressure gradient was 5 mmHg. Impella CP was removed in the following hours. The patient remained haemodynamically stable and asymptomatic at rest. Nevertheless, AR, as expected, remained severe (see Supplementary material online , Video S5 ). Therefore, a cardiac computed tomography (CT) scan, in order to plan transcatheter aortic valve implantation (TAVI), was performed: aortic annulus area was 469 mm 2 , cusps were not calcified. Coronary CT evaluation did not show significant atherosclerotic stenosis. Subsequently, through right arterial femoral access, an Edwards Sapien 3, 26 mm bioprosthesis, was implanted in aortic position. Considering the absence of calcification on aortic cusps, a slight over-inflation of the balloon (2 mL) compared with the recommended value was performed to promote anchoring of the prosthesis. Final procedural aortography showed correct position of the prosthesis and absence of significant residual regurgitation (see Supplementary material online , Video S6 ), haemodynamic parameters remained stable and an increase in diastolic blood pressure (from 45 to 70 mmHg) was observed after prosthesis implantation. Patient remained stable in the following days. Echocardiogram showed normal trans-prosthetic gradients (mean gradient of 9 mmHg), the absence of para-valvular leaks, improvement of LV systolic function (EF 60%) while residual MR remained mild . Clinical conditions gradually improved and, after 1 week, the patient was transferred to a cardiologic rehabilitation centre.
| 4.058594
| 0.965332
|
sec[2]/p[3]
|
en
| 0.999996
|
PMC12032388
|
https://doi.org/10.1093/ehjcr/ytaf185
|
[
"systolic",
"mmhg",
"pressure",
"impella",
"support",
"cardiac",
"aortic",
"remained",
"leaflets",
"function"
] |
[
{
"code": "BA00.2",
"title": "Isolated systolic hypertension"
},
{
"code": "BC60",
"title": "Atrial premature depolarization"
},
{
"code": "BB62.Z",
"title": "Mitral valve prolapse, unspecified"
},
{
"code": "BC70",
"title": "Ventricular premature depolarization"
},
{
"code": "BA00.0",
"title": "Combined diastolic and systolic hypertension"
},
{
"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 ===
[BA00.2] Isolated systolic hypertension
Also known as: Isolated systolic hypertension | systolic hypertension | systolic HTN - [hypertension]
[BC60] Atrial premature depolarization
Definition: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat
Also known as: Atrial premature depolarization | atrial extrasystoles | ectopic atrial beats | premature atrial contraction | premature atrial beats
[BB62.Z] Mitral valve prolapse, unspecified
Also known as: Mitral valve prolapse, unspecified | Mitral valve prolapse | systolic click-murmur syndrome | ballooning mitral valve | Barlow syndrome
[BC70] Ventricular premature depolarization
Definition: Ventricular depolarization occurring earlier than the expected ventricular depolarization initiated by the sinoatrial node or another supraventricular pacemaker.
Also known as: Ventricular premature depolarization | premature ventricular complex | premature ventricular contraction | premature ventricular systole | ventricular ectopic beats
[BA00.0] Combined diastolic and systolic hypertension
Also known as: Combined diastolic and systolic hypertension | diastolic and systolic hypertension | diastolic hypertension with systolic hypertension | diastolic and systolic HTN - [hypertension]
[EH90.Z] Pressure ulcer of unspecified grade
Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer
[MB23.L] Pressured speech
Definition: Speech in which the person feels undue pressure to get the words out. The person’s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening.
Also known as: Pressured speech
Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders
[MD30.Z] Chest pain, unspecified
Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure
[CB22.Y] Other specified diseases of mediastinum, not elsewhere classified
Also known as: Other specified diseases of mediastinum, not elsewhere classified | Hernia of mediastinum | mediastinal hernia | mediastinal herniation | Infectious mediastinitis
[BA2Z] Hypotension, unspecified
Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure
=== GRAPH WALKS ===
--- Walk 1 ---
[BA00.2] Isolated systolic hypertension
--PARENT--> [BA00] Essential hypertension
Def: Essential (primary) hypertension, accounting for 95% of all cases of hypertension, is defined as high blood pressure for which a secondary cause cannot be found....
--EXCLUDES--> [?] Background retinopathy and retinal vascular changes
Def: Background retinopathy is the earliest visible change to the retina in diabetes, characterised by some retinal vascular changes, e.g. the capillaries in the retina may become blocked, they may bulge s...
--- Walk 2 ---
[BA00.2] Isolated systolic hypertension
--PARENT--> [BA00] Essential hypertension
Def: Essential (primary) hypertension, accounting for 95% of all cases of hypertension, is defined as high blood pressure for which a secondary cause cannot be found....
--EXCLUDES--> [?] Background retinopathy and retinal vascular changes
Def: Background retinopathy is the earliest visible change to the retina in diabetes, characterised by some retinal vascular changes, e.g. the capillaries in the retina may become blocked, they may bulge s...
--- Walk 3 ---
[BC60] Atrial premature depolarization
Def: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat...
--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--> [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...
--- Walk 4 ---
[BC60] Atrial premature depolarization
Def: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat...
--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--> [BC60] Atrial premature depolarization
Def: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat...
--- Walk 5 ---
[BB62.Z] Mitral valve prolapse, unspecified
--PARENT--> [BB62] Mitral valve prolapse
--CHILD--> [BB62.Y] Other specified nonrheumatic mitral valve prolapse
--- Walk 6 ---
[BB62.Z] Mitral valve prolapse, unspecified
--PARENT--> [BB62] Mitral valve prolapse
--EXCLUDES--> [?] Marfan syndrome
Def: Marfan syndrome is a systemic disease of connective tissue characterised by a variable combination of cardiovascular, musculo-skeletal, ophthalmic and pulmonary manifestations. Cardiovascular involvem...
|
[
"[BA00.2] Isolated systolic hypertension\n --PARENT--> [BA00] Essential hypertension\n Def: Essential (primary) hypertension, accounting for 95% of all cases of hypertension, is defined as high blood pressure for which a secondary cause cannot be found....\n --EXCLUDES--> [?] Background retinopathy and retinal vascular changes\n Def: Background retinopathy is the earliest visible change to the retina in diabetes, characterised by some retinal vascular changes, e.g. the capillaries in the retina may become blocked, they may bulge s...",
"[BA00.2] Isolated systolic hypertension\n --PARENT--> [BA00] Essential hypertension\n Def: Essential (primary) hypertension, accounting for 95% of all cases of hypertension, is defined as high blood pressure for which a secondary cause cannot be found....\n --EXCLUDES--> [?] Background retinopathy and retinal vascular changes\n Def: Background retinopathy is the earliest visible change to the retina in diabetes, characterised by some retinal vascular changes, e.g. the capillaries in the retina may become blocked, they may bulge s...",
"[BC60] Atrial premature depolarization\n Def: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat...\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--> [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...",
"[BC60] Atrial premature depolarization\n Def: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat...\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--> [BC60] Atrial premature depolarization\n Def: Cardiac electrical depolarization arising from the atria, occurring earlier than the expected sinus beat...",
"[BB62.Z] Mitral valve prolapse, unspecified\n --PARENT--> [BB62] Mitral valve prolapse\n --CHILD--> [BB62.Y] Other specified nonrheumatic mitral valve prolapse",
"[BB62.Z] Mitral valve prolapse, unspecified\n --PARENT--> [BB62] Mitral valve prolapse\n --EXCLUDES--> [?] Marfan syndrome\n Def: Marfan syndrome is a systemic disease of connective tissue characterised by a variable combination of cardiovascular, musculo-skeletal, ophthalmic and pulmonary manifestations. Cardiovascular involvem..."
] |
BA00.2
|
Isolated systolic hypertension
|
[
{
"from_icd11": "BC60",
"icd10_code": "I491",
"icd10_title": "Atrial premature depolarization"
},
{
"from_icd11": "BC60",
"icd10_code": "I49",
"icd10_title": "Other cardiac arrhythmias"
},
{
"from_icd11": "BB62.Z",
"icd10_code": "I341",
"icd10_title": "Nonrheumatic mitral (valve) prolapse"
},
{
"from_icd11": "BC70",
"icd10_code": "I493",
"icd10_title": "Ventricular premature depolarization"
},
{
"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"
}
] |
I491
|
Atrial premature depolarization
|
Table 3 Example GPT-4o and Claude-3 response to a diagnostic uncertainty question Question GPT-4o Response Claude-3 Response You are a family doctor working in a rural northern community of 3000 people. A 56-year-old female comes in today complaining of right neck pain extending into her right shoulder area. She is right hand dominant. Her symptoms started gradually over a year ago but have become more bothersome. She is now waking from sleep with neck discomfort and intermittent right arm tingling. The patient smokes approximately half a pack of cigarettes per day and drinks a bottle of beer every night with dinner. She has been struggling with a diet program for the past 5 years and over the last year, her BMI has increased from 34 to 36. On exam of the neck, she guards against pain but is able to flex her neck to half range and extend to one quarter range. Bilateral side flexion and rotation is reduced to half-range with ipsilateral stretching. Passive range of motion is full and pain free. Postural exam reveals a lordotic cervical spine and a kyphotic thoracic spine (she is slumping). Trigger points are positive over the affected area but not in the lower limbs. Neurologic exam is normal. What investigations should you consider? A. ESR, C-reactive protein, Rheumatoid Factor, ANA B. nerve conduction testing C. no immediate investigations required D. shoulder MRI CORRECT ANSWER : C. no immediate investigations required B. nerve conduction testing For the 56-year-old female patient presenting with chronic right neck pain extending into her shoulder, along with intermittent tingling in her right arm, the following investigations should be considered: Option B: Nerve conduction testing - This test would be beneficial given the patient’s symptoms of tingling, which suggest a possible nerve involvement. Nerve conduction studies can help identify whether there is nerve damage or nerve dysfunction, which could be contributing to her symptoms. Option D: Shoulder MRI - An MRI of the shoulder might also be warranted due to the location of the pain and the duration of her symptoms. MRI can provide detailed images of the soft tissues, bones, and nerves in the shoulder area, helping to identify any structural causes of her pain, such as rotator cuff tears, bursitis, or other abnormalities that could be exacerbating her neck pain. Option A (ESR, C-reactive protein, Rheumatoid Factor, ANA) - These tests are generally used to investigate inflammatory or autoimmune conditions. While these could be considered if there was a suspicion of an inflammatory or autoimmune process, the clinical presentation described does not strongly suggest these as the primary cause of her symptoms. Option C (no immediate investigations required) - Given the chronicity and severity of the patient’s symptoms, particularly with the impact on her sleep and daily function, pursuing diagnostic investigations to identify the underlying cause is advisable rather than delaying further evaluation. Therefore, based on the clinical scenario, nerve conduction testing (B) would be the most relevant initial investigations to consider. This would help in assessing the possible neurological contributions to her symptoms, guiding further management. C. no immediate investigations required Based on the clinical presentation and examination findings, the most appropriate investigations to consider for this patient would be C. No immediate investigations required. The patient’s history and physical examination findings are consistent with a diagnosis of cervical spondylosis or cervical osteoarthritis, which is a degenerative condition of the cervical spine that commonly occurs with aging. The gradual onset of neck pain radiating to the shoulder, intermittent arm tingling, and reduced range of motion with ipsilateral stretching are typical features of cervical spondylosis. The presence of trigger points in the affected area and the postural findings of a lordotic cervical spine and kyphotic thoracic spine (slumping posture) further support this diagnosis. In cases of uncomplicated cervical spondylosis, where the neurological examination is normal and there are no red flags (such as fever, significant trauma, or progressive neurological deficits), immediate investigations are generally not necessary. Option A, which includes inflammatory markers (ESR, CRP) and autoantibody tests (Rheumatoid Factor, ANA), would be more appropriate if there were concerns for an inflammatory or autoimmune condition, such as rheumatoid arthritis or other inflammatory arthropathies. Option B, nerve conduction testing, would be valuable if there were significant neurological deficits or suspicion of a peripheral neuropathy, but the normal neurological examination in this case does not warrant such testing at this stage. Option D, a shoulder MRI, might be considered if there were concerns for a rotator cuff or other shoulder joint pathology, but the clinical presentation and examination findings predominantly point towards a cervical spine etiology. In this case, the initial management would involve conservative measures, such as analgesics, lifestyle modifications (smoking cessation, weight loss, and postural correction), and physical therapy or exercise recommendations. If symptoms persist or worsen, or if neurological deficits develop, further investigations, such as cervical spine X-rays or an MRI, may be warranted at a later stage.
| 3.951172
| 0.884277
|
sec[2]/p[5]
|
en
| 0.999996
|
39394122
|
https://doi.org/10.1186/s12909-024-06115-5
|
[
"investigations",
"shoulder",
"cervical",
"nerve",
"pain",
"neck",
"spine",
"option",
"this",
"conduction"
] |
[
{
"code": "QA04.Z",
"title": "Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified"
},
{
"code": "QA0Z",
"title": "Examination or investigation, unspecified"
},
{
"code": "QA00.A",
"title": "Skin or other sensitisation tests"
},
{
"code": "QA0Y",
"title": "Other examination or investigation"
},
{
"code": "QA05",
"title": "Person consulting for explanation of investigation findings"
},
{
"code": "ME86.D0",
"title": "Shoulder syndrome"
},
{
"code": "FB53.Z",
"title": "Shoulder lesions, unspecified"
},
{
"code": "NC10.Y&XA2ND5",
"title": "Haematoma of shoulder"
},
{
"code": "FB53.0",
"title": "Adhesive capsulitis of shoulder"
},
{
"code": "JB06.0",
"title": "Obstructed labour due to shoulder dystocia"
}
] |
=== ICD-11 CODES FOUND ===
[QA04.Z] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified
Also known as: Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified | Examination or observation for reasons other than suspected diseases or conditions or administrative purposes | observation NOS | observation without need for further medical care | investigation NOS
[QA0Z] Examination or investigation, unspecified
Also known as: Examination or investigation, unspecified | special investigations and examinations
[QA00.A] Skin or other sensitisation tests
Also known as: Skin or other sensitisation tests | diagnostic skin or sensitisation tests | general skin examination | Skin tests for bacterial disease | Skin tests for hypersensitivity
[QA0Y] Other examination or investigation
Also known as: Other examination or investigation | Routine examination of specific system
[QA05] Person consulting for explanation of investigation findings
Also known as: Person consulting for explanation of investigation findings | explanation of investigation finding
[ME86.D0] Shoulder syndrome
Definition: A shoulder syndrome is defined by shoulder pain with one or more of the following problems: limitations of movement, local tenderness, crepitus or periarticular calcification in imaging.
Also known as: Shoulder syndrome
Excludes: Arthropathies | Shoulder lesions | Chronic primary musculoskeletal pain
[FB53.Z] Shoulder lesions, unspecified
Also known as: Shoulder lesions, unspecified | Shoulder lesions | enthesopathy of shoulder region | lesion of shoulder
[FB53.0] Adhesive capsulitis of shoulder
Definition: This is a condition characterised by spontaneous onset of shoulder pain accompanied by progressive loss of active and passive ranges of motion.
Also known as: Adhesive capsulitis of shoulder | Frozen shoulder | pericapsulitis of shoulder | duplay bursitis | adhesive shoulder peritendinitis
Includes: Frozen shoulder
[JB06.0] Obstructed labour due to shoulder dystocia
Also known as: Obstructed labour due to shoulder dystocia | obstructed delivery due to impacted shoulder | impacted shoulder causing obstructed labour | labour obstructed by impacted shoulders | labour obstructed by shoulder dystocia or impaction
Includes: Impacted shoulders
=== GRAPH WALKS ===
--- Walk 1 ---
[QA04.Z] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified
--PARENT--> [QA04] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes
--CHILD--> [QA04.0] Blood-alcohol or blood-drug test
--- Walk 2 ---
[QA04.Z] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified
--PARENT--> [QA04] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes
--CHILD--> [QA04.0] Blood-alcohol or blood-drug test
--- Walk 3 ---
[QA0Z] Examination or investigation, unspecified
--PARENT--> [?] Contact with health services for purposes of examination or investigation
--CHILD--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out
Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...
--- Walk 4 ---
[QA0Z] Examination or investigation, unspecified
--PARENT--> [?] Contact with health services for purposes of examination or investigation
--EXCLUDES--> [?] Clinical findings in blood, blood-forming organs, or the immune system
--- Walk 5 ---
[QA00.A] Skin or other sensitisation tests
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--EXCLUDES--> [?] Examination or encounter for administrative purposes
--- Walk 6 ---
[QA00.A] Skin or other sensitisation tests
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--CHILD--> [QA00.2] Routine newborn health examination
Def: Health examination for infant under 29 days of age...
|
[
"[QA04.Z] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified\n --PARENT--> [QA04] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes\n --CHILD--> [QA04.0] Blood-alcohol or blood-drug test",
"[QA04.Z] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified\n --PARENT--> [QA04] Examination or observation for reasons other than suspected diseases or conditions or administrative purposes\n --CHILD--> [QA04.0] Blood-alcohol or blood-drug test",
"[QA0Z] Examination or investigation, unspecified\n --PARENT--> [?] Contact with health services for purposes of examination or investigation\n --CHILD--> [QA02] Medical observation or evaluation for suspected diseases or conditions, ruled out\n Def: Persons without signs or symptoms or a diagnosis when suspected of having an abnormal condition which requires study, but who, after examination and observation, show no need for further treatment or ...",
"[QA0Z] Examination or investigation, unspecified\n --PARENT--> [?] Contact with health services for purposes of examination or investigation\n --EXCLUDES--> [?] Clinical findings in blood, blood-forming organs, or the immune system",
"[QA00.A] Skin or other sensitisation tests\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --EXCLUDES--> [?] Examination or encounter for administrative purposes",
"[QA00.A] Skin or other sensitisation tests\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --CHILD--> [QA00.2] Routine newborn health examination\n Def: Health examination for infant under 29 days of age..."
] |
QA04.Z
|
Examination or observation for reasons other than suspected diseases or conditions or administrative purposes, unspecified
|
[
{
"from_icd11": "QA04.Z",
"icd10_code": "Z0471",
"icd10_title": "Encounter for examination and observation following alleged adult physical abuse"
},
{
"from_icd11": "QA04.Z",
"icd10_code": "Z0472",
"icd10_title": "Encounter for examination and observation following alleged child physical abuse"
},
{
"from_icd11": "QA04.Z",
"icd10_code": "Z0489",
"icd10_title": "Encounter for examination and observation for other specified reasons"
},
{
"from_icd11": "QA04.Z",
"icd10_code": "Z049",
"icd10_title": "Encounter for examination and observation for unspecified reason"
},
{
"from_icd11": "QA04.Z",
"icd10_code": "Z048",
"icd10_title": "Encounter for examination and observation for other specified reasons"
},
{
"from_icd11": "QA04.Z",
"icd10_code": "Z04",
"icd10_title": "Encounter for examination and observation for other reasons"
},
{
"from_icd11": "QA04.Z",
"icd10_code": "Z045",
"icd10_title": ""
},
{
"from_icd11": "QA0Z",
"icd10_code": "Z00-Z13",
"icd10_title": ""
},
{
"from_icd11": "QA00.A",
"icd10_code": "Z015",
"icd10_title": ""
},
{
"from_icd11": "QA05",
"icd10_code": "Z71",
"icd10_title": "Persons encountering health services for other counseling and medical advice, not elsewhere classified"
},
{
"from_icd11": "QA05",
"icd10_code": "Z712",
"icd10_title": "Person consulting for explanation of examination or test findings"
},
{
"from_icd11": "FB53.Z",
"icd10_code": "M7581",
"icd10_title": "Other shoulder lesions, right shoulder"
},
{
"from_icd11": "FB53.Z",
"icd10_code": "M7591",
"icd10_title": "Shoulder lesion, unspecified, right shoulder"
},
{
"from_icd11": "FB53.Z",
"icd10_code": "M7592",
"icd10_title": "Shoulder lesion, unspecified, left shoulder"
},
{
"from_icd11": "FB53.Z",
"icd10_code": "M7580",
"icd10_title": "Other shoulder lesions, unspecified shoulder"
}
] |
Z0471
|
Encounter for examination and observation following alleged adult physical abuse
|
The patient was placed in the supine position after tracheal intubation and general anesthesia. All of procedures were performed by one surgery team. MRI and CT scan were performed in bilateral hips. The surgical procedure included removing the necrotic lesions, preparation of the bone window, harvest of the iliac bone flap, graft of the iliac bone flap, and anastomosis of the vessels. A 12 cm incision was made along the line between iliac and patella at the starting point of 4 cm below the anterior superior iliac spine of the affected side . The skin and subcutaneous tissue were dissected, and the lateral femoral cutaneous nerve was exposed and protected. The ascending and transverse branches of the lateral circumflex femoral artery emerge were exposed through the intermuscular spaces space between tensor fasciae latae muscle and sartorius muscle and between the vastus lateralis muscle and rectus femoris muscle . After partial separation laterally, the distal end was cut and ligated, and the proximal end was clamped with a vascular clamp. Then, the hip joint capsule was dissected in the shape of a cross to expose the femoral neck and the anterior side of the femoral head. The bone window was designed on the femoral neck (about 3 cm × 1.2 cm) . Under direct vision, the necrotic lesions were removed with an osteotome and a grinding drill. The articular cartilage surface and the thin layer of subchondral bone were preserved. The femoral neck of the bone window was debrided and the partial capsule was removed . The required length, width, and thickness of the iliac bone flap were measured (typically 4 cm × 2 cm × 1.2 cm). According to the measurement data, the iliac bone flap based on deep circumflex iliac vessels was designed and cut out on the contralateral sides . The skin, subcutaneous tissue, external oblique aponeurosis, and obliquus internus abdominis were excised and deep circumflex iliac vessels were exposed in the deep obliquus internus abdominis. The deep circumflex iliac vessels were separated and dissected, and the branches along the way were treated with electrocoagulation or ligation to avoid bleeding. The lateral femoral cutaneous nerve, iliohypogastric nerve, and ilioinguinal nerve were then separated and protected. After the deep iliacus was separated, the inner plate of iliac bone as exposed. The iliac bone flap was cut at 2–3 cm lateral to the anterior superior iliac spine, and the outer layer of the iliac crest and iliac bone was preserved. An iliac bone flap of 4 cm × 2 cm × 1.2 cm was harvested; the communication branches of the deep circumflex iliac vessels and the iliac crest vessels were cut and ligated. Retrograde dissection was performed until the starting point of the deep circumflex vessel, and the deep circumflex iliac vessels were cut off after confirming that the blood supply of iliac bone was reliable . Part of the cancellous bone of the iliac bone was scraped for use. After complete hemostasis of the donor site wound was conducted, the negative pressure drainage was placed. After the reduction of the iliac crest, the drill hole of the Kirschner wire was sutured with the 2–0 absorbable line. The incision was closed layer by layer and subcutaneous suture was performed. The iliac bone flap was properly trimmed. After successful trial, the cancellous bone was implanted into the femoral head, and the iliac bone flap was inserted into the bone groove . Under the microscope, the deep circumflex iliac vessels were anastomosed with the transverse branch (or ascending branch) of the lateral circumflex femoral artery and their accompanying veins . After confirming that blood was well ventilated and there was no active bleeding in the wound, drainage was placed and the incision was closed layer by layer. Fig. 1 Surgical steps. a A 12 cm incision was made along the line between iliac and patella at the starting point of 4 cm below the anterior superior iliac spine of the affected side. b The ascending and transverse branches of the lateral circumflex femoral artery emerge were exposed through the intermuscular spaces space between tensor fasciae latae muscle and sartorius muscle and between the vastus lateralis muscle and rectus femoris muscle. c The bone window was designed on the femoral neck (about 3 cm × 1.2 cm). d Under direct vision, the necrotic lesions were removed with an osteotome and a grinding drill. The articular cartilage surface and the thin layer of subchondral bone were preserved. The femoral neck of the bone window was debrided and the partial capsule was removed. e The required length, width, and thickness of the iliac bone flap were measured (typically 4 cm × 2 cm × 1.2 cm). f An iliac bone flap of 4 cm × 2 cm × 1.2 cm was harvested, the ramus communicans of the deep circumflex iliac vessels and the iliac crest vessels were cut and ligated. Retrograde dissection was performed until the starting point of the deep circumflex vessel, and the deep circumflex iliac vessels were cut off after confirming that the blood supply of iliac bone was reliable. g The iliac bone flap was properly trimmed. After successful trial, the cancellous bone was implanted into the femoral head, and the iliac bone flap was inserted into the bone groove. h Under the microscope, the deep circumflex iliac vessels were anastomosed with the transverse branch (or ascending branch) of the lateral circumflex femoral artery and their accompanying veins
| 4.074219
| 0.860352
|
sec[1]/sec[1]/p[0]
|
en
| 0.999996
|
31779640
|
https://doi.org/10.1186/s13018-019-1440-2
|
[
"iliac",
"bone",
"circumflex",
"femoral",
"flap",
"vessels",
"muscle",
"layer",
"window",
"exposed"
] |
[
{
"code": "BD30.10&XA83D6",
"title": "Acute thromboembolic iliac artery occlusion"
},
{
"code": "BD30.11&XA83D6",
"title": "Acute thrombotic iliac artery occlusion"
},
{
"code": "NB90.6Y&XA83D6",
"title": "Iliac artery haematoma"
},
{
"code": "BD52.3",
"title": "Rupture of artery"
},
{
"code": "NB53.6",
"title": "Strain or sprain of sacroiliac joint"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "FB84.Z",
"title": "Osteomyelitis or osteitis, unspecified"
},
{
"code": "FB80.Z",
"title": "Disorder of bone density or structure, unspecified"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "FB86.1Z",
"title": "Bone hyperplasias, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[BD52.3] Rupture of artery
Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula
Excludes: traumatic rupture of artery - see injury of blood vessel by body region
[NB53.6] Strain or sprain of sacroiliac joint
Definition: Aberrant biomechanical functions of the joints between the ilia and the sacrum, which may be as a result of local disease, systemic disease, postural strain or trauma.
Also known as: Strain or sprain of sacroiliac joint | Innominate sprain of sacral junction | Innominate strain of sacral junction | Strain of sacroiliac joint | sacroiliac sprain
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS
[FB84.Z] Osteomyelitis or osteitis, unspecified
Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease
[FB80.Z] Disorder of bone density or structure, unspecified
Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[FB86.1Z] Bone hyperplasias, unspecified
Also known as: Bone hyperplasias, unspecified | Bone hyperplasias
=== GRAPH WALKS ===
--- Walk 1 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--CHILD--> [?] Injuries to the thorax
--- Walk 2 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--EXCLUDES--> [?] Pathological fracture
--- Walk 3 ---
[NB53.6] Strain or sprain of sacroiliac joint
Def: Aberrant biomechanical functions of the joints between the ilia and the sacrum, which may be as a result of local disease, systemic disease, postural strain or trauma....
--PARENT--> [NB53] Dislocation or strain or sprain of joints or ligaments of lumbar spine or pelvis
--EXCLUDES--> [?] Dislocation or strain or sprain of joint or ligaments of hip
Def: A collective term for muscle and ligament injuries of the tissues associated with, or displacement of the bones of, the hip....
--- Walk 4 ---
[NB53.6] Strain or sprain of sacroiliac joint
Def: Aberrant biomechanical functions of the joints between the ilia and the sacrum, which may be as a result of local disease, systemic disease, postural strain or trauma....
--PARENT--> [NB53] Dislocation or strain or sprain of joints or ligaments of lumbar spine or pelvis
--CHILD--> [NB53.1] Dislocation of lumbar vertebra
|
[
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --CHILD--> [?] Injuries to the thorax",
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Pathological fracture",
"[NB53.6] Strain or sprain of sacroiliac joint\n Def: Aberrant biomechanical functions of the joints between the ilia and the sacrum, which may be as a result of local disease, systemic disease, postural strain or trauma....\n --PARENT--> [NB53] Dislocation or strain or sprain of joints or ligaments of lumbar spine or pelvis\n --EXCLUDES--> [?] Dislocation or strain or sprain of joint or ligaments of hip\n Def: A collective term for muscle and ligament injuries of the tissues associated with, or displacement of the bones of, the hip....",
"[NB53.6] Strain or sprain of sacroiliac joint\n Def: Aberrant biomechanical functions of the joints between the ilia and the sacrum, which may be as a result of local disease, systemic disease, postural strain or trauma....\n --PARENT--> [NB53] Dislocation or strain or sprain of joints or ligaments of lumbar spine or pelvis\n --CHILD--> [NB53.1] Dislocation of lumbar vertebra"
] |
BD30.10&XA83D6
|
Acute thromboembolic iliac artery occlusion
|
[
{
"from_icd11": "BD52.3",
"icd10_code": "I772",
"icd10_title": "Rupture of artery"
},
{
"from_icd11": "NB53.6",
"icd10_code": "S336XXA",
"icd10_title": "Sprain of sacroiliac joint, initial encounter"
},
{
"from_icd11": "NB53.6",
"icd10_code": "S336",
"icd10_title": "Sprain of sacroiliac joint"
},
{
"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"
}
] |
I772
|
Rupture of artery
|
A 55-year-old Japanese female was hospitalized with right hypochondrial pain. Laboratory tests showed elevated hepatobiliary enzymes and C-reactive protein. Serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were 0.8 ng/ml and 3.2 U/ml, respectively. Enhanced computed tomography (eCT) imaging revealed a 49 × 47 mm mass at the neck of the gallbladder, with suspected invasion of the liver and right hepatic artery . Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated displacement of the upper bile duct. Intraductal ultrasonography (IDUS) showed irregular wall thickening and disappearance of the wall structure in bile ducts from the B4 branch to distal B2 and B3. Percutaneous transhepatic biliary biopsy revealed a poorly differentiated carcinoma . The patient was diagnosed with unresectable gallbladder cancer [GBC (T4N0M0 stage IVA)]. Cisplatin plus gemcitabine chemotherapy was initiated. After six courses of chemotherapy without severe adverse events, a CT examination showed that the mass in the neck of the gallbladder had shrunk to 30 mm, ERCP showed improvement of the hilar duct stenosis , and IDUS revealed localized wall thickening in the extra pancreatic ducts, starting at the branch of the left and right hepatic ducts. A biopsy of the bile duct mucosa showed no malignant cells in the branch of the left and right hepatic ducts, the left hepatic duct, or the intrapancreatic ducts . The patient was scheduled for conversion surgery. The right hepatic artery was in close proximity to the tumor and involvement was suspected; the left hepatic artery was distant from the tumor. In addition, segment 4a was included in the resection range for gallbladder bed resection. Right and segment 4a liver resection and extrahepatic bile duct resection was scheduled. The residual liver capacity was 40% according to the planned surgical procedure. The indocyanine green (ICG) 15-minute value was 4.6% and the plasma clearance rate of ICG (ICGK) was 0.162. The future liver remnant ICGK (ICGK-F) was 0.065, which met the standard hepatectomy range at our hospital, and the ICGK-F was > 0.05; thus, surgery was performed. We performed a right liver/S4a resection, extrahepatic duct resection, and cholangiojejunostomy. The surgical findings showed no retention of ascites, peritoneal dissemination, or liver metastases. After Kocher maneuver, #16 lymph node was not swelling and did not dissect. The # 13a lymph node was dissected from the posterior surface of the pancreatic head. The anterior surface of the hepatoduodenal ligament was dissected, and the # 8 lymph node was dissected. The common bile duct was dissected at the upper edge of the duodenum and the pancreatic stump was sutured. The stump of the common bile duct was examined by immediate frozen-section analysis, and no malignant cells were found. The right hepatic artery, which ran on the dorsal side of the bile duct, was fixed by the bile duct and could not be dissected. The right hepatic artery was ligated and dissected at the bifurcation. The #12b and 12p lymph nodes were dissected, and the right branch of the portal vein was ligated and dissected at the bifurcation of the left and right portal veins. After right and S4a liver dissection was performed, the left bile duct and jejunum were anastomosed. The histopathologic diagnosis showed that the tumor cells had shrunk to 2 × 1 mm, and that R0 resection of the T2aN0M0 stage II tumor was successful. Residual tumor cells were found in a small part of the gallbladder neck and gallbladder wall at the hilum of the liver. The perimeter of the tumor cells was highly fibrotic, obscuring the layered structure of the gallbladder wall, gallbladder bed, and extrahepatic bile duct. We reasoned that the change was due to the disappearance of tumor cells associated with chemotherapy. Most of the gallbladder wall was highly fibrotic, with no residual tumor cells. No tumor cells were found in the mucosal epithelium of the cystic duct and intrahepatic extrahepatic bile duct. A high degree of fibrosis was observed near the right hepatic artery in the hilar region, but no infiltration of tumor cells was observed. No exposure of tumor cells was observed at the left intrahepatic bile duct stump . Fig. 1 CT revealed a 49 × 47 mm mass at the neck of the gallbladder, with suspected infiltration of the liver and right hepatic artery. Fig. 2 Endoscopic retrograde cholangiopancreatography revealed displacement of the upper bile duct. Intraductal ultrasonography showed irregular wall thickening and disappearance of the wall structure in bile ducts from the B4 branch to distal B2 and B3. Percutaneous transhepatic biliary biopsy revealed a poorly differentiated carcinoma. Fig. 3 After six courses of chemotherapy, computed tomography examination showed that the mass in the neck of the gallbladder had shrunk to 3 cm, and endoscopic retrograde cholangiopancreatography showed improvement of hilar duct stenosis. Fig. 4 Intraductal ultrasonography revealed localized wall thickening in the extra-pancreatic ducts starting at the branch of the left and right hepatic ducts. Biopsy of bile duct mucosa found no malignant cells in the branch of the left and right hepatic ducts, the left hepatic duct, or the intrapancreatic ducts. Fig. 5 Histopathologic diagnosis found that the tumor cells had shrunk to 2 × 1 mm, and that R0 resection of the T2 (SS) N0M0 stage II tumor was successful.
| 3.998047
| 0.976074
|
sec[1]/p[0]
|
en
| 0.999997
|
35039070
|
https://doi.org/10.1186/s13256-021-03248-9
|
[
"duct",
"bile",
"hepatic",
"tumor",
"cells",
"gallbladder",
"ducts",
"liver",
"wall",
"resection"
] |
[
{
"code": "DC10.02",
"title": "Obstruction of bile duct"
},
{
"code": "DC10.00",
"title": "Obstruction of cystic duct"
},
{
"code": "DC13",
"title": "Cholangitis"
},
{
"code": "LB20.23",
"title": "Structural developmental anomalies of cystic duct"
},
{
"code": "DC10.2",
"title": "Fistula of gallbladder or bile duct"
},
{
"code": "LB20.2Y",
"title": "Other specified structural developmental anomalies of bile ducts"
},
{
"code": "ME24.35&XA6R80",
"title": "Perforation of bile duct"
},
{
"code": "DB9Z",
"title": "Diseases of liver, unspecified"
},
{
"code": "DB97.Z",
"title": "Inflammatory liver disease, unspecified"
},
{
"code": "DB99.7",
"title": "Hepatic failure without mention whether acute or chronic"
}
] |
=== ICD-11 CODES FOUND ===
[DC10.02] Obstruction of bile duct
Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis
Excludes: with cholelithiasis
[DC10.00] Obstruction of cystic duct
Also known as: Obstruction of cystic duct | cystic duct obstruction | cystic ductal obstruction | obstructed cystic duct | Acquired cystic duct atresia
[DC13] Cholangitis
Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS
Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis
[LB20.23] Structural developmental anomalies of cystic duct
Also known as: Structural developmental anomalies of cystic duct | congenital deformity of cystic duct | cystic duct anomaly | cystic duct deformity | cystic duct distortion
[DC10.2] Fistula of gallbladder or bile duct
Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.
Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula
[LB20.2Y] Other specified structural developmental anomalies of bile ducts
Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct
[DB9Z] Diseases of liver, unspecified
Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy
[DB97.Z] Inflammatory liver disease, unspecified
Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS
[DB99.7] Hepatic failure without mention whether acute or chronic
Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[DC10.02] Obstruction of bile duct
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--CHILD--> [?] Mirizzi syndrome
Def: This is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common bile duct (CBD) or common hepatic duct, resulting in o...
--- Walk 2 ---
[DC10.02] Obstruction of bile duct
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--CHILD--> [?] Calculus of gallbladder or cystic duct with acute cholecystitis
Def: Stones in gallbladder or cystic duct present with acute inflammation of the gall bladder wall typically follows the cystic duct obstruction by the stone....
--- Walk 3 ---
[DC10.00] Obstruction of cystic duct
--PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts
Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--- Walk 4 ---
[DC10.00] Obstruction of cystic duct
--PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts
Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--- Walk 5 ---
[DC13] Cholangitis
--EXCLUDES--> [?] Calculus of bile duct with cholangitis
Def: Stones in bile duct present with inflammation of bile duct....
--PARENT--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--- Walk 6 ---
[DC13] Cholangitis
--EXCLUDES--> [?] Calculus of bile duct with cholangitis
Def: Stones in bile duct present with inflammation of bile duct....
--CHILD--> [?] Calculus of bile duct with acute cholangitis
Def: Stones in bile duct present with acute inflammation of bile duct....
|
[
"[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Mirizzi syndrome\n Def: This is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common bile duct (CBD) or common hepatic duct, resulting in o...",
"[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Calculus of gallbladder or cystic duct with acute cholecystitis\n Def: Stones in gallbladder or cystic duct present with acute inflammation of the gall bladder wall typically follows the cystic duct obstruction by the stone....",
"[DC10.00] Obstruction of cystic duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...",
"[DC10.00] Obstruction of cystic duct\n --PARENT--> [DC10.0] Obstruction of gallbladder or bile ducts\n Def: This is obstruction in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...",
"[DC13] Cholangitis\n --EXCLUDES--> [?] Calculus of bile duct with cholangitis\n Def: Stones in bile duct present with inflammation of bile duct....\n --PARENT--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...",
"[DC13] Cholangitis\n --EXCLUDES--> [?] Calculus of bile duct with cholangitis\n Def: Stones in bile duct present with inflammation of bile duct....\n --CHILD--> [?] Calculus of bile duct with acute cholangitis\n Def: Stones in bile duct present with acute inflammation of bile duct...."
] |
DC10.02
|
Obstruction of bile duct
|
[
{
"from_icd11": "DC10.02",
"icd10_code": "K831",
"icd10_title": "Obstruction of bile duct"
},
{
"from_icd11": "DC13",
"icd10_code": "K8309",
"icd10_title": "Other cholangitis"
},
{
"from_icd11": "DC13",
"icd10_code": "K8301",
"icd10_title": "Primary sclerosing cholangitis"
},
{
"from_icd11": "DC13",
"icd10_code": "K830",
"icd10_title": "Cholangitis"
},
{
"from_icd11": "DC10.2",
"icd10_code": "K833",
"icd10_title": "Fistula of bile duct"
},
{
"from_icd11": "DC10.2",
"icd10_code": "K823",
"icd10_title": "Fistula of gallbladder"
},
{
"from_icd11": "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"
}
] |
K831
|
Obstruction of bile duct
|
The patient was the third child born to healthy unrelated Caucasian parents. The pregnancy was unremarkable with normal antenatal ultrasound scans, liquor volume, and fetal movements. Normal delivery at 38 weeks’ gestation followed induction of labour for fetal bradycardia. Birth weight was 3.97 kg and head circumference 36.5 cm (both 75th to 91st centile). He did not require any resuscitation but was noted to have a right-sided Erbs palsy, left-sided positional talipes and torticollis, which all resolved with physiotherapy. He had small medial epicanthic folds, asymmetric ears with a left extended crus helix and a small capillary haemangioma of the right thigh but otherwise his appearance was normal. He was floppy and struggled to breastfeed from birth, necessitating intermittent nasogastric feeds from 24 h of age. Although subsequently established on bottle-feeding, he fed extremely slowly and by 6 weeks his weight had dropped to the 0.4th centile. He slept for long periods, had poor tone and head control and a weak cry. His developmental milestones were globally delayed. At 10 weeks he was hospitalised for investigation of faltering growth. He was found to be in type 2 respiratory failure and was intubated and transferred to the paediatric intensive care unit where he received invasive ventilation and inotropes for 4 days. A sleep study revealed central hypoventilation with low baseline oxygen saturation (mean 93%) during quiet sleep (normal 95–100%), bradypnoea with a mean respiratory rate 16/min (normal for 6–9 weeks 27–49 breaths/min), a mixture of central and obstructive events during sleep (total Apnoea-Hypopnoea Index 3.3 events/h) and hypercapnia (>6.7 kPa/50 mmHg) during 20% of quiet sleep . He was therefore commenced on nocturnal BiPAP (Bilevel positive airway pressure ventilation). He had severe central hypotonia and head lag, right-sided ptosis, poor suck, and antigravity movements only. Knee jerks were brisk with extensor plantar responses and ankle clonus bilaterally. He passed his newborn hearing screen. He was noted to have roving eye movements, and ophthalmological assessment revealed structurally normal eyes with moderate hypermetropia, pale optic nerves and blonde fundi. Flash visual evoked potentials (VEPs) were small and suggestive of bilateral generalised visual pathway dysfunction. There was no evidence of facial weakness or tongue fasciculation. Echocardiogram, ECG, diaphragmatic ultrasound, and MRI brain were all unremarkable. The patient’s clinical features are summarised in Table 1 . Table 1 Phenotypic features of individuals reported with biallelic variants in P4HTM . Report Current Rahikkala et al. and Kaasinen et al. Maddirevula et al. Total (%) Family F1 F2 F3 F4 F5 F1 F2 F3 F4 Predicted P4HTM protein consequence [Nationality] p.(Gln190Leufs*9) /p.(Trp220*) [UK] c.1073G>A (hom) predicted in-frame del exon 6 [Finnish] p.(Gln96Profs*29) / p.(His161Pro) [North American] p.(Gln532*) (hom) [Turkish] p.(Val317Phefs*30) [Syrian] c.1073G>A (hom) predicted in-frame del exon 6 [Finnish] p.(Arg296_Arg358 delinsSer) (hom)—in-frame del exon 6 [Saudi] p.(Arg471Ser) (hom) [Qatar] p.(Val317Phefs*30) (hom) [Syrian] p.(Asn274Glufs*11) (hom) [Saudi] P1 P2 P3 P4 P5 P6 P7 P8 P9 P10 P11 P12 P13 P14 P15 P16 P17 P18 P19 P20 N = 21 Age (Age deceased) (7 months) (5 years) 18 years 13 years (7 months) (8 years) 3 years (7 months) 31 years 29 years 18 years 21 years 55 years (61 years) (8 years) 7 years ?11 years 4 years 2 years 3 years 1 year Sex M F M M M M M M M F M M F F F F F M M F M M:F 13:8 Hypotonia ++ + + + ++ ++ ++ + + + + + + + + + + + + + + 21/21 (100) Ambulant (NA) + + + (NA) − − (NA) + − − + + − − b + b + b + b − b − b − b 9/18 (50) b Language (NA) SS SS NV (NA) NV NV (NA) SS NV NV NV NV NV P/A − − P/A P/A P/A P/A NV 8/18 (44) ID or global delay GD ID ID ID GD ID ID ID ID ID ID ID ID ID GD ID ID ID GD GD GD 21/21 (100) Seizures − + − + + + + + − + + − + + − − − − − − − 10/21 (48) OSA − + + + (NR) − − − − − + + NR NR − − − − + − − 6/18 (33) Hypoventilation +(C) − +(C) +(C) + +(C) +(C) + − − − +(C) NR NR − − − − + + + 11/19 (58) Recurrent pneumonia + + + + (+) + + − − − − + + NR − + − − + + − 12/20 (60) Sleep behaviour abn − − − + − − − + + − − + − − NR NR NR NR NR NR NR 4/14 (29) Eye Refractive error/strabismus + + + + (NR) + + − + + + + + + + NR NR NR NR NR NR 13/14 (93) Abnormal eye movements + − − + + + − + + − − + − − + + − − + + + 12/21 (57) Pale fundi + − + a NR NR + − NR + + + + − − NR − − NR − − − 7/16 (44) Pale optic nerves + + − − NR − − NR − − − − − − NR − − NR − − − 2/17 (12) Thermoregulation abn − − − + − + + − − + − − − − − NR NR NR NR NR NR 4/15 (27) Abn muscle/RCE + + + NR NR + NR NR NR − NR NR NR + NR NR NR NR NR NR NR 5/6 (83) Other findings Mild fatty liver degeneration, hyperphagia Precocious adrenarche Cortical blindness Normal muscle histology. RCE-NR Left ocular dermoid Keratoconus Mild fatty liver degeneration, Atrophic cerebellum Small PDA Hypothyroid, spinal dural AV fistula Cortical blindness Abn abnormality, ( C ) confirmed central hypoventilation, F female, GD global developmental delay, ID intellectual disability, M male, NA not applicable, NR not reported, NV non-verbal, OSA obstructive sleep apnoea, P/A poor or absent speech, Pt patient, RCE respiratory chain enzymes, SS simple sentences. a temporal disc pallor. b using data from case descriptions due to discrepancies in Table 1 from Maddirevula et al. .
| 3.902344
| 0.981445
|
sec[2]/sec[0]/p[0]
|
en
| 0.999996
|
34285383
|
https://doi.org/10.1038/s41431-021-00932-8
|
[
"sleep",
"movements",
"small",
"head",
"sided",
"poor",
"respiratory",
"hypoventilation",
"pale",
"predicted"
] |
[
{
"code": "7B2Z",
"title": "Sleep-wake disorders, unspecified"
},
{
"code": "MG41",
"title": "Sleep disturbance, not elsewhere classified"
},
{
"code": "7A20.Z",
"title": "Narcolepsy, unspecified"
},
{
"code": "7B00.1",
"title": "Sleepwalking disorder"
},
{
"code": "7A26",
"title": "Insufficient sleep syndrome"
},
{
"code": "8A0Z",
"title": "Movement disorders, unspecified"
},
{
"code": "8A0Y",
"title": "Other specified movement disorders"
},
{
"code": "6B60.8Y",
"title": "Dissociative neurological symptom disorder, with other specified movement disturbance"
},
{
"code": "8A07",
"title": "Certain specified movement disorder"
},
{
"code": "8D43.4",
"title": "Movement disorders due to toxicity"
}
] |
=== ICD-11 CODES FOUND ===
[7B2Z] Sleep-wake disorders, unspecified
Also known as: Sleep-wake disorders, unspecified | sleep disorders
[MG41] Sleep disturbance, not elsewhere classified
Also known as: Sleep disturbance, not elsewhere classified | sleep disturbance, unspecified
Excludes: Sleep-wake disorders
[7A20.Z] Narcolepsy, unspecified
Also known as: Narcolepsy, unspecified | Narcolepsy | narcolepsy nos | narcoleptic syndrome | paroxysmal sleep
[7B00.1] Sleepwalking disorder
Definition: Sleepwalking disorder is characterised by ambulation and other complex behaviours during a partial arousal from deep sleep.
Also known as: Sleepwalking disorder | sleep walking | sleepwalking | somnambulism | sleep walking disorder
[7A26] Insufficient sleep syndrome
Definition: Insufficient sleep syndrome occurs when an individual persistently fails to obtain the amount of sleep required relative to their own physiological sleep requirements to maintain normal levels of alertness and wakefulness and is thus chronically sleep deprived. The curtailed sleep pattern is present most days for at least several months.
The person’s ability to initiate and maintain sleep is unimpaired. Sleep time is often markedly extended on weekend nights or during holidays compared to weekd
Also known as: Insufficient sleep syndrome | Behaviourally induced hypersomnia | nonorganic origin somnolence | primary hypersomnia | hypersomnia of nonorganic origin
Includes: Behaviourally induced hypersomnia
Excludes: Narcolepsy
[8A0Z] Movement disorders, unspecified
Also known as: Movement disorders, unspecified | extrapyramidal and movement disorders | abnormal movement NOS | disorder of basal ganglia | basal ganglia disease
[8A0Y] Other specified movement disorders
Also known as: Other specified movement disorders | Other movement disorders, not elsewhere classified | chorea NOS | Familial congenital mirror movements | Primary progressive freezing gait
[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
[8A07] Certain specified movement disorder
Definition: Neurologic motor disorders that present with slowness of movement (bradykinesia or hypokinesia) or abnormal involuntary movements (hyperkinesias) as a result of genetic, infectious, toxic, metabolic, inflammatory, or vascular abnormalities.
Also known as: Certain specified movement disorder
[8D43.4] Movement disorders due to toxicity
Definition: Movements of the body such as hyperkinesias, dyskinesias, myoclonus, chorea, tremor and tics produced by toxicity either by toxin or drug, e.g. toxicity by manganese, neuroleptic drugs, calcium channel blockers, gastrointestinal prokinetics, antiarrhythmics and antidepressants that may induce Parkinsonism.
Also known as: Movement disorders due to toxicity
=== GRAPH WALKS ===
--- Walk 1 ---
[7B2Z] Sleep-wake disorders, unspecified
--PARENT--> [07] Sleep-wake disorders
Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...
--CHILD--> [?] Insomnia disorders
Def: Insomnia disorders are characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for...
--- Walk 2 ---
[7B2Z] Sleep-wake disorders, unspecified
--PARENT--> [07] Sleep-wake disorders
Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...
--CHILD--> [?] Insomnia disorders
Def: Insomnia disorders are characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for...
--- Walk 3 ---
[MG41] Sleep disturbance, not elsewhere classified
--EXCLUDES--> [?] Sleep-wake disorders
Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...
--CHILD--> [?] Insomnia disorders
Def: Insomnia disorders are characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for...
--- Walk 4 ---
[MG41] Sleep disturbance, not elsewhere classified
--PARENT--> [?] General symptoms
--RELATED_TO--> [?] Symptom or complaint of a body part
--- Walk 5 ---
[7A20.Z] Narcolepsy, unspecified
--PARENT--> [7A20] Narcolepsy
Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...
--CHILD--> [7A20.0] Narcolepsy, Type 1
Def: Type 1 narcolepsy is a disorder of excessive sleepiness due to a deficiency of hypothalamic hypocretin (orexin) signaling. In addition to daily periods of irrepressible need to sleep or daytime lapses...
--- Walk 6 ---
[7A20.Z] Narcolepsy, unspecified
--PARENT--> [7A20] Narcolepsy
Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...
--CHILD--> [7A20.Z] Narcolepsy, unspecified
|
[
"[7B2Z] Sleep-wake disorders, unspecified\n --PARENT--> [07] Sleep-wake disorders\n Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...\n --CHILD--> [?] Insomnia disorders\n Def: Insomnia disorders are characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for...",
"[7B2Z] Sleep-wake disorders, unspecified\n --PARENT--> [07] Sleep-wake disorders\n Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...\n --CHILD--> [?] Insomnia disorders\n Def: Insomnia disorders are characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for...",
"[MG41] Sleep disturbance, not elsewhere classified\n --EXCLUDES--> [?] Sleep-wake disorders\n Def: Sleep-wake disorders are characterised by difficulty initiating or maintaining sleep (insomnia disorders), excessive sleepiness (hypersomnolence disorders), respiratory disturbance during sleep (sleep...\n --CHILD--> [?] Insomnia disorders\n Def: Insomnia disorders are characterised by the complaint of persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for...",
"[MG41] Sleep disturbance, not elsewhere classified\n --PARENT--> [?] General symptoms\n --RELATED_TO--> [?] Symptom or complaint of a body part",
"[7A20.Z] Narcolepsy, unspecified\n --PARENT--> [7A20] Narcolepsy\n Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...\n --CHILD--> [7A20.0] Narcolepsy, Type 1\n Def: Type 1 narcolepsy is a disorder of excessive sleepiness due to a deficiency of hypothalamic hypocretin (orexin) signaling. In addition to daily periods of irrepressible need to sleep or daytime lapses...",
"[7A20.Z] Narcolepsy, unspecified\n --PARENT--> [7A20] Narcolepsy\n Def: Narcolepsy is a disorder characterised by daily periods of irrepressible need to sleep or daytime lapses into sleep occurring for at least several months, accompanied by abnormal manifestations of REM...\n --CHILD--> [7A20.Z] Narcolepsy, unspecified"
] |
7B2Z
|
Sleep-wake disorders, unspecified
|
[
{
"from_icd11": "7B2Z",
"icd10_code": "G4753",
"icd10_title": "Recurrent isolated sleep paralysis"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4762",
"icd10_title": "Sleep related leg cramps"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4761",
"icd10_title": "Periodic limb movement disorder"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4752",
"icd10_title": "REM sleep behavior disorder"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4750",
"icd10_title": "Parasomnia, unspecified"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4763",
"icd10_title": "Sleep related bruxism"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4754",
"icd10_title": "Parasomnia in conditions classified elsewhere"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G4769",
"icd10_title": "Other sleep related movement disorders"
},
{
"from_icd11": "7B2Z",
"icd10_code": "F519",
"icd10_title": "Sleep disorder not due to a substance or known physiological condition, unspecified"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G478",
"icd10_title": "Other sleep disorders"
},
{
"from_icd11": "7B2Z",
"icd10_code": "G479",
"icd10_title": "Sleep disorder, unspecified"
},
{
"from_icd11": "7B2Z",
"icd10_code": "F518",
"icd10_title": "Other sleep disorders not due to a substance or known physiological condition"
},
{
"from_icd11": "7B2Z",
"icd10_code": "F51",
"icd10_title": "Sleep disorders not due to a substance or known physiological condition"
},
{
"from_icd11": "7B2Z",
"icd10_code": "F512",
"icd10_title": ""
},
{
"from_icd11": "7B2Z",
"icd10_code": "G47",
"icd10_title": "Sleep disorders"
}
] |
G4753
|
Recurrent isolated sleep paralysis
|
A term male newborn was delivered by emergency cesarean section to a 27-year-old primigravida with gestational diabetes. The mother had followed nutritional recommendations and had taken no medication during pregnancy. The newborn was large-for-gestational-age, had an umbilical arterial pH of 6.92 and an APGAR score of 1 at 1 min. After cardiorespiratory resuscitation, his APGAR scores were 8 and 10 at 5 and 10 min respectively. His blood tests revealed acidosis, hypoglycemia, severe multiorgan involvement and impaired coagulation, requiring whole body cooling, mechanical ventilation, empiric antibiotic treatment, analgesia, sedation, PN, glucose infusions and clotting factor replacement in the first week of life. Subsequently, the newborn’s clinical condition and laboratory findings improved, the whole body cooling and mechanical ventilation were stopped on day 4 and 7 respectively and full oral feeding was reached on day 14. Despite laboratory findings of multiorgan involvement returned to normal, ALT elevation and direct hyperbilirubinemia persisted beyond the age of 3 weeks (Table 1 ). Biliary atresia, congenital infections, α1-antitrypsin deficiency, thyroid dysfunction, cystic fibrosis and metabolic disorders were excluded. Genetic analysis of the main hepatobiliary transporters discovered a novel heterozygous missense variant in the ABCB11 gene . According to current ACMG guidelines the variant was classified as likely pathogenic . Furthermore, 2 heterozygous variants, both classified as variants of unknown significance were identified in the gene ATP8B1 encoding the biliary aminophospholipid transporter . Treatment with ursodeoxycholic acid (UDCA) was initiated on day 28. Due to persisting cholestasis, occasional increase of gamma-glutamyl transferase (GGT) and rising levels of liver transaminases (without an obvious reason) a diagnostic liver biopsy was performed at the age of 3.5 months. Liver histology showed giant cell transformation, lobular inflammation, bile retention inside the hepatocytes and bile canaliculi and mild portal fibrosis and ductal proliferation . These findings resembled histological presentation of PFIC2 . Specifically, identification of bile plugs within the hepatocytes and bile canaliculi suggested dysfunction of bile elimination mechanisms. Interestingly, immunohistochemical staining revealed almost completely abolished canalicular BSEP expression . No additional medication was initiated in our patient. His clinical course improved continuously. UDCA therapy was discontinued at the age of 6 months due to normalization of serum bilirubin levels. Serum liver enzymes returned to normal by the age of 14 months. Our patient showed normal physical development and had normal liver ultrasound findings as well as biochemical liver function tests during the follow-up controls performed on the regular basis till the age of 5 years. Since surrogate parameters of hepatocellular injury and cholestasis improved, we believe that BSEP loss was of transient nature and found it unethical to perform a second liver biopsy for the histochemical proof of recovery. Table 1 Evolution of biochemical parameters of liver injury Laboratory test 0–24 h 24–72 h 5 day 3 weeks 1.5 months 3 months 6 months 12 months 16 months 45 months ALT (U/L) 857 (< 67) 485 (< 67) 180 (< 67) 74 (< 67) 268 (< 59) 406 (< 59) 250 (< 45) 71 (< 45) 30 (< 45) 19 (< 54) AST (U/L) 2145 (< 77) 697 (< 77) 98 (< 77) 89 (< 77) 261 (< 57) 304 (< 57) 112 (< 43) 59 (< 43) 30 (< 43) 28 (< 43) LDH (U/L) 9082 (< 700) 4628 (< 700) 1583 (< 700) 391 (< 700) 301 (160–430) 306 (160–430) n.m. n.m. 257 (120–340) 257 (120–340) Bilirubin total (mg/dL) 2.5 (< 1.5) 4.8 (< 1.5) 3.38 (< 1.5) 8.08 (< 1.5) 11.07 (0.1–1.2) 5.8 (0.1–1.2) 0.46 (0.1–1.2) n.m. 0.17 (0.1–1.2) 0.35 (0.1–1.2) Bilirubin conj. (mg/dL) n.m. n.m. n.m. n.m. 8.87 (< 0.2) n.m. n.m. n.m. n.m. n.m. AP (U/L) 108 (< 310) 103 (< 310) n.m. 304 (< 310) 363 (< 380) n.m. n.m. n.m. 127 (< 320) 130 (155–370) GGT (U/L) 166 (< 216) 165 (< 216) 54 (< 216) 128 (< 216) 83 (< 162) 188 (< 162) 241 (< 76) 52 (< 76) 20 (< 38) 13 (< 38) Lactate (mmol/L) 13.8 (0.5–2.7) 6.0 (0.5–2.7) 1.4 (0.5–2.7) 0.9 (0.5–2.7) 0.5 (0.5–2.7) n.m. n.m. n.m. n.m. n.m. PT (%) 18 (70–120) 34 (70–120) 78 (70–120) 82 (70–120) n.m. 98 (70–120) 98 (70–120) n.m. n.m. n.m. For each parameter, the age-dependent reference ranges are presented in brackets ALT alanine aminotransferase, AST aspartate aminotransferase, AP alkaline phosphatase, GGT gamma-glutamyl transferase, LDH lactate dehydrogenase, n.m . not measured, PT prothrombin time Fig. 1 a. and b. Hepatocellular edema, multinucleated hepatocytes (arrows), accumulation of bile pigment inside the bile canaliculi and hepatocytes (black arrowheads) and mild portal infiltration of neutrophil and eosinophil granulocytes (white and grey arrowheads respectively) is presented. Original magnification: 60 x. pv: portal vein, cv: central vein. c. Immunohistochemical stainings for BSEP (BS transporter) and MRP2 (canalicular bilirubin and glutathione transporter) are shown in the control and patient’s liver specimens. As shown, BSEP-positive inclusions retained in the hepatocellular cytoplasm and no transporter was detected on the canalicular membrane. The internal control MPR2 shows preserved canalicular expression. Original magnification 100x. The specificity of immunohistochemical staining was confirmed by negative control (not shown)
| 4.152344
| 0.96875
|
sec[1]/p[0]
|
en
| 0.999996
|
32646411
|
https://doi.org/10.1186/s12887-020-02201-x
|
[
"liver",
"bile",
"transporter",
"hepatocytes",
"canalicular",
"bsep",
"bilirubin",
"newborn",
"respectively",
"laboratory"
] |
[
{
"code": "DB9Z",
"title": "Diseases of liver, unspecified"
},
{
"code": "DB97.Z",
"title": "Inflammatory liver disease, unspecified"
},
{
"code": "DB99.7",
"title": "Hepatic failure without mention whether acute or chronic"
},
{
"code": "LB20.0Y",
"title": "Other specified structural developmental anomalies of liver"
},
{
"code": "LB20.0Z",
"title": "Structural developmental anomalies of liver, unspecified"
},
{
"code": "DC10.2",
"title": "Fistula of gallbladder or bile duct"
},
{
"code": "DC10.02",
"title": "Obstruction of bile duct"
},
{
"code": "DC13",
"title": "Cholangitis"
},
{
"code": "LB20.2Y",
"title": "Other specified structural developmental anomalies of bile ducts"
},
{
"code": "ME24.35&XA6R80",
"title": "Perforation of bile duct"
}
] |
=== ICD-11 CODES FOUND ===
[DB9Z] Diseases of liver, unspecified
Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy
[DB97.Z] Inflammatory liver disease, unspecified
Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS
[DB99.7] Hepatic failure without mention whether acute or chronic
Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS
[LB20.0Y] Other specified structural developmental anomalies of liver
Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity
[LB20.0Z] Structural developmental anomalies of liver, unspecified
Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver
[DC10.2] Fistula of gallbladder or bile duct
Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.
Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula
[DC10.02] Obstruction of bile duct
Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis
Excludes: with cholelithiasis
[DC13] Cholangitis
Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS
Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis
[LB20.2Y] Other specified structural developmental anomalies of bile ducts
Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct
=== GRAPH WALKS ===
--- Walk 1 ---
[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
--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 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--> [DB97.0] Idiopathic granulomatous hepatitis
--- Walk 5 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--CHILD--> [DB99.0] Chronic liver disease
--- Walk 6 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--EXCLUDES--> [?] Fibropolycystic liver disease
|
[
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --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 --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....",
"[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--> [DB97.0] Idiopathic granulomatous hepatitis",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.0] Chronic liver disease",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --EXCLUDES--> [?] Fibropolycystic liver disease"
] |
DB9Z
|
Diseases of liver, unspecified
|
[
{
"from_icd11": "DB9Z",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7689",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K769",
"icd10_title": "Liver disease, unspecified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K77",
"icd10_title": "Liver disorders in diseases classified elsewhere"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K762",
"icd10_title": "Central hemorrhagic necrosis of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K70-K77",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K778",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K72",
"icd10_title": "Hepatic failure, not elsewhere classified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K76",
"icd10_title": "Other diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K768",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7581",
"icd10_title": "Nonalcoholic steatohepatitis (NASH)"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7589",
"icd10_title": "Other specified inflammatory liver diseases"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K759",
"icd10_title": "Inflammatory liver disease, unspecified"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K752",
"icd10_title": "Nonspecific reactive hepatitis"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K75",
"icd10_title": "Other inflammatory liver diseases"
}
] |
K7681
|
Hepatopulmonary syndrome
|
A 55-year-old Japanese woman had developed right-lateral chest and back pain 2 months prior to admission to our hospital. Thirteen years previously, she had undergone concurrent bilateral salpingo-oophorectomy and total hysterectomy for right ovarian tumor in other institution. She had no past history of other neoplasms. Physical examination revealed deep-tendon hyperreflexia in the lower extremities but no muscle weakness. Blood tests were unremarkable apart from a high serum concentration of cancer antigen 125 (134 U/mL; cutoff value, 35 U/mL). On fluorodeoxyglucose (FDG) positron emission tomography the maximum standardized uptake value (SUVmax) was 6.6 in the right paraspinal region at the level of Th12 and 8.8 in the right thyroid lobe; however, fine-needle aspiration cytology of the latter yielded no evidence of malignancy. CT scan and magnetic resonance imaging (MRI) revealed an irregular mass in the right arch of Th12 vertebral bone that protruded into the spinal canal through the intervertebral foramen and was infiltrating surrounding soft tissue, the whole mass being of 35 × 78 × 36 mm . No primary tumor was detected in other organs or the abdominal or pleural cavities. Pathological examination of a CT-guided needle biopsy of the paraspinal lesion demonstrated papillary proliferation of epithelial cells with blunt nuclear atypia against a fibrotic background with psammomatous calcification . Immunohistochemically, the neoplastic cells were positive for paired box 8 (PAX8) (Roche Diagnostics; Basel, Switzerland), estrogen receptor (ER) (Roche Diagnostics), and Wilms’ tumor 1 (WT1) (Roche Diagnostics), but negative for thyroglobulin (Nichirei; Tokyo, Japan) , thyroid transcription factor 1 (TTF1) (Roche Diagnostics), progesterone receptor (Roche Diagnostics), S100 protein (Roche Diagnostics), and calretinin (Roche Diagnostics). Staining for P53 (Roche Diagnostics) showed a non-mutational “wild type” pattern . Because the lesion was suspected of being a metastatic neoplasm from the previous ovarian tumor, we obtained the relevant clinicopathologic and operative records and found that our patient had had a 13- × 11- × 9-cm cystic tumor that did not involve the ovarian surface . Peritoneal cytology was negative; however, the tumor had been ruptured intraoperatively. Lymph-node biopsy was not performed during the original surgery. The six slides available for microscopic review in retrospect, which included all the 6 sections (1 on each slide) submitted for the previous diagnosis of the primary tumor, showed cuboidal to columnar epithelium with minimal cytologic atypia proliferating in hierarchical branches with no invasive features, micropapillary components, or peritoneal implants , the diagnosis being conventional Stage IC1 SBT/APST according to the current World Health Organization (WHO) and International Federation of Gynecology and Obstetrics 2014 classifications. All the above-listed immunochemistry markers were identical in the previous ovarian tumor and the present paraspinal neoplasm, except for Ki-67 (Agilent Technologies; Santa Clara, CA, USA), which had labeling indices of 1 and 5%, respectively. It was therefore concluded that the paraspinal lesion was a bone metastasis of transformed LGSC originating from the previous SBT/APST in the right ovary. The patient underwent radiotherapy (30 Gray in 10 fractions) for the paraspinal lesion, which relieved her pain, followed by chemotherapy treatment with paclitaxel and carboplatin plus bevacizumab. She remains alive with right-sided pleural effusion and suspected metastases in the Th3 and Th4 vertebrae 168 months after the initial surgery. Fig. 1 Imaging of the paraspinal lesion. a Positron emission tomography-CT fusion image demonstrating high fluorodeoxyglucose uptake (SUVmax 6.6). b and c Axial CT image showing a mixed osteosclerotic and osteolytic mass in the right arch of the Th12 vertebra (circled) on soft tissue ( b ) and bone ( c ) windows, protruding into the spinal canal (arrow heads). d Coronal reconstruction CT image revealing a bone metastasis infiltrating into surrounding soft tissue with peritoneal penetration through the diaphragm. e T2-weighted MRI image showing slightly high signal intensity in the same location (circled) Fig. 2 Photomicrographs of CT-guided needle biopsy of paraspinal neoplasm. a Small uniform columnar or round cells can be seen forming confluent papillae associated with psammoma bodies against a fibrous background (hematoxylin and eosin [HE] stain, × 200). b Neoplastic cells positive for PAX8 (immunohistochemical [IHC] stain, × 200). c Positive for ER (IHC, × 200). d Positive for WT1 (IHC, × 200). e Negative for thyroglobulin (IHC, × 200). f P53 wild-type expression (IHC, × 200) Fig. 3 Original tumor in the right ovary a Photograph of operative specimen showing a soft tan, friable, intracystic and exophytic papillary tumor with occasional confluent excrescences. b Photograph showing of operative specimen showing delicate papillae with irregular contours but no detectable surface involvement or stromal invasion (HE, loupe view). c Photomicrograph showing hierarchical architecture with larger papillae branching into smaller ones with detached cell clusters or single cells (HE, × 100). d Photomicrograph showing ciliated and secretory cells with scanty cytoplasm and oval to round nuclei with finely distributed chromatin and rare mitotic figures. (HE, × 400)
| 4.15625
| 0.95459
|
sec[1]/sec[0]/p[0]
|
en
| 0.999997
|
29960592
|
https://doi.org/10.1186/s13000-018-0720-1
|
[
"tumor",
"roche",
"diagnostics",
"paraspinal",
"cells",
"lesion",
"ovarian",
"bone",
"that",
"soft"
] |
[
{
"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": "NE60",
"title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified"
},
{
"code": "MD41",
"title": "Clinical findings on diagnostic imaging of lung"
},
{
"code": "ME21",
"title": "Clinical findings on diagnostic imaging of liver or biliary tract"
},
{
"code": "ME91",
"title": "Clinical findings on diagnostic imaging of limbs"
},
{
"code": "ME90",
"title": "Clinical findings on diagnostic imaging of skull and head"
}
] |
=== 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
[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
[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
[ME90] Clinical findings on diagnostic imaging of skull and head
Also known as: Clinical findings on diagnostic imaging of skull and head | Abnormal diagnostic imaging of head | Abnormal diagnostic imaging of skull
Excludes: Intracranial space-occupying lesion
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Localised adiposity
Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....
--PARENT--> [?] Overweight or localised adiposity
Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--PARENT--> [?] Symptoms or signs of blood, blood-forming organs, or the immune system
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [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--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --PARENT--> [?] Overweight or localised adiposity\n Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --PARENT--> [?] Symptoms or signs of blood, blood-forming organs, or the immune system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs"
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 73-year-old man visited a previous hospital due to upper abdominal pain. The patient had a past history of diabetes mellitus, hypertension, hyperlipidemia, and vestibular schwannoma. Abdominal computed tomography (CT) scan revealed wall thickening of the swollen gallbladder and a 26-mm hypovascular tumor in contact with the common hepatic artery (CHA) (> 180°), the celiac artery (< 180°), and portal vein at the pancreatic body . The patient was diagnosed as pancreatic body cancer, and acute cholecystitis had also occurred. Laparoscopic cholecystectomy was performed for the acute cholecystitis, and simultaneous washing cytology was negative. After that, the patient was referred to our hospital for further examination and treatment of the pancreatic cancer. All of the examined tumor markers were within the normal range (CEA 1.7 ng/ml, CA19-9 2.0 ng/ml, DUPAN-2 60 U/ml, SPan-1 1.0 U/ml, CA-125 12.4 U/ml). Since serum CA19-9 was at an undetectable level, Lewis antigen of the patient might be negative. No liver metastasis was found by gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI). According to the National Comprehensive Cancer Network (NCCN) Guidelines Version 2.2016, the resectability was determined to be “borderline resectable.” Distal pancreatectomy with celiac artery resection (DP-CAR) after neoadjuvant chemotherapy (NAC) was planned. Two courses of gemcitabine (GEM) plus S-1 combination therapy (GS) were performed as NAC . GEM was given at a dose of 1000 mg/m 2 on days 1 and 8 of a 21-day cycle, and S-1 was administered at a dose of 40 mg/m 2 twice daily on days 1–14 followed by a 7-day rest. Enhanced CT scan after NAC showed a 21-mm pancreatic tumor, indicating stable disease (SD) in the Response Evaluation Criteria in Solid Tumors (RECIST) . EOB-MRI and fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) after NAC revealed no distant metastases. Coil embolization of the CHA and left gastric artery was done 3 days before surgery in order to prevent ischemic changes of the liver and stomach. Laparotomy was performed for DP-CAR 3 months after the initial diagnosis. A 3-mm tumor was detected on the surface of the liver (segment IV) and was removed. The liver tumor was diagnosed as adenocarcinoma by intraoperative frozen sections . Therefore, resection of the primary tumor was not performed. Three subsequent courses of GS were administered. Afterward, no distant metastases were seen in CT scan, MRI, or FDG-PET . The RECIST was unevaluable due to the artifact of the coil. DP-CAR was performed 6 months after the initial diagnosis. Intraoperative findings showed negative washing cytology and no distant metastases. The operative time was 429 min, and the amount of bleeding was 1150 ml. The proliferation of atypical cells with low papillary structure and disruption of the cell polarity was observed histologically in the main pancreatic duct. The tumor cells had nuclear enlargement and nuclei of irregular shape in the invasive portion, showing degeneration by chemotherapy. The histological diagnosis was well-differentiated tubular adenocarcinoma . TNM classification of the Union for International Cancer Control (UICC) (7th edition) was ypT1 ypN1 M1, Stage IV. No carcinoma cells were detected in the surgical margin (R0). Because of the widespread fibrous tissue and some residual tumor cells, the histopathological effect of chemotherapy was determined as grade III in the Evans classification . Although grade C of delayed gastric emptying (DGE), defined by the International Study Group of Pancreatic Surgery (ISGPS), developed after the surgery, the patient was discharged after 91 postoperative days. S-1 was administered every other day at a dose of 100 mg/day from 6 months after the resection up to the present. The patient has been alive with no recurrence for 5 years from an initial diagnosis and 4.5 years after DP-CAR. Fig. 1 Abdominal CT scan at the initial diagnosis at the previous hospital. The white arrows indicate the pancreatic tumor. a A 26-mm hypovascular tumor in contact with the common hepatic artery (CHA) (> 180°) was seen in the pancreatic body. b The main tumor contacted the PV and bifurcation of Ce. CHA common hepatic artery, Ce celiac artery, SA splenic artery, PV portal vein Fig. 2 Abdominal CT scan after two courses of GS. The white arrows indicate the pancreatic tumor. a The size of the main tumor was reduced from 26 mm to 21 mm. The abnormal shadow of the soft tissue around CHA did not increase. b The abnormal shadow around the bifurcation of Ce did not change. CHA common hepatic artery, Ce celiac artery, SA splenic artery Fig. 3 Intraoperative frozen sections. Adenocarcinoma cells invading the liver. Hematoxylin and eosin staining (×200, bar; 100 μm) Fig. 4 FDG-PET after three subsequent courses of GS. The main tumor of the pancreatic body had an abnormal accumulation of SUV max 3.8. Distant metastasis was not detected Fig. 5 Representative histological photographs of resected specimen (hematoxylin and eosin staining). a The viable adenocarcinoma cells invaded into pancreatic tissue with the formation of various ductal structures (×50, bar; 500 μm). b The tumor cells extended to the main pancreatic ducts (×100, bar; 250 μm). c The tissue around the CHA was replaced with fibrous tissue (×50, bar; 500 μm). d The fibrous tissue included many histiocytes containing hemosiderin (arrowhead) (×400, bar; 50 μm)
| 3.996094
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999999
|
29285651
|
https://doi.org/10.1186/s40792-017-0409-9
|
[
"tumor",
"pancreatic",
"artery",
"cells",
"tissue",
"scan",
"liver",
"main",
"abdominal",
"common"
] |
[
{
"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": "DC3Z",
"title": "Diseases of pancreas, unspecified"
},
{
"code": "DC3Y",
"title": "Other specified diseases of pancreas"
},
{
"code": "LB21.3",
"title": "Agenesis-aplasia of pancreas"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "DC35.0",
"title": "Atrophy of pancreas"
}
] |
=== ICD-11 CODES FOUND ===
[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
[DC3Z] Diseases of pancreas, unspecified
Also known as: Diseases of pancreas, unspecified
[DC3Y] Other specified diseases of pancreas
Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis
[LB21.3] Agenesis-aplasia of pancreas
Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.
Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[DC35.0] Atrophy of pancreas
Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F92] Neoplasms of unknown behaviour of skin
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature
Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature....
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --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--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature\n Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature....",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...."
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 61-year-old female patient with ACC of the right maxilla was referred to the Implant Department in Tehran University of Medical Sciences. The patient had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. There was no need for radiotherapy according to the surgery team. The remaining teeth in maxilla included #7, #9, #10, #11, and #15. Clinical and radiographic examination of maxilla revealed a three-unit FPD with right lateral incisor and left central incisor retainers, a four-unit FPD with left canine and left second molar retainers, two post and core crowns on first premolars, and an extensive amalgam restoration on left second molar. All maxillary teeth had unfavorable C/R ratio and were hopeless according to severe caries and severe periodontitis . So the clinical decision for the maxilla was extraction of all remaining teeth and insertion of six implants . In order to fabricate a maxillary IIO, a pick-up impression was taken with the existing obturator with irreversible hydrocolloid (Kerr, USA) prior to implant surgery. The teeth were removed from the cast (cast surgery) and acrylic denture teeth (Myerson, Trinidad and Tobago) were replaced. Teeth arrangement was approved by patient on the articulator. IIO was processed to use immediately after teeth extraction. In implant surgery appointment, open sinus lift was performed and six fixtures were inserted in maxilla using two-stage surgery in the place of #7 (Dentium/NR line, internal hexagon, Korea) and #9, #10, #11, #13, and #14 (Dentium/Implantium, internal hexagon, Korea). Also in mandible, three fixtures were inserted in place of teeth #20 (Dentium/Implantium, internal hexagon, Korea) and #29 and #20 (Dentium/NR line, internal hexagon, Korea). Immediately after surgery, tissue conditioner (TC) (COE-COMFORT, GC, America) was applied in the intaglio surface of IIO ( Figure 3(a) ). During the healing period, TC was replaced weekly. Six months after implants insertion, second stage surgery was performed and healing abutments were placed. IIO was relieved in place of healing abutments and TC was applied again ( Figure 3(b) ). Two weeks later, primary impressions with irreversible hydrocolloid (Kerr, USA) were taken. Custom trays were fabricated and open-tray impression copings were placed, hand tightened, and verified with periapical X-ray for proper seating. After border-molding the intact maxilla and then the defect area, open-tray final impression was made with soft putty and light body AC silicon (Panasil, Kettenbach, Germany) simultaneously. The trial record bases were fabricated and bite registration record was taken. In the next appointment, the teeth arrangement were tried-in. The interocclusal-space (IOS) and buccolingual distance were measured on the casts with periodontal probe by using the putty-silicon-index. The decision was to fabricate five-unit implant-supported FPD in anterior segment due to excessive maxillary protrusion. A bar and three ball attachments were used in the maxillary posterior segment. Angled abutments (15° angled abutments, Dentium, Korea) for implant-supported FPD on #7, #9, and #10 were used. Castable abutments (Metal Direct Casting abutment, Dentium, Korea) of the same implant system were used for bar fabrication on #11, #13, and #14. Associated ball and bar attachments (Rhein83 Srl, USA) were selected . Metal framework of implant-supported FPD and bar and ball attachment were waxed up according to the putty index to remain within the contour of the maxillary obturator and then surveyed in a determined path of insertion. Rest seats were prepared on wax up of FPD abutments and guide plans were determined. Superstructures and metal frameworks were tried-in for passive fitness and have been checked with periapical X-ray. Porcelain was applied on metal frames of FPD. Because of excessive IOS, pink porcelain was used in the cervical to simulate the gingiva (FP3). The acrylic denture teeth were arranged on definitive denture base. FPD was surveyed again to determine optimal undercuts for retention of ISO. Teeth arrangement and the FPD were tried-in. After patient's acceptance, a closed-hollow-bulb ISO was processed and the FPD was glazed. At the delivery appointment, the abutments and superstructures were seated and torqued according to the manufacturer's instruction (25–30 NCm). The clinical elastic O-rings were placed inside the metal housings of the obturator. FPD was cemented temporarily (TempBond, Kerr, USA) and ISO was inserted in the patient's mouth simultaneously . In order to make functional impression at the end of delivery appointment, TC (COE-COMFORT, GC, America) was used to improve the peripheral seal and consequently speech ability . The patient was instructed to use the ISO day and night and only remove it for oral hygiene. In the mandible, implant-supported FPD and crown were selected . A soft guard was fabricated on the maxillary FPD . It should be used whenever the ISO is removed for cleaning or changing the caps. After 7 days, the sore spots were relieved off the ISO and TC was applied again for another week. Two weeks after delivery, the patient was satisfied and there was not any traumatic ulcer. ISO with applied-tissue-conditioner was poured and processed again . Fortunately, during one-year follow-up, patient did not have any discomfort and speech problem. The caps were changed every 6 months.
| 3.996094
| 0.969727
|
sec[1]/p[0]
|
en
| 0.999996
|
28473930
|
https://doi.org/10.1155/2017/5458617
|
[
"teeth",
"implant",
"used",
"abutments",
"maxilla",
"maxillary",
"dentium",
"korea",
"metal",
"obturator"
] |
[
{
"code": "DA07.6Y",
"title": "Other specified disturbances in tooth eruption"
},
{
"code": "LA30.0",
"title": "Anodontia"
},
{
"code": "QA00.8",
"title": "Dental examination"
},
{
"code": "LA30.3",
"title": "Hyperdontia"
},
{
"code": "DA0A.Y",
"title": "Other specified disorders of teeth and supporting structures"
},
{
"code": "GC7A",
"title": "Disorders of breast augmentation"
},
{
"code": "QB51.7",
"title": "Presence of orthopaedic joint implants"
},
{
"code": "QB51.Y",
"title": "Presence of other specified devices other than cardiac or vascular implants"
},
{
"code": "QB51.5",
"title": "Presence of endocrine implants"
},
{
"code": "QB51.6",
"title": "Presence of tooth-root or mandibular implants"
}
] |
=== ICD-11 CODES FOUND ===
[DA07.6Y] Other specified disturbances in tooth eruption
Also known as: Other specified disturbances in tooth eruption | Neonatal teeth | Natal teeth | Advanced tooth eruption | precocious dentition
Includes: Neonatal teeth | Advanced tooth eruption
[LA30.0] Anodontia
Definition: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associated abnormalities. Rare but more common than complete anodontia is hypodontia.
Also known as: Anodontia | agomphiasis | agomphosis | anodontism | complete absence of teeth
[QA00.8] Dental examination
Also known as: Dental examination | examination of teeth
[LA30.3] Hyperdontia
Definition: Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth.
Also known as: Hyperdontia | Supplementary teeth | Supernumerary teeth | supernumerary tooth | supplemental teeth
Includes: Supplementary teeth | Supernumerary teeth | distomolar
[DA0A.Y] Other specified disorders of teeth and supporting structures
Also known as: Other specified disorders of teeth and supporting structures | Alveolar process haemorrhage | alveolar haemorrhage | Barodontalgia | aerodontalgia
[GC7A] Disorders of breast augmentation
Definition: A group of disorders that may arise in concert with or subsequent to the surgical placement of breast implants.
Also known as: Disorders of breast augmentation | Capsule contraction or scarring | Implant rupture
[QB51.7] Presence of orthopaedic joint implants
Also known as: Presence of orthopaedic joint implants | presence of joint implant | replacement of joint by artificial or mechanical device or prosthesis | Presence of shoulder-joint implant | presence of shoulder joint replacment prosthesis
[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
[QB51.5] Presence of endocrine implants
Also known as: Presence of endocrine implants | presence of insulin pump
Includes: presence of insulin pump
[QB51.6] Presence of tooth-root or mandibular implants
Also known as: Presence of tooth-root or mandibular implants | presence of tooth root implant | presence of mandibular implant
=== GRAPH WALKS ===
--- Walk 1 ---
[DA07.6Y] Other specified disturbances in tooth eruption
--PARENT--> [DA07.6] Disturbances in tooth eruption
--CHILD--> [DA07.61] Ankylosis of teeth
Def: Tooth ankylosis is the solid fixation of a tooth, resulting from fusion of the cementum and alveolar bone, with obliteration of the periodontal ligament. It is uncommon in deciduous dentition, and ver...
--- Walk 2 ---
[DA07.6Y] Other specified disturbances in tooth eruption
--PARENT--> [DA07.6] Disturbances in tooth eruption
--CHILD--> [DA07.60] Teething syndrome
Def: Gum and jaw discomfort when an infant’s teeth emerges. Teething typically starts between 4 and 7 months of age and lasts until about the age of 3 years. Most common symptoms include irritability, cryi...
--- Walk 3 ---
[LA30.0] Anodontia
Def: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associat...
--PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues
--RELATED_TO--> [?] Root anomaly
Def: Common presence of fused roots showed by X-ray film that short or long root, supernumerary root, or fused roots. These root anomalies are commonly seen in permanent molars, especially in third molars ...
--- Walk 4 ---
[LA30.0] Anodontia
Def: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associat...
--PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues
--RELATED_TO--> [?] Disturbances in tooth eruption
--- Walk 5 ---
[QA00.8] Dental examination
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--EXCLUDES--> [?] Special screening examination for neoplasms
--- Walk 6 ---
[QA00.8] Dental examination
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--EXCLUDES--> [?] Examination or encounter for administrative purposes
|
[
"[DA07.6Y] Other specified disturbances in tooth eruption\n --PARENT--> [DA07.6] Disturbances in tooth eruption\n --CHILD--> [DA07.61] Ankylosis of teeth\n Def: Tooth ankylosis is the solid fixation of a tooth, resulting from fusion of the cementum and alveolar bone, with obliteration of the periodontal ligament. It is uncommon in deciduous dentition, and ver...",
"[DA07.6Y] Other specified disturbances in tooth eruption\n --PARENT--> [DA07.6] Disturbances in tooth eruption\n --CHILD--> [DA07.60] Teething syndrome\n Def: Gum and jaw discomfort when an infant’s teeth emerges. Teething typically starts between 4 and 7 months of age and lasts until about the age of 3 years. Most common symptoms include irritability, cryi...",
"[LA30.0] Anodontia\n Def: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associat...\n --PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues\n --RELATED_TO--> [?] Root anomaly\n Def: Common presence of fused roots showed by X-ray film that short or long root, supernumerary root, or fused roots. These root anomalies are commonly seen in permanent molars, especially in third molars ...",
"[LA30.0] Anodontia\n Def: Anodontia is a genetic disorder commonly defined as the absence of all teeth, affecting both temporary and permanent dentitions, and is extremely rarely encountered in a pure form without any associat...\n --PARENT--> [LA30] Structural developmental anomalies of teeth and periodontal tissues\n --RELATED_TO--> [?] Disturbances in tooth eruption",
"[QA00.8] Dental examination\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --EXCLUDES--> [?] Special screening examination for neoplasms",
"[QA00.8] Dental examination\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --EXCLUDES--> [?] Examination or encounter for administrative purposes"
] |
DA07.6Y
|
Other specified disturbances in tooth eruption
|
[
{
"from_icd11": "LA30.0",
"icd10_code": "K000",
"icd10_title": "Anodontia"
},
{
"from_icd11": "QA00.8",
"icd10_code": "Z012",
"icd10_title": "Encounter for dental examination and cleaning"
},
{
"from_icd11": "LA30.3",
"icd10_code": "K001",
"icd10_title": "Supernumerary teeth"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96652",
"icd10_title": "Presence of left artificial knee joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96649",
"icd10_title": "Presence of unspecified artificial hip joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96641",
"icd10_title": "Presence of right artificial hip joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96653",
"icd10_title": "Presence of artificial knee joint, bilateral"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96651",
"icd10_title": "Presence of right artificial knee joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96643",
"icd10_title": "Presence of artificial hip joint, bilateral"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96642",
"icd10_title": "Presence of left artificial hip joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96611",
"icd10_title": "Presence of right artificial shoulder joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96619",
"icd10_title": "Presence of unspecified artificial shoulder joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96612",
"icd10_title": "Presence of left artificial shoulder joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96659",
"icd10_title": "Presence of unspecified artificial knee joint"
},
{
"from_icd11": "QB51.7",
"icd10_code": "Z96629",
"icd10_title": "Presence of unspecified artificial elbow joint"
}
] |
K000
|
Anodontia
|
Patient 2 was a 29-year-old man who presented at a local hospital with fever and ostealgia on December 30, 2012. Blood examination revealed a WBC count of 18.04 × 10 9 /L, HGB of 135 g/L, and PLT of 98 × 10 9 /L. A bone marrow examination revealed the presence of t(9; 22) (q34; q11) in a cytogenetic evaluation, and a positive BRC-ABL p190 transcript was detected by QRT-PCR. He was thus diagnosed with Ph-positive ALL. The patient was given chemotherapy with the VDLP protocol in January 2013, and the symptoms were alleviated. He then received multiple consolidated chemotherapies with vincristine, daunorubicin, cyclophosphamide, and prednisone (VDCP), hyper-CVAD-A, hyper-CVAD-B, VDP, and hyper-CVAD-B regimens, followed by haploidentical allogeneic HSCT on September 12, 2013. During the HSCT, he received infusions of bone marrow and peripheral blood stem cells (mononuclear cells 7.08 × 10 8 /kg, CD34 + cells 3.02 × 10 6 /kg). In addition, 31 mL of umbilical cord blood (total nucleated cells 1 × 10 7 /kg) was infused on September 25, 2013. During the HSCT, the patient had a history of intestinal acute graft-versus-host disease (aGVHD), but this resolved with anti-rejection treatments. However, flow cytometry of bone marrow cells detected positive MRD 6 months after transplantation. The patient was given targeted therapy with imatinib mesylate, but 2 weeks later, the MRD was found to have progressed. He then received chemotherapy with the VDCP protocol, but he was still MRD-positive. Due to imatinib resistance, therapy with dasatinib was started and MRD-negative status was achieved. However, the patient stopped dasatinib therapy for 1 month due to the adverse reaction of pleural effusion. Positive BCR-ABL p190 transcript was detected (0.29%) in bone marrow cells by QRT-PCR on April 7, 2015. Positive BCR-ABL p190 transcript was still detected (1.95%) by QRT-PCR on June 10, 2015. The patient chose to continue dasatinib therapy. Positive MRD was still detected by flow cytometry (0.78%) and QRT-PCR (4.74%) in bone marrow cells on June 23, 2015. Chemotherapy was given to prevent recurrence on June 25, 2015, but the patient did not finish the chemotherapy due to infection. Then, cryopreserved donor peripheral blood stem cells (1 × 10 7 /kg) were infused on June 30, 2015. The patient was admitted to our hospital on August 17, 2015. Blood examination revealed a WBC count of 3.6 × 10 9 /L, HGB of 88 g/L, and PLT of 77 × 10 9 /L. Flow cytometry of bone marrow cells revealed 26% abnormal immature cells, with a B-cell phenotype accompanied by myeloperoxidase (MPO) expression. STR examination of bone marrow cells revealed incomplete donor chimerism (87% of donor origin). Peripheral blood mononuclear cells (PBMCs, 100 mL) were collected to prepare anti-CD19 CAR T-cells on August 25, 2015. Lymphodepleting chemotherapy with the FC regimen (cyclophosphamide 60 mg/kg, day −8; fludarabine 25 mg/m 2 , days −4 to −3) was given on August 29, 2015. However, he developed a high fever and hypotension during the chemotherapy; we then reduced the chemotherapy dose. After anti-infection and rehydration treatment, the patient's body temperature returned to normal, and the hypotension resolved. On day −1, 2 days after chemotherapy, the patient exhibited persistent disease with 24% blasts present in bone marrow. Then, anti-CD19 CAR T-cells were infused at a total dose of 1.0 × 10 6 CAR-positive T-cells/kg (transduction efficiency was 30%) in a single dose. No immediate infusion-related toxic effect was noted, but he developed a fever and hypotension on day +1. Anti-infection treatment was ineffective, with increased cytokine levels , CRP (107.5 mg/L), and ferritin (15,570.1 ng/mL), indicating grade 4 CRS. Tocilizumab (8 mg/kg) was given on day +6 after the infusion; the patient's body temperature dropped to normal quickly. On day +8, a bone marrow myelogram revealed immature lymphocytes accounting for 1.5%, and abnormal lymphocytes accounting for 14.5% (considering CAR T-cells). Both flow cytometry and QRT-PCR of bone marrow cells indicated MRD-negative status . During this time period, anti-CD19 CAR T-cells revealed rapid expansion in the peripheral blood . However, the patient developed abdominal pain and diarrhea on September 15, 2015 (day +9), and the symptoms became aggravated gradually, with diarrhea reaching more than 20 times per day. Cytomegalovirus DNA in blood and multiple stool bacterial cultures were negative. Anti-diarrheal and anti-infection treatments were ineffective. STR of bone marrow cells revealed full donor chimerism on September 28, 2015. An electronic colonoscopy revealed mucosal congestion and edema of the whole large intestine . A pathological examination suggested mucosal chronic inflammation, surface erosion, and granulation tissue hyperplasia. There was more inflammatory cell infiltration in the mesenchyme . A diagnosis of intestinal aGVHD was made in accordance with these clinical and histopathological manifestations. The patient was given anti-rejection treatment, with methylprednisolone, methotrexate, and cyclosporine for 3 weeks. His symptoms improved gradually; he was kept on maintenance treatment with cyclosporine for 1 month. On October 8, 2015 (day +32), the patient was MRD-negative in terms of bone marrow cells by flow cytometry and QRT-PCR . At the last follow-up (6 months after infusion), he was in complete molecular remission and still alive.
| 4.050781
| 0.973633
|
sec[1]/p[1]
|
en
| 0.999996
|
28002337
|
https://doi.org/10.1097/MD.0000000000005676
|
[
"cells",
"bone",
"marrow",
"anti",
"blood",
"chemotherapy",
"flow",
"cytometry",
"september",
"however"
] |
[
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "FB84.Z",
"title": "Osteomyelitis or osteitis, unspecified"
},
{
"code": "FB80.Z",
"title": "Disorder of bone density or structure, unspecified"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "FB86.1Z",
"title": "Bone hyperplasias, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS
[FB84.Z] Osteomyelitis or osteitis, unspecified
Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease
[FB80.Z] Disorder of bone density or structure, unspecified
Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[FB86.1Z] Bone hyperplasias, unspecified
Also known as: Bone hyperplasias, unspecified | Bone hyperplasias
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of carbohydrate metabolism
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--CHILD--> [MF92] Chyluria
Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white....
--- Walk 3 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Mucolipidosis type 4
Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...
--PARENT--> [?] Sphingolipidosis
--- Walk 4 ---
[5C56.20] Mucolipidosis
--RELATED_TO--> [?] Wolman disease
Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...
--PARENT--> [?] Liver disease due to disorders of lysosomal storage
Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function....
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.0] Sickle cell trait
Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF92] Chyluria\n Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white....",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Sphingolipidosis",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Wolman disease\n Def: Wolman disease represents the most severe manifestation of lysosomal acid lipase deficiency and can present in the fetus (hepatomegaly, ascites, calcified adrenal glands), or more typically in the fir...\n --PARENT--> [?] Liver disease due to disorders of lysosomal storage\n Def: This is liver disease due to a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function....",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.0] Sickle cell trait\n Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ..."
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "FC0Z",
"icd10_code": "XIII",
"icd10_title": ""
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86672",
"icd10_title": "Other chronic osteomyelitis, left ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86172",
"icd10_title": "Other acute osteomyelitis, left ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86171",
"icd10_title": "Other acute osteomyelitis, right ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86671",
"icd10_title": "Other chronic osteomyelitis, right ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X7",
"icd10_title": "Other osteomyelitis, ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X8",
"icd10_title": "Other osteomyelitis, other site"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X6",
"icd10_title": "Other osteomyelitis, lower leg"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X9",
"icd10_title": "Other osteomyelitis, unspecified sites"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M8668",
"icd10_title": "Other chronic osteomyelitis, other site"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86662",
"icd10_title": "Other chronic osteomyelitis, left tibia and fibula"
}
] |
D571
|
Sickle-cell disease without crisis
|
Patient 2 was an 18-year-old female patient who had suffered from oral mucosal candidiasis since the age of five years, when she presented a hypocalcemic seizure revealing hypoparathyroidism (Table 1 ). AIRE gene sequencing showed that she was compound heterozygous for two loss-of-function variants (c.415C > T / c.967_979del). This patient subsequently developed autoimmune adrenal insufficiency, alopecia , diabetes insipidus and renal potassium wasting at the ages of 7, 10, 12.5 and 13 years, respectively. Diabetes insipidus was suspected because of a sudden increase in water intake to up to 4 L per day and was confirmed by a water deprivation test and the absence of a neurohypophysis on brain MRI . Desmopressin treatment was initiated, and the management of water, sodium and potassium intakes was challenging due to the combination of adrenal insufficiency, renal potassium leakage and diabetes insipidus. At the age of 15 years treatment with ruxolitinib 10 mg two times a day (12.5 mg/m 2 /day) was initiated for alopecia, with the dose increased to 20 mg two times a day (25mg/m 2 /day) after three months. Hair regrowth was evident after 12 months of treatment . After two years of follow-up, the alopecia had fully resolved , making it possible to taper the dose to 10 mg two times a day, with the response sustained over an additional six months of follow-up. In addition to improving hair growth, this treatment also improved other manifestations (Table 1 ). First, despite adequate desmopressin substitution at a dose of up to 160 mg/day, the patient initially complained of persistent hyperdiuresis confirmed by repeated measurements of natremia above or at the upper limit of the normal range (mean ± SD: 144.1 ± 1.18 mmol/L; n = 16). Following the introduction of ruxolinitib, she had several episodes of water intoxication, antidiuresis and her natremia decreased significantly leading to a progressive decrease of desmopressin dose and the cessation of this treatment at last follow-up . Second, potassium supplements were decreased considerably, from 3 g/day to 0.5 g/day, and this change in dose was accompanied by a lessening of cramps and a progressive increase in serum potassium concentrations . Third, biochemical hallmarks of hypoparathyroidism improved upon ruxolinitib treatment, suggesting an increase in PTH secretion. Hypoparathyroidism is characterized by hypocalcemia, hyperphosphatemia and an inappropriately low level of parathormone. It is managed by stimulating calcium uptake in the digestive tract with alfacalcidol, a vitamin D analog. Upon ruxolitinib treatment, we observed a significant decrease in serum phosphate levels (from 1.78 ± 0.42 to 1.20 ± 0.18 mmol/L) and a stabilization of serum calcium levels (2.35 ± 0.29 to 2.25 ± 0.21 mmol/L), and alfacalcidol dose was tapered (1.9 ± 0.5 to 1.7 ± 0.4 µg/day) . Finally, mucosal candidiasis has not recurred since the introduction of ruxolitinib. Fig. 1 Course of alopecia in Patient 2 Photographs before the introduction of ruxolinitib ( A ) and after 12 ( B ) and 24 ( C ) months of treatment in patient 2 Fig. 2 Course of the disease in Patient 2 ( A - B ) Course of natremia. Diabetes insipidus was treated by substitution with desmopressin; the treatment and dose are indicated by the green bars (right y axis). Note the sodium concentration above or at the upper limit of the normal range (mean ± SD: 144.1 ± 1.18 mmol/L; n = 16) before ruxolinitib treatment (black bars) and the recurrent episodes of hyponatremia during the course of ruxolinitib treatment ( A ), suggesting an excess of desmopressin and leading to a gradual decrease of desmopressin dose and the discontinuation of this treatment at the most recent follow-up visit ( B ). Na (blood sodium determination); the reference range is 136–146 mmol/L; the red asterisk indicates the period during which the patient received baricitinib. Follow-up spans of 3.5 years and 2.5 years before and after the initiation of ruxolinitib (R), respectively. ( C - D ) Renal potassium wasting was suspected when serum potassium concentration fell below the normal range despite adrenal insufficiency, a condition associated with hyperkalemia. Potassium supplements were prescribed at a dose of up to 3 g/day (empty bars) leading to a slow, but steady increase in blood potassium concentration and a decrease in potassium supplement intake. K (blood potassium determination); the reference range is 3.5–4.5 mmol/L. Follow-up spans of 3.5 years and 2.5 years before and after of the initiation of ruxolinitib, respectively. ( E – F ) Hypoparathyroidism was treated with alfacalcidol; treatment and dose are indicated by the blue bars (right y axis). Blood phosphate levels decreased on ruxolinitib treatment, from 1.78 ± 0.42 to 1.20 ± 0.18 mmol/L, this decrease being associated with an increase in the percentage of measurements within the normal range from 30 to 91%. Concomitantly, the requirement for alfacalcidol to sustain blood calcium level (calcium 2.35 ± 0.29 and 2.25 ± 0.21 mmol/L; 56 and 62% of measurements in the normal range before and during ruxolinitib treatment, respectively) decreased from 1.9 ± 0.5 to 1.7 ± 0.4 µg/day. Ca (blood calcium determination); the reference range is 2.2–2.6 mmol/L; Pi (blood phosphate determination); the reference range is 0.95–1.45 mmol/L. Follow-up spans of 3.5 years and 2.5 years before and after the initiation of ruxolinitib, respectively
| 4.21875
| 0.955078
|
sec[2]/sec[1]/p[0]
|
en
| 0.999996
|
38112858
|
https://doi.org/10.1007/s10875-023-01629-x
|
[
"potassium",
"mmol",
"ruxolinitib",
"range",
"blood",
"this",
"desmopressin",
"respectively",
"increase",
"decrease"
] |
[
{
"code": "5C77",
"title": "Hypokalaemia"
},
{
"code": "5C76",
"title": "Hyperkalaemia"
},
{
"code": "BC65.0",
"title": "Long QT syndrome"
},
{
"code": "GB90.46",
"title": "Tubular disorders of sodium or potassium transport"
},
{
"code": "KB63.3Z",
"title": "Disturbances of potassium balance of newborn, unspecified"
},
{
"code": "GB42.1",
"title": "Albuminuria, Grade A3"
},
{
"code": "GB42.0",
"title": "Albuminuria, Grade A2"
},
{
"code": "MA18.0Y",
"title": "Other specified elevated blood glucose level"
},
{
"code": "QA00.6Y",
"title": "Other specified examination of eyes or vision"
},
{
"code": "4B00.0Z",
"title": "Neutropaenia, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[5C77] Hypokalaemia
Also known as: Hypokalaemia | Potassium [K] deficiency | Potassium deficiency | hypokalaemic syndrome | hypopotassaemia
[5C76] Hyperkalaemia
Also known as: Hyperkalaemia | Potassium [K] excess | Potassium [K] overload | hyperaemic syndrome | hyperpotassaemia
Includes: Potassium [K] excess | Potassium [K] overload
[BC65.0] Long QT syndrome
Definition: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an increased risk of sudden cardiac death.
Also known as: Long QT syndrome | Congenital long QT syndrome | Familial long QT syndrome | Long QT syndrome type 1 | Long QT syndrome type 2
[GB90.46] Tubular disorders of sodium or potassium transport
Definition: Abnormalities of the renal tubules resorptive or secretory functions, inherited or acquired.
Also known as: Tubular disorders of sodium or potassium transport | Inherited tubular disorders of potassium or sodium transport | Acquired tubular disorders of potassium or sodium transport associated with causes classified elsewhere
Excludes: Fanconi syndrome
[KB63.3Z] Disturbances of potassium balance of newborn, unspecified
Also known as: Disturbances of potassium balance of newborn, unspecified | Disturbances of potassium balance of newborn | transitory disorder of potassium in newborn | transitory disorder of potassium balance in newborn
[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
[QA00.6Y] Other specified examination of eyes or vision
Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia
[4B00.0Z] Neutropaenia, unspecified
Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range
=== GRAPH WALKS ===
--- Walk 1 ---
[5C77] Hypokalaemia
--PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance
--CHILD--> [5C71] Hyperosmolality or hypernatraemia
Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles...
--- Walk 2 ---
[5C77] Hypokalaemia
--PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance
--CHILD--> [5C72] Hypo-osmolality or hyponatraemia
Def: Serum sodium concentrations of less than 135 mEq/L; decreased serum concentration of osmotically active particles...
--- Walk 3 ---
[5C76] Hyperkalaemia
--RELATED_TO--> [?] Hyperkalaemia of newborn
Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L....
--PARENT--> [?] Disturbances of potassium balance of newborn
Def: A paediatric condition characterised by abnormally high or low levels of potassium in the blood in a newborn, when the normal range is defined as 3.5 to 5.5 mmol/L....
--- Walk 4 ---
[5C76] Hyperkalaemia
--RELATED_TO--> [?] Hyperkalaemia of newborn
Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L....
--PARENT--> [?] Hyperkalaemia
--- Walk 5 ---
[BC65.0] Long QT syndrome
Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre...
--PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder
--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....
--- Walk 6 ---
[BC65.0] Long QT syndrome
Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre...
--PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder
--PARENT--> [?] Cardiac arrhythmia
Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular....
|
[
"[5C77] Hypokalaemia\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C71] Hyperosmolality or hypernatraemia\n Def: Serum sodium concentrations in excess of 145 mmol/L; increased serum concentration of osmotically active particles...",
"[5C77] Hypokalaemia\n --PARENT--> [?] Disorders of fluid, electrolyte or acid-base balance\n --CHILD--> [5C72] Hypo-osmolality or hyponatraemia\n Def: Serum sodium concentrations of less than 135 mEq/L; decreased serum concentration of osmotically active particles...",
"[5C76] Hyperkalaemia\n --RELATED_TO--> [?] Hyperkalaemia of newborn\n Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L....\n --PARENT--> [?] Disturbances of potassium balance of newborn\n Def: A paediatric condition characterised by abnormally high or low levels of potassium in the blood in a newborn, when the normal range is defined as 3.5 to 5.5 mmol/L....",
"[5C76] Hyperkalaemia\n --RELATED_TO--> [?] Hyperkalaemia of newborn\n Def: Hyperkalaemia is defined as serum potassium greater than 5.5 mmol/L....\n --PARENT--> [?] Hyperkalaemia",
"[BC65.0] Long QT syndrome\n Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre...\n --PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder\n --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....",
"[BC65.0] Long QT syndrome\n Def: A congenital disorder of ventricular myocardial repolarization characterised by a prolonged QT interval on the electrocardiogram (ECG) that can lead to symptomatic ventricular arrhythmias and an incre...\n --PARENT--> [BC65] Cardiac arrhythmia associated with genetic disorder\n --PARENT--> [?] Cardiac arrhythmia\n Def: This is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heartbeat may be too fast or too slow, and may be regular or irregular...."
] |
5C77
|
Hypokalaemia
|
[
{
"from_icd11": "5C77",
"icd10_code": "E876",
"icd10_title": "Hypokalemia"
},
{
"from_icd11": "5C76",
"icd10_code": "E875",
"icd10_title": "Hyperkalemia"
},
{
"from_icd11": "BC65.0",
"icd10_code": "I498",
"icd10_title": "Other specified cardiac arrhythmias"
},
{
"from_icd11": "BC65.0",
"icd10_code": "I49",
"icd10_title": "Other cardiac arrhythmias"
},
{
"from_icd11": "GB90.46",
"icd10_code": "N2589",
"icd10_title": "Other disorders resulting from impaired renal tubular function"
},
{
"from_icd11": "GB90.46",
"icd10_code": "N258",
"icd10_title": "Other disorders resulting from impaired renal tubular function"
},
{
"from_icd11": "KB63.3Z",
"icd10_code": "P743",
"icd10_title": "Disturbances of potassium balance of newborn"
}
] |
E876
|
Hypokalemia
|
A 60 years old male patient presented to the clinic with a primary complain of unilateral neck swelling and local pain. He first noticed this swelling about 5 weeks ago in the left lateral neck. Since then this neck lump has been getting larger rapidly and extending to his left clavicular region. Clinical examination reveals a non-tender 4 cm lesion within the left root of neck at the level V. The lesion was firm, immobile and adherent to the adjacent tissues extending downwards to the left clavicle. Past medical history was non contributary. Clinical findings are suggestive for a possible malignant lesion so the patient immediately underwent an extensive diagnostic work-up. Blood tests including biochemical and malignant biomarkers were in normal range. U/S examination reveals a large complex mixed cystic/solid mass at the root of the neck on the left side. The mass filled the supraclavicular fossa. Medially, it extended over the front of the clavicle and even on the infero-anterior aspect of the clavicle. It measured approximately 4.4 × 3.4 cm in the coronal plane and axially around 6.6 cm. These findings were confirmed by full body-CT scan, which also described the presence of the mass effect on left subclavian vein and left lower portion of the left internal jugular vein . MRI depicted no infiltration of the branchial plexus . In addition, there was no evidence of cervical lymphadenopathy. The PET-CT scan showed a FDG avid necrotic cervical node at the left neck. Cone U/S-guided biopsy of the lesion reveals an atypical epitheliod population, without evidence of lymph node existence in the specimen. Local immunohistochemistry was positive for p63 and CK5/6, and negative for CEA, Melan-A, PSA, CDX2, CK7, CK20, TTF1 and S100. Additional stains for CD30, OCT ¾, EBER-ISH, EMA and synaptophysin was negative and staining for p16 show strong uniform nuclear positivity. Immunohistochemistry failed to indicate the exact origin of the neoplasm. However, the combination of head and neck position, squamous cell markers (positive basaloid cell staining) and HPV surrogate p16 positivity maybe associated with a metastatic carcinoma of primary tumour which was probably located at the head and neck region (probably oropharyngeal portion). Nevertheless, multiple biopsies from the oropharyngeal region including tongue, tonsils and nasal cavity were normal. Furthermore the patient underwent tonsillectomy and the microscopical examination of the specimen was normal. Surgical excision of the mass was decided. An anterior incision according to the dartevelle approach was performed . This approach gave us the opportunity to carefully dissect the neck and thoracic portion of the tumour. By the end of the operation the gap occurring by the successfully complete resection of the mass, left clavicle and first rib was covered by a vascular muscle flap from the major pectoralis muscle. Microscopic examination of the mass surrounding the clavicle showed nests of epithelial cells with pseudoglandular structures and evidence of focal keratinisation together with central necrosis. There was perineural invasion without evidence of lympovascular tumor infiltration.The clavicle bone fragment showed no abnormality and cervical lymph nodes IV and V were negative for malignant disease. The patient after 7 days discharged without any major postoperative complication and scheduled to radiotherapy. However in the context of the possible muscle flap necrosis the radiation therapy was postoponed until the viability was confirmed. Follow-up of the patient after one year showed no evidence of metastastic disease or disease progression . Fig. 1 CT of thorax. There is a bilobular low-density mass with an intermediate density wall in the left side of root neck measuring approximately 6.5 × 3 cm in maximum axial dimensions and 4 cm craniocaudially. It abuts the superior aspect of clavicle extending of anterior and posterior to it. The periostal was seen sclerotic in the left clavicle in comparison to the right side. The left subclavian vein and lower left great internal jugular vein appear to be compressed by the mass. Fig. 1 Fig. 2 MRI of the upper thorax and brachial plexus. A cystic mass with infilterating nodular enhancing walls centred at head of clavicule, infiltrates the clavicular and sternal heads of the left sternocleidomastoid muscle, the sternohyoid muscle inferiorly and the medial end of the first rib. The clavicle is infiltrated from the head medially to the mid-third laterally over a distance of at least 6 cm. In the neck and posteriorly the left ICA is well clear of the mass, but the distal left IJV is not well seen. Subclavian vein and distal vertebral vein run immediately posterior to the mass and are inseparable from it. Subclavian artery and brachial plexus do not appear to infiltrated. Fig. 2 Fig. 3 Intraoperative picture of the mass and its adhesions to the underlying first rib. The mass was totally resected with the underlying first rib and clavicle. Fig. 3 Fig. 4 CT after the operation. There is residual, poorly defined soft tissue within the surgical bed, which is thought to represent a combination of post-surgical change and interval radiotherapy, rather than recurrent or residual tumour. Fig. 4 Fig. 5 Coronal planes preoperatively in MRI (a) and CT (b) scan. Imaging one year after removal of clavicle, first rib and tumor. No evidence of disease recurrence (c). Fig. 5
| 3.996094
| 0.980469
|
sec[1]/p[0]
|
en
| 0.999996
|
32058306
|
https://doi.org/10.1016/j.ijscr.2019.12.019
|
[
"neck",
"clavicle",
"vein",
"evidence",
"muscle",
"lesion",
"subclavian",
"head",
"this",
"extending"
] |
[
{
"code": "ME86.C",
"title": "Symptom or complaint of the neck"
},
{
"code": "LA6Z",
"title": "Structural developmental anomalies of the neck, unspecified"
},
{
"code": "ME84.0",
"title": "Cervical spine pain"
},
{
"code": "FA71",
"title": "Torticollis"
},
{
"code": "NA23.4Y",
"title": "Other specified strain or sprain of cervical spine"
},
{
"code": "LB72.Y",
"title": "Other specified structural developmental anomalies of shoulder girdle"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "ME85",
"title": "Stiffness of joint"
},
{
"code": "FB80.Y",
"title": "Other specified disorders of bone density or structure"
},
{
"code": "NC12.0Z",
"title": "Fracture of clavicle, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[ME86.C] Symptom or complaint of the neck
Also known as: Symptom or complaint of the neck | Neck syndrome
Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain
[LA6Z] Structural developmental anomalies of the neck, unspecified
Also known as: Structural developmental anomalies of the neck, unspecified | Malformations of the neck
[ME84.0] Cervical spine pain
Definition: This is a condition which is usually characterised by pain or discomfort in the neck region and can be caused by numerous spinal problems. It may be a feature of virtually every disorder and disease that occurs above the shoulder blades.
Also known as: Cervical spine pain | cervical pain | neck ache | nonspecific pain in the neck region | cervicalgia
Includes: cervicalgia
Excludes: cervical disc degeneration | Chronic primary cervical pain | Chronic secondary musculoskeletal pain
[FA71] Torticollis
Also known as: Torticollis | contracture of neck | wry neck | wry neck/torticollis | Intermittent torticollis
Excludes: Cervical dystonia | Congenital torticollis | current injury - see injury of spine by body region
[NA23.4Y] Other specified strain or sprain of cervical spine
Also known as: Other specified strain or sprain of cervical spine | Strain of cervical spine | cervical strain | Strain of cervical anterior longitudinal ligament | Sprain of cervical spine
[LB72.Y] Other specified structural developmental anomalies of shoulder girdle
Also known as: Other specified structural developmental anomalies of shoulder girdle | Clavicular hypoplasia or aplasia | Absent clavicle | Medial condensing osteitis of clavicle | Congenital pseudoarthrosis of clavicle
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[ME85] Stiffness of joint
Definition: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes.
Also known as: Stiffness of joint | joint stiffness | stiff joint | stiffness in joint | Stiffness of joint, multiple sites
[FB80.Y] Other specified disorders of bone density or structure
Also known as: Other specified disorders of bone density or structure | Bone dysplasia | Inherited bone dysplasia | Acquired bone dysplasia | Drug-induced bone dysplasia
[NC12.0Z] Fracture of clavicle, unspecified
Also known as: Fracture of clavicle, unspecified | Fracture of clavicle | fracture of collar bone | collar bone fracture dislocation
=== GRAPH WALKS ===
--- Walk 1 ---
[ME86.C] Symptom or complaint of the neck
--PARENT--> [ME86] Symptom or complaint of a body part
--CHILD--> [ME86.0] Symptom or complaint of the ankle
--- Walk 2 ---
[ME86.C] Symptom or complaint of the neck
--PARENT--> [ME86] Symptom or complaint of a body part
--CHILD--> [ME86.2] Symptom or complaint of the back
--- Walk 3 ---
[LA6Z] Structural developmental anomalies of the neck, unspecified
--PARENT--> [?] Structural developmental anomalies of the neck
Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies primarily affecting one body system
Def: A deformation established before birth of an anatomical structure....
--- Walk 4 ---
[LA6Z] Structural developmental anomalies of the neck, unspecified
--PARENT--> [?] Structural developmental anomalies of the neck
Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....
--CHILD--> [LA62] Congenital torticollis
--- Walk 5 ---
[ME84.0] Cervical spine pain
Def: This is a condition which is usually characterised by pain or discomfort in the neck region and can be caused by numerous spinal problems. It may be a feature of virtually every disorder and disease t...
--EXCLUDES--> [?] Chronic primary cervical pain
Def: Chronic primary cervical pain is chronic pain in the muscles, bones, joints or tendons of the neck region that is characterised by significant emotional distress (anxiety, anger/frustration or depress...
--PARENT--> [?] Chronic primary musculoskeletal pain
Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...
--- Walk 6 ---
[ME84.0] Cervical spine pain
Def: This is a condition which is usually characterised by pain or discomfort in the neck region and can be caused by numerous spinal problems. It may be a feature of virtually every disorder and disease t...
--EXCLUDES--> [?] Intervertebral disc degeneration
--CHILD--> [?] Intervertebral disc degeneration of cervical spine with bony spur at the vertebra
|
[
"[ME86.C] Symptom or complaint of the neck\n --PARENT--> [ME86] Symptom or complaint of a body part\n --CHILD--> [ME86.0] Symptom or complaint of the ankle",
"[ME86.C] Symptom or complaint of the neck\n --PARENT--> [ME86] Symptom or complaint of a body part\n --CHILD--> [ME86.2] Symptom or complaint of the back",
"[LA6Z] Structural developmental anomalies of the neck, unspecified\n --PARENT--> [?] Structural developmental anomalies of the neck\n Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies primarily affecting one body system\n Def: A deformation established before birth of an anatomical structure....",
"[LA6Z] Structural developmental anomalies of the neck, unspecified\n --PARENT--> [?] Structural developmental anomalies of the neck\n Def: Any condition caused by failure of the neck to correctly develop during the antenatal period....\n --CHILD--> [LA62] Congenital torticollis",
"[ME84.0] Cervical spine pain\n Def: This is a condition which is usually characterised by pain or discomfort in the neck region and can be caused by numerous spinal problems. It may be a feature of virtually every disorder and disease t...\n --EXCLUDES--> [?] Chronic primary cervical pain\n Def: Chronic primary cervical pain is chronic pain in the muscles, bones, joints or tendons of the neck region that is characterised by significant emotional distress (anxiety, anger/frustration or depress...\n --PARENT--> [?] Chronic primary musculoskeletal pain\n Def: Chronic primary musculoskeletal pain is chronic pain in the muscles, bones, joints or tendons that is characterised by significant emotional distress (anxiety, anger/frustration or depressed mood) or ...",
"[ME84.0] Cervical spine pain\n Def: This is a condition which is usually characterised by pain or discomfort in the neck region and can be caused by numerous spinal problems. It may be a feature of virtually every disorder and disease t...\n --EXCLUDES--> [?] Intervertebral disc degeneration\n --CHILD--> [?] Intervertebral disc degeneration of cervical spine with bony spur at the vertebra"
] |
ME86.C
|
Symptom or complaint of the neck
|
[
{
"from_icd11": "LA6Z",
"icd10_code": "Q680",
"icd10_title": "Congenital deformity of sternocleidomastoid muscle"
},
{
"from_icd11": "LA6Z",
"icd10_code": "Q180",
"icd10_title": "Sinus, fistula and cyst of branchial cleft"
},
{
"from_icd11": "LA6Z",
"icd10_code": "Q188",
"icd10_title": "Other specified congenital malformations of face and neck"
},
{
"from_icd11": "LA6Z",
"icd10_code": "Q10-Q18",
"icd10_title": ""
},
{
"from_icd11": "LA6Z",
"icd10_code": "Q182",
"icd10_title": "Other branchial cleft malformations"
},
{
"from_icd11": "ME84.0",
"icd10_code": "M542",
"icd10_title": "Cervicalgia"
},
{
"from_icd11": "ME84.0",
"icd10_code": "M530",
"icd10_title": "Cervicocranial syndrome"
},
{
"from_icd11": "ME84.0",
"icd10_code": "M531",
"icd10_title": "Cervicobrachial syndrome"
},
{
"from_icd11": "FA71",
"icd10_code": "M436",
"icd10_title": "Torticollis"
},
{
"from_icd11": "FA71",
"icd10_code": "M43",
"icd10_title": "Other deforming dorsopathies"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89351",
"icd10_title": "Hypertrophy of bone, right femur"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89361",
"icd10_title": "Hypertrophy of bone, right tibia"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M8938",
"icd10_title": "Hypertrophy of bone, other site"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89371",
"icd10_title": "Hypertrophy of bone, right ankle and foot"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89363",
"icd10_title": "Hypertrophy of bone, right fibula"
}
] |
Q680
|
Congenital deformity of sternocleidomastoid muscle
|
A 43-year-old woman was admitted to our hospital because of a tumor on the back of her head. She had undergone hemodialysis due to end-stage kidney disease caused by IgA nephropathy when she was 32 years old. The next year, she received an ABO-compatible living-related kidney transplant from her father. Her allograft kidney was maintained by immunosuppressive therapy consisting of tacrolimus, mycophenolate mofetil (MMF), and methylprednisolone. After transplantation, her serum creatinine level remained stable at 1.5 mg/dL. In addition, her serum trough level of tacrolimus was mostly controlled at 3 to 5 ng/ml after transplantation. The patient’s clinical course is outlined in Fig. 1 . Ten years after transplantation, she noticed a soft and compressible tumor on the left back of her head, and the major axis rapidly increased from 2 to 4 cm within 2 months . Echography revealed the characteristics of the tumor, including border irregularity, heterogeneity, and hypervascularity, suggesting malignant properties. Surgical resection of the tumor was then performed for diagnosis and treatment. Histological findings revealed solid aggregations of neoplastic cells that varied in size in the thickness of the dermis and subcutaneous tissue exclusively . There were many luminal structures that varied in shape inside the aggregations. Coagulative necrosis containing eosinophilic products and lipid granules in the cytoplasm of the cells was demonstrated in alveolar structures of the tumor on hematoxylin-eosin staining . In addition, a high rate of neoplastic cells was stained by Ki-67 (MIB-1 index, 22%), diagnosing the neoplasm as SC. To diagnose the MTS, further screening of visceral tumors was performed. The examinations revealed an early-stage adenocarcinoma in the transverse colon, which was subsequently treated with endoscopic mucosal resection. To make a definite diagnosis of MTS, we performed the following examinations of the tumors: 1) MSI gene locus assay, 2) immunohistochemical staining with MMR gene proteins, and 3) DNA direct sequencing of MMR genes. We performed MSI gene locus assays with the Promega MSI Analysis System , which consists of five mononucleotide repeat markers (BAT-25, BAT-26, NR-21, NR-24, and MONO-27) and two pentanucleotide markers (Penta C and Penta D). MSI in three of the seven markers was positive (MSI-H), indicating a high probability of MTS. HNPCC/MTS is induced by defective MMR due to germline mutations in any one of the DNA MMR genes. The deficiency of MMR is commonly demonstrated by the lack of any MMR proteins—MSH2, MSH6, MLH1, or PMS2—in neoplasms. The DNA MMR system mainly consists of two different heterodimers: MutSα (ex. MSH2-MSH6) and MutSβ (ex. MLH1-PMS2), and its defect, cause a dysfunction in the repair of base-base mismatches and small insertions and deletions, leading to the development of neoplasms . Immunohistochemical staining demonstrated the disappearance of MMR gene proteins in neoplastic cells of both the SC and colon cancer. All four MMR gene proteins—MSH2, MSH6, MLH1, and PMS2—were positive in normal epidermis and sebocytes, while the neoplastic cells of the SC were negative for MSH2 and MSH6 . The colon cancer also exhibited the significant disappearance of two MMR gene proteins (MSH2, MSH6), but normal development of MLH1 and PMS2. Furthermore, the patient’s familial history included only one brother with colon cancer, at 48 years of age. The patient’s genetic assessment using real-time PCR/direct sequencing detected a germline mutation of c.1226_1227delAG, p.Gln409ArgfsX7 in MSH2 exon 7, which was previously reported as the cause of HNPCC , and finally we diagnosed her with MTS. Thus, a low dose of everolimus, a mammalian target of rapamycin (mTOR) inhibitor, was administered and the serum trough level of tacrolimus dropped to 2 ng/ml at a dose of 1 mg/day to prevent further development of neoplasms due to MTS. Fig. 1 The patient’s clinical course. TAC, tacrolimus; mPSL, methylprednisolone; MMF, mycophenolate mofetil; AZA, azathioprine; ABOc-KTx, ABO-compatible kidney transplantation; RBx, renal biopsy; S-Cr, serum creatinine Fig. 2 Clinical and pathological presentation of sebaceous carcinoma. a Sebaceous carcinoma with an axis of 4 cm on the top of the head. The tumor was soft and elastic, and the central lesion had an ulcerated surface. b At low magnification with hematoxylin-eosin staining, the sebaceous carcinoma was seen to be present exclusively in subcutaneous tissue and to contain scattered lobular or tubular structures within stromal tissues covered with fibrous capsules. c At high magnification, each lobule consisted of basaloid-like cells and sebocyte-like cells with vacuolated cytoplasm, which were partly necrotized Fig. 3 Microsatellite instability (MSI) gene locus assay using the Promega MSI Analysis System, consisting of five mononucleotide repeat markers (BAT-25, BAT-26, NR-21, NR-24, and MONO-27) and two pentanucleotide markers (Penta C and Penta D), showing MSI in three of the seven gene loci (MSI-H). a Control. b Sebaceous carcinoma in this case Fig. 4 Immunohistochemical staining for DNA mismatch repair-related proteins (MMR proteins MSH2, MSH6, MLH1, and PMS2). The sebaceous carcinoma (white arrow) lacked MSH6 ( a ) and MSH2 ( b ) MMR proteins, but showed positive staining for PMS2 ( c ) and MLH1 ( d ). Normal epidermis and sebocytes (black arrow) expressed all four MMR proteins
| 4.316406
| 0.848633
|
sec[1]/p[0]
|
en
| 0.999996
|
31664942
|
https://doi.org/10.1186/s12882-019-1592-7
|
[
"proteins",
"gene",
"cells",
"tumor",
"staining",
"markers",
"sebaceous",
"carcinoma",
"kidney",
"tacrolimus"
] |
[
{
"code": "5B71",
"title": "Protein deficiency"
},
{
"code": "5B7Z",
"title": "Unspecified undernutrition"
},
{
"code": "DA96.02",
"title": "Malabsorption or intolerance of specific nutrients"
},
{
"code": "MF96.Z",
"title": "Proteinuria, unspecified"
},
{
"code": "3B61.1",
"title": "Acquired thrombophilia"
},
{
"code": "9A70.Y",
"title": "Other specified hereditary corneal dystrophies"
},
{
"code": "GB81",
"title": "Autosomal dominant polycystic kidney disease"
},
{
"code": "8A02.12",
"title": "Dystonia associated with heredodegenerative disorders"
},
{
"code": "5C50.E0",
"title": "Classical organic aciduria"
},
{
"code": "8E02.0",
"title": "Genetic Creutzfeldt-Jakob disease"
}
] |
=== ICD-11 CODES FOUND ===
[5B71] Protein deficiency
Also known as: Protein deficiency | protein deprivation
[5B7Z] Unspecified undernutrition
Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS
[DA96.02] Malabsorption or intolerance of specific nutrients
Definition: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken for food allergy, which is primarily involving the immune reaction against the food.
Also known as: Malabsorption or intolerance of specific nutrients | Carbohydrate intolerance other than lactose | disorder of carbohydrate absorption | Malabsorption due to intolerance to carbohydrate | carbohydrate intolerance
[MF96.Z] Proteinuria, unspecified
Also known as: Proteinuria, unspecified | Proteinuria | Albuminuria NOS | Proteinuria NOS
[3B61.1] Acquired thrombophilia
Definition: A disease caused by determinants arising after birth. This disease is characterised by abnormality of blood coagulation that increases the risk of thrombosis, clots in blood vessels. This disease may present with deep vein thrombosis or pulmonary embolism. Confirmation is identification of abnormal blood coagulation in a blood sample.
Also known as: Acquired thrombophilia | Gaisbock syndrome | polycythaemia due to stress | stress erythrocytosis | stress polycythaemia
[9A70.Y] Other specified hereditary corneal dystrophies
Also known as: Other specified hereditary corneal dystrophies | Epithelial juvenile corneal dystrophy | TGFBI - [transforming growth factor beta-induced] gene | Granular corneal dystrophy | granular-lattice corneal dystrophy
Includes: Granular corneal dystrophy
[GB81] Autosomal dominant polycystic kidney disease
Definition: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and due to mutations on chromosomes 16 and 4. Non-renal manifestations can include cysts in the liver and less commonly pancreas. Cerebral arterial aneurysms with subarachnoid haemorrhage, and other non-renal vascular abnormalities can also occur.
Also known as: Autosomal dominant polycystic kidney disease | adult polycystic kidney disease | Polycystic kidney, adult type | APCKD - [autosomal polycystic kidney disease] | Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis
[8A02.12] Dystonia associated with heredodegenerative disorders
Definition: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen.
Also known as: Dystonia associated with heredodegenerative disorders | Dystonia due to autosomal dominant disorders | Rapid-onset dystonia-parkinsonism | Dystonia due to dentatorubropallidoluysian atrophy | Dystonia due to Huntington disease
[5C50.E0] Classical organic aciduria
Definition: This a term used to classify a group of metabolic disorders which disrupt normal amino acid metabolism, particularly branched-chain amino acids, causing a buildup of acids which are usually not present.
Also known as: Classical organic aciduria | Methylmalonic aciduria - homocystinuria | Methylmalonic acidaemia - homocystinuria | Methylmalonic aciduria - homocystinuria type cbl C | Methylmalonic acidaemia - homocystinuria type cbl C
[8E02.0] Genetic Creutzfeldt-Jakob disease
Definition: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain.
Also known as: Genetic Creutzfeldt-Jakob disease | CJD - [Creutzfeldt-Jakob disease] | Creutzfeldt-Jakob | Creutzfeldt-Jakob disease | JCD - [Jakob-Creutzfeldt disease]
=== GRAPH WALKS ===
--- Walk 1 ---
[5B71] Protein deficiency
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--CHILD--> [5B50] Underweight in infants, children or adolescents
--- Walk 2 ---
[5B71] Protein deficiency
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--CHILD--> [5B51] Wasting in infants, children or adolescents
--- Walk 3 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--PARENT--> [?] Nutritional disorders
Def: Nutritional disorders in all their forms result from imbalances (excess or deficiency) in energy and/or specific macro and micronutrients. They occur when the intake of essential macronutrients and mi...
--- Walk 4 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--EXCLUDES--> [?] Human immunodeficiency virus disease associated with wasting syndrome
Def: This is a lentivirus (slowly replicating retrovirus) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threaten...
--- Walk 5 ---
[DA96.02] Malabsorption or intolerance of specific nutrients
Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...
--RELATED_TO--> [?] Lactose intolerance
Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...
--PARENT--> [?] Disorders of carbohydrate absorption or transport
--- Walk 6 ---
[DA96.02] Malabsorption or intolerance of specific nutrients
Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...
--RELATED_TO--> [?] Lactose intolerance
Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...
--CHILD--> [?] Primary lactase deficiency
|
[
"[5B71] Protein deficiency\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --CHILD--> [5B50] Underweight in infants, children or adolescents",
"[5B71] Protein deficiency\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --CHILD--> [5B51] Wasting in infants, children or adolescents",
"[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --PARENT--> [?] Nutritional disorders\n Def: Nutritional disorders in all their forms result from imbalances (excess or deficiency) in energy and/or specific macro and micronutrients. They occur when the intake of essential macronutrients and mi...",
"[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --EXCLUDES--> [?] Human immunodeficiency virus disease associated with wasting syndrome\n Def: This is a lentivirus (slowly replicating retrovirus) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threaten...",
"[DA96.02] Malabsorption or intolerance of specific nutrients\n Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...\n --RELATED_TO--> [?] Lactose intolerance\n Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...\n --PARENT--> [?] Disorders of carbohydrate absorption or transport",
"[DA96.02] Malabsorption or intolerance of specific nutrients\n Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...\n --RELATED_TO--> [?] Lactose intolerance\n Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...\n --CHILD--> [?] Primary lactase deficiency"
] |
5B71
|
Protein deficiency
|
[
{
"from_icd11": "5B71",
"icd10_code": "E46",
"icd10_title": "Unspecified protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E440",
"icd10_title": "Moderate protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E441",
"icd10_title": "Mild protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E640",
"icd10_title": "Sequelae of protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E44",
"icd10_title": "Protein-calorie malnutrition of moderate and mild degree"
},
{
"from_icd11": "5B71",
"icd10_code": "E45",
"icd10_title": "Retarded development following protein-calorie malnutrition"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E43",
"icd10_title": "Unspecified severe protein-calorie malnutrition"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E538",
"icd10_title": "Deficiency of other specified B group vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E569",
"icd10_title": "Vitamin deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E638",
"icd10_title": "Other specified nutritional deficiencies"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E639",
"icd10_title": "Nutritional deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E41",
"icd10_title": "Nutritional marasmus"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E539",
"icd10_title": "Vitamin B deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E568",
"icd10_title": "Deficiency of other vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E649",
"icd10_title": "Sequelae of unspecified nutritional deficiency"
}
] |
E46
|
Unspecified protein-calorie malnutrition
|
The pedigree for the family with KIF1A variant is shown in Fig. 1 . All the enrolled family members were previously diagnosed with undiagnosed intellectual disability and spastic paraplegia. Clinical manifestations of patients with dominant KIF1A variant enrolled in this study were described in Table 1 . Patient I.1, who was initially evaluated at the age of 35 years, is a woman from South Korea with mild cognitive impairment, optic nerve atrophy, and peripheral sensorimotor polyneuropathy affecting bilateral lower extremities. She underwent achilles tendon release operation due to spastic gait at age 17. On examination, she had both knee spasticity, Babinski reflex, and hyperreflexs on knees and ankles. She had increased tone and spasticity in the lower extremities with extensor plantar responses bilaterally. Family history is significant for her mother and two sisters with severe intellectual disability and spastic paraplegia. Patient II.1, who was evaluated at the age of 10 years, is a first daughter of patient I.1. She presented with mild cognitive impairment and spastic paraplegia. She was unable to roll over and had poor head control at the age of 6 months. She could walk alone at the age of 21 months. Her language development was delayed so that she only spoke a few words. She was then diagnosed with optic nerve hypoplasia at the age of 10 years. On examination, she had microcephaly (head circumference <3rd percentile) and her reflexes were hyperactive. Brain MRI revealed thinning of corpus callosum and ill-defined lesion of periventricular white matter . She showed thoracolumbar scoliosis. Patient II.2, who is a 7-year-old-girl with tip-toe walking, is a second daughter of patient I.1. She could walk first time when she was 18 months old. She was obese (body mass index 98.4th percentile). On examination, she has deformities on ankles, widening popliteal angle, and anterior pelvic tilting. She also showed moderate cognitive impairment and dysarthria. Reflexes were hyperactive and her strength was within normal limits for her age. Ophthalmologic evaluation showed pale optic disc. Brain MRIs showed thinning of corpus callosum and ill-defined lesion of periventricular white matter. Patient II.3, a 5-year-old-boy, had both equinus deformity and walked with spastic gait. He had both knees spasticity, Babinski reflex, and hyperreflexs on knees and ankles, and had great function with his hands. He developed partial seizure attack when he was 4 years old. Ophthalmologic examination showed pale optic disc. Brain MRIs showed thinning of corpus callosum and ill-defined lesion of periventricular white matter. He showed mild intellectual disability with speech delay. Figure 1 Familial segregation of the KIF1A variant. Pedigree structure of a family with c.773C > T (p.Thr258Met) variant in KIF1A . Black symbols represent patients with KIF1A . Arrow indicates proband. Only participants in the study for whom DNA is available for analysis are numbered. Table 1 Clinical manifestations of patients with KIF1A variant enrolled in this study as well as a summary of clinical characteristics in the three previous reports of patients with de novo KIF1A mutations. Patient I.1 Patient II.1 Patient II.2 Patient II3 Nieh et al . 16 Hotchkiss et al . 17 Hotchkiss et al . 17 KIF1A mutation c.773 C > T (T258M) c.773 C > T (T258M) c.773 C > T (T258M) c.773 C > T (T258M) Various de novo missense mutations c.595 G > A (G199R) c.902 G > A (R307Q) Gender Female Female Female Male 4 female, 2 male Male Male Age (years) 35 10 7 5 1.5–16 6 14 Cognition & language Mild ID with language delay Mild ID with language delay Moderate ID with language delay Mild ID with language delay Severe global developmental delay Severe cognitive impairment with language delay Severe cognitive impairment with language delay Ophthalmologic involvement Optic nerve atrophy Optic nerve hypoplasia Pale optic disks Pale optic disks 3/6 Optic nerve atrophy 4/6 cortical visual impairment 1/6 abnormal eye movements, 1/6 cataracts Nystagmus, pale optic disks Pale optic disks Brain MRI nd Thinning of corpus callosum Thinning of corpus callosum Thinning of corpus callosum 6/6 progressive cerebral and cerebellar atrophy Thinning of corpus callosum, cerebellar Atrophy Thinning of corpus callosum, cerebellar atrophy Microcephaly nd Yes (<3rd percentile) No (25th percentile) No (10th percentile) 4/6 yes No (25th percentile) Yes (3rd percentile) Contractures Ankles(Achilles tendon release at age 17yrs), knees, elbow Elbows, ankles, knees Ankles, knees Ankles nd Ankles(Achilles tendon release at age 6mo) Elbows, ankles, knees Spine Scoliosis Scoliosis Normal Normal nd Minor kyphosis Scoliosis NCV testing Sensorimotor polyneuropathy in lower extremities nd nd nd nd Axonal sensory-motor polyneuropathy Distal motor neuropathy with absent sensory responses in upper and lower extremities Epilepsy no no no yes 2/6 seizures 4/6 no seizures No yes nd, not done. Figure 2 Axial T2-weighted magnetic resonance image of patients. ( A , Patient II.1; B , Patient II.2; C , Patient II.3) MRI shows thinning of corpus callosum on axial T2- weighted image which is shown in yellow arrow. Figure 3 Fluid-attenuated inversion recovery (FLAIR) magnetic resonance image of patients. ( A , Patient II.1; B , Patient II.2; C , Patient II.3) FLAIR imaging shows ill-defined lesion of periventricular white matter which is shown in yellow circle.
| 4.089844
| 0.672363
|
sec[1]/sec[0]/p[0]
|
en
| 0.999995
|
28970574
|
https://doi.org/10.1038/s41598-017-12999-9
|
[
"optic",
"ankles",
"thinning",
"corpus",
"callosum",
"language",
"delay",
"knees",
"percentile",
"patients"
] |
[
{
"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": "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"
}
] |
=== ICD-11 CODES FOUND ===
[9C40.BZ] Optic atrophy, unspecified
Also known as: Optic atrophy, unspecified | Optic atrophy | optic nerve atrophy | Primary optic atrophy | OA - [optic atrophy]
[9C40.Z] Disorder of the optic nerve, unspecified
Also known as: Disorder of the optic nerve, unspecified | Disorder of the optic nerve | disease of optic cranial nerve | disease of optic nerve | disease of second cranial nerve
[9C40.1Y] Other specified optic neuritis
Also known as: Other specified optic neuritis | Idiopathic inflammatory optic neuropathy | Idiopathic demyelinating optic neuropathy | optic nerve inflammation | optic nerve neuropathy
[9C40.B0] Congenital optic atrophy
Also known as: Congenital optic atrophy
[9C40.Y] Other specified disorder of the optic nerve
Also known as: Other specified disorder of the optic nerve | Nutritional optic neuropathy | nutritional amblyopia | Toxic optic neuropathy | Haemorrhage in optic nerve sheath
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[9C40.BZ] Optic atrophy, unspecified
--PARENT--> [9C40.B] Optic atrophy
Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...
--CHILD--> [9C40.B1] Acquired optic atrophy
--- Walk 2 ---
[9C40.BZ] Optic atrophy, unspecified
--PARENT--> [9C40.B] Optic atrophy
Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...
--RELATED_TO--> [?] Leber hereditary optic neuropathy
Def: Optic nerve disorders caused by mutations in mitochondrial DNA...
--- Walk 3 ---
[9C40.Z] Disorder of the optic nerve, unspecified
--PARENT--> [9C40] Disorder of the optic nerve
--RELATED_TO--> [?] Congenital malformation of optic disc
--- Walk 4 ---
[9C40.Z] Disorder of the optic nerve, unspecified
--PARENT--> [9C40] Disorder of the optic nerve
--RELATED_TO--> [?] Malignant neoplasm of the optic nerve
--- Walk 5 ---
[9C40.1Y] Other specified optic neuritis
--PARENT--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--PARENT--> [9C40] Disorder of the optic nerve
--- Walk 6 ---
[9C40.1Y] Other specified optic neuritis
--PARENT--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--PARENT--> [9C40] Disorder of the optic nerve
|
[
"[9C40.BZ] Optic atrophy, unspecified\n --PARENT--> [9C40.B] Optic atrophy\n Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...\n --CHILD--> [9C40.B1] Acquired optic atrophy",
"[9C40.BZ] Optic atrophy, unspecified\n --PARENT--> [9C40.B] Optic atrophy\n Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...\n --RELATED_TO--> [?] Leber hereditary optic neuropathy\n Def: Optic nerve disorders caused by mutations in mitochondrial DNA...",
"[9C40.Z] Disorder of the optic nerve, unspecified\n --PARENT--> [9C40] Disorder of the optic nerve\n --RELATED_TO--> [?] Congenital malformation of optic disc",
"[9C40.Z] Disorder of the optic nerve, unspecified\n --PARENT--> [9C40] Disorder of the optic nerve\n --RELATED_TO--> [?] Malignant neoplasm of the optic nerve",
"[9C40.1Y] Other specified optic neuritis\n --PARENT--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...\n --PARENT--> [9C40] Disorder of the optic nerve",
"[9C40.1Y] Other specified optic neuritis\n --PARENT--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...\n --PARENT--> [9C40] Disorder of the optic nerve"
] |
9C40.BZ
|
Optic atrophy, unspecified
|
[
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47213",
"icd10_title": "Primary optic atrophy, bilateral"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47291",
"icd10_title": "Other optic atrophy, right eye"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47292",
"icd10_title": "Other optic atrophy, left eye"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H4720",
"icd10_title": "Unspecified optic atrophy"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H4722",
"icd10_title": "Hereditary optic atrophy"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47239",
"icd10_title": "Glaucomatous optic atrophy, unspecified eye"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H472",
"icd10_title": "Optic atrophy"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H48",
"icd10_title": ""
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H480",
"icd10_title": ""
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47012",
"icd10_title": "Ischemic optic neuropathy, left eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47099",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47091",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, right eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47093",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, bilateral"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47019",
"icd10_title": "Ischemic optic neuropathy, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47013",
"icd10_title": "Ischemic optic neuropathy, bilateral"
}
] |
H47213
|
Primary optic atrophy, bilateral
|
A 64-year-old woman had undergone lower gastrointestinal endoscopy by her previous physician after fecal occult blood testing during a medical checkup yielded a positive result. The patient was referred to our department for surgery after endoscopic examination revealed a lesion in the ileocecal region with substantial extension into the appendiceal orifice, and endoscopic treatment was judged too difficult. The patient was 152 cm tall, weighed 57 kg, and had a body mass index of 24.5 kg/m 2 . She had a history of chronic renal failure and lipid metabolism disorder. Preoperative blood samples showed no anemia and no elevation of tumor marker levels. Lower gastrointestinal endoscopy revealed a 30 mm, laterally spreading tumor in the cecum, occupying two-thirds of the appendiceal opening . A biopsy specimen revealed a suspected well-differentiated adenocarcinoma. Thoracoabdominal computed tomography (CT) showed no obvious regional lymphadenopathy or distant metastasis. The preoperative diagnosis was appendiceal cancer cT1N0M0 stage I. We planned laparoscopic right colectomy plus Japanese D3 lymph node dissection. The surgery was performed through 5 ports. A camera port was inserted at the umbilicus and forceps ports were inserted in a square pattern to the left and right upper and lower abdomen. Starting with a cranial approach, the mesenteric base of the transverse colon was identified with the pancreatic submargin and dissection was advanced between the stomach and duodenum. Adhesion between the transverse colon and duodenum was strong, and each piece was carefully dissected and the hepatic curvature was taken down. No damage requiring repair was evident in the duodenum within visible range . The ileocecal vein/artery and right branch of the middle colonic artery were clipped and resected. After mesenteric processing, the specimen was dissected with a stapler and removed. Reconstruction was performed intracorporeally by delta anastomosis. The operation time was 2 h 52 min, with blood loss of 7 ml. The pathological diagnosis was high-grade tubular adenoma. Postoperatively, the patient developed temporary ileus and required nasogastric intubation, but she recovered without further intervention. Postoperative laboratory data showed slight anemia (hemoglobin 10.7 g/dl) and slightly elevated C-reactive protein (10.6 g/l), with gradual improvements over time. The patient was scheduled for discharge from hospital on postoperative day 10, but on the morning of the proposed day of discharge, she suddenly vomited blood. Contrast-enhanced CT of the abdomen showed a large amount of hemorrhage in the stomach, suggesting a large volume of gastrointestinal bleeding . Free air was observed near the duodenal bulb . No extravasation was apparent. Despite urgent blood transfusion, vital signs remained unstable and emergency surgery was performed for upper gastrointestinal bleeding and suspected perforation of the upper gastrointestinal tract . When the laparotomy was performed through upper and lower midline abdominal incisions, pale hematogenous ascites was observed around the duodenum. The left side of the duodenal bulb, bordering the pancreas, showed an area of fragile duodenal wall and partial perforation, with active bleeding from the inside . However, visualizing the origin of bleeding in the duodenum proved difficult, so the duodenum was divided circumferentially to confirm the bleeding point, then hemostasis was achieved with ligation . The left posterior wall of the duodenum was found to be missing, exposing the pancreas. For reconstruction, the jejunum was separated with a stapler then elevated by the posterior colonic route. The elevated jejunum and duodenal section were then anastomosed in an end-to-side manner. The gastric transection was detached with a stapler after trimming. Gastric jejunal anastomosis and Brown anastomosis were added . A drain was placed before and after the duodenojejunal anastomosis, and the surgery was completed. The operation time was 3 h 25 min, with blood loss of 1351 ml. Postoperatively, the patient was admitted to an intensive care unit for systemic management. Postoperative vital signs were stable and she was extubated on postoperative day 1 and transferred to a general ward on postoperative day 3. Follow-up CT of the abdomen on postoperative day 5 showed no active bleeding, and the patient started drinking water on postoperative day 7. She resumed eating on postoperative day 10. As abdominal symptoms did not worsen, she was discharged home on postoperative day 21. Fig. 1 Colonoscopy. Colonoscopy shows a 30 mm, laterally spreading tumor located in the cecum Fig. 2 Intraoperative findings. a , b Dissection between the mesentery and duodenum ( a ) followed by lymph node dissection ( b ) Fig. 3 Contrast-enhanced CT. a Contrast-enhanced CT of the abdomen shows a large amount of hemorrhage in the stomach, suggesting massive gastrointestinal bleeding. b Free air is observed near the duodenal bulb (arrow) Fig. 4 Course of gastrointestinal hemorrhage Fig. 5 Schema of emergency surgery. a Duodenal bulb is partially perforated with active bleeding from the inside. b After dissection of the duodenum. c Reconstruction. The jejunum is dissected and elevated via the posterior colonic route. The ascending jejunum and transected duodenum are anastomosed at the end, with the addition of gastric jejunal anastomosis and Brown anastomosis
| 3.855469
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999999
|
38227092
|
https://doi.org/10.1186/s40792-024-01816-x
|
[
"duodenum",
"postoperative",
"bleeding",
"gastrointestinal",
"blood",
"anastomosis",
"duodenal",
"dissection",
"abdomen",
"bulb"
] |
[
{
"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": "NE81.0Z",
"title": "Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified"
},
{
"code": "NE81.3",
"title": "Postsurgical leak"
},
{
"code": "QF00",
"title": "Acquired absence of limb"
},
{
"code": "DB30.2",
"title": "Adhesions of large intestine with obstruction"
},
{
"code": "MG30.21",
"title": "Chronic postsurgical pain"
}
] |
=== 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
[NE81.0Z] Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified
Also known as: Haemorrhage or haematoma of other or unspecified site complicating a procedure, not elsewhere classified | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | postoperative haemorrhage | postoperative bleeding | Haemorrhage at any site resulting from a procedure
[NE81.3] Postsurgical leak
Also known as: Postsurgical leak | postoperative leak | Postsurgical air leak | postoperative air leak | Postsurgical bile leak
Excludes: Malfunction or complication of external stoma of digestive organs | Tracheostomy malfunction
[QF00] Acquired absence of limb
Also known as: Acquired absence of limb | post traumatic loss of limb | postoperative loss of limb | bilateral amputee | amputee
Includes: postoperative loss of limb | post traumatic loss of limb
Excludes: Other acquired deformities of limbs | Congenital absence of thigh or lower leg with foot present | Congenital absence of both lower leg and foot
[DB30.2] Adhesions of large intestine with obstruction
Definition: Large bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis.
Also known as: Adhesions of large intestine with obstruction | Postoperative obstruction of the large intestine
[MG30.21] Chronic postsurgical pain
Definition: Chronic postsurgical pain is chronic pain developing or increasing in intensity after a surgical procedure and persisting beyond the healing process, i.e. at least 3 months after surgery. The pain is either localised to the surgical field, projected to the innervation territory of a nerve situated in this area, or referred to a dermatome (after surgery/injury to deep somatic or visceral tissues). Other causes of pain including infection, malignancy etc. need to be excluded as well as pain contin
Also known as: Chronic postsurgical pain | postsurgical pain | chronic postoperative pain | chronic postamputation pain | Chronic pain after spinal surgery
Includes: Chronic pain after spinal surgery | Chronic pain after herniotomy | Chronic pain after hysterectomy
=== 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....
--RELATED_TO--> [?] Duodenal ulcer
Def: Duodenal ulcer is defined as a distinct breach in the mucosa of the duodenum as a result of caustic effects of acid and pepsin in the lumen. Histologically, duodenal ulcer is identified as necrosis of...
--- 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 --RELATED_TO--> [?] Duodenal ulcer\n Def: Duodenal ulcer is defined as a distinct breach in the mucosa of the duodenum as a result of caustic effects of acid and pepsin in the lumen. Histologically, duodenal ulcer is identified as necrosis of...",
"[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 77-year-old man, with well-controlled hepatitis B virus (HBV) by entecavir (HBsAg positive, HBsAb negative, HBcAb positive, HBeAg negative, and undetectable HBV-DNA), was diagnosed with a primary HCC and was treated with radiofrequency ablation (RFA) in January 2010 at the previous hospital. Ten months later, he was admitted to our hospital because of the intrahepatic recurrences and then treated with RFA and with partial hepatectomy. One year later, he had a recurrence at the needle site of RFA on the chest wall and local resection was performed. However, he showed multiple and bilateral lung metastases with local recurrence at the chest wall, whereas there was no viable lesion in the liver. At that time, liver function was categorized as Child-Pugh class A with normal range of blood counts, electrolytes, and renal functions. Sorafenib was introduced 400 mg twice a day (total 800 mg/day), and there was no significant adverse event 1 week after the administration. Just after 1 month, when we checked, he is in a good general condition only with slight hand rubefaction that does not influence the treatment continuation and his laboratory data are without unexpected values (the serum total bilirubin 1.4 mg/dl, AST 33 IU/L, ALT 24 IU/L); he had general fatigue and appetite loss, and those symptoms gradually worsened despite improvement of the skin reaction. Two months after the induction of sorafenib, the symptoms aggressively worsened, and the laboratory data demonstrated significantly worsened liver functions in the serum bilirubin value (total bilirubin 28.6 mg/dl, direct bilirubin 20.4 mg/dl), transaminase values , and other liver enzymes (Table 1 ), without significant evidence of HBV reactivation. By computed tomography, there is no significant finding such as intra- and extra-biliary duct dilatation and intrahepatic recurrence. Therefore, the fatal liver dysfunction was diagnosed due to sorafenib-related adverse event. We stopped the intake of sorafenib and treated with stronger Neo-Minophagen C and ursodeoxycholic acid. While serum transaminase values decreased in response to the above treatments, the serum bilirubin level did not change. As a next therapeutic approach, we started hyperbaric oxygen therapy (HBOT) every business day from day 8. HBOT was provided with a monoplace hyperbaric chamber. He was accommodated for about an hour and a half in the chamber, where the ambient pressure with pure oxygen increased two times higher than the local atmospheric pressure in 10 to 15 min; it was maintained for 60 min and was relieved back to the atmospheric pressure gradually in the same or more time spent than the increasing time. Thereafter, the serum bilirubin level started to decrease depending on the number of times of HBOT, and he could sustain himself with oral take . Interestingly, the serum bilirubin levels failed to decrease during the weekend without HBOT. For example, while gradual decrease of the serum total bilirubin level was observed in the interval only on weekdays between days 15 (18.9 mg/dl) and 18 (17.4 mg/dl), there is no change of the bilirubin level in the interval including a weekend between days 18 and 22 (17.7 mg/dl). This tendency was observed during the prominent hyperbilirubinemia. A liver biopsy was performed, and the microscopic findings demonstrated cholestasis, degeneration, and necrosis in hepatocytes with lymphocyte infiltration . On day 43 from the start of treatment, although a phenobarbital was administered in addition to HBOT in anticipation of further improvement in bilirubin level, an additional phenobarbital treatment seemed to be not effective. After 2 months of treatment, serum bilirubin level was around 3 mg/dl and he was discharged and restarted to treat HCC with tegafur/uracil leucovorin, but as progression of the lung metastases, he died 1 year after discharge. Table 1 Laboratory data on admission Total-bilirubin 28.6 mg/dl α-fetoprotein (AFP) 98.2 ng/ml PT 16.3 s D-Bilirubin 20.4 mg/dl AFP-L3 20.1 % PT 60 % Albumin 3.3 g/dl PIVKA-II 876 mAU/ml PT 1.47 ALT 1098 U/l CEA 3 ng/ml APTT 39.4 s AST 1611 U/l APTT 67 % Ammonia 29 μg/dl White blood cell 4300/μl Bile acid 175 μmol/l Neutrocytes 68 % γ-GTP 136 mg/dl Hemoglobin 12.7 g/dl LDH 70 U/l Platelet counts 7.3 × 10 3 /μl ALP 606 U/l Child-Pugh score 8 (grade B) Cholinesterase 116 U/l MELD score 23 CRP 3.09 mg/dl BUN 12.8 mg/dl Creatinine 0.85 mg/dl PT 60 % PT-INR 1.47 ALT alanine transaminase, AST aspartate aminotransferase, γ-GTP γ-glutamyl transpeptidase, LDH lactate dehydrogenase, ALP alkaline phosphatase, CRP C-reactive protein, BUN blood urea nitrogen, PT prothrombin time, PT-INR prothrombin time-international normalized ratio, PIVKA-II des-γ-carboxy prothrombin, CEA carcinoembryonic antigen Fig. 1 Time course of treatment and improvement of the liver dysfunction. AST aspartate aminotransferase, ALT alanine aminotransferase, T-Bil total bilirubin, D-Bil direct bilirubin, UDCA ursodeoxycholic acid, HBOT hyperbaric oxygen therapy, SNMC stronger neo-minophagen C Fig. 2 Pathological findings of sorafenib-induced liver dysfunction revealed by needle biopsy. a There are fibrous thickening in Glisson’s capsules, moderate P-P bridging fibrosis, piecemeal necrosis, and ridging necrosis in part. b There are moderate hepatocytic degeneration and necrosis, lymphocytic infilterate to Glisson’s cupsule, hepatocytic balooning, and cholestasis in hepatocyte
| 4.097656
| 0.962891
|
sec[1]/p[0]
|
en
| 0.999998
|
26943680
|
https://doi.org/10.1186/s40792-016-0131-z
|
[
"bilirubin",
"liver",
"serum",
"time",
"total",
"hbot",
"sorafenib",
"necrosis",
"treated",
"recurrence"
] |
[
{
"code": "5C90.1",
"title": "Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport"
},
{
"code": "5C58.00",
"title": "Crigler-Najjar syndrome"
},
{
"code": "5C58.0Z",
"title": "Disorders of bilirubin metabolism or excretion, unspecified"
},
{
"code": "5C58.Z",
"title": "Inborn errors of porphyrin or heme metabolism, unspecified"
},
{
"code": "KA86",
"title": "Neonatal kernicterus"
},
{
"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 ===
[5C90.1] Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport
Definition: These are liver diseases due to disorders of porphyrin and bilirubin metabolism and transport
Also known as: Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport | disease of bilirubin metabolism | disorder of bilirubin metabolism | Liver diseases due to porphyria | Other disorders of bilirubin metabolism or excretion
Excludes: Defects of catalase and peroxidase
[5C58.00] Crigler-Najjar syndrome
Definition: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activity. Two types have been described, CNS types 1 and 2, depending on whether the enzymatic deficit is complete or partial: clinical manifestations vary accordingly. Patients present with isolated jaundice that appears early in life. Biological analyses detect severe unconjugated hyperbilirubinemia wit
Also known as: Crigler-Najjar syndrome | Bilirubin uridinediphosphate glucuronosyltransferase deficiency | Hereditary unconjugated hyperbilirubinaemia | Bilirubin-UGT deficiency | UGT deficiency
[5C58.0Z] Disorders of bilirubin metabolism or excretion, unspecified
Also known as: Disorders of bilirubin metabolism or excretion, unspecified | Disorders of bilirubin metabolism or excretion
[5C58.Z] Inborn errors of porphyrin or heme metabolism, unspecified
Also known as: Inborn errors of porphyrin or heme metabolism, unspecified | Inborn errors of porphyrin or heme metabolism | defects of catalase and peroxidase | disorders of porphyrin and bilirubin metabolism | Disorders of porphyrin or heme metabolism
[KA86] Neonatal kernicterus
Definition: Kernicterus is a pathologic diagnosis of the neonate that is characterised by yellow staining of the basal ganglia following elevated bilirubin concentrations in the blood and/or a breech in the blood brain barrier more common in the premature infant or the sick term neonate. It is characterised later in infancy and childhood by hearing deficits, choreoathetosis, and varying degrees of cognitive deficit.
Also known as: Neonatal kernicterus | bilirubin encephalopathy | nuclear jaundice | kernicterus of newborn NOS | hyperbilirubinaemia encephalopathy
Excludes: kernicterus due to inborn errors of metabolism
[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 ---
[5C90.1] Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport
Def: These are liver diseases due to disorders of porphyrin and bilirubin metabolism and transport...
--RELATED_TO--> [?] Variegate porphyria
Def: Variegate porphyria is a form of acute hepatic porphyria characterised by the occurrence of neuro-visceral attacks with or without the presence of cutaneous lesions (bullous photodermatitis)....
--PARENT--> [?] Hepatic porphyrias affecting the skin
--- Walk 2 ---
[5C90.1] Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport
Def: These are liver diseases due to disorders of porphyrin and bilirubin metabolism and transport...
--RELATED_TO--> [?] Porphyria cutanea tarda
Def: Porphyria cutanea tarda (PCT) is due to an accumulation of uroporphyrins in plasma from blockage of the normal haem synthetic pathway in the liver at the level of uroporphyrinogen decarboxylase (URO-D...
--PARENT--> [?] Hepatic porphyrias affecting the skin
--- Walk 3 ---
[5C58.00] Crigler-Najjar syndrome
Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...
--PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion
--CHILD--> [5C58.00] Crigler-Najjar syndrome
Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...
--- Walk 4 ---
[5C58.00] Crigler-Najjar syndrome
Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...
--PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion
--CHILD--> [5C58.01] Gilbert syndrome
Def: Gilbert's syndrome is an inherited liver disorder characterised by jaundice due to unconjugated hyperbilirubinemia, resulting from a partial deficiency in hepatic bilirubin glucuronosyltransferase act...
--- Walk 5 ---
[5C58.0Z] Disorders of bilirubin metabolism or excretion, unspecified
--PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion
--CHILD--> [5C58.00] Crigler-Najjar syndrome
Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...
--- Walk 6 ---
[5C58.0Z] Disorders of bilirubin metabolism or excretion, unspecified
--PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion
--RELATED_TO--> [?] Neonatal hyperbilirubinaemia
Def: A condition characterised as an increased level of bilirubin above 85 µmol/l (5 mg/dL) which manifests as yellowing of the eyes, skin, and other tissues of a newborn due to excessive break-down of red...
|
[
"[5C90.1] Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport\n Def: These are liver diseases due to disorders of porphyrin and bilirubin metabolism and transport...\n --RELATED_TO--> [?] Variegate porphyria\n Def: Variegate porphyria is a form of acute hepatic porphyria characterised by the occurrence of neuro-visceral attacks with or without the presence of cutaneous lesions (bullous photodermatitis)....\n --PARENT--> [?] Hepatic porphyrias affecting the skin",
"[5C90.1] Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport\n Def: These are liver diseases due to disorders of porphyrin and bilirubin metabolism and transport...\n --RELATED_TO--> [?] Porphyria cutanea tarda\n Def: Porphyria cutanea tarda (PCT) is due to an accumulation of uroporphyrins in plasma from blockage of the normal haem synthetic pathway in the liver at the level of uroporphyrinogen decarboxylase (URO-D...\n --PARENT--> [?] Hepatic porphyrias affecting the skin",
"[5C58.00] Crigler-Najjar syndrome\n Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...\n --PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion\n --CHILD--> [5C58.00] Crigler-Najjar syndrome\n Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...",
"[5C58.00] Crigler-Najjar syndrome\n Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...\n --PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion\n --CHILD--> [5C58.01] Gilbert syndrome\n Def: Gilbert's syndrome is an inherited liver disorder characterised by jaundice due to unconjugated hyperbilirubinemia, resulting from a partial deficiency in hepatic bilirubin glucuronosyltransferase act...",
"[5C58.0Z] Disorders of bilirubin metabolism or excretion, unspecified\n --PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion\n --CHILD--> [5C58.00] Crigler-Najjar syndrome\n Def: Crigler-Najjar syndrome is an autosomal recessive disorder of bilirubin metabolism characterised by unconjugated hyperbilirubinemia due to a hepatic deficit of bilirubin glucuronosyltransferase activi...",
"[5C58.0Z] Disorders of bilirubin metabolism or excretion, unspecified\n --PARENT--> [5C58.0] Disorders of bilirubin metabolism or excretion\n --RELATED_TO--> [?] Neonatal hyperbilirubinaemia\n Def: A condition characterised as an increased level of bilirubin above 85 µmol/l (5 mg/dL) which manifests as yellowing of the eyes, skin, and other tissues of a newborn due to excessive break-down of red..."
] |
5C90.1
|
Liver diseases due to disorders of porphyrin or bilirubin metabolism or transport
|
[
{
"from_icd11": "5C90.1",
"icd10_code": "E806",
"icd10_title": "Other disorders of bilirubin metabolism"
},
{
"from_icd11": "5C58.00",
"icd10_code": "E805",
"icd10_title": "Crigler-Najjar syndrome"
},
{
"from_icd11": "5C58.0Z",
"icd10_code": "E807",
"icd10_title": "Disorder of bilirubin metabolism, unspecified"
},
{
"from_icd11": "5C58.0Z",
"icd10_code": "R179",
"icd10_title": ""
},
{
"from_icd11": "5C58.Z",
"icd10_code": "E803",
"icd10_title": "Defects of catalase and peroxidase"
},
{
"from_icd11": "5C58.Z",
"icd10_code": "E80",
"icd10_title": "Disorders of porphyrin and bilirubin metabolism"
},
{
"from_icd11": "KA86",
"icd10_code": "P57",
"icd10_title": "Kernicterus"
},
{
"from_icd11": "KA86",
"icd10_code": "P570",
"icd10_title": "Kernicterus due to isoimmunization"
},
{
"from_icd11": "KA86",
"icd10_code": "P578",
"icd10_title": "Other specified kernicterus"
},
{
"from_icd11": "KA86",
"icd10_code": "P579",
"icd10_title": "Kernicterus, 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"
}
] |
E806
|
Other disorders of bilirubin metabolism
|
In our case observation, we had a 71-year-old obese (body mass index (BMI) 33, weight 204.8 pounds/92.9 kg, height 66 inches/167.64 cm) African American male who looked younger than his age with a relevant past medical history ( Table S1 , Past medical history for details and Table S2 for Home medication list) of uncontrolled hypertension but controlled hyperlipidemia, compensated Class IA systolic cardiomyopathy with ejection fraction 35–40%, coronary heart disease, diabetes hemoglobinA1c (HgA1c 8.3%), pulmonary embolism (PE) from provoked leg injury-related deep vein thrombosis (DVT) on warfarin International Normalized Ratio (INR) 2–3 due to recurrence in 2015, pelvo-abdominal horse-shoe kidney, Gold class 1A chronic obstructive pulmonary disease (COPD), fatty liver, mild anemia, tobacco use in remission and intermittent alcohol. He presented with 4–6 days of subjective fever, and worsening sinus and cough symptoms causing dyspnea and dizziness with mild exertion from walking to the bathroom from bed. He also had generalized weakness and cough with clear to yellow phlegm. He had no chest pain, orthopnea, or paroxysmal nocturnal dyspnea but had palpitations on mild exertion. Patient denied nausea, vomiting, diarrhea, dysuria or leg swelling. On arrival, he was alert and oriented. His significant vital signs at rest ( Table S3 ) were afebrile, with a heart rate of 87–98 and BP (blood pressure) of 201/110–140/92, and RR (respiratory rate) of 14–18. He was hypoxic on room air with O 2 sats (oxygen saturation) of 93% at room air, but when he stood up to go to the bathroom, his O 2 sats dropped to 85% on room air, RR rose to 24, HR rose to 120, and SBP (systolic blood pressure) dropped to 96. He was stabilized and required 2–3 L of oxygen saturation with 94–96% and intravenous normal saline fluids for hypotensive SBP. He also felt dizzy getting up. On exam, he was feeling weak but alert and oriented to name, place and date. He was ambulatory, but only for a very short distance before he would decompensate, as mentioned above. He had rhonchi in both lungs diffusely with no other significant findings on other organ systems. Significant negative exam findings were no jugular venous pressure (JVP), heart murmur, or leg edema. His significant bloodwork showed he was positive for the Covid-19 molecular test, elevated liver function tests (LFT) ( Table 1 ), elevated COVID inflammatory panel with normal pro-BNP (brain natriuretic peptide) and troponin-I ( Table 2 ), urine showing glucosuria and a high specific gravity of 1.024. A low vitamin D of 11 and folate of 5.2 were noted ( Table 3 ). His prothrombin time and international normalized ratio (PT/INR) was therapeutic at 2.5 with elevated platelets at 480/uL, and mild, stable anemia ( Table 4 ). Chest X-ray and CT angiography (CTA) showed no pulmonary embolism (PE) but bilateral multilobe ground-glass opacities (GGO). His electrocardiogram (EKG) was sinus tachycardia with no ST-T changes. Table 5 presents the blood chemistry. On admission, the patient received fluids and methylprednisolone (80 mg drip), and remdesivir was started the following day along with community bacterial pneumonia antibiotics (ceftriaxone 2 g with azithromycin 500 mg) and mometasone inhaler. He received COVID-19 related supplements including vitamin C, vitamin D, zinc, melatonin, thiamine, and folate as part of his inpatient medications ( Table S4 ). He declined experimental treatment. He repeatedly declined consent for convalescent plasma. He was generally improving as perceived by the patient symptomatically and based on his inflammatory markers ( Table 4 ) and other labs, except for platelet count, which was high on admission but dropped to normal on day 4 ( Table 1 ). He did not require supplemental oxygen at rest or walking short distances within the room but it was still required for walking during physical therapy by day 3. He expressed the desire to go home on oxygen as needed when remdesivir infusion was completed. Unfortunately, on Day 4, he decompensated suddenly late afternoon with a mild rise in troponin-I (0.06) and a D-Dimer rise to >20 from 1.1 ( Table 4 ), while being therapeutic on warfarin since admission. His anemia was stable although his white blood cells (WBC) rose ( Table 1 ). We attributed this to methylprednisolone. His cultures showed no growth in both blood and urine. His chest X-ray from late the night before showed worsening of infiltrates. His oxygen requirement increased from 2 L to 4 L later on the day of decompensation. The patient did not believe our concerns of an impending critical adverse event. After educating the patient in the presence of our African American respiratory therapist, we immediately ordered the conversion of warfarin to therapeutic Lovenox in addition to EKG, telemetry, and CTA for PE. Unfortunately, we were too late; while going for CTA, he died from cardio-pulmonary arrest with initial supraventricular tachycardia (SVT) with a rapid ventricular response (RVR) and then pulseless electrical activity (PEA) that could not be reversed. CPR (cardio-pulmonary resuscitation) teams documented right heart strain on bedside echo when in PEA. Unfortunately, the family declined postmortem, but we were able to get levels of IL-4, IL-8 and confirmed COVID-19 positive antibodies ( Table 6 ) from a small tube of blood left from that day. There was not enough blood for other studies.
| 3.908203
| 0.981934
|
sec[1]/p[0]
|
en
| 0.999996
|
34680499
|
https://doi.org/10.3390/biomedicines9101382
|
[
"blood",
"pulmonary",
"oxygen",
"heart",
"room",
"covid",
"warfarin",
"anemia",
"walking",
"chest"
] |
[
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
},
{
"code": "CB40.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 ===
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
[MA12.4] Finding of steroid agent in blood
Also known as: Finding of steroid agent in blood | steroid in blood
[MA12.2] Finding of hallucinogen in blood
Also known as: Finding of hallucinogen in blood | hallucinogen in blood
[CB40.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 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Pregnancy, childbirth or the puerperium
Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--CHILD--> [?] Diseases of spleen
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.4Z] Haematuria, unspecified
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.4Z] 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--> [MA12.0] Finding of opiate drug in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.1] Finding of cocaine in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Diseases of spleen",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] 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--> [MA12.0] Finding of opiate drug in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
A 25-year-old male was presented in October 2004 with a monthly history of a gradually enlarging, painless, left cervical mass. He had no history of prior thyroid disorder or other disease. Clinically the mass was hard in palpation, firmly attached to the surrounding tissues and was located at the anatomic area of the carotide triangle. Thorough physical examination revealed only a marginal hepatomegaly and splenomegaly. Routine blood tests, biochemical markers and thyroid function tests – including triiodothyronine (T 3 ), thyroid stimulating hormone (TSH), thyreoglobulin and anti-thyroid antibodies- were within normal limits, with the exception of a moderately elevated erythrocyte sedimentation rate (ESR = 44). Subsequent cervical and thoracic CT scan revealed a multilobular mass (4,3 × 4,7 × 7 cm) probably arising from the left thyroid lobe, with infiltrating features and heterogeneous density with regions of central necrosis and hemorrhage. The mass submerged into the anterior-posterior mediastinum, in proximity with the great vessels of the heart, dislocating the left common carotid artery and the left vagus nerve without infiltrating them . Significant mediastinal lymphadenopathy was also noted, whereas ultrasound of the abdomen excluded liver involvement. Differential diagnosis included thyroid carcinoma, lymphoma, thymoma, malignant congenital branchiac cyst or cystic hygroma and germ cell tumours of the upper mediastinum. Fine-needle aspiration biopsy of the cervical mass was performed and the cytological findings were consistent with papillary thyroid carcinoma with anaplastic features. Based on these findings, the patient was referred for surgical removal of the lesion. At surgery, a large mass, measuring 9,5 × 6,3 × 4,5 cm was found behind the left srenocleidomastoid muscle, located lateral to the left carotid artery/jugular vein and was not firmly adhered to the left thyroid lobe. The mass was easily separated from the surrounded tissues and was removed. Based on the results of preoperative fine needle aspiration biopsy, a total thyroidectomy was performed at the same time. Pathology examination of the mass revealed extensive infiltration by large or giant malignant cells with morphological features consistent with syncytiotrophoblasts within necrotic and hemorrhagic elements . Positive immunohistochemical staining with β-subunit of human chorionic gonadotrophin (β-hCG) suggested the diagnosis of choriocarcinoma of the upper mediastinum . The pre-operation serum concentration of β-hCG was >100.000 mIU/ml, whereas the immediate post-operation levels declined to 17.300 mIU/ml. Alpha- fetoprotein (a-FP) and carcinoembryonic antigen (CEA) levels were within normal limits, while lactate dehydrogenase (LDH) level was two-fold higher than the normal upper limit. Based on these data, scrotal ultrasound examination was performed, disclosing a small multilobular mass measuring 2,1 cm in greatest diameter-not evident at previously performed physical examination- located on the upper pole of the left testicle with echomorphological and hemodynamic characteristics consistent with seminomatous tumour. Subsequently, the patient underwent left radical inguinal orchiectomy with high ligation of the left spermatic cord and implantation of synthetic testicular prothesis. Histological diagnosis of the testicular tumour revealed almost typical seminoma (1,8 × 1,2 × 1 cm) consisting of large clear-cytoplasm cells with hypodense nucleus and a few atypical mitosis, without any signs of infiltration of rete testis or the spermatic cord. Complete inhibition of spermatogenesis and hyperplastic reaction of Leydig cells were also observed . Although immunohistochemical staining for β-hCG was positive in a few cells, their morphological characteristics did not meet the diagnostic criteria for syncytiotrophoblasts . On postoperative day six (6), the patient developed slightly painful cervical mass at the anatomic site of the first surgical intervention and β-hCG levels started rising up again (β-hCG = 29.850 mIU/ml) . Complete pre-therapeutic staging was immediately performed, including negative CT scan of the brain and negative bone scan, whereas CT scan of the thorax and the abdomen disclosed multiple round metastatic nodules of various size (0,1 – 2 cm) in both lungs and marginally enlarged iliac and para-aortic lymph nodes without liver or other parenchymal organ involvement. In November 2004, one month after his initial admission to the hospital, the patient received 1 st line chemotherapy for high-risk germ cell tumour with the BEP regimen (Bleomycin 30 mg: d 1 -d 8 -d 15 , Etoposide 100 mg/m 2 : d 1 -d 5 and Cisplatin 20 mg/m 2 : d 1 -d 5 in 21-day cycles). Pre-chemotherapy levels of β-hCG were 93.400 mIU/ml. The patient completed 4 cycles of therapy without experiencing remarkable toxicity (Neutropenia grade I-II according to the NCI-CTC criteria) and is currently asymptomatic, with ongoing complete clinical and biochemical remission according to the RECIST criteria (No evidence of tumour mass, regression of all enlarged lymph nodes, necrotic post-chemotherapy elements in the remaining lung nodules confirmed by CT-guided fine-needle aspiration biopsy and PET scan and consecutively normal levels of β-hCG). A schematic presentation of the whole diagnosis and treatment course including β-hCG titer and chest Xray findings is illustrated in Fig. 5
| 4.070313
| 0.976563
|
sec[1]/p[0]
|
en
| 0.999997
|
17112390
|
https://doi.org/10.1186/1472-6890-6-8
|
[
"thyroid",
"scan",
"cervical",
"without",
"cells",
"tumour",
"located",
"including",
"within",
"features"
] |
[
{
"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": "MB71.Y",
"title": "Other specified clinical findings on diagnostic imaging of central nervous system"
},
{
"code": "NE60",
"title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified"
},
{
"code": "JA66.3",
"title": "Abnormal ultrasonic finding on antenatal screening of mother"
},
{
"code": "PB28",
"title": "Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance"
},
{
"code": "PC98",
"title": "Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance"
}
] |
=== ICD-11 CODES FOUND ===
[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
[MB71.Y] Other specified clinical findings on diagnostic imaging of central nervous system
Also known as: Other specified clinical findings on diagnostic imaging of central nervous system | Epidural haemorrhage, localised, no generalised mass effect or midline shift | Epidural haemorrhage, confined to a small region in relation to a fracture | Epidural haemorrhage, size less than 1 x 1 x 1 cm, not in relation to a fracture | Epidural haemorrhage, mass effect or midline shift less than 0.5 cm
[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
Also known as: Harmful effects of drugs, medicaments or biological substances, not elsewhere classified | drugs, medicaments or biological substances, toxicity not elsewhere classified | adverse drug effects | drug reaction NOS | drug allergy NOS
Excludes: Alcohol intoxication | pathological drug intoxication | hypersensitivity reaction to correctly administered drug
[JA66.3] Abnormal ultrasonic finding on antenatal screening of mother
Definition: A sign characterised by an abnormality detected by ultrasound during an antenatal screening of the mother.
Also known as: Abnormal ultrasonic finding on antenatal screening of mother | antenatal ultrasound scan abnormal
[PB28] Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance
Also known as: Unintentional exposure to or harmful effects of other or unspecified drug, medicament or biological substance | accidental overdose of other or unspecified drug, medicament or biological substance | accidental poisoning by other or unspecified drug, medicament or biological substance | other or unspecified drug, medicament or biological substance taken in error | accidental drug overdose
[PC98] Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance
Also known as: Intentional self-harm by exposure to other or unspecified drug, medicament or biological substance | Intentional self-poisoning by and exposure to other or unspecified drug, medicament or biological substance | Intentional overdose of other or unspecified drug, medicament or biological substance | self-administered overdose by drugs | Intentional self-harm by exposure to or harmful effects of systemic antibiotics
=== GRAPH WALKS ===
--- Walk 1 ---
[5A03.Z] Thyroiditis, unspecified
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system
Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....
--- Walk 2 ---
[5A03.Z] Thyroiditis, unspecified
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--CHILD--> [5A03.0] Acute thyroiditis
Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....
--- Walk 3 ---
[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified
--PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system
Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....
--CHILD--> [5A00] Hypothyroidism
--- Walk 4 ---
[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified
--PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system
Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....
--PARENT--> [?] Endocrine diseases
--- Walk 5 ---
[5A03.Y] Other specified thyroiditis
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--EXCLUDES--> [?] Thyrotoxicosis
Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...
--- Walk 6 ---
[5A03.Y] Other specified thyroiditis
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--CHILD--> [5A03.0] Acute thyroiditis
Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....
|
[
"[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --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\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.0] Acute thyroiditis\n Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial....",
"[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism",
"[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --PARENT--> [?] Endocrine diseases",
"[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...",
"[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.0] Acute thyroiditis\n Def: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial...."
] |
5A03.Z
|
Thyroiditis, unspecified
|
[
{
"from_icd11": "5A03.Z",
"icd10_code": "E069",
"icd10_title": "Thyroiditis, unspecified"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E064",
"icd10_title": "Drug-induced thyroiditis"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E065",
"icd10_title": "Other chronic thyroiditis"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E06",
"icd10_title": "Thyroiditis"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E062",
"icd10_title": "Chronic thyroiditis with transient thyrotoxicosis"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E0781",
"icd10_title": "Sick-euthyroid syndrome"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E0789",
"icd10_title": "Other specified disorders of thyroid"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E079",
"icd10_title": "Disorder of thyroid, unspecified"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E034",
"icd10_title": "Atrophy of thyroid (acquired)"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E00-E07",
"icd10_title": ""
},
{
"from_icd11": "5A0Z",
"icd10_code": "E07",
"icd10_title": "Other disorders of thyroid"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E078",
"icd10_title": "Other specified disorders of thyroid"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5A00.2Z",
"icd10_code": "E033",
"icd10_title": "Postinfectious hypothyroidism"
},
{
"from_icd11": "5A03.0",
"icd10_code": "E060",
"icd10_title": "Acute thyroiditis"
}
] |
E069
|
Thyroiditis, unspecified
|
A 76-year-old woman was referred to our hospital because of a nodule in the right upper lobe. The patient had no respiratory symptoms. The computed tomography (CT) scan of the chest revealed a 2.3 × 1.6 cm nodule, and the patient was diagnosed with pulmonary adenocarcinoma (cT1bN0M0, stage IA, according to the TNM classification of the Union for International Cancer Control (UICC), 7th edition; cT1cN0M0, stage 1A3, according to the UICC, 8th edition). The patient had no smoking history. Her comorbidities consisted of hypertension and hyperlipidemia. The right upper lobectomy was performed in November 2015, and the pathological stage was pT1bN2M0, stage IIIA. Genomic analysis revealed the epidermal growth factor receptor ( EGFR ) gene mutation L858R in exon 21. Immunohistochemical analysis revealed a programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) of < 1%. The patient was under watchful observation without adjuvant chemotherapy. Multiple mediastinal and right hilar lymph node metastases were found in February 2018. Radiation therapy alone was selected because the recurrence of the disease was limited to the local region and the patient was 79 years old at the time of recurrence. Radiation therapy amounting to a total dose of 60.0 Gy, distributed in 30 fractions, was performed over a period of 6 weeks. The 3D radiotherapy-planning technique was used. In the first 4 weeks, 40.0 Gy was distributed in 20 fractions using opposing anterior-posterior fields . In the subsequent 2 weeks, an additional 20.0 Gy was distributed in 10 fractions using 10 beams for covering multiple mediastinal lymph node metastases but sparing the spinal cord and hilum of the left lung. The planning target volume included multiple mediastinal and right hilar lymph nodes, with a 10 mm margin to account for microscopic disease, internal moving, and setup errors. The percentage volume of lung receiving a dose of more than 20 Gy (V20) was 29.3%. Static radiotherapy was delivered using a 10 MV X-ray and five fractions per week. A chest CT scan performed 6 weeks after the irradiation therapy showed reduction of the lymph node metastases. However, left hilar and right supraclavicular lymph node metastases and multiple pulmonary metastases were newly observed outside of the irradiation field . EGFR tyrosine kinase inhibitor (TKI) treatment was planned as a start. Interestingly, a follow-up chest CT scan performed 12 weeks after the completion of irradiation therapy showed complete disappearance of the multiple pulmonary metastases associated with radiation pneumonitis . However, there was no change in the size of the left hilar and the right supraclavicular lymph node metastases, which was confirmed by 18-fluorodeoxyglucose positron-emission tomography (PET)/CT . The patient was therefore under watchful observation, without receiving EGFR-TKI treatment. A follow up CT scan performed 6 months after the completion of irradiation therapy showed a slight increase in the size of the lymph node metastases, but no reappearance of multiple pulmonary metastases nodules . The levels of serum carcinoembryonic antigen (CEA) dropped from 154.5 ng/mL to 30.9 ng/mL after the irradiation therapy and further decreased to 6.8 ng/mL by 3 months post irradiation therapy. The levels, however, increased again to 19.7 ng/mL at 6 months after completion of the irradiation therapy . No cytotoxic chemotherapy or EGFR-TKI was given during the period. The number of CD8 + lymphocytes was 190/μL at 3 months and 356/μL at 4 months after irradiation. Fig. 1 Radiation therapy to a total dose of 60.0 Gy, distributed in 30 fractions, was performed over a period of 6 weeks. In the first 4 weeks, the treatment was prescribed to the 100% isodose curve to a total dose of 40.0 Gy distributed in 20 fractions using opposing anterior-posterior fields ( a , b ). An additional 20.0 Gy was distributed in 10 fractions using 10 beams in the subsequent 2 weeks ( c , d ). The curves represent 100% isodose (red), 95% isodose (yellow), 50% isodose (purple), and 30% isodose (blue) ( a , c ). Gross tumor volume, clinical target volume, and planning target volume are shown in red, pink, and yellow, respectively ( b , d ) Fig. 2 A computed tomography scan of the chest, performed 6 weeks after the irradiation therapy against multiple mediastinal and right hilar lymph node metastases, showed appearance of multiple pulmonary nodules in both lungs, suggesting metastases (column A). A follow-up computed tomography scan of the chest, performed 12 weeks after the irradiation therapy, showed complete disappearance of the multiple pulmonary metastases associated with radiation pneumonitis (column B) Fig. 3 Positron-emission tomography/computed tomography scan, performed 12 weeks after the irradiation therapy, showed the uptake of 18-fluorodeoxyglucose in the right supraclavicular ( a ) and the left hilar ( b ) lymph nodes Fig. 4 A follow-up computed tomography scan of the chest, performed 6 months after the irradiation therapy, showed radiation pneumonitis but no reappearance of pulmonary metastases in either lung Fig. 5 Clinical course. The levels of serum carcinoembryonic antigen (CEA) dropped from 154.5 ng/mL to 30.9 ng/mL after the irradiation therapy and further decreased to 6.8 ng/mL at 3 months post treatment; however, the levels increased again to 19.7 ng/mL at 6 months after completion of the irradiation therapy
| 4.046875
| 0.969238
|
sec[1]/p[0]
|
en
| 0.999996
|
30961547
|
https://doi.org/10.1186/s12885-019-5566-8
|
[
"irradiation",
"metastases",
"multiple",
"lymph",
"scan",
"tomography",
"pulmonary",
"node",
"fractions",
"chest"
] |
[
{
"code": "QC48.Y",
"title": "Other specified personal history of medical treatment"
},
{
"code": "8E61.0",
"title": "Radiation-induced brain injury"
},
{
"code": "8E61.1",
"title": "Spinal cord irradiation"
},
{
"code": "DA08.Y",
"title": "Other specified diseases of hard tissues of teeth"
},
{
"code": "9B10.2Y",
"title": "Other specified cataracts"
},
{
"code": "2E2Z",
"title": "Malignant neoplasm metastasis, unspecified"
},
{
"code": "2E03",
"title": "Malignant neoplasm metastasis in bone or bone marrow"
},
{
"code": "2E08",
"title": "Metastatic malignant neoplasm involving skin"
},
{
"code": "2E0Y&XA25Q2",
"title": "Malignant neoplasm metastasis in pelvic viscera"
},
{
"code": "2D8Y&XA1WN1",
"title": "Malignant neoplasm metastasis in oral cavity"
}
] |
=== ICD-11 CODES FOUND ===
[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
[8E61.0] Radiation-induced brain injury
Definition: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-delayed injury and late-delayed injury although the three may overlap.
Also known as: Radiation-induced brain injury | Brain irradiation effect | Brain irradiation syndrome | Injury to the brain from therapeutic cranial irradiation | Post radiation brain injury
[8E61.1] Spinal cord irradiation
Also known as: Spinal cord irradiation | Myelopathy due to spinal cord irradiation | Brachial plexopathy due to spinal cord irradiation | Lumbosacral plexopathy due to spinal cord irradiation
[DA08.Y] Other specified diseases of hard tissues of teeth
Also known as: Other specified diseases of hard tissues of teeth | Decalcification of teeth | Dentine hypersensitivity | dentin sensitivity | sensitive dentine
[9B10.2Y] Other specified cataracts
Also known as: Other specified cataracts | Cataract in systemic disorders | Cataract in degenerative disorders | Cataract in inflammatory disorders | Tetanic cataract
[2E2Z] Malignant neoplasm metastasis, unspecified
Also known as: Malignant neoplasm metastasis, unspecified | secondary malignant neoplasm | metastasis | metastases | disseminated metastases
[2E03] Malignant neoplasm metastasis in bone or bone marrow
Definition: The spread of a malignant neoplasm from a primary site to the skeletal system. The majority of metastatic neoplasms to the bone are carcinomas.
Also known as: Malignant neoplasm metastasis in bone or bone marrow | bone metastasis | bony metastasis | osseous metastasis | secondary cancer of bone
[2E08] Metastatic malignant neoplasm involving skin
Definition: Involvement of the skin by metastatic spread from a known or unknown primary malignant neoplasm. The secondary deposit may result from local migration of malignant cells, or from regional lymphatic or haematogenous spread from more distant sites.
Also known as: Metastatic malignant neoplasm involving skin | cutaneous metastasis | metastasis to skin, any site | skin metastasis | skin secondaries
=== GRAPH WALKS ===
--- Walk 1 ---
[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 2 ---
[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 3 ---
[8E61.0] Radiation-induced brain injury
Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...
--PARENT--> [8E61] Post radiation injury of the nervous system
--RELATED_TO--> [?] Post radiation polyneuropathy
--- Walk 4 ---
[8E61.0] Radiation-induced brain injury
Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...
--PARENT--> [8E61] Post radiation injury of the nervous system
--CHILD--> [8E61.0] Radiation-induced brain injury
Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...
--- Walk 5 ---
[8E61.1] Spinal cord irradiation
--PARENT--> [8E61] Post radiation injury of the nervous system
--CHILD--> [8E61.0] Radiation-induced brain injury
Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...
--- Walk 6 ---
[8E61.1] Spinal cord irradiation
--PARENT--> [8E61] Post radiation injury of the nervous system
--PARENT--> [?] Postprocedural disorders of the nervous system
|
[
"[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--> [QC48.0] Personal history of long-term use of anticoagulants",
"[8E61.0] Radiation-induced brain injury\n Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...\n --PARENT--> [8E61] Post radiation injury of the nervous system\n --RELATED_TO--> [?] Post radiation polyneuropathy",
"[8E61.0] Radiation-induced brain injury\n Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...\n --PARENT--> [8E61] Post radiation injury of the nervous system\n --CHILD--> [8E61.0] Radiation-induced brain injury\n Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...",
"[8E61.1] Spinal cord irradiation\n --PARENT--> [8E61] Post radiation injury of the nervous system\n --CHILD--> [8E61.0] Radiation-induced brain injury\n Def: Injury to the brain from therapeutic cranial irradiation which may be divided temporally into three syndromes: Acute or early toxicity which is consequent upon immediate exposure to radiation, early-d...",
"[8E61.1] Spinal cord irradiation\n --PARENT--> [8E61] Post radiation injury of the nervous system\n --PARENT--> [?] Postprocedural disorders of the nervous system"
] |
QC48.Y
|
Other specified personal history of medical treatment
|
[
{
"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": "8E61.0",
"icd10_code": "T66XXXA",
"icd10_title": "Radiation sickness, unspecified, initial encounter"
},
{
"from_icd11": "8E61.0",
"icd10_code": "T66XXXS",
"icd10_title": "Radiation sickness, unspecified, sequela"
},
{
"from_icd11": "8E61.0",
"icd10_code": "T66",
"icd10_title": "Radiation sickness, unspecified"
},
{
"from_icd11": "9B10.2Y",
"icd10_code": "H268",
"icd10_title": "Other specified cataract"
},
{
"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"
}
] |
Z794
|
Long term (current) use of insulin
|
A 59‐year‐old female patient presented with progressive dyspnea (New York Heart Association III–IV), general fatigue, and long‐term oxygen therapy at our outpatient clinic for PH. One year before, the patient was successfully treated with percutaneous PV isolation by radiofrequency ablation for AF. Approximately 7 months later, a follow‐up showed a peak tricuspid regurgitation velocity of 4.1 m/s and dilatation of the right atrium (31 cm 2 ) and ventricle (right ventricular [RV] basal end‐diastolic diameter 48 mm), as well as pleural effusion, indicating a high clinical probability for the presence of PH according to the current 2022 ESC/ERS Guidelines for the diagnosis and treatment of PH. 6 Cardiovascular computed tomography (CT) excluded the presence of coronary heart disease as underlying causes but demonstrated severe PVS secondary to the ablation procedure with relevant stenosis of all four PVs. The left superior PV (LSPV) and segmental branch of the right superior PV were totally occluded, and the inferior PVs presented with stenosis . Additionally, signs of chronic thromboembolic disease were present, including wall‐adherent thrombi, mosaic perfusion, and disparities in segmental vessel size. Consequently, right heart catheterization (RHC) was performed as the gold standard for diagnosing and classifying PH. RHC showed a combined pre‐ and postcapillary PH (mean pulmonary arterial pressure 42 mmHg/systolic pulmonary arterial pressure 72 mmHg/diastolic pulmonary arterial pressure 24 mmHg/pulmonary arterial wedge pressure 16 mmHg/pulmonary vascular resistance 4 WU/diastolic pulmonary gradient 8 mmHg). Laboratory results revealed signs of acute decompensated heart failure with brain natriuretic peptide (BNP) elevation of 2.373 pg/ml (ref.: <100 pg/ml) and troponin I 69.5 pg/ml (ref.: <24 pg/ml), creatinine kinase within the normal range (51 U/l). C‐reactive protein was slightly elevated (116 mg/l; ref.: <5 mg/l). Blood count and renal function were in the normal range. The initial treatment with intravenous diuretics did not result in the improvement of symptoms. A bilateral interstitial pneumonia was demonstrated, and antibiotic therapy was initiated. Three days later, the patient deteriorated into cardiogenic shock (hypotension, sinus tachycardia, impaired peripheral oxygenation, centralization). At this time and in the context of the limited conservative treatment options of acute on chronic right heart failure, introducer cannulas were placed percutaneously by Seldinger technique in the right femoral artery and vein preemptively expecting the potential need for extracorporeal membrane oxygenation (ECMO) support. Within this procedure, the patient developed lactate acidosis, nonsustained ventricular tachycardia, and hemodynamic fragility, resulting in an in‐hospital cardiac arrest with asystole. Cardiopulmonary resuscitation (CPR) was performed for 2 min. Shortly later, the patient had an additional episode of asystole and CPR for another 4 min and endotracheal intubation was performed. In the first return of spontaneous circulation (ROSC), a decision for the temporary use of mechanical circulatory support by veno‐arterial ECMO (V f ‐A f d‐ECMO, Cardiohelp; Getinge) as a rescue procedure for bridging to angioplasty was made. Venous cannulation was performed using a 23 F/55 cm cannula (Maquet; Getinge) and arterial cannulation was performed using a 15 F/23 cm cannula (Maquet; Getinge). An additional arterial cannula distal to the femoral artery cannula for perfusion of the limb was established. Initial revolutions per minute were 4110 rpm generating 4.5 L/min ECMO blood flow. One day after initiation of V f ‐A f d‐ECMO, oxygenation worsened because of progressive pneumonia. Massive pleural effusion on the right side impaired the oxygenation therefore a thoracentesis was performed. Arterial blood gas analysis showed hypoxemia (partial pressure of oxygen [paO 2 ]: 56 mmHg) requiring a high concentration of inspired oxygen and positive end‐expiratory pressure (FiO 2 70%, positive end‐expiratory pressure 10 mbar). PaO 2 /FiO 2 (P/F) ratio was 80 mmHg, which suggested severe hypoxemia. The decision for ECMO support was made and therapy was escalated with an additional venous cannula (19 F/15 cm) inserted into the right jugular vein for V f ‐A f dV j ‐ECMO. Separate monitoring of the returning blood flows of the jugular and the femoral cannula was performed by using an ultrasonic flow computer (SonoTT; medicovation). Temporarily, the venous return was controlled by compression of the venous cannula. The patient's left ventricular systolic pump function was always preserved. Both echocardiographic aortic valve opening and pulse pressure were measured adequately. Four days after cannulation, the patient was transferred to a center specialized in angioplasty of the PV. Since PV dilatation and stenting of LSPV and left inferior PV, as well as balloon dilatation of RIPV, was performed successfully , the intervention of the right superior segmental PV failed. After retransferring to our hospital, the clinical course improved, particularly the reduction of artificial ventilation up to the explantation of the V f ‐A f dV j ‐ECMO. Neurological examination revealed an alert patient with preserved communication. After tracheostomy and placement of a percutaneous gastroscopy tube, the patient was transferred to a weaning clinic for recovery.
| 4.121094
| 0.967773
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC9941841
|
https://doi.org/10.1002/pul2.12189
|
[
"arterial",
"pressure",
"ecmo",
"mmhg",
"cannula",
"pulmonary",
"heart",
"blood",
"oxygenation",
"venous"
] |
[
{
"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": "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 ===
[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
[EH90.Z] Pressure ulcer of unspecified grade
Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer
[MB23.L] Pressured speech
Definition: Speech in which the person feels undue pressure to get the words out. The person’s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening.
Also known as: Pressured speech
Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders
[MD30.Z] Chest pain, unspecified
Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure
[CB22.Y] Other specified diseases of mediastinum, not elsewhere classified
Also known as: Other specified diseases of mediastinum, not elsewhere classified | Hernia of mediastinum | mediastinal hernia | mediastinal herniation | Infectious mediastinitis
[BA2Z] Hypotension, unspecified
Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure
=== GRAPH WALKS ===
--- Walk 1 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--EXCLUDES--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--- Walk 2 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--CHILD--> [?] Chronic arterial occlusive disease
--- 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
--EXCLUDES--> [?] Nonorgan specific systemic autoimmune disorders
--PARENT--> [?] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--- Walk 5 ---
[BD52.3] Rupture of artery
--PARENT--> [BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Leukocytoclastic vasculitis
Def: Leukocytoclastic vasculitis (hypersensitivity vasculitis; hypersensitivity angiitis) is a histopathological term commonly used to denote a small-vessel vasculitis. It may be localised to the skin or m...
--- 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--> [?] Certain specified obstetric trauma
Def: Any injury characterised by maternal trauma. These injuries are caused by or subsequent to the process of (or any intervention related to) pregnancy, or labour and delivery....
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....",
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease",
"[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 --EXCLUDES--> [?] Nonorgan specific systemic autoimmune disorders\n --PARENT--> [?] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....",
"[BD52.3] Rupture of artery\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Leukocytoclastic vasculitis\n Def: Leukocytoclastic vasculitis (hypersensitivity vasculitis; hypersensitivity angiitis) is a histopathological term commonly used to denote a small-vessel vasculitis. It may be localised to the skin or m...",
"[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--> [?] Certain specified obstetric trauma\n Def: Any injury characterised by maternal trauma. These injuries are caused by or subsequent to the process of (or any intervention related to) pregnancy, or labour and delivery...."
] |
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
|
Figure 1 shows the bony structures surrounding the left orbit and left nasal cavity with removal of the lacrimal bone, part of the maxilla, and part of the frontal bone. The inferomedial orbital wall fracture was addressed using the combination of transorbital subciliary incision and an endoscopic transnasal approach to release adhesions and incarcerations. The first step was to manipulate the inferior wall, starting with a prelacrimal approach via the nasal cavity . The surgeons elevated the bone and maxillary sinus mucosa of the infraorbital wall at the fracture site as a pedicled local bone-mucosal flap , while the transorbital surgeon collaborated with them to restore the orbital contents . The height of the posterior margin of the orbital floor was accurately determined by identifying the infraorbital nerve, then proceeding posteriorly to locate the inferior margin of the greater wing of the sphenoid bone . After completing the manipulation of the infraorbital wall, the ethmoid sinus was opened and the fractured bone fragments and mucosa of the medial orbital wall were removed . The orbital contents were retracted laterally by the transorbital surgeon, allowing the transnasal surgeon to safely manipulate the medial orbital wall . The transorbital surgeon inserted a 1-mm-thick silicone sheet (Eyeball Restraint Insert; Koken, Tokyo, Japan) into the orbit, positioning it along the inferior wall to the medial side, while the transnasal surgeon was responsible for reconstructing the medial wall, especially the deep medial part of the orbit and the side closest to the skull base . While the transorbital surgeon held the silicone sheet in place along the orbit, the transnasal surgeon placed another 1-mm-thick silicone sheet in an inverted U-shape in the opened ethmoid sinus; gauze coated with ointment was applied to secure the sheet along the orbit and prevent it from deviating medially . Once the silicone sheet was securely positioned, the transnasal surgeon restored the pedicled local bone-mucosal flap of the infraorbital wall to its original position . The inferior wall of the maxillary sinus was stabilized by inflating a balloon and confirming that it was in the correct position . The mucosal incision made during the prelacrimal approach was then closed with sutures . Fig. 1 Schema showing steps of the double silicone procedure. A Inferomedial orbital wall fracture. Brown areas indicate the fractured inferomedial orbital wall. B Fractured bone fragments of the medial wall are removed, while those of the inferior wall are preserved as much as possible. C The transparent turquoise structure indicates the first silicone sheet implanted along the orbit. D The transparent blue structure indicates the second silicone sheet implanted in the ethmoid sinus. E The bone-mucosal flap of the infraorbital wall has been relocated to its original position. F The balloon is implanted in the maxillary sinus and the infraorbital wall is fixed. The green structure indicates the balloon Fig. 2 Endoscopic images of the procedure up to the placement of the first silicone sheet along the orbit. A The inside of the left maxillary sinus is observed from the prelacrimal approach. B The bone and mucosa at the fracture site of the infraorbital wall are elevated as a pedicled bone-mucosal flap to release adhesions with the orbital contents. C The transnasal surgeon and transorbital surgeon collaborate to restore the orbital contents. D The correct orbital height is confirmed by identifying the infraorbital nerve and the inferior margin of the greater wing of the sphenoid bone. E The inferior turbinate is placed in its original position, and manipulation of the ethmoid sinus is initiated. F The ethmoid sinus has been opened and the bone and mucosa at the fracture site of the medial orbital wall are removed. The orbital contents are retracted laterally by the transorbital surgeon. G The transorbital surgeon inserts a 1-mm-thick silicone sheet into the orbit transorbitally; the endoscopist provides support and places the sheet in the proper position. H The silicone sheet is placed along the orbit. BMF bone-mucosal flap; ES ethmoid sinus; GW greater wing of sphenoid bone; ION infraorbital nerve; IT inferior turbinate; MS maxillary sinus; MT middle turbinate; NLD nasolacrimal duct; NS nasal septum; OC orbital contents; SO silicone sheet in the orbit Fig. 3 Stepwise endoscopic images of the procedure from the placement of the second silicone sheet to the end of surgery. A The second silicone sheet is placed into the ethmoid sinus by the transnasal surgeon. B The silicone sheet is implanted in the ethmoid sinus to form an inverted U-shape. C The inverted U-shaped silicone sheet is fixed in place by insertion of gauze coated with ointment. D After the silicone sheet is fixed in the ethmoid sinus, the maxillary sinus is manipulated. E The bone-mucosal flap is moved back to its normal position. F The orbit and maxillary sinus are completely separated by the bone-mucosal flap. G A balloon is placed in the maxillary sinus and the infraorbital wall is fixed. H The incision used in the prelacrimal approach is sutured, and the nasal cavity is restored. BMF bone-mucosal flap; ION infraorbital nerve; IT inferior turbinate; MS maxillary sinus; MT middle turbinate; NLD nasolacrimal duct; NS nasal septum; SE silicone sheet in the ethmoid sinus; SO silicone sheet in the orbit
| 4.09375
| 0.768555
|
sec[1]/p[0]
|
en
| 0.999996
|
37831133
|
https://doi.org/10.1007/s00405-023-08257-6
|
[
"wall",
"sinus",
"sheet",
"bone",
"silicone",
"orbital",
"surgeon",
"orbit",
"infraorbital",
"ethmoid"
] |
[
{
"code": "LB0Y",
"title": "Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord"
},
{
"code": "PA82",
"title": "Unintentional striking against stationary object"
},
{
"code": "NB50.Y&XA3KX0&XJ1C6",
"title": "Haematoma of abdominal wall"
},
{
"code": "DC51.1",
"title": "Peritoneal adhesions"
},
{
"code": "LB73.1Z",
"title": "Structural developmental anomalies of chest wall, unspecified"
},
{
"code": "CA0A.Z",
"title": "Chronic rhinosinusitis, unspecified"
},
{
"code": "CA0Y&XA3523",
"title": "Nasal sinus obstruction"
},
{
"code": "CA0J.Y",
"title": "Other specified nasal polyp"
},
{
"code": "LB03.Y",
"title": "Other specified structural developmental anomalies of umbilical cord"
},
{
"code": "DA09.61",
"title": "Periapical abscess with sinus"
}
] |
=== ICD-11 CODES FOUND ===
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Also known as: Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord | Congenital deformity of abdominal wall | abdominal wall defect NOS
[PA82] Unintentional striking against stationary object
Also known as: Unintentional striking against stationary object | striking against stationary object | striking against or struck by other objects | Walked into wall
[DC51.1] Peritoneal adhesions
Definition: Disorders of peritoneum sticking by scar tissue or fibrosis
Also known as: Peritoneal adhesions | abdominal adhesion | adhesive peritoneal band | peritoneal adhesion | peritoneal band
Excludes: Adhesions of large intestine with obstruction | Postprocedural pelvic peritoneal adhesions | Intestinal adhesions or bands of small intestine with obstruction
[LB73.1Z] Structural developmental anomalies of chest wall, unspecified
Also known as: Structural developmental anomalies of chest wall, unspecified | Structural developmental anomalies of chest wall | Malformations of chest wall
[CA0A.Z] Chronic rhinosinusitis, unspecified
Also known as: Chronic rhinosinusitis, unspecified | Chronic rhinosinusitis | Chronic sinusitis | chronic sinusitis NOS | unspecified sinusitis
[CA0J.Y] Other specified nasal polyp
Also known as: Other specified nasal polyp | Polyp of nasal cavity | Polyp of the nasopharynx | nasopharyngeal polyp | Polyp of adenoid tissue
[LB03.Y] Other specified structural developmental anomalies of umbilical cord
Also known as: Other specified structural developmental anomalies of umbilical cord | Umbilical cord calcifications | Omphalomesenteric duct remnants or cysts | Vitelline duct remnants and cysts | Persistent omphalomesenteric duct
[DA09.61] Periapical abscess with sinus
Also known as: Periapical abscess with sinus | Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus | periapical abscess fistula
Includes: Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus
=== GRAPH WALKS ===
--- Walk 1 ---
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
--PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....
--CHILD--> [LB01] Omphalocele
Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce...
--- Walk 2 ---
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
--PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....
--CHILD--> [LB02] Gastroschisis
Def: Gastroschisis is a congenital abdominal wall defect characterised by viscera protruding, without a covering sac, from the fetal abdomen on the right lateral base of the umbilicus....
--- Walk 3 ---
[PA82] Unintentional striking against stationary object
--PARENT--> [?] Unintentional exposure to object, not elsewhere classified
--CHILD--> [PA80] Unintentionally struck by projectile from firearm
--- Walk 4 ---
[PA82] Unintentional striking against stationary object
--PARENT--> [?] Unintentional exposure to object, not elsewhere classified
--EXCLUDES--> [?] Assault by exposure to object not elsewhere classified
--- Walk 5 ---
[DC51.1] Peritoneal adhesions
Def: Disorders of peritoneum sticking by scar tissue or fibrosis...
--EXCLUDES--> [?] Postprocedural pelvic peritoneal adhesions
Def: A condition caused by or subsequent to any pelvic intervention leading to damage and inflammation of the peritoneum. This condition is characterised by fibrous bands of scar tissue and abnormal connec...
--PARENT--> [?] Postprocedural disorders of genitourinary system
Def: Any disorder caused by or subsequent to any intervention of the genitourinary system....
--- Walk 6 ---
[DC51.1] Peritoneal adhesions
Def: Disorders of peritoneum sticking by scar tissue or fibrosis...
--EXCLUDES--> [?] Intestinal adhesions or bands of small intestine with obstruction
Def: Small bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....
--CHILD--> [?] Postoperative obstruction of the small intestine
|
[
"[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB01] Omphalocele\n Def: Omphalocele is an embryopathy classified in the group of abdominal celosomias and is characterised by a large hernia of the abdominal wall, centred on the umbilical cord, in which the protruding visce...",
"[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n --PARENT--> [?] Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord\n Def: Any condition caused by failure of the diaphragm, abdominal wall or umbilical cord to correctly develop during the antenatal period....\n --CHILD--> [LB02] Gastroschisis\n Def: Gastroschisis is a congenital abdominal wall defect characterised by viscera protruding, without a covering sac, from the fetal abdomen on the right lateral base of the umbilicus....",
"[PA82] Unintentional striking against stationary object\n --PARENT--> [?] Unintentional exposure to object, not elsewhere classified\n --CHILD--> [PA80] Unintentionally struck by projectile from firearm",
"[PA82] Unintentional striking against stationary object\n --PARENT--> [?] Unintentional exposure to object, not elsewhere classified\n --EXCLUDES--> [?] Assault by exposure to object not elsewhere classified",
"[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Postprocedural pelvic peritoneal adhesions\n Def: A condition caused by or subsequent to any pelvic intervention leading to damage and inflammation of the peritoneum. This condition is characterised by fibrous bands of scar tissue and abnormal connec...\n --PARENT--> [?] Postprocedural disorders of genitourinary system\n Def: Any disorder caused by or subsequent to any intervention of the genitourinary system....",
"[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Intestinal adhesions or bands of small intestine with obstruction\n Def: Small bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....\n --CHILD--> [?] Postoperative obstruction of the small intestine"
] |
LB0Y
|
Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
|
[
{
"from_icd11": "PA82",
"icd10_code": "W2209XA",
"icd10_title": "Striking against other stationary object, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2201XA",
"icd10_title": "Walked into wall, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2211XA",
"icd10_title": "Striking against or struck by driver side automobile airbag, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W228XXS",
"icd10_title": "Striking against or struck by other objects, sequela"
},
{
"from_icd11": "PA82",
"icd10_code": "W2203XD",
"icd10_title": "Walked into furniture, subsequent encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2203XA",
"icd10_title": "Walked into furniture, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W228XXD",
"icd10_title": "Striking against or struck by other objects, subsequent encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2212XA",
"icd10_title": "Striking against or struck by front passenger side automobile airbag, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W2209XS",
"icd10_title": "Striking against other stationary object, sequela"
},
{
"from_icd11": "PA82",
"icd10_code": "W228XXA",
"icd10_title": "Striking against or struck by other objects, initial encounter"
},
{
"from_icd11": "PA82",
"icd10_code": "W22",
"icd10_title": "Striking against or struck by other objects"
},
{
"from_icd11": "DC51.1",
"icd10_code": "K660",
"icd10_title": "Peritoneal adhesions (postprocedural) (postinfection)"
},
{
"from_icd11": "LB73.1Z",
"icd10_code": "Q766",
"icd10_title": "Other congenital malformations of ribs"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J329",
"icd10_title": "Chronic sinusitis, unspecified"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J324",
"icd10_title": "Chronic pansinusitis"
}
] |
W2209XA
|
Striking against other stationary object, initial encounter
|
A 30-year-old primigravida at 22 0/7 gestational weeks (GW) was admitted to our hospital in suspicion of an acute hepatitis B infection. She had presented herself in another hospital with slight nausea and vomiting, pruritus, slight jaundice, dark urine, a fairly affected overall condition, and a positive blood test for acute hepatitis B infection. The source of the infection remained unknown. Her blood pressure, heart rate, and oxygen saturation were normal, as well as her urine analysis besides an elevated bilirubin level. She showed no signs of edema or hyperreflexia but slight jaundice and icteric sclera. Her cardiac and pulmonary status was unaffected, and her temperature was elevated to 38.8°C. Her laboratory work-up showed a progressive hepatic failure ( Table 1 ). HELLP syndrome, intoxication with acetaminophen, Wilson's disease, hepatic neoplasia, acute fatty liver of pregnancy, autoimmune hepatitis, and alpha-1-antitrypsin deficiency as other potential etiologies of acute liver failure were excluded by laboratory testing. The infection screening revealed an acute hepatitis B infection with a viral load of 170.000.000 IU/mL. Other infections as hepatitis A, hepatitis C, HIV, cytomegalovirus (CMV), epstein barr virus, herpes simplex virus, varicella zoster virus, syphilis, toxoplasmosis, and parvovirus B19 could be excluded. Her personal medical history showed only an infection with chlamydia trachomatis in early pregnancy, which had been treated with azithromycin. Her family history revealed no cases of known hepatitis B infections. The fetus was sonographically unaffected and well developed according to her gestational age at admission. A multidisciplinary team of hepatologists, surgeons, and obstetricians took care of the patient. An antiviral therapy with tenofovir, 245 mg orally once a day, was initiated immediately. But the patient, who dearly wanted to keep the pregnancy, had to be added to the super-urgent liver transplantation list two days after admission according to Clichy criteria because of rapid progression of hepatic failure and encephalopathy (lab MELD 33) ( Table 1 ). After graft allocation and within 24 hours, an orthotopic liver transplantation with cava preserving technique (piggy back) and intermittent portocaval shunt was performed to avoid any cava clamping during transplantation. The operation was uneventful (six-hour surgery, transfusion of 2 U red blood cells, and low pressors). Intraoperatively, an additional treatment with hepatitis B immunoglobulin was started and continued for 10 days in a dose of 10.000 IU per day intravenously. Thereafter, it was continued to maintain the anti-HBs titer >100 IU/mL. Postoperatively, treatment with tenofovir was continued until 28 6/7 GW. Afterwards, it was changed to lamivudine 100 mg p.o. daily because of an increase of liver enzymes. Immunosuppression consisted of corticosteroids and tacrolimus. The corticosteroids were applied intravenously for the first five days postoperatively in declining doses of methylprednisolone from 250 to 40 mg, followed by decreasing doses of prednisolone orally from 20 mg to 5 mg until delivery. Tacrolimus was applied orally in doses between 5 mg and 12 mg with the goal to achieve a blood level of six to eight ng/mL. On the first postoperative day, the patient could be extubated without any problems and recovered quickly. The histopathological examination of the explanted liver confirmed subtotal necrosis of the liver with extensive cholestasis and predominantly lymphocytic hepatitis. Subsequent maternal sonographic controls and laboratory testing showed normal liver function and perfusion. Subsequent biopsies of the transplanted liver due to elevated liver enzymes at day six after transplantation, could exclude a graft rejection. Eleven days after liver transplantation fetal sonography revealed hepatomegaly and intracranial ventriculomegaly ( Figure 1(a) ). Additionally, small hematomas in the plexus choroideus on both sides and a subdural bleeding in the posterior cranial fossa were detected ( Figure 1(b) ). Therefore, an additional MRI of the fetus was arranged five days later and confirmed a mild ventriculomegaly on both sides. However, the hepatomegaly could not be confirmed. Repeated sonographic and MRI examinations showed total restitution of the former findings during the course of pregnancy ( Figure 1(c) ). Because the patient suffered from preterm uterine contractions, tocolytic agents in form of nifedipine 60 mg orally twice a day in an off-label-use were applied and had to be changed to intravenous admission of hexoprenaline at 28 4/7 GW because of ongoing contractions. The patient developed gestational diabetes, which could be well controlled by diet. With 34 GW a CMV reactivation was detected and treated with CMV immunoglobulins intravenously. An elective cesarean delivery was performed at 36 0/7 GW due to increasing discomfort and strong demand of the patient. A healthy male newborn of 2700 g (42. percentile) was delivered with an APGAR score of 6-4-7 and an umbilical artery pH of 7.39. The child was transferred to our neonatal intensive care unit for better surveillance. A fetal hepatitis B and CMV infection could be excluded by serological testing of the fetal blood and urine. The mother's and child's course were uneventful and they were dismissed eight and 20 days after the cesarean section, respectively.
| 3.960938
| 0.975098
|
sec[1]/p[0]
|
en
| 0.999996
|
24383021
|
https://doi.org/10.1155/2013/356560
|
[
"liver",
"hepatitis",
"infection",
"blood",
"transplantation",
"pregnancy",
"orally",
"because",
"gestational",
"urine"
] |
[
{
"code": "DB9Z",
"title": "Diseases of liver, unspecified"
},
{
"code": "DB97.Z",
"title": "Inflammatory liver disease, unspecified"
},
{
"code": "DB99.7",
"title": "Hepatic failure without mention whether acute or chronic"
},
{
"code": "LB20.0Y",
"title": "Other specified structural developmental anomalies of liver"
},
{
"code": "LB20.0Z",
"title": "Structural developmental anomalies of liver, unspecified"
},
{
"code": "1E50.Z",
"title": "Acute viral hepatitis, unspecified"
},
{
"code": "DB97.2",
"title": "Chronic hepatitis, not elsewhere classified"
},
{
"code": "1E5Z",
"title": "Viral hepatitis, unspecified"
},
{
"code": "1E51.0Z",
"title": "Chronic hepatitis B, unspecified"
},
{
"code": "1H0Z",
"title": "Infection, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[DB9Z] Diseases of liver, unspecified
Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy
[DB97.Z] Inflammatory liver disease, unspecified
Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS
[DB99.7] Hepatic failure without mention whether acute or chronic
Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS
[LB20.0Y] Other specified structural developmental anomalies of liver
Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity
[LB20.0Z] Structural developmental anomalies of liver, unspecified
Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver
[1E50.Z] Acute viral hepatitis, unspecified
Also known as: Acute viral hepatitis, unspecified | Acute viral hepatitis | acute anicteric hepatitis | Acute hepatitis NOS | acute viral hepatitis non-A non-B NEC
[DB97.2] Chronic hepatitis, not elsewhere classified
Also known as: Chronic hepatitis, not elsewhere classified | Chronic hepatitis, unspecified | Chronic active hepatitis NEC | Other specified chronic hepatitis | Chronic persistent hepatitis NEC
Includes: Chronic hepatitis, unspecified | Other specified chronic hepatitis
Excludes: hepatitis (chronic): granulomatous NEC | Drug-induced or toxic liver disease | hepatitis (chronic): viral
[1E5Z] Viral hepatitis, unspecified
Also known as: Viral hepatitis, unspecified | anicteric hepatitis
[1E51.0Z] Chronic hepatitis B, unspecified
Also known as: Chronic hepatitis B, unspecified | Chronic hepatitis B | Chronic hepatitis B without delta agent | chronic HBV - [hepatitis B virus] infection | hepatitis B NOS
[1H0Z] Infection, unspecified
Also known as: Infection, unspecified | infection NOS | infectious disease NOS | infection unknown | infection process NOS
=== 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
--CHILD--> [DB90] Infectious liver disease
--- 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....
--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....
--CHILD--> [DB99.2] Hepatorenal syndrome
|
[
"[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 --CHILD--> [DB90] Infectious liver disease",
"[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 --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 --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
|
A 38-year-old primigravida with well-controlled gestational diabetes mellitus (GDM) was introduced from her home doctor to our hospital, presenting with mild fever, liver dysfunction, elevated ferritin, low platelet count, and proteinuria at 30 weeks and 5 days of gestation. She was diagnosed with AOSD 6 years ago in our hospital based on typical symptoms, including fever, malaise, cervical lymphadenopathy, rash, liver disfunction, and high serum ferritin levels. Although the rheumatologists performed biopsies of her bone marrow and lymph node, the results of these examination were normal and the possibility of other hematologic diseases was denied. After the combination treatment with systemic steroid and tocilizumab administration, she was in complete clinical remission without medication at conception. Upon arrival, her body temperature, blood pressure, and heart rate were 37.7 °C, 101/63 mmHg, and 103 beats/min. In systemic physical examinations, no abnormalities were found. The laboratory findings at arrival are presented in Table 2 ; The results indicated liver dysfunction, low platelet, and elevated IL-18 and aldolase levels. No apparent coagulopathy findings were observed. Basic infectious disease tests including Epstein–Barr virus and cytomegalovirus were all negative. Nonstress test and fetal sonography revealed perfect biophysical profile scoring of her fetus, mild polyhydramnios (maximum vertical pocket of amnion: 8.3 cm), and an estimated fetal body weight (EFBW) of 1663 g (+ 0.8 standard deviation [SD]). However, splenomegaly was detected by additional abdominal sonography. Although HELLP syndrome or AFLP was suspected upon admission according to liver dysfunction and low platelet count at third trimester and termination of pregnancy could be possible, her clinical course and examination results did not match well to Sibai’s criteria for HELLP syndrome and Swansea’s criteria for AFLP . Moreover, her general condition and fetal status did not require urgent intervention. Considering the findings such as mild fever, elevated ferritin level, high level of IL-18, splenomegaly, and good fetal status, she was ultimately diagnosed with recurrence flare of AOSD by us and some rheumatologists. Thus, systemic steroid pulse therapy (first dose: 250 mg of methylprednisolone [mPSL] for 3 days) was initiated and switched to oral prednisolone (PSL) thereafter. Additionally, the patient was carefully followed up by frequent laboratory tests and transabdominal fetal sonography. Figure 1 illustrates her clinical course after hospitalization at 30 gestational weeks. Clinical AOSD findings such as fever, liver dysfunction, and high ferritin level were well controlled for 3 weeks after the initiation of systemic steroid therapy; hence, the oral PSL dosage was gradually reduced. However, another steroid pulse therapy was needed for the second flare of AOSD that happened at her 33 gestational weeks with elevated liver enzymes and rash on her trunk. In her clinical course, although with maintained uneventful fetal status, the growth of the fetus had been gradually restricted, resulting in intrauterine growth restriction (IUGR). At 36 weeks and 0 days of gestation, she had irregular uterine contractions without apparent infectious findings, and preterm premature rupture of membrane (pPROM). Finally, she spontaneously delivered a female infant transvaginally at 36 weeks and 3 days of gestation. Her infant had a low birth weight but was very healthy; the Apgar score was 9/10, and pH of the umbilical artery was 7.312. Moreover, no abnormal findings of the amniotic fluid at delivery and no pathological features in her placenta and umbilical cord were found. At 12 days postpartum, she had elevated ferritin levels and extremely low platelet count, indicating the third AOSD flare by a rheumatologist; thus, the dosage of oral PSL was increased and maintained for months. During her follow-up checkup as an outpatient by rheumatologists at 1 year postpartum, her C-reactive protein (CRP) and ferritin levels were within the reference range, and her platelet count gradually increased, indicating a well-controlled AOSD. Table 2 Laboratory findings Value Reference intervals, unit T-Bil 0.7 0.4–1.5, mg/dl AST 491 13–30, U/L ALT 438 7–23, U/L LDH 653 124–222, U/L γ-GTP 10 9–32, U/L BUN 6.4 8.0–20.0, mg/dl Cre 0.58 0.46–0.79, mg/dl BS 84 80–110, mg/dl UA 3.3 2.6–7.0, mg/dl CRP 1.81 0.00–0.14, mg/dl TG 163 30–149, mg/dl Ferritin 281 5–157, ng/ml WBC 2980 3300–8600, /μl RBC 3.93 3.86–4.92, × 10 6 /μl Hb 10.7 11.6–14.8, g/dl Ht 32.5 35.1–44.4, % Plt 108 158–348, × 10 3 /μl PT-INR 0.89 0.90–1.10 APTT 33 25–35, seconds Fib 407 200–400, mg/dl AT III 96 80–130, % Urinary protein 0.33 0.02–0.12, g/day IL-18 175,116 0–211, pg/ml Aldolase 30.6 2.5–7.5, U/L Fig. 1 Clinical course, laboratory data, and treatment of the patient. Initial mPSL pulse therapy was provided for 3 days after 30 weeks and 5 days of gestation and then switched to oral PSL therapy. At 33 weeks and 0 days of gestation, another pulse therapy was provided for the second flare. EFBW was restricted gradually from − 0.6 SD to − 1.5 SD. At 36 weeks and 0 days of gestation, this patient started irregular uterine contractions and finally delivered a healthy infant spontaneously at 36 weeks and 3 days of gestation. At 12 days postpartum, she experienced the third flare, and oral PSL therapy was maintained
| 4.039063
| 0.974609
|
sec[1]/p[0]
|
en
| 0.999997
|
33627085
|
https://doi.org/10.1186/s12884-021-03648-1
|
[
"ferritin",
"gestation",
"liver",
"aosd",
"fetal",
"platelet",
"flare",
"oral",
"well",
"fever"
] |
[
{
"code": "8A01.1Y",
"title": "Other specified secondary chorea"
},
{
"code": "JA61.Y",
"title": "Other specified venous complications in pregnancy"
},
{
"code": "JA8E",
"title": "Maternal care related to prolonged pregnancy"
},
{
"code": "JA01.Y",
"title": "Other specified ectopic pregnancy"
},
{
"code": "JA61.Z",
"title": "Venous complications in pregnancy, unspecified"
},
{
"code": "JA82.5",
"title": "Maternal care for multiple gestation with malpresentation of one fetus or more"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[8A01.1Y] Other specified secondary chorea
Also known as: Other specified secondary chorea | Chorea due to Neuroacanthocytosis | McLeod syndrome | Chorea due to Neurodegeneration with brain iron accumulation type 1 | Chorea due to inherited ataxia
[JA61.Y] Other specified venous complications in pregnancy
Also known as: Other specified venous complications in pregnancy | Venous thrombosis in pregnancy | antepartum thrombosis NOS | Gestational thrombosis NOS | thrombosis in pregnancy NOS
[JA8E] Maternal care related to prolonged pregnancy
Definition: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period.
Also known as: Maternal care related to prolonged pregnancy | post-term pregnancy | pregnancy beyond 42 weeks of gestation | prolonged gestation | postmature pregnancy
Includes: Post-term
[JA01.Y] Other specified ectopic pregnancy
Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy
[JA61.Z] Venous complications in pregnancy, unspecified
Also known as: Venous complications in pregnancy, unspecified | Venous complications in pregnancy | Gestational phlebopathy, NOS
[JA82.5] Maternal care for multiple gestation with malpresentation of one fetus or more
Also known as: Maternal care for multiple gestation with malpresentation of one fetus or more | abnormal presentation in multiple gestation
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[8A01.1Y] Other specified secondary chorea
--PARENT--> [8A01.1] Secondary Chorea
Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another. Chorea can be seen in a variety of metabolic, immunological and o...
--PARENT--> [8A01] Choreiform disorders
Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another....
--- Walk 2 ---
[8A01.1Y] Other specified secondary chorea
--PARENT--> [8A01.1] Secondary Chorea
Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another. Chorea can be seen in a variety of metabolic, immunological and o...
--EXCLUDES--> [?] Benign hereditary chorea
Def: Benign hereditary chorea should be considered in people with a relatively stable, nonprogressive chorea, in whom childhood onset and an autosomal dominant family history are present. Benign hereditary...
--- Walk 3 ---
[JA61.Y] Other specified venous complications in pregnancy
--PARENT--> [JA61] Venous complications in pregnancy
--EXCLUDES--> [?] Venous complications in the puerperium
--- Walk 4 ---
[JA61.Y] Other specified venous complications in pregnancy
--PARENT--> [JA61] Venous complications in pregnancy
--CHILD--> [JA61.0] Varicose veins of lower extremity in pregnancy
--- Walk 5 ---
[JA8E] Maternal care related to prolonged pregnancy
Def: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period....
--PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems
Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...
--PARENT--> [18] 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 6 ---
[JA8E] Maternal care related to prolonged pregnancy
Def: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period....
--PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems
Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...
--CHILD--> [JA80] Maternal care related to multiple gestation
|
[
"[8A01.1Y] Other specified secondary chorea\n --PARENT--> [8A01.1] Secondary Chorea\n Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another. Chorea can be seen in a variety of metabolic, immunological and o...\n --PARENT--> [8A01] Choreiform disorders\n Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another....",
"[8A01.1Y] Other specified secondary chorea\n --PARENT--> [8A01.1] Secondary Chorea\n Def: Chorea consists of irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another. Chorea can be seen in a variety of metabolic, immunological and o...\n --EXCLUDES--> [?] Benign hereditary chorea\n Def: Benign hereditary chorea should be considered in people with a relatively stable, nonprogressive chorea, in whom childhood onset and an autosomal dominant family history are present. Benign hereditary...",
"[JA61.Y] Other specified venous complications in pregnancy\n --PARENT--> [JA61] Venous complications in pregnancy\n --EXCLUDES--> [?] Venous complications in the puerperium",
"[JA61.Y] Other specified venous complications in pregnancy\n --PARENT--> [JA61] Venous complications in pregnancy\n --CHILD--> [JA61.0] Varicose veins of lower extremity in pregnancy",
"[JA8E] Maternal care related to prolonged pregnancy\n Def: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period....\n --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems\n Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...\n --PARENT--> [18] 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 ...",
"[JA8E] Maternal care related to prolonged pregnancy\n Def: Pregnancy that has exceeded a duration of 42 weeks from the last menstrual period....\n --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems\n Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...\n --CHILD--> [JA80] Maternal care related to multiple gestation"
] |
8A01.1Y
|
Other specified secondary chorea
|
[
{
"from_icd11": "JA8E",
"icd10_code": "O480",
"icd10_title": "Post-term pregnancy"
},
{
"from_icd11": "JA8E",
"icd10_code": "O481",
"icd10_title": "Prolonged pregnancy"
},
{
"from_icd11": "JA8E",
"icd10_code": "O48",
"icd10_title": "Late pregnancy"
},
{
"from_icd11": "JA8E",
"icd10_code": "O480 ",
"icd10_title": ""
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O2293",
"icd10_title": "Venous complication in pregnancy, unspecified, third trimester"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O228X3",
"icd10_title": "Other venous complications in pregnancy, third trimester"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O228X1",
"icd10_title": "Other venous complications in pregnancy, first trimester"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O228X2",
"icd10_title": "Other venous complications in pregnancy, second trimester"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O2291",
"icd10_title": "Venous complication in pregnancy, unspecified, first trimester"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O2292",
"icd10_title": "Venous complication in pregnancy, unspecified, second trimester"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O22",
"icd10_title": "Venous complications and hemorrhoids in pregnancy"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O228",
"icd10_title": "Other venous complications in pregnancy"
},
{
"from_icd11": "JA61.Z",
"icd10_code": "O229",
"icd10_title": "Venous complication in pregnancy, unspecified"
},
{
"from_icd11": "JA82.5",
"icd10_code": "O325",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
}
] |
O480
|
Post-term pregnancy
|
Our patient is a 12-year-old girl with ulcerative pancolitis, diagnosed at age 10 at an outside facility. On diagnosis, she presented with a one-month history of abdominal pain, hematochezia, and a twenty-pound weight loss with a pediatric ulcerative colitis activity index (PUCAI) score of 60. Colonoscopy at initial diagnosis reported pancolitis with pathology showing chronic active colitis and crypt architecture changes. At the time of presentation to our facility, she was in clinical remission on infliximab 10 mg/kg every 4 weeks which had recently been increased secondary to an undetectable drug level. She presented with fevers and insidious onset of bone pain at multiple sites. The pain initially began a few weeks prior in her lower back and migrated to her left clavicle and bilateral metatarsals. Vital signs on admission were significant for the following: blood pressure, 100/53 mmHg; pulse rate, 124 beats/min; and body temperature, 38.9 °C. On exam, her left shoulder was exquisitely tender to palpation with overlying erythema. Additionally, her bilateral feet were tender to touch with erythema and fluctuance around her bilateral great toes. Foot radiographs demonstrated mild soft tissue swelling and fat stranding . Laboratory findings included white blood cell count 9.6 × 10^3/uL with 74% PMN’s and 10% lymphocytes, hemoglobin 11.4 g/dL, platelet 413 × 10^3/uL, albumin 3.3 g/dL, INR 1.52, erythrocyte sedimentation rate (ESR) 54 mm/hr., C-reactive protein (CRP) 185.9 mg/L. Blood cultures were obtained on admission. Nuclear infection imaging demonstrated focal uptake in the left acromion concerning for osteomyelitis . Single-photon emission computerized tomography (SPECT) scan also demonstrated lytic changes at the left acromial apophysis . To better elucidate the anatomy of the joint, a magnetic resonance imaging (MRI) of the left shoulder was performed which also supported the diagnosis of osteomyelitis . Despite this finding, antibiotics were not initiated, and patient was taken to the operating room for further exploration. Surgical incision and drainage of the left acromion and bilateral metatarsophalangeal (MTP) joints revealed copious purulence concerning for multifocal infection and abscess. Bacterial cultures and PCR were performed on the fluid from the left acromion and bilateral metatarsophalangeal joints prior to the initiation of IV Vancomycin and Ceftriaxone. Despite these interventions, the patient continued to be febrile, tachycardic and intermittently hypotensive with suboptimal pain control. Inflammatory markers continued to remain elevated. IV antibiotics were thus discontinued after 3 days. Biopsy of the left acromion was performed which revealed acute and chronic osteomyelitis with areas of necrosis and granulomatous inflammation . Aerobic, anaerobic, fungal and acid-fast bacteria (AFB) cultures and pan-bacterial PCR were negative from the joint fluid prior to the start of antibiotics eluding to a non-infectious cause. Methylprednisolone 1000 mg IV daily was initiated inpatient for a three-day course per Rheumatology recommendations with marked improvement in fever, pain and inflammatory markers. Patient was discharged on Prednisone 30 mg twice daily and started on Methotrexate 20 mg SQ weekly to be further managed by Rheumatology. The patient was seen in Rheumatology clinic 2 weeks following discharge and continued to remain afebrile and asymptomatic. She was followed monthly in Rheumatology clinic and was tapered off of steroids 5 months following her initial presentation. She has remained on Methotrexate 20 mg SQ weekly. She continued to have complete resolution of joint symptoms off of steroids without any limitations in joint movements. Furthermore, patient has followed closely with Pediatric Gastroenterology where she continues to remain in clinical remission on infliximab 10 mg/kg every 4 weeks. A colonoscopy was repeated 8 months following discharge from the hospital which showed mild proctitis. Fig. 1 Right foot radiograph demonstrated mild soft tissue swelling and fat stranding (white arrow) which can be seen with cellulitis or edema. No definite radiographic evidence of osteomyelitis was identified Fig. 2 Nuclear Infection Imaging: 99 m Tc Ceretec WBC scan demonstrates abnormal focal radiotracer uptake at the left shoulder on delayed whole-body imaging (black arrow). Abnormal focal radiotracer uptake is also seen in the bowel of the right lower quadrant and pelvis, consistent with the patient’s history of ulcerative colitis (black arrowhead) Fig. 3 Single-photon emission computerized tomography (SPECT) scan demonstrates lytic changes at the left acromial apophysis and colon (white arrows) Fig. 4 Left shoulder MRI axial images demonstrate signal characteristics consistent with osteomyelitis at the acromial apophysis: hyperintense (brighter) on T2 weighted imaging ( a ) and hypointense (darker) on T1 weighted imaging ( b ) with contrast enhancement on post-gadolinium T1 weighted imaging with fat suppression (white arrow c ). Cortical disruption (arrowhead b ) and an overlying fluid collection (arrowhead a ) are also present Fig. 5 Acute and chronic osteomyelitis with areas of marrow fibrosis (red arrow) and dense lymphoplasmacytic inflammatory infiltrate (blue arrow) Fig. 6 Acute and chronic osteomyelitis with dense inflammatory infiltrate. Neutrophil (blue arrowhead) and lymphocyte (red arrow)
| 3.933594
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999997
|
32571258
|
https://doi.org/10.1186/s12887-020-02215-5
|
[
"imaging",
"osteomyelitis",
"arrow",
"pain",
"which",
"shoulder",
"white",
"acromion",
"joint",
"inflammatory"
] |
[
{
"code": "5A74.Y",
"title": "Other specified adrenocortical insufficiency"
},
{
"code": "MB27.3",
"title": "Disturbance of body image"
},
{
"code": "MD41",
"title": "Clinical findings on diagnostic imaging of lung"
},
{
"code": "ME21",
"title": "Clinical findings on diagnostic imaging of liver or biliary tract"
},
{
"code": "ME91",
"title": "Clinical findings on diagnostic imaging of limbs"
},
{
"code": "FB84.Z",
"title": "Osteomyelitis or osteitis, unspecified"
},
{
"code": "FB84.1",
"title": "Other acute osteomyelitis"
},
{
"code": "FB84.Y",
"title": "Other specified osteomyelitis or osteitis"
},
{
"code": "1A72.0",
"title": "Gonococcal infection of musculoskeletal system"
},
{
"code": "1A09.Y/FB84.Z",
"title": "Salmonella osteomyelitis"
}
] |
=== ICD-11 CODES FOUND ===
[5A74.Y] Other specified adrenocortical insufficiency
Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism
[MB27.3] Disturbance of body image
Definition: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it.
Also known as: Disturbance of body image
[MD41] Clinical findings on diagnostic imaging of lung
Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging.
Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass
[ME21] Clinical findings on diagnostic imaging of liver or biliary tract
Also known as: Clinical findings on diagnostic imaging of liver or biliary tract | Abnormal diagnostic imaging of liver | Nonvisualisation of gallbladder
[ME91] Clinical findings on diagnostic imaging of limbs
Also known as: Clinical findings on diagnostic imaging of limbs | abnormal diagnostic imaging of limbs
[FB84.Z] Osteomyelitis or osteitis, unspecified
Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease
[FB84.1] Other acute osteomyelitis
Also known as: Other acute osteomyelitis | Other acute osteomyelitis, multiple sites | Other acute osteomyelitis, shoulder region | Other acute osteomyelitis, clavicle | Other acute osteomyelitis, scapula
[FB84.Y] Other specified osteomyelitis or osteitis
Also known as: Other specified osteomyelitis or osteitis | Other chronic osteomyelitis | Garre's disease | chronic or old osteomyelitis with or without mention of periostitis | chronic bone abscess
[1A72.0] Gonococcal infection of musculoskeletal system
Definition: This is a species of Gram-negative coffee bean-shaped diplococci bacteria responsible for the sexually transmitted infection gonorrhoea. This diagnosis is of the musculoskeletal system.
Also known as: Gonococcal infection of musculoskeletal system | Infection of the musculoskeletal system due to Neisseria gonorrhoeae | Gonococcal infection of joint | gonococcal infection of joint NOS | Gonococcal arthritis
Includes: Gonococcal arthritis | Gonococcal bursitis | Gonococcal osteomyelitis
=== GRAPH WALKS ===
--- Walk 1 ---
[5A74.Y] Other specified adrenocortical insufficiency
--PARENT--> [5A74] Adrenocortical insufficiency
Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...
--CHILD--> [5A74.1] Adrenal crisis
Def: Adrenal crisis is a life-threatening condition that indicates severe adrenal insufficiency caused by insufficient levels of cortisol....
--- Walk 2 ---
[5A74.Y] Other specified adrenocortical insufficiency
--PARENT--> [5A74] Adrenocortical insufficiency
Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...
--CHILD--> [5A74.1] Adrenal crisis
Def: Adrenal crisis is a life-threatening condition that indicates severe adrenal insufficiency caused by insufficient levels of cortisol....
--- Walk 3 ---
[MB27.3] Disturbance of body image
Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it....
--PARENT--> [MB27] Symptoms or signs involving perceptual disturbance
Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....
--PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings
--- Walk 4 ---
[MB27.3] Disturbance of body image
Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it....
--PARENT--> [MB27] Symptoms or signs involving perceptual disturbance
Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....
--CHILD--> [MB27.0] Depersonalisation
Def: Experiencing the self as strange or unreal, or feeling detached from, or as though one were an outside observer of, one’s thoughts, feelings, sensations, body, or actions. Depersonalization may take t...
--- Walk 5 ---
[MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
--PARENT--> [?] Clinical findings in the respiratory system
--CHILD--> [MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
--- Walk 6 ---
[MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
--PARENT--> [?] Clinical findings in the respiratory system
--CHILD--> [MD42] Results of function studies of the respiratory system
|
[
"[5A74.Y] Other specified adrenocortical insufficiency\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --CHILD--> [5A74.1] Adrenal crisis\n Def: Adrenal crisis is a life-threatening condition that indicates severe adrenal insufficiency caused by insufficient levels of cortisol....",
"[5A74.Y] Other specified adrenocortical insufficiency\n --PARENT--> [5A74] Adrenocortical insufficiency\n Def: A condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol. It may also include impaired production of aldosterone (a mineralocorticoid), which reg...\n --CHILD--> [5A74.1] Adrenal crisis\n Def: Adrenal crisis is a life-threatening condition that indicates severe adrenal insufficiency caused by insufficient levels of cortisol....",
"[MB27.3] Disturbance of body image\n Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it....\n --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance\n Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....\n --PARENT--> [?] Mental or behavioural symptoms, signs or clinical findings",
"[MB27.3] Disturbance of body image\n Def: Excessively negative, distorted, or inaccurate perception of one's own body or parts of it....\n --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance\n Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....\n --CHILD--> [MB27.0] Depersonalisation\n Def: Experiencing the self as strange or unreal, or feeling detached from, or as though one were an outside observer of, one’s thoughts, feelings, sensations, body, or actions. Depersonalization may take t...",
"[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...",
"[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD42] Results of function studies of the respiratory system"
] |
5A74.Y
|
Other specified adrenocortical insufficiency
|
[
{
"from_icd11": "MD41",
"icd10_code": "R911",
"icd10_title": "Solitary pulmonary nodule"
},
{
"from_icd11": "MD41",
"icd10_code": "R91",
"icd10_title": "Abnormal findings on diagnostic imaging of lung"
},
{
"from_icd11": "ME21",
"icd10_code": "R932",
"icd10_title": "Abnormal findings on diagnostic imaging of liver and biliary tract"
},
{
"from_icd11": "ME91",
"icd10_code": "R936",
"icd10_title": "Abnormal findings on diagnostic imaging of limbs"
},
{
"from_icd11": "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"
}
] |
R911
|
Solitary pulmonary nodule
|
A 57-year-old man presented with jaundice. There was no past history of hepatitis or blood transfusion. Blood tests showed high levels of bilirubin, protein induced by vitamin K absence or antagonist-II (PIVKA-II) and carbohydrate antigen 19-9 (CA19-9). The indocyanine green retention test (ICG R 15) could not be evaluated due to obstructive jaundice ( Table 1 a). Computed tomography (CT) scans showed a tumor 40 mm in diameter located in segment 6 with TT in the common hepatic bile duct . Endoscopic retrograde cholangiography (ERCP) showed TT in the right hepatic duct and the common bile duct . An endoscopic nasobiliary drainage (ENBD) tube was inserted in the left liver. ENBD was performed instead of percutaneous transhepatic biliary drainage (PTBD) due to the risk of tumor dissemination and bleeding, and insufficient dilation of the left intrahepatic bile duct. The level of total bilirubin in the bile (LTB) from the left liver as a future remnant liver was calculated at 1 week and 2 weeks after ENBD. LTB was calculated by multiplying bile density and volume obtained by ENBD . One week after ENBD, the total bilirubin density was 16.9 mg/dL and the bile volume was 205 ml. Two weeks after ENBD, the total bilirubin density was 46.0 mg/dL and the bile volume was 235 ml. The LTB from the left liver increased from 34.6 mg to 108.1 mg. However, bleeding from the TT and cholangitis occurred so thatneither the patient’s general condition nor the serum level of bilirubin improved. One month after admission, the patient underwent thrombectomy in the bile duct, transection of the right hepatic bile duct and ligation of the right hepatic artery due to bleeding from the thrombus . The bilirubin level immediately improved, and he was discharged from the hospital . However, TT in the right portal vein developed and he was admitted to the hospital for a second operation. The serum level of total bilirubin was 1.3 mg/dl and ICG R 15 was 34% at the second admission. Although the volume of bile could not be measured, the total bilirubin density in the bile from the left liver by ERCP was 40 mg/dL ( Table 1 b). 99m T-galactosyl human serum albumin ( 99m Tc-GSA) scintigraphy revealed a reduced accumulation of GSA in the right liver. In addition, left liver hypertrophy was observed on GSA scintigraphy . We judged that right hepatectomy was possible because of the following reasons: (1) decrease in the serum level of total bilirubin, (2) hypertrophy of the left liver similar to portal vein embolization, (3) sufficient future remnant liver function on the basis of the total bilirubin density in the bile from the left liver. The patient underwent right hepatectomy for HCC. The total operation time was 326 min, and the total blood loss was 6264 g. The pathological findings yielded a diagnosis of moderately differentiated HCC with macroscopic portal vein and bile duct TT . There was no intrahepatic metastasis, and the surgical margin was negative. The patient’s postoperative course was uneventful, and he was discharged on postoperative day 30 and he is well without recurrence 10 years after surgery. Table 1 Laboratory data and liver function (a). Sequential data of the bilirubin level from the left liver (future remnant liver) (b). Table 1 (a) 1st. admission Before hepatectomy 1st. admission Before hepatectomy Alb (g/dL) 2.8 2.2 WBC (/μL) 15290 10690 T-bil (mg/dL) 31.9 1.7 Hb (g/dL) 13.6 10.7 D-bil (IU/L) 22.5 1.3 Hct (%) 38.2 33.2 AST (IU/L) 67 64 Plt (/μL) 48.8 × 10 4 21.6 × 10 4 ALT (IU/L) 51 41 LDH (IU/L) 425 204 PT (%) 66.7 62.4 ChE (IU/L) 125 NA ALP (IU/L) 784 701 HCV-Ab negative γGTP (IU/L) 223 323 HBs-Ag negative BUN (mg/dL) 21.3 14.4 HBs-Ab negative Cr (mg/dL) 1.08 0.83 CRP (mg/dL) 8.63 4.86 AFP (ng/dL) 42 103 PIVKA-II (mAU/mL) 11736 NA Child-Pugh B B CEA (ng/mL) 1.6 NA Liver damage C B CA19-9 (U/mL) 2828 188 ICGR15 (%) NA 34 (b) 1 week after ENBD 2 week after ENBD Before hepatectomy ENBD bile volume (ml/day) 205 235 NA Total bilirubin density from the left liver (mg/dL) 16.9 46.0 40.0 LTB from the left liver (mg) 34.6 108.1 NA LTB: The level of total bilirubin in the bile. Fig. 1 Computed tomography showed a tumor, 40 × 38 mm in diameter, enhanced in the arterial phase (a, b) and washed out in the portal phase (c, d) in segment 6 of the liver (arrow). The right intrahepatic bile duct was dilated and tumor thrombus in the bile duct was detected (arrow head c). Endoscopic retrograde cholangiography showed a filling defect from the right hepatic duct to the common hepatic duct (arrow, e). Fig. 1 Fig. 2 As initial operation, we performed thrombectomy in the bile duct, transection of the right hepatic bile duct, ligation of the right hepatic artery, and external drainage of the bile duct in the right lobe (a, b schema). Macroscopic findings showed tumor thrombus in the bile duct (c). Fig. 2 Fig. 3 Trends in liver function after initial surgery. Fig. 3 Fig. 4 Computed tomography before the second operation showed the tumor in segment 6 decreased in size (arrow a, b: arterial phase, c, d: portal phase). However, a tumor thrombus had developed in the right main portal vein (arrow head b, d). 99m Tc-GSA scintigraphy revealed a reduced accumulation of GSA in the right liver (e, f). Fig. 4 Fig. 5 Macroscopic (a) and microscopic (b) findings showed tumor thrombi in the right hepatic bile duct (arrow head) and the right hepatic portal vein (arrow). Fig. 5
| 4.058594
| 0.964844
|
sec[1]/p[0]
|
en
| 0.999998
|
31585354
|
https://doi.org/10.1016/j.ijscr.2019.09.030
|
[
"bile",
"liver",
"duct",
"bilirubin",
"total",
"hepatic",
"enbd",
"tumor",
"portal",
"arrow"
] |
[
{
"code": "DC10.2",
"title": "Fistula of gallbladder or bile duct"
},
{
"code": "DC10.02",
"title": "Obstruction of bile duct"
},
{
"code": "DC13",
"title": "Cholangitis"
},
{
"code": "LB20.2Y",
"title": "Other specified structural developmental anomalies of bile ducts"
},
{
"code": "ME24.35&XA6R80",
"title": "Perforation of bile duct"
},
{
"code": "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 ===
[DC10.2] Fistula of gallbladder or bile duct
Definition: This is an abnormal connection or passageway between gallbladder or bile duct and other organs.
Also known as: Fistula of gallbladder or bile duct | fistula of gallbladder | gallbladder fistula | Cholecystocolic fistula | Cholecystoduodenal fistula
[DC10.02] Obstruction of bile duct
Also known as: Obstruction of bile duct | extrahepatic biliary obstruction | extrahepatic bile duct obstruction | bile duct obstruction | bile stasis
Excludes: with cholelithiasis
[DC13] Cholangitis
Also known as: Cholangitis | acute cholangiolitis | ascending cholangitis | cholangiolitis | cholangitis NOS
Excludes: chronic nonsuppurative destructive cholangitis | cholangitis with cholelithiasis | Primary sclerosing cholangitis
[LB20.2Y] Other specified structural developmental anomalies of bile ducts
Also known as: Other specified structural developmental anomalies of bile ducts | Anomalous arrangement of pancreatobiliary ducts | Aberrant hepatic duct | Accessory hepatic duct | accessory liver duct
[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 ---
[DC10.2] Fistula of gallbladder or bile duct
Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....
--PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts
Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....
--RELATED_TO--> [?] Perforation of gallbladder or bile ducts
Def: This is perforation in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....
--- Walk 2 ---
[DC10.2] Fistula of gallbladder or bile duct
Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....
--PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts
Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....
--CHILD--> [DC10.2] Fistula of gallbladder or bile duct
Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....
--- Walk 3 ---
[DC10.02] Obstruction of bile duct
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--PARENT--> [?] Diseases of gallbladder or biliary tract
Def: This is a group of conditions characterised as being in or associated with the gallbladder (an organ) and the biliary tract (the passageways for bile)....
--- Walk 4 ---
[DC10.02] Obstruction of bile duct
--EXCLUDES--> [?] Cholelithiasis
Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...
--CHILD--> [?] Calculus of gallbladder or cystic duct with acute cholecystitis
Def: Stones in gallbladder or cystic duct present with acute inflammation of the gall bladder wall typically follows the cystic duct obstruction by the stone....
--- Walk 5 ---
[DC13] Cholangitis
--EXCLUDES--> [?] Primary biliary cholangitis
Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...
--EXCLUDES--> [?] Alcoholic cirrhosis of liver without hepatitis
Def: Alcoholic cirrhosis is an advanced pathological stage of alcoholic liver disease characterised by diffuse fibrosis that links portal tracts and central veins, distortion of the hepatic architecture an...
--- Walk 6 ---
[DC13] Cholangitis
--EXCLUDES--> [?] Primary biliary cholangitis
Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...
--CHILD--> [?] Oesophageal varices with bleeding in primary biliary cholangiopathy
Def: This refers to abnormally dilated veins in the lining of oesophagus with sign of bleeding in patients with primary biliary cirrhosis....
|
[
"[DC10.2] Fistula of gallbladder or bile duct\n Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....\n --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts\n Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....\n --RELATED_TO--> [?] Perforation of gallbladder or bile ducts\n Def: This is perforation in the small organ that aids mainly in fat digestion and concentrates bile produced by the liver and in any of a number of long tube-like structures that carry bile....",
"[DC10.2] Fistula of gallbladder or bile duct\n Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....\n --PARENT--> [DC10] Acquired anatomical alterations of gallbladder or bile ducts\n Def: This considers the structure in the alterations of the gall bladder and the long tube-like structures that carry bile....\n --CHILD--> [DC10.2] Fistula of gallbladder or bile duct\n Def: This is an abnormal connection or passageway between gallbladder or bile duct and other organs....",
"[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --PARENT--> [?] Diseases of gallbladder or biliary tract\n Def: This is a group of conditions characterised as being in or associated with the gallbladder (an organ) and the biliary tract (the passageways for bile)....",
"[DC10.02] Obstruction of bile duct\n --EXCLUDES--> [?] Cholelithiasis\n Def: Cholelithiasis is calculus of gallbladder, cystic duct or bile duct. Most stones in the gallbladder are asymptomatic, but the most common initial symptom is biliary colic before the development of com...\n --CHILD--> [?] Calculus of gallbladder or cystic duct with acute cholecystitis\n Def: Stones in gallbladder or cystic duct present with acute inflammation of the gall bladder wall typically follows the cystic duct obstruction by the stone....",
"[DC13] Cholangitis\n --EXCLUDES--> [?] Primary biliary cholangitis\n Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...\n --EXCLUDES--> [?] Alcoholic cirrhosis of liver without hepatitis\n Def: Alcoholic cirrhosis is an advanced pathological stage of alcoholic liver disease characterised by diffuse fibrosis that links portal tracts and central veins, distortion of the hepatic architecture an...",
"[DC13] Cholangitis\n --EXCLUDES--> [?] Primary biliary cholangitis\n Def: Primary biliary cholangitis is characterised by progressive destruction and disappearance of the intralobular bile duct epithelial cells leading to cholestasis (high alkaline phosphatase and GGT {gamm...\n --CHILD--> [?] Oesophageal varices with bleeding in primary biliary cholangiopathy\n Def: This refers to abnormally dilated veins in the lining of oesophagus with sign of bleeding in patients with primary biliary cirrhosis...."
] |
DC10.2
|
Fistula of gallbladder or bile duct
|
[
{
"from_icd11": "DC10.2",
"icd10_code": "K833",
"icd10_title": "Fistula of bile duct"
},
{
"from_icd11": "DC10.2",
"icd10_code": "K823",
"icd10_title": "Fistula of gallbladder"
},
{
"from_icd11": "DC10.02",
"icd10_code": "K831",
"icd10_title": "Obstruction of bile duct"
},
{
"from_icd11": "DC13",
"icd10_code": "K8309",
"icd10_title": "Other cholangitis"
},
{
"from_icd11": "DC13",
"icd10_code": "K8301",
"icd10_title": "Primary sclerosing cholangitis"
},
{
"from_icd11": "DC13",
"icd10_code": "K830",
"icd10_title": "Cholangitis"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7689",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K769",
"icd10_title": "Liver disease, unspecified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K77",
"icd10_title": "Liver disorders in diseases classified elsewhere"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K762",
"icd10_title": "Central hemorrhagic necrosis of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K70-K77",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K778",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K72",
"icd10_title": "Hepatic failure, not elsewhere classified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K76",
"icd10_title": "Other diseases of liver"
}
] |
K833
|
Fistula of bile duct
|
A 30-year-old schizophrenic patient decided to visit the dentist office because of a toothache. The patient complained of burning sensation and dryness in her mouth and sleep disturbances. One week prior to the visit, the patient had stopped taking antipsychotic drugs prescribed by a psychiatrist, which she had taken at the following doses: aripiprazole 30 mg/day, perazine 100 mg/day, and carbamazepine 800 mg/day. She admitted to having taken the drugs irregularly. The patient either discontinued the treatment for several days or had taken double doses on subsequent days ‘to feel better faster’. The patient had poor insight into the illness, did not see a need for regular treatment of schizophrenia, and reported depressive mood caused by ‘chips in the teeth’. She had a history of neuroleptic malignant syndrome caused by risperidone treatment, therefore she was unwilling to take antipsychotic drugs, or she reduced the dosage by herself, being afraid of adverse events. During oral cavity and dental examination at the dentist office, the patient was diagnosed with circular and root caries, thick dental plaque, oral mucositis in the form of ulcerations, mucosal redness and dryness, as well as spontaneous mucosal lacerations. Food residues were also detected. Silness-Löe plaque index (PI) amounted to 2.29 and approximal plaque index (API) by Lange was 100% . It was also found that her tongue tended to stick to the palate due to saliva hyposecretion. This condition caused difficulties in eating and bolus forming, affected her taste perception, and resulted in oversensitivity to the temperature of drunk liquids, as well as reduced appetite. In addition, the patient complained of halitosis ( fetor ex ore ), speaking difficulties, as well as throat dryness and soreness. The patient underwent sialometry which measured stimulated and unstimulated saliva secretion. Saliva hyposecretion was diagnosed, and it amounted to 0.5 ml/min following unstimulated saliva secretion and to 0.7 ml/min following stimulated saliva secretion (chewing of a gum). Unstimulated and stimulated saliva secretion was tested threefold within 6 min, 2 h after breakfast. With regards to numerous conditions concerning the patient’s dentition, she received periodontal treatment. The treatment involved supra- and subgingival plaque deposits removal (scaling) together with periodontal pocket irrigation and root debridement in order to reduce plaque deposits (bacterial biofilm) and to accelerate the cell healing process. An invasive treatment involved teeth 16, 17, and 33 with third degree root caries, tooth 26 with fourth degree caries, and due to esthetic reasons, tooth 43 with second degree root caries. Third degree dental caries were processed and filled with glass-ionomer cement (Ketac Molar®, 3 M ESPE, St. Paul, MN, USA). For a deep cavity of tooth 26, an additional self-hardening calcium hydroxide base (Life®, Kerr Corporation, Orange, CA, USA) was used. For esthetic reasons, caries on labial surfaces of teeth 33 and 43 were filled with complex material using the sandwich technique (Herculite®, Kerr Corporation, Orange, CA, USA). Following the treatment, the exposed root surfaces of all the teeth were covered with 35% CHX varnish (EC40™ Biodent®, Certichem, Nijmenen, Netherlands) for preventive reasons. Afterwards, the patient was once more instructed how to keep good oral cavity hygiene and how to perform routine oral hygiene activities correctly. It was recommended that the patient precisely remove food residues and dental plaque with the use of a nonabrasive fluoride toothpaste (Elmex, Colgate GABA Therwill, Switzerland) after each meal, and rinse her mouth with alcohol-free mouthwashes containing 0.1% chlorhexidine (Eludril Classic, Pierre Fabre Medicament, Warsaw, Poland). For xerostomia treatment, a pilocarpine-based formulation was applied with splitting daily dosage of 10 mg/day. During policarpine treatment, the patient was instructed to drink more liquids, in the amount of 2 l/day, to prevent from drug-induced dehydration. Following policarpine treatment and full recovery from the oral infection and dental caries, it was recommended that the patient applies artificial saliva based on mucin, carboxymethylcellulose, and glycerine. In addition to periodontal treatment, the patient underwent psychiatric treatment and participated in psychoeducation on schizophrenia. Psychiatric treatment involved administering olanzapine at a dose of 25 mg/day, which allowed for improvement in patient’s mental health. The psychotic symptoms (delusions and hallucinations) ceased, and cognitive functions returned to normal. The patient underwent individual cognitive behavioral therapy (CBT) and participated in psychoeducation. After 4 weeks, the patient had her oral hygiene status once more examined with the use of the indexes previously applied. Silness-Löe plaque index amounted to 0.58 and approximal plaque index to 23%, which indicated significant dental plaque reduction. After 12 weeks, all the teeth were covered again with 35% CHX varnish (EC40™ Biodent®, Certichem, Nijmenen, Netherlands). The amount of Streptococcus mutant was significantly decreased in saliva and dental plaque. Effectiveness of EC40 was confirmed by the direct contact test (DCT) (Nunclon Delta Surface; Nunc, Roskilde, Denmark). The DCT was used to assess the antimicrobial activity of the CHX varnishes .
| 4.070313
| 0.974609
|
sec[1]/p[0]
|
en
| 0.999998
|
25810747
|
https://doi.org/10.1186/s12991-015-0052-4
|
[
"plaque",
"saliva",
"dental",
"caries",
"oral",
"teeth",
"root",
"which",
"index",
"secretion"
] |
[
{
"code": "8A40.Z",
"title": "Multiple sclerosis, unspecified"
},
{
"code": "BD4Z",
"title": "Chronic arterial occlusive disease, unspecified"
},
{
"code": "CB20",
"title": "Pleural plaque"
},
{
"code": "BB2Y",
"title": "Other specified pericarditis"
},
{
"code": "9B74.0",
"title": "Retinal artery occlusions"
},
{
"code": "ME20.Y",
"title": "Other specified clinical findings in specimens from digestive organs or abdominal cavity"
},
{
"code": "DA04.6",
"title": "Disturbances of salivary secretion"
},
{
"code": "EK02.21",
"title": "Irritant contact dermatitis due to saliva"
},
{
"code": "DA07.3",
"title": "Disturbances in tooth formation"
},
{
"code": "DA09.61",
"title": "Periapical abscess with sinus"
}
] |
=== ICD-11 CODES FOUND ===
[8A40.Z] Multiple sclerosis, unspecified
Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis
[BD4Z] Chronic arterial occlusive disease, unspecified
Also known as: Chronic arterial occlusive disease, unspecified | PVD - [peripheral vascular disease] | arteriosclerotic peripheral disease | peripheral arteriosclerosis | peripheral arterial occlusive disease
[CB20] Pleural plaque
Definition: 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 inhalation of the inciting exposure.
Also known as: Pleural plaque | Pleural plaque with presence of asbestos | asbestos-induced pleural plaque | pleural plaque disease due to asbestosis | pleural plaques with asbestos
[BB2Y] Other specified pericarditis
Also known as: Other specified pericarditis | Certain diseases of pericardium | Chronic adhesive pericarditis | adherent pericarditis | adherent pericardium
[9B74.0] Retinal artery occlusions
Also known as: Retinal artery occlusions | retina artery narrowing | retinal artery spasm | spasm of ophthalmic artery | retinal spasm
Includes: Retinal artery branch occlusion
[ME20.Y] Other specified clinical findings in specimens from digestive organs or abdominal cavity
Also known as: Other specified clinical findings in specimens from digestive organs or abdominal cavity | Abnormal findings in peritoneal fluid | abnormal peritoneal fluid | abnormality in peritoneal fluid | Abnormal findings in saliva
[DA04.6] Disturbances of salivary secretion
Definition: A group of conditions characterised by an increase or decrease in saliva secretion.
Also known as: Disturbances of salivary secretion | salivary secretion disturbance | sialosis | Absent salivary secretion | aptyalia
Excludes: Dry mouth
[EK02.21] Irritant contact dermatitis due to saliva
Definition: Perioral irritant contact dermatitis caused by repetitive or prolonged contact with saliva.
Also known as: Irritant contact dermatitis due to saliva | Irritant contact eczema due to saliva | Irritant contact dermatitis due to dribbling or teething | Irritant contact eczema due to dribbling/teething | Perioral irritant contact dermatitis due to lip-licking
[DA07.3] Disturbances in tooth formation
Definition: A group of conditions characterised by disturbances in tooth formation.
Also known as: Disturbances in tooth formation | disturbance of tooth formation | Dental dysplasia | disorder of tooth formation | Florid cemento-osseous dysplasia
Includes: Dental dysplasia | Florid cemento-osseous dysplasia | Regional odontodysplasia
Excludes: Hutchinson teeth and mulberry molars in congenital syphilis | mottled teeth
[DA09.61] Periapical abscess with sinus
Also known as: Periapical abscess with sinus | Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus | periapical abscess fistula
Includes: Dental abscess with sinus | Dentoalveolar abscess with sinus | Dental sinus
=== GRAPH WALKS ===
--- Walk 1 ---
[8A40.Z] Multiple sclerosis, unspecified
--PARENT--> [8A40] Multiple sclerosis
Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...
--PARENT--> [?] Multiple sclerosis or other white matter disorders
Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....
--- Walk 2 ---
[8A40.Z] Multiple sclerosis, unspecified
--PARENT--> [8A40] Multiple sclerosis
Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...
--CHILD--> [8A40.2] Secondary progressive multiple sclerosis
--- Walk 3 ---
[BD4Z] Chronic arterial occlusive disease, unspecified
--PARENT--> [?] Chronic arterial occlusive disease
--CHILD--> [BD40] Atherosclerotic chronic arterial occlusive disease
--- Walk 4 ---
[BD4Z] Chronic arterial occlusive disease, unspecified
--PARENT--> [?] Chronic arterial occlusive disease
--CHILD--> [BD42] Raynaud phenomenon
Def: Raynaud phenomenon describes an exaggerated vascular response to cold temperature or emotional stimuli resulting in episodic digital ischaemia. It is characterised by paroxysmal vasoconstriction produ...
--- Walk 5 ---
[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...
--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 6 ---
[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...
--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...
|
[
"[8A40.Z] Multiple sclerosis, unspecified\n --PARENT--> [8A40] Multiple sclerosis\n Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...\n --PARENT--> [?] Multiple sclerosis or other white matter disorders\n Def: This is a group of conditions involving demyelination, damage to the myelin sheath which protects nerve axons and is responsible for neurotransmission....",
"[8A40.Z] Multiple sclerosis, unspecified\n --PARENT--> [8A40] Multiple sclerosis\n Def: Multiple Sclerosis (MS) is a chronic, inflammatory demyelinating disease of the central nervous system. Three categories of multiple sclerosis have been outlined: Relapsing/remitting, secondary progre...\n --CHILD--> [8A40.2] Secondary progressive multiple sclerosis",
"[BD4Z] Chronic arterial occlusive disease, unspecified\n --PARENT--> [?] Chronic arterial occlusive disease\n --CHILD--> [BD40] Atherosclerotic chronic arterial occlusive disease",
"[BD4Z] Chronic arterial occlusive disease, unspecified\n --PARENT--> [?] Chronic arterial occlusive disease\n --CHILD--> [BD42] Raynaud phenomenon\n Def: Raynaud phenomenon describes an exaggerated vascular response to cold temperature or emotional stimuli resulting in episodic digital ischaemia. It is characterised by paroxysmal vasoconstriction produ...",
"[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...\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...",
"[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...\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..."
] |
8A40.Z
|
Multiple sclerosis, unspecified
|
[
{
"from_icd11": "8A40.Z",
"icd10_code": "G35",
"icd10_title": "Multiple sclerosis"
},
{
"from_icd11": "8A40.Z",
"icd10_code": "G370",
"icd10_title": "Diffuse sclerosis of central nervous system"
},
{
"from_icd11": "8A40.Z",
"icd10_code": "G375",
"icd10_title": "Concentric sclerosis [Balo] of central nervous system"
},
{
"from_icd11": "BD4Z",
"icd10_code": "I739",
"icd10_title": "Peripheral vascular disease, unspecified"
},
{
"from_icd11": "BD4Z",
"icd10_code": "I73",
"icd10_title": "Other peripheral vascular diseases"
},
{
"from_icd11": "CB20",
"icd10_code": "J920",
"icd10_title": "Pleural plaque with presence of asbestos"
},
{
"from_icd11": "CB20",
"icd10_code": "J929",
"icd10_title": "Pleural plaque without asbestos"
},
{
"from_icd11": "CB20",
"icd10_code": "J90-J94",
"icd10_title": ""
},
{
"from_icd11": "CB20",
"icd10_code": "J92",
"icd10_title": "Pleural plaque"
},
{
"from_icd11": "9B74.0",
"icd10_code": "H34239",
"icd10_title": "Retinal artery branch occlusion, unspecified eye"
},
{
"from_icd11": "9B74.0",
"icd10_code": "H3401",
"icd10_title": "Transient retinal artery occlusion, right eye"
},
{
"from_icd11": "9B74.0",
"icd10_code": "H34231",
"icd10_title": "Retinal artery branch occlusion, right eye"
},
{
"from_icd11": "9B74.0",
"icd10_code": "H3412",
"icd10_title": "Central retinal artery occlusion, left eye"
},
{
"from_icd11": "9B74.0",
"icd10_code": "H3402",
"icd10_title": "Transient retinal artery occlusion, left eye"
},
{
"from_icd11": "9B74.0",
"icd10_code": "H34232",
"icd10_title": "Retinal artery branch occlusion, left eye"
}
] |
G35
|
Multiple sclerosis
|
A 56-year-old female visited our hospital for the treatment of chronic hepatitis C in 1996. She was 153 cm in height and weighed 53.0 kg. In 1984, she had received surgery for an ovarian cyst and showed abnormally high transaminase levels at that time. She had never received blood transfusions, did not consume alcohol, and had no other history of serious illness. However, she had suffered from allergic reactions to several medicines, including urticaria following chloramphenicol and tetracycline treatments, angioedema from a sulfa drug, a reddish skin reaction following a patch test for fosfomycin calcium and skin disinfection with ethanol, and suffered from liver injury after treatment with oxatomide. In 1991, she was diagnosed with chronic hepatitis C, and in 1995, she was treated with IFN-α2b for 6 months. Although a transient biochemical response was achieved, hepatitis relapsed 7 months after cessation of IFN therapy, prompting treatment with ursodeoxycholic acid (UDCA). After a subsequent visit to our hospital, laboratory examinations revealed the following biochemical levels: aspartate aminotransferase, 117 IU/l; alanine aminotransferase (ALT), 189 IU/l; albumin, 5.0 g/dl; γ-glutamyl transpeptidase, 26 IU/l; platelet count, 16.3 × 10 4 /µl; α-fetoprotein (AFP) <5 ng/ml. She carried HCV genotype 1 and had a viral load of 5.5 Meq/ml. Hepatitis B virus surface antigens and antinuclear antibodies were negative, and thyroid function was normal. Abdominal ultrasound showed no cirrhosis, no fatty liver, and no mass lesions in the liver, and the patient was diagnosed with chronic hepatitis C genotype 1, with a high viral load that was refractory to IFN monotherapy. After addition of glycyrrhizin injections to UDCA therapy, her ALT levels gradually decreased, but fluctuated between 40 and 70 IU/l . In April 2002, examinations of a liver biopsy revealed chronic hepatitis (New Inuyama classification F2/A2), and combination therapy commenced with daily administration of 6 mega units (MU) IFN-α2b for 2 weeks and then three times per week, and RBV at 600 mg/day. Four weeks later, HCV-RNA levels were assessed using an Amplicor Monitor and decreased from 400 to less than 0.5 KIU/ml. However, the patient complained of an occasionally slow pulse, and a Holter electrocardiogram (ECG) after 5 weeks of treatment revealed advanced atrial ventricular (AV) block . After 6 weeks of treatment, the patient complained of palpitation attacks that persisted for more than 4 h, and ECG monitoring revealed supraventricular tachycardia of 170 beats/min . After hospital admission, her symptoms gradually subsided but sometimes relapsed, and Holter ECG showed similar supraventricular tachycardia and AV block type 2 of the second degree . Although an echocardiogram assessment showed no abnormalities, IFN treatment was considered to be the cause of arrhythmia and was stopped at the 7th week of therapy. For 4 months, arrhythmia occurred intermittently after IFN discontinuation, but it completely disappeared thereafter. She was then treated with glycyrrhizin injections and UDCA therapy. However, her ALT levels were not controlled and AFP levels gradually increased to more than 10 ng/ml. In 2007, treatment with 90-µg pegIFN-α2a every 7–10 days was started to control hepatitis. ALT and AFP levels subsequently normalized, but mild cough and sputum occurred from the 8th week of treatment. A local doctor then medicated the patient with an antitussive agent, but her symptoms deteriorated and she complained of shortness of breath at the 11th week of pegIFN-α2a treatment. Although her ALT and AFP levels remained normal and HCV-RNA levels decreased to 8.2 KIU/ml, a fine crackle was heard in her bilateral anterior lower chest, and her KL-6 levels increased to 780 U/ml. Although pulmonary function tests were normal, high-resolution computed tomography (HRCT) of the chest revealed bilateral linear and lenticular interstitial opacities, predominantly in the lung bases and periphery, indicating IP . Thus, PegIFN-α2a treatments were immediately discontinued, and the patient was administered theophylline and expectorants. Gradual recovery was observed, and no respiratory symptoms appeared after 3 months, even after cessation of treatments. Although HRCT observations were almost unchanged, serum KL-6 decreased to 427 U/ml, and glycyrrhizin injections and UDCA therapy were resumed. In 2008, the patient strongly requested treatment with IFN following insufficient efficacy of other treatments and commenced with 6-MU doses of nIFN-β three times a week under careful observation. Although no respiratory symptoms occurred and AFP levels were normalized, her ALT levels were insufficiently controlled, HCV-RNA levels were unchanged (from 4.9 to 4.9 log IU/ml), and the treatment was stopped after 6 months. Fig. 1 Clinical course of the patient Fig. 2 a Holter ECG was taken after 5 weeks of interferon-α2b plus ribavirin treatment and showed advanced atrial ventricular (AV) block. b Monitor ECG was taken on admission (6 weeks of treatment) and shows supraventricular tachycardia with 172 beats/min. c Holter ECG was taken on 4th day of admission and shows second degree AV block type 2 Fig. 3 High-resolution computed tomography scan taken after 10 weeks of peginterferon-α2a treatment showing bilateral linear and lenticular interstitial opacities predominantly in the lung bases and periphery
| 4.078125
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999997
|
25132867
|
https://doi.org/10.1007/s12328-014-0500-8
|
[
"hepatitis",
"although",
"treatments",
"liver",
"udca",
"holter",
"block",
"that",
"however",
"glycyrrhizin"
] |
[
{
"code": "DB97.Z",
"title": "Inflammatory liver disease, unspecified"
},
{
"code": "1E50.Z",
"title": "Acute viral hepatitis, unspecified"
},
{
"code": "DB97.2",
"title": "Chronic hepatitis, not elsewhere classified"
},
{
"code": "1E5Z",
"title": "Viral hepatitis, unspecified"
},
{
"code": "1E51.0Z",
"title": "Chronic hepatitis B, unspecified"
},
{
"code": "PL14.B",
"title": "Delayed treatment"
},
{
"code": "QC12",
"title": "Procedure not carried out because of patient's decision for reasons other than belief or group pressure"
},
{
"code": "QC48.Z",
"title": "Personal history of medical treatment, unspecified"
},
{
"code": "QA07.Z",
"title": "Follow-up examination after treatment for conditions other than malignant neoplasms, unspecified"
},
{
"code": "8A0Y",
"title": "Other specified movement disorders"
}
] |
=== ICD-11 CODES FOUND ===
[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
[1E50.Z] Acute viral hepatitis, unspecified
Also known as: Acute viral hepatitis, unspecified | Acute viral hepatitis | acute anicteric hepatitis | Acute hepatitis NOS | acute viral hepatitis non-A non-B NEC
[DB97.2] Chronic hepatitis, not elsewhere classified
Also known as: Chronic hepatitis, not elsewhere classified | Chronic hepatitis, unspecified | Chronic active hepatitis NEC | Other specified chronic hepatitis | Chronic persistent hepatitis NEC
Includes: Chronic hepatitis, unspecified | Other specified chronic hepatitis
Excludes: hepatitis (chronic): granulomatous NEC | Drug-induced or toxic liver disease | hepatitis (chronic): viral
[1E5Z] Viral hepatitis, unspecified
Also known as: Viral hepatitis, unspecified | anicteric hepatitis
[1E51.0Z] Chronic hepatitis B, unspecified
Also known as: Chronic hepatitis B, unspecified | Chronic hepatitis B | Chronic hepatitis B without delta agent | chronic HBV - [hepatitis B virus] infection | hepatitis B NOS
[PL14.B] Delayed treatment
Also known as: Delayed treatment | avoidable delay in treatment | Problem associated with delayed administration of a needed medication | Problem associated with delayed surgery
Excludes: Incorrect timing of drug or medicament, as mode of injury | Non provision of necessary procedure
[QC12] Procedure not carried out because of patient's decision for reasons other than belief or group pressure
Also known as: Procedure not carried out because of patient's decision for reasons other than belief or group pressure | intervention not carried out because of patient's decision for reasons other than belief or group pressure | refusal of treatment | intervention cancelled because of patient's decision for reasons other than belief or group pressure
[QC48.Z] Personal history of medical treatment, unspecified
Also known as: Personal history of medical treatment, unspecified | Personal history of medical treatment | history of medical treatment
[QA07.Z] Follow-up examination after treatment for conditions other than malignant neoplasms, unspecified
Also known as: Follow-up examination after treatment for conditions other than malignant neoplasms, unspecified | Follow-up examination after treatment for conditions other than malignant neoplasms | medical surveillance following treatment for conditions other than malignant neoplasms | follow-up examination NOS | examination following treatment NOS
[8A0Y] Other specified movement disorders
Also known as: Other specified movement disorders | Other movement disorders, not elsewhere classified | chorea NOS | Familial congenital mirror movements | Primary progressive freezing gait
=== GRAPH WALKS ===
--- Walk 1 ---
[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 2 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--CHILD--> [DB97.1] Hepatic berylliosis
--- Walk 3 ---
[1E50.Z] Acute viral hepatitis, unspecified
--PARENT--> [1E50] 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...
--CHILD--> [1E50.0] Acute hepatitis A
Def: Acute liver injury and inflammation caused by recent and short-term (less than 6 months) infection with hepatitis A virus (HAV). Transmission is by the faecal-oral route. Diagnosis is confirmed by pre...
--- Walk 4 ---
[1E50.Z] Acute viral hepatitis, unspecified
--PARENT--> [1E50] 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...
--RELATED_TO--> [?] Cytomegaloviral hepatitis
Def: A disease of the hepatic system, caused by an infection with human cytomegalovirus. This disease is characterised by fever, acute pharyngitis, fatigue, lymphadenopathy, or jaundice. Transmission is by...
--- Walk 5 ---
[DB97.2] Chronic hepatitis, not elsewhere classified
--EXCLUDES--> [?] Viral hepatitis
Def: A group of liver diseases caused by infection with one or more of the five hepatitis viruses, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E viruses. The in...
--CHILD--> [?] Viral hepatitis complicating pregnancy, childbirth or the puerperium
--- Walk 6 ---
[DB97.2] Chronic hepatitis, not elsewhere classified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--PARENT--> [?] Diseases 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",
"[1E50.Z] Acute viral hepatitis, unspecified\n --PARENT--> [1E50] 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...\n --CHILD--> [1E50.0] Acute hepatitis A\n Def: Acute liver injury and inflammation caused by recent and short-term (less than 6 months) infection with hepatitis A virus (HAV). Transmission is by the faecal-oral route. Diagnosis is confirmed by pre...",
"[1E50.Z] Acute viral hepatitis, unspecified\n --PARENT--> [1E50] 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...\n --RELATED_TO--> [?] Cytomegaloviral hepatitis\n Def: A disease of the hepatic system, caused by an infection with human cytomegalovirus. This disease is characterised by fever, acute pharyngitis, fatigue, lymphadenopathy, or jaundice. Transmission is by...",
"[DB97.2] Chronic hepatitis, not elsewhere classified\n --EXCLUDES--> [?] Viral hepatitis\n Def: A group of liver diseases caused by infection with one or more of the five hepatitis viruses, hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and hepatitis E viruses. The in...\n --CHILD--> [?] Viral hepatitis complicating pregnancy, childbirth or the puerperium",
"[DB97.2] Chronic hepatitis, not elsewhere classified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --PARENT--> [?] Diseases of liver"
] |
DB97.Z
|
Inflammatory liver disease, unspecified
|
[
{
"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"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K758",
"icd10_title": "Other specified inflammatory liver diseases"
},
{
"from_icd11": "1E50.Z",
"icd10_code": "B179",
"icd10_title": "Acute viral hepatitis, unspecified"
},
{
"from_icd11": "1E50.Z",
"icd10_code": "B178",
"icd10_title": "Other specified acute viral hepatitis"
},
{
"from_icd11": "1E50.Z",
"icd10_code": "B17",
"icd10_title": "Other acute viral hepatitis"
},
{
"from_icd11": "DB97.2",
"icd10_code": "K739",
"icd10_title": "Chronic hepatitis, unspecified"
},
{
"from_icd11": "DB97.2",
"icd10_code": "K732",
"icd10_title": "Chronic active hepatitis, not elsewhere classified"
},
{
"from_icd11": "DB97.2",
"icd10_code": "K738",
"icd10_title": "Other chronic hepatitis, not elsewhere classified"
},
{
"from_icd11": "DB97.2",
"icd10_code": "K73",
"icd10_title": "Chronic hepatitis, not elsewhere classified"
},
{
"from_icd11": "DB97.2",
"icd10_code": "K730",
"icd10_title": "Chronic persistent hepatitis, not elsewhere classified"
},
{
"from_icd11": "DB97.2",
"icd10_code": "K731",
"icd10_title": "Chronic lobular hepatitis, not elsewhere classified"
}
] |
K7581
|
Nonalcoholic steatohepatitis (NASH)
|
An 85-year-old woman was referred to our hospital because of nausea, vomiting, and right lower abdominal pain. She had been admitted to our hospital 2 months previously because of infection enteritis. After her hospital discharge, she had experienced diarrhea and constipation repeatedly. Her medical history included appendicitis, collagenous colitis, myocardial infarction, hypertension, and asthma. Her regular medications included aspirin, several depressors, and stomach medication; she was not taking any herbal medication. On examination, her body temperature was 38.5 °C, and she had shaking chill and tenderness in the right abdomen. Her blood workup showed a white blood cell count of 20,480/μL; the levels of all other blood parameters, including C-reactive protein, were normal. An abdominal computed tomography (CT) revealed thickened wall and stricture of the ileum near the terminal ileum, with dilation and fluid accumulation in the small bowel . No decreased bowel wall enhancement was detected and there were some enlarged lymph nodes in the surrounding mesentery. She was diagnosed with recurrent infection enteritis associated with ileus and was admitted to the hospital for bowel rest and antibiotic treatment. Although she showed improvement soon after hospitalization, her symptoms eventually relapsed on day 9. Colonoscopy showed circumferential stenosis of the ileum 20 cm from the ileocecal valve, with no epithelial lesion . Enterography revealed about 2 cm circumferential stenosis. As neoplastic tumorous lesion or scar formation after inflammation was suspected, we performed laparoscopic partial small bowel resection. Intraoperative findings showed a depressed part of the ileum that corresponded to the stricture lesion; however, no other inflammatory lesions were observed in the small bowel and the mesentery, and no ascites was noted . The stenotic part of the ileum was located 30 cm from the ileocecal valve, and we performed partial bowel resection, saving the ileocecal valve. Gross findings showed ulceration and distention of the proximal small bowel . Pathological evaluation showed ulcer formation, fibrotic change of the lamina propria and submucosa, crypt destruction, and some other changes induced by ischemia. These ischemic lesions were caused by smooth muscle degeneration of the venous wall from the mesentery to the submucosa . No calcification and hyalinization were observed in the venous walls. Congo red staining did not demonstrate amyloid deposition. In contrast, the arteries accompanying these veins were all intact; however, mild sclerotic changes were detected. Furthermore, such venous pathological changes are found in an area with slight mucosal changes , which was located at the proximal end of the specimen. We diagnosed the patient with ischemic enteritis that resulted from smooth muscle degeneration of the mesenteric and submucosal veins, associated with bowel obstruction by postinflammatory fibrosis. She was discharged after the treatment for surgical site infection. About 1.5 years postoperatively, she was referred to our hospital again because of chronic diarrhea. Colonoscopy and biopsy were conducted, and she was diagnosed with collagenous colitis with suspected eosinophilic colitis. She has been followed up without treatment because the adjustments to her medication successfully alleviated her symptoms. Fig. 1 Abdominal CT findings. CT images revealed wall thickening and stricture of the small bowel (arrow) and fat stranding around the lesion ( a axial view, b coronal view). A wide range of small bowel distension and fluid accumulation in the lumen were observed, showing small bowel obstruction ( c ). There were no specific findings indicating disorder of blood circulation or any characteristics, such as calcification over the mesenteric veins and the bowel walls Fig. 2 Colonoscopy and contrast study findings. Colonoscopy showed circumferential stenosis of the terminal ileum and a little edematous red mucosa, but no obvious epithelial lesion ( a ). Contrast study demonstrated the narrowed section of the ileum (arrow) ( b ) Fig. 3 Intraoperative findings. Stenosis part of the ileum showed constriction of the serosa, without any obvious findings of ischemia ( a ). There were no inflammatory or ischemic lesions in the remaining part of the small bowel, mesentery, and intra-abdominal fat ( b ) Fig. 4 Gross specimen. Gross appearance revealed deep ulceration that penetrates the mesentery and caused stenosis of the ileum and the dilated proximal bowel ( a fresh, b after formalin fixative) Fig. 5 Histopathological findings of the ischemic lesion of the small bowel. Venous wall from the mesentery to the submucosa showed degeneration (arrows) that caused ulceration and some other ischemic changes in the affected mucosa ( a HE, × 20). Mesenteric vein showed degeneration, decrease in the number of smooth muscle cells, and narrowing of the lumen (arrowhead). The accompanying artery was patent; however, mild sclerotic changes were observed (A) ( b HE, × 100 c EvG, × 100 d smooth muscle actin immunostaining, × 100) Fig. 6 Pathological findings of the no stenotic part of the resected bowel. The venous wall of the mesentery showed degeneration of the smooth muscle cells and thickening; however, the lumen was patent (arrow) (HE, × 20). Mild ischemic mucosal changes were detected, such as low, flat, and wide villi
| 4.105469
| 0.972168
|
sec[1]/p[0]
|
en
| 0.999998
|
34982272
|
https://doi.org/10.1186/s40792-021-01353-x
|
[
"bowel",
"ileum",
"small",
"mesentery",
"changes",
"wall",
"lesion",
"ischemic",
"stenosis",
"part"
] |
[
{
"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": "1A40.0&XA0QT6",
"title": "Ileum inflammation"
},
{
"code": "QF01.Y",
"title": "Other specified acquired absence of organs"
},
{
"code": "NB91.71&XA0QT6",
"title": "Laceration of ileum"
},
{
"code": "LB15.1",
"title": "Atresia of small intestine"
},
{
"code": "NB91.7Y&XA0QT6",
"title": "Haematoma of ileum"
}
] |
=== 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
[QF01.Y] Other specified acquired absence of organs
Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball
[LB15.1] Atresia of small intestine
Definition: Jejunoileal atresias and stenoses are major causes of neonatal intestinal obstruction. Atresia refers to a congenital obstruction with complete occlusion of the intestinal lumen. It accounts for 95% of obstructions. Four types of jejunoileal atresias are described. They can range from having a small area of blockage or web to missing large sections of the intestines.
Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn. The ileal atresia is more common than j
Also known as: Atresia of small intestine | Congenital stenosis of small intestine | Congenital absence of small intestine | congenital small intestinal stricture NOS | Multiple-level intestinal atresia
Includes: Congenital absence of small intestine | Congenital stenosis of small intestine
=== GRAPH WALKS ===
--- Walk 1 ---
[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--> [DB30.0] Intussusception of the large intestine
Def: Intussusception occurs when a segment of bowel invaginatetes, or telescopeds, into adjacent distal bowel, leading to obstruction and possibly ischemic injury. Colonic intussusception is a relatively u...
--- 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 ...
--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 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....
--RELATED_TO--> [?] Short bowel syndrome in neonate
Def: Short bowel syndrome in neonate is a condition originating in the perinatal period in which nutrients are not properly absorbed due to either surgical removal of a large portion of the small intestine...
--PARENT--> [?] Neonatal malabsorption syndromes
--- 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....
--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 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...
--RELATED_TO--> [?] Angiodysplasia of colon
Def: Small dilated submucosal vessels of colonic mucosa with perforating vessels going through the muscularis mucosae....
--- 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 --CHILD--> [DB30.0] Intussusception of the large intestine\n Def: Intussusception occurs when a segment of bowel invaginatetes, or telescopeds, into adjacent distal bowel, leading to obstruction and possibly ischemic injury. Colonic intussusception is a relatively u...",
"[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...",
"[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 --RELATED_TO--> [?] Short bowel syndrome in neonate\n Def: Short bowel syndrome in neonate is a condition originating in the perinatal period in which nutrients are not properly absorbed due to either surgical removal of a large portion of the small intestine...\n --PARENT--> [?] Neonatal malabsorption syndromes",
"[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...",
"[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 --RELATED_TO--> [?] Angiodysplasia of colon\n Def: Small dilated submucosal vessels of colonic mucosa with perforating vessels going through the muscularis mucosae....",
"[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
|
The patient presented with a pseudoaneurysm and a localised rupture. It was feared that this would progress to a free rupture during the period of intravenous antibiotics and we decided that urgent surgical treatment was necessary. Due to his advanced age and medical history (especially insulin usage for type 2 diabetes mellitus), we determined that he would have a low tolerance for prosthetic graft replacement and performed TEVAR as an emergency procedure. Meropenem and vancomycin were administered intravenously before the TEVAR procedure. If a stent graft was placed extensively on the proximal side, there would be an increased risk of paraplegia. Therefore, a 28 × 100 mm GORE TAG device (W. L. Gore and Associates, Flagstaff, Ariz) was implanted during the procedure to cover the aortic aneurysm protrusion (6 cm proximally from the protrusion and 4 cm distally from the protrusion). One week after TEVAR, a blood culture taken before TEVAR yielded Escherichia coli, so the antibiotic therapy was switched to cefotaxime. The inflammatory response decreased, and the patient remained afebrile; however, CT performed 17 days after TEVAR revealed that the abscess cavity had extended beyond the proximal edge (3.5 cm from the implanted stent graft), i.e., in the area uncovered by the graft . The aortic wall had become fragile due to infection in this uncovered area and was at risk of rupture. Considering the need for a sufficient landing zone, we implanted a 31 × 150 mm GORE TAG device (W. L. Gore and Associates, Flagstaff, Ariz) on the proximal side with a 3 cm overlap to the previous stent graft. Furthermore, considering the possibility that the patient was refractory to cefotaxime, the antibiotic therapy was switched to meropenem. However, the abscess cavity continued to enlarge , and we decided to perform a surgical intervention. The patient was re-evaluated for his eligibility for a prosthetic graft replacement; however, the procedure was deemed too invasive due to the initial preoperative risk as well as the patient's worsening frailty. Instead, abscess debridement and pedicled tissue flap were performed for further infection control. The use of the omentum for the pedicled tissue flap was deemed difficult owing to the patient’s history of pancreatoduodenectomy; thus, LDM flaps were selected instead. Preoperative CT showed that on the proximal side, the upper edge of the stent graft was 6.5 cm from the upper edge of the abscess (17.5 cm from the aortic aneurysm protrusion), and on the distal side, the lower edge of the stent graft was 3.5 cm from the lower edge of the abscess (4.5 cm from the aortic aneurysm protrusion). We also confirmed from the preoperative CT that there was no endoleak in the aortic aneurysm and no blood flow from the branch arteries into the aortic aneurysm. Based on the above, because there was sufficient landing zone and no blood flow into the aortic aneurysm, we judged that the risk of bleeding was low. Eighteen days after the second TEVAR, a thoracoscopic abscess debridement was performed to prevent damage to the LDMs intended for use in the pedicled tissue flap. This operation was performed through a small incision made 10 cm away from the left fifth intercostal space. The abscess was located in a sub-adventitial space using ultrasound, and a 5 cm long-axis incision was made through the aortic adventitia. The abscess was debrided and its cavity was cleaned; following this, drains were placed. Similar to the blood culture, a pus culture also yielded Escherichia coli . Seven days after abscess debridement, stent graft wrapping was performed using LDM flaps constructed with the thoracodorsal artery as the feeding vessel. The surgery was performed through thoracotomy at the left fifth intercostal space. We widened the previously debrided aortic exenteration site in a cephalocaudal direction and completely unroofed the abscess cavity. The stent graft was partially exposed , and the abscess cavity was thoroughly flushed. The LDM flaps were guided into the thoracic cavity from the second intercostal space and wrapped around the stent graft . One week after the stent graft wrapping procedure, debridement of necrosis skin and wound closure were performed using a rectus abdominis musculocutaneous flap due to skin necrosis in the area where the LDM was harvested. Two weeks after the stent graft wrapping procedure, the antibiotic therapy was switched from meropenem to cefotiam based on the pus culture results; it was administered intravenously for 6 weeks after abscess debridement. The patient was then switched to oral levofloxacin, and a lifelong oral antibiotics policy was adopted. Fig. 2 CT performed 17 days after TEVAR revealed that the abscess cavity had extended beyond the proximal edge from the implanted stent graft, i.e., in the area uncovered by the graft ( A : three days after the initial TEVAR; B : 17 days after the initial TEVAR) Fig. 3 Despite antibiotic treatment after TEVAR, contrast-enhanced CT suggests abscess expansion over time ( A : three days after the initial TEVAR; B : 29 days after the initial TEVAR) Fig. 4 Operative image of stent graft wrapping using latissimus dorsi muscle (LDM) Flaps. The stent graft is partially exposed when the abscess cavity is released ( A ). The LDM flaps are guided into the thoracic cavity from the second intercostal space and wrapped around the stent graft ( B )
| 3.871094
| 0.973145
|
sec[1]/p[1]
|
en
| 0.999998
|
36732803
|
https://doi.org/10.1186/s13019-023-02155-y
|
[
"graft",
"abscess",
"stent",
"tevar",
"that",
"aortic",
"cavity",
"aneurysm",
"edge",
"protrusion"
] |
[
{
"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": "1B75.3",
"title": "Pyogenic abscess of the skin"
},
{
"code": "FB30",
"title": "Infectious myositis"
},
{
"code": "FA10.Z",
"title": "Direct infections of joint, unspecified"
},
{
"code": "FB84.Y",
"title": "Other specified osteomyelitis or osteitis"
},
{
"code": "FB40.0",
"title": "Infectious tenosynovitis"
}
] |
=== 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
[1B75.3] Pyogenic abscess of the skin
Definition: A pus-producing abscess of the skin most commonly due to bacterial infection by Staphylococcus aureus. It is prone to develop where the normal anatomy is disturbed as in pilonidal disease, an epidermoid cyst or around foreign bodies such as surgical sutures.
Also known as: Pyogenic abscess of the skin | abscess NOS
[FB30] Infectious myositis
Definition: Infective myositis is an acute, subacute, or chronic infection of skeletal muscle and may be caused by a wide range of infecting organisms. Immunosuppression, particularly as the result of HIV infection, is an important predisposing factor.
Also known as: Infectious myositis | Bacterial myositis | Bacterial pyomyositis | Tropical muscle abscess | Tropical pyomyositis
[FA10.Z] Direct infections of joint, unspecified
Also known as: Direct infections of joint, unspecified | Direct infections of joint | septic arthritis | pyogenic arthritis | arthritis due to infection
[FB84.Y] Other specified osteomyelitis or osteitis
Also known as: Other specified osteomyelitis or osteitis | Other chronic osteomyelitis | Garre's disease | chronic or old osteomyelitis with or without mention of periostitis | chronic bone abscess
[FB40.0] Infectious tenosynovitis
Also known as: Infectious tenosynovitis | Bacterial infection of tendon sheath | Fungal infection of tendon sheath | Mycobacterial infection of tendon sheath | Parasitic infection of tendon sheath
=== 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
--CHILD--> [NE80] Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified
--- 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--> [NE82] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified
--- 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--> [EL50] Unsatisfactory surgical scar of skin
Def: A surgical skin scar with a poor functional or cosmetic outcome....
--- 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--> [EL52] Myocutaneous flap necrosis
Def: Necrosis of a surgical flap containing both skin and muscle...
--- 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--> [EL52] Myocutaneous flap necrosis
Def: Necrosis of a surgical flap containing both skin and muscle...
|
[
"[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--> [NE80] Injury or harm arising following infusion, transfusion or therapeutic injection, not elsewhere classified",
"[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--> [NE82] Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified",
"[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--> [EL50] Unsatisfactory surgical scar of skin\n Def: A surgical skin scar with a poor functional or cosmetic outcome....",
"[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--> [EL52] Myocutaneous flap necrosis\n Def: Necrosis of a surgical flap containing both skin and muscle...",
"[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--> [EL52] Myocutaneous flap necrosis\n Def: Necrosis of a surgical flap containing both skin and muscle..."
] |
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
|
The patient was a 29-year-old female, a herder by occupation. The place of residence was a traditional husbandry area. About 3 months before admission, the patient developed a mass on the left neck with no obvious incentive, with a diameter of 2 cm and no obvious tenderness. The mass gradually increased within 3 months, and by the time of admission, the mass had grown to a size of 6 × 5 cm. One month after the appearance of the mass in the neck, the patient found that a mass with similar characteristics also appeared in front of the left shoulder joint, and gradually increased to an area of 5 × 4 cm on admission . The patient had no other systemic specific complaints or positive signs, no family history, and was admitted to the hospital 5 years ago for surgery for a breast abscess. Diet and sleep were normal and there were no manifestations of wasting disease. X-ray and CT examination found that the patient's cervical vertebrae were mildly lateralized to the affected side, and the left clavicle showed swelling bone destruction, combined with cystic masses in the surrounding soft tissues, considering the possibility of echinococcus granulosus cyst . There were sporadic nodules in both lungs of the patient, some of which were cystic, and the rest were calcified . Consider that the patient is more likely to suffer from pulmonary echinococcus. Since there was no significant discomfort, the patient decided to treat the skeletal lesion first and treat the pulmonary hydatid with medication and follow-up. Serological examination (colloidal gold) suggests that the patient's serum is positive for anti-Echinococcus granulosus natural antigen antibodies: anti-EgCF antibodies( +), anti-EgP antibodies( +), anti-EgB antibodies( +), anti-Em2 antibodies(-). There were no specific manifestations in the rest of the patient's blood examinations. After discussion by the medical team, it was decided to treat the patient with surgery and remove the clavicle completely. Surgery process: After general anesthesia, the patient was placed in a supine position with a pillow to elevate the shoulder of the affected side. A horizontal incision of about 10 cm in length was made with the cyst at the front of the shoulder joint and below the outer clavicle (hereinafter referred to as the lateral cyst) as the center, and the skin and dermis were incised layer by layer. A cyst with a size of about 8 × 6 × 5 cm was seen under the skin. blunt dissection . Subsequently, the same surgical incision was made with the cyst in the anterior chest wall and the medial clavicle as the center. Exploration revealed a cyst about 10 × 4 × 3 cm in size (hereinafter referred to as medial cyst), wrapping the medial side of the clavicle and extending to the sternoclavicular joint . Cut the surface of medial cyst and see several daughter cysts of different sizes inside. Remove the daughter cysts one by one and then remove the remaining external cyst . After that, the lateral cyst was completely removed from the root . Careful exploration showed that there were no residual cysts in the subcutaneous cavities on both sides, and the lateral and medial cysts were not connected under the skin. The incision was soaked in 20% hypertonic saline for 30 min . Next, separate the adhesion around the clavicle, expose and disconnect the acromioclavicular joint and sternoclavicular joint, and pay attention to protecting the branches of the supraclavicular nerve . Pull out the complete clavicle from the medial incision , rinse with hypertonic saline again, and then close the surgical wounds on both sides layer by layer. Inspection of the resected cyst and clavicle. An increase in clavicle volume is seen, with several bony cortical defects in the anterior aspect of the sternal end, the anterior aspect of the acromion end, and the area where the posterior subclavian groove joins the conoid tubercle, with significant local thinning of the bone cortex of the lesion and several daughter cysts visible inside . The excised bone tissue specimens are sent for pathological examination. Foreign body granuloma formation is observed next to the bone cortex, and the characteristic endocyst structure of the hydatid cyst is seen within the local granuloma, including the outer cell-free laminar compression-like structure and the inner germinal layer, with fibrous tissue proliferation and histiocyte aggregation in the background . The Patient's postoperative subcutaneous drainage device was removed as scheduled, and the wound healed well without secondary infection. The patient was given oral albendazole at 20 mg/kg per day according to body weight in 2 oral doses for 1 month after surgery, for a total of 5 courses of treatment with a 1-week interval. The patient was instructed to perform functional exercise of the left shoulder 2 weeks after surgery. At the one-year postoperative follow-up, no new cysts were found locally. The patient expressed satisfaction with the treatment effect. Except for the inability to engage in prolonged or strenuous weight-bearing activities, the patient believed that the function of her upper limb could meet the basic needs of life. Fig. 1 Preoperative appearance and imaging findings of lesions Fig. 2 Surgical procsedure and intraoperative performance Fig. 3 Excised specimen appearance Fig. 4 Pathological manifestations of skeletal specimens (4a:HE 100 × , 4b:HE 400 × , 4c:HE 100 ×)
| 3.888672
| 0.981934
|
sec[1]/p[0]
|
en
| 0.999998
|
36949399
|
https://doi.org/10.1186/s12879-023-08149-4
|
[
"cyst",
"clavicle",
"that",
"cysts",
"joint",
"anti",
"antibodies",
"layer",
"about",
"shoulder"
] |
[
{
"code": "FB80.5",
"title": "Solitary bone cyst"
},
{
"code": "EK70.Z",
"title": "Cutaneous cysts, unspecified"
},
{
"code": "FB4Y",
"title": "Other specified disorders of synovium or tendon"
},
{
"code": "CA0C",
"title": "Cyst or mucocele of nose or nasal sinus"
},
{
"code": "9A7Y",
"title": "Other specified disorders of the cornea"
},
{
"code": "LB72.Y",
"title": "Other specified structural developmental anomalies of shoulder girdle"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "ME85",
"title": "Stiffness of joint"
},
{
"code": "FB80.Y",
"title": "Other specified disorders of bone density or structure"
},
{
"code": "NC12.0Z",
"title": "Fracture of clavicle, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[FB80.5] Solitary bone cyst
Definition: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cases involving the jaw bone have been reported.
Also known as: Solitary bone cyst | cyst of bone | local cyst of bone | simple bone cyst | solitary bone cyst, unspecified site
Excludes: solitary cyst of jaw
[EK70.Z] Cutaneous cysts, unspecified
Also known as: Cutaneous cysts, unspecified | Cutaneous cysts | Follicular cysts of skin and subcutaneous tissue
[FB4Y] Other specified disorders of synovium or tendon
Also known as: Other specified disorders of synovium or tendon | Shortening of tendon | short tendon | Shortening of tibialis anterior | Contracture of tendon
[CA0C] Cyst or mucocele of nose or nasal sinus
Definition: A condition which refers to diseases of the nose and nasal sinus that cause a cyst or mucocele.
A mucocele is any dilatation (typically pathologic) with accumulation of mucus. Mucoceles are benign, epithelium-lined cysts filled with mucus, which can form in the paranasal sinuses. These structures may cause symptoms if sufficiently large or if exerting pressure on surrounding anatomic structures. Symptomatic mucoceles typically require surgical intervention. Mucoceles should be differentiated fro
Also known as: Cyst or mucocele of nose or nasal sinus | cyst of sinus | mucocele of sinus | Cyst of maxillary sinus | cyst of maxillary antrum
[9A7Y] Other specified disorders of the cornea
Also known as: Other specified disorders of the cornea | Secondary disorders of sclera or cornea | Disorders of sclera and cornea in diseases classified elsewhere | Secondary keratitis or keratoconjunctivitis | Keratitis and keratoconjunctivitis in other diseases classified elsewhere
[LB72.Y] Other specified structural developmental anomalies of shoulder girdle
Also known as: Other specified structural developmental anomalies of shoulder girdle | Clavicular hypoplasia or aplasia | Absent clavicle | Medial condensing osteitis of clavicle | Congenital pseudoarthrosis of clavicle
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[ME85] Stiffness of joint
Definition: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes.
Also known as: Stiffness of joint | joint stiffness | stiff joint | stiffness in joint | Stiffness of joint, multiple sites
[FB80.Y] Other specified disorders of bone density or structure
Also known as: Other specified disorders of bone density or structure | Bone dysplasia | Inherited bone dysplasia | Acquired bone dysplasia | Drug-induced bone dysplasia
[NC12.0Z] Fracture of clavicle, unspecified
Also known as: Fracture of clavicle, unspecified | Fracture of clavicle | fracture of collar bone | collar bone fracture dislocation
=== GRAPH WALKS ===
--- Walk 1 ---
[FB80.5] Solitary bone cyst
Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas...
--EXCLUDES--> [?] Other cysts of jaw
Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo...
--CHILD--> [?] Solitary cyst jaw
--- Walk 2 ---
[FB80.5] Solitary bone cyst
Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas...
--EXCLUDES--> [?] Other cysts of jaw
Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo...
--EXCLUDES--> [?] Stafne mandibular bone cavity
Def: Although commonly called a Stafne cyst, this entity is not a true cyst but rather a cavity due to a focal cortical defect of the medial aspect of the mandible. It is found most frequently in middle-ag...
--- Walk 3 ---
[EK70.Z] Cutaneous cysts, unspecified
--PARENT--> [EK70] Cutaneous cysts
--CHILD--> [EK70.1] Trichilemmal cyst
Def: A trichilemmal (pilar) cyst is a common, typically non-tender, intradermal or subcutaneous cyst. The cysts are typically confined to the scalp and are often multiple. They usually occur sporadically b...
--- Walk 4 ---
[EK70.Z] Cutaneous cysts, unspecified
--PARENT--> [EK70] Cutaneous cysts
--CHILD--> [EK70.2] Digital myxoid pseudocyst
Def: Digital myxoid cysts (DMCs) are benign ganglion cysts of the digits, which typically present as a small dome-shaped, often translucent papule on the dorsum of the terminal phalanx and/or as longitudin...
--- Walk 5 ---
[FB4Y] Other specified disorders of synovium or tendon
--PARENT--> [?] Disorders of synovium or tendon
Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....
--CHILD--> [FB41] Spontaneous rupture of synovium or tendon
Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join...
--- Walk 6 ---
[FB4Y] Other specified disorders of synovium or tendon
--PARENT--> [?] Disorders of synovium or tendon
Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....
--CHILD--> [FB41] Spontaneous rupture of synovium or tendon
Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join...
|
[
"[FB80.5] Solitary bone cyst\n Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas...\n --EXCLUDES--> [?] Other cysts of jaw\n Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo...\n --CHILD--> [?] Solitary cyst jaw",
"[FB80.5] Solitary bone cyst\n Def: A solitary bone cyst is a benign non-epithelial bone cavity that is asymptomatic and that is found most commonly in the second decade of life by chance. The long bones are most often affected, but cas...\n --EXCLUDES--> [?] Other cysts of jaw\n Def: This is mostly odontogenic cysts but may be also of non-odontogenic source. The mandible and maxilla are the bones with the highest prevalent of cysts in the human body owing to odontogenic and develo...\n --EXCLUDES--> [?] Stafne mandibular bone cavity\n Def: Although commonly called a Stafne cyst, this entity is not a true cyst but rather a cavity due to a focal cortical defect of the medial aspect of the mandible. It is found most frequently in middle-ag...",
"[EK70.Z] Cutaneous cysts, unspecified\n --PARENT--> [EK70] Cutaneous cysts\n --CHILD--> [EK70.1] Trichilemmal cyst\n Def: A trichilemmal (pilar) cyst is a common, typically non-tender, intradermal or subcutaneous cyst. The cysts are typically confined to the scalp and are often multiple. They usually occur sporadically b...",
"[EK70.Z] Cutaneous cysts, unspecified\n --PARENT--> [EK70] Cutaneous cysts\n --CHILD--> [EK70.2] Digital myxoid pseudocyst\n Def: Digital myxoid cysts (DMCs) are benign ganglion cysts of the digits, which typically present as a small dome-shaped, often translucent papule on the dorsum of the terminal phalanx and/or as longitudin...",
"[FB4Y] Other specified disorders of synovium or tendon\n --PARENT--> [?] Disorders of synovium or tendon\n Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....\n --CHILD--> [FB41] Spontaneous rupture of synovium or tendon\n Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join...",
"[FB4Y] Other specified disorders of synovium or tendon\n --PARENT--> [?] Disorders of synovium or tendon\n Def: This is a group of disorders which affect the synovial joint lining (synovium) and also tendons....\n --CHILD--> [FB41] Spontaneous rupture of synovium or tendon\n Def: This is a spontaneous rupture to a fluid-filled sac containing viscous fluid which normally acts to decrease friction and also provides a cushion between bones and tendons and/or muscles around a join..."
] |
FB80.5
|
Solitary bone cyst
|
[
{
"from_icd11": "FB80.5",
"icd10_code": "M85412",
"icd10_title": "Solitary bone cyst, left shoulder"
},
{
"from_icd11": "FB80.5",
"icd10_code": "M85441",
"icd10_title": "Solitary bone cyst, right hand"
},
{
"from_icd11": "FB80.5",
"icd10_code": "M8548",
"icd10_title": "Solitary bone cyst, other site"
},
{
"from_icd11": "FB80.5",
"icd10_code": "M8540",
"icd10_title": "Solitary bone cyst, unspecified site"
},
{
"from_icd11": "FB80.5",
"icd10_code": "M854",
"icd10_title": "Solitary bone cyst"
},
{
"from_icd11": "EK70.Z",
"icd10_code": "L729",
"icd10_title": "Follicular cyst of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "EK70.Z",
"icd10_code": "L728",
"icd10_title": "Other follicular cysts of the skin and subcutaneous tissue"
},
{
"from_icd11": "EK70.Z",
"icd10_code": "L60-L75",
"icd10_title": ""
},
{
"from_icd11": "EK70.Z",
"icd10_code": "L72",
"icd10_title": "Follicular cysts of skin and subcutaneous tissue"
},
{
"from_icd11": "CA0C",
"icd10_code": "J341",
"icd10_title": "Cyst and mucocele of nose and nasal sinus"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89351",
"icd10_title": "Hypertrophy of bone, right femur"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89361",
"icd10_title": "Hypertrophy of bone, right tibia"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M8938",
"icd10_title": "Hypertrophy of bone, other site"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89371",
"icd10_title": "Hypertrophy of bone, right ankle and foot"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89363",
"icd10_title": "Hypertrophy of bone, right fibula"
}
] |
M85412
|
Solitary bone cyst, left shoulder
|
A 44-year-old Caucasian woman came to the attention of our Rheumatology Unit in 2009 for evaluation of her chronic and debilitating lumbodorsal pain (Visual Analog Scale 8/10) which had recently caused her to quit her job as a cook. She was 166 cm (65.5 inches) in height, 80 kg (176 lb) in weight, and had normal intelligence. She reported that her low back pain started at age 12 and has been persistent thereafter. Lumbosacral spine X-rays performed at that time revealed “marble bones” for which she was diagnosed with “osteopetrosis” and unsuccessfully treated with non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Pain exacerbated with time and later also involved the cervical spine, elbows, wrists, and shoulders. At age 20, the patient reported lower limb paresthesias and recurrent episodes of nephrolithiasis and frontoparietal headache without nausea or vomiting. In the same period, she noticed the appearance of coarse “facial changes” that became more evident with time, as illustrated in photographs brought to our attention. Between ages 25 and 30, the patient suffered from sinusitis, recurrent bilateral trigeminal neuralgia, bilateral carpal tunnel syndrome, dysgeusia and hypo-/anosmia, oral cavity paresthesias, arthralgias of upper and lower limbs, and self-limiting episodes of unilateral facial palsy. At age 35, external hearing aids were placed due to complete, bilateral, and mixed hearing loss caused by the narrowing of internal and external acoustic meati. Previous CT scans of the petrous bone showed bilateral exostoses in the inner ear, whereas the vestibular system and the semicircular canals were normal. At presentation, clinical examination revealed a deepened and widened jaw with increased gonial angle, frontal bossing, flat nasal bridge, hypertelorism, and torus palatinus . There were no syndactyly or evident deformations of extracranial bones. Laboratory findings were normal, including complete blood count (CBC) and serum hemoglobin 13.4 g/dL (reference values: 11.5–15), calcium 9.9 mg/dL (8.6–10.2), phosphorus 3.2 mg/dL (2.7–4.5), ALP 54 IU/L (35–105), 25(OH)D 12.8 ng/mL (11–70), osteoprotegerin 2.3 pmol/L (1.4–6), RANKL 0.02 pmol/L (<6), PTH 49 pg/mL (13–54), C-reactive protein 0.1 mg/dL (<0.5), P1NP 68.4 ng/mL (15.1–73.9), C-terminal telopeptide (CTX) 0.220 ng/mL (<0.6), and sclerostin 1.3 ng/mL (0.5–2.4). The patient underwent a complete skeletal survey which revealed endosteal hyperostosis and severe osteosclerosis affecting clavicles, ribs, vertebrae, hip , limbs, and cranium , in the absence of deformities except for the square jaw. She denied previous bone fractures and reported inability to float in water. Bone scintigraphy with technetium-99 m did not show any abnormal accumulations. Dual-energy X-ray absorptiometry ( DEXA ) scan (GE Medical Systems, Lunar) revealed Z -score +11.1 ( T -score +10.8) and bone mineral density (BMD) of 2.5 g/cm 2 for L1-L4 spine, Z -score +6.2 ( T -score +6.5), and BMD of 1.8 g/cm 2 for femoral neck, and Z -score +8.1 (T-score +8.5) and BMD of 2 g/cm 2 for total hip. The patient never suffered from vision disturbances, and visual field testing was normal. However, the ophthalmologist found bilateral papilledema, which prompted further testing for intracranial hypertension. Head CT scan and MRI revealed normal ventricular system but detected mild cerebellar tonsillar herniation through the foramen magnum. Neither pyramidal tract signs nor cerebellar disturbances were present. Genetic analysis through Sanger-sequencing detected the heterozygous missense mutation A242T in exon 4 of the LRP5 gene coding for the first β-propeller domain of the LRP5 protein and showed a G/A transition in position 51145 of DNA. The patient reported that none of her relatives ever had facial deformities or radiologic findings suggesting hyperostosis. The patient’s mother and father died at age 61 and 70, respectively, both from ischemic heart attack; none of them apparently ever performed DEXA scan. Her 47-year-old sister and her two adolescent children had normal DEXA scans and were in good health. Her 40-year-old brother suffered from chronic low back pain but refused to undergo any investigation. In 2013, hysteroannessiectomy was performed due to leiomyomas, thereby inducing iatrogenic menopause. At the latest evaluation in May 2022, the patient reported diffuse joint pain compatible with osteoarthritis, sleep disturbances with fibromyalgia-like symptoms, recurrent frontoparietal headaches, and numbness of oral cavity and limbs. DEXA scan performed in the same period revealed Z -score +11.0 ( T -score +10.4) and BMD of 2.4 g/cm 2 for lumbar spine, Z -score +5.1 ( T -score +4.4) and BMD of 1.5 g/cm 2 for femoral neck, and Z -score +6.9 ( T -score +6.4) and BMD of 1.8 g/cm 2 for total hip. Fig. 1 Clinical examination of our patient revealed flat nasal bridge, frontal bossing, and deepened and widened jaw with increased gonial angle. Written informed consent was obtained from the patient for publication of the photograph Fig. 2 X-rays showing endosteal hyperostosis of femurs and osteosclerosis of hip and vertebrae. Written informed consent was obtained from the patient for publication of the radiograph Fig. 3 X-rays showing severe osteosclerosis of the skull, particularly at the base. Written informed consent was obtained from the patient for publication of the radiograph7
| 4.085938
| 0.973145
|
sec[2]/p[0]
|
en
| 0.999997
|
37659026
|
https://doi.org/10.1007/s11657-023-01319-6
|
[
"score",
"pain",
"which",
"that",
"spine",
"bone",
"dexa",
"scan",
"rays",
"time"
] |
[
{
"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": "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 ===
[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
[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 ---
[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....
--PARENT--> [?] Certain disorders originating in the perinatal period
Def: A group of any other paediatric conditions that occur during the period of time around childbirth, especially the five months before and one month after birth....
--- Walk 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 --PARENT--> [?] Certain disorders originating in the perinatal period\n Def: A group of any other paediatric conditions that occur during the period of time around childbirth, especially the five months before and one month after birth....",
"[KD30.1] 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
| |
So we have performed now our endonasal endoscopic approach. We are working transclival exposing the right carotid artery on the paraclival segment down to the lacerum segment. Now we are exposing the paraclinoidal artery on the left side. Now we are drilling the midclivus and we start seeing tumor invading in between the two layers of dura, as is so typical for these clival chordomas. I am now getting a good margin inferiorly to make sure that is all clean of tumor. Now we are working on removing the posterior clinoids on both sides as well as the dorsum sella. We are Dopplering the anterior wall of the cavernous sinus so that we can directly incise the anterior wall without injuring the carotid artery. Once we open the anterior wall of the cavernous sinus, we obtain significant venous bleeding that is actually easily controlled with gentle packing. As we open the cavernous sinus, we identify the inferior hypophyseal artery. I am now opening the anterior wall of the cavernous sinus superiorly all the way towards the clinoidal segment of the carotid artery. We are now cutting the floor of the cavernous sinus giving access to the posterior clinoid. We see tumor invading the posterior clinoid. This happens to be a very prominent posterior clinoid and a large inferior hypophyseal artery located just above it. I am trying to carefully dissect the posterior clinoid from the dura but the dural attachments are very robust. I am seeing here now the inferior parasellar ligament. This is being transected. This attaches the medial wall of the cavernous sinus to the carotid and after transecting this ligament, I can now mobilize better the posterior clinoid and the medial wall of the cavernous sinus, but still we have the attachment by the inferior hypophyseal artery, which I have to coagulate and transect, and after this I can finally cut the dura that surrounds the posterior clinoid. This is going to allow me to now use a dissector to gently remove the posterior clinoid. We can see its posterolateral extension and I can now remove the posterior clinoid completely, the dorsum sella, and now we are removing the posterior clinoid on the left side of the patient. In this case, since I have more space, I can do it in an extradural fashion, but still I get venous bleeding from the cavernous sinus, which is easily controlled. Finally, removing the dorsum sella, posterior clinoid allows me to remove all the tumor that is invading the interdural space, and this outer layer of dura is going to be extensively removed. I am seeing now the sixth nerve at the interdural segment now on the left side, and now on the right side I am cutting the dura around the Dorello’s canal, making sure with electrical stimulation that I am preserving the abducens nerve. It is very important to reach the limit; this is the inferior petrosal sinus bleeding there and I trim all this dura because it’s potentially involved with tumor. That dural thickening there is the petrosphenoidal or Gruber’s ligament that is located just posterior to the abducens nerve. Here are some anatomy pictures showing this complex anatomy of the abducens nerve, Dorello’s canal, petrosphenoidal ligament, and the different segments of the abducens nerve. I continue dissecting the dura that is thickened and potentially involved with tumor. I am doing the similar operation on the patient’s left side, preserving the sixth nerve but at the same time maximizing the resection of the dura, and that is the penetration of the tumor through the inner dural layer and through the arachnoid into the subarachnoid space. I am doing a wide dural opening because all this dura is also potentially involved and needs to be transected. Unfortunately, because of the previous operation, there are significant adhesions between the dura, the arachnoid, and the basilar artery. This requires very careful meticulous dissection to prevent a vascular injury. We are finally able to remove all this dura and separate it safely from the basilar artery. There is a small remnant of tissue that is very adherent to the wall of the basilar artery. This requires again very careful meticulous technique to achieve a complete resection but at the same time without causing any vascular injury. This is done with sharp dissection, mostly avoiding pulling that could injure the basilar artery. After this portion is finished, we identify the invasion of the tumor into the brainstem. We are going to find a plane to safely dissect this pontine perforating branch. There is also significant scar tissue in this area, which makes the operation more difficult, but I am now finding a plane between brainstem and tumor and I can finally start scooping the tumor out from the inside of the brainstem. I find another pontine perforating branch inferiorly and posteriorly, and this has to be very carefully preserved. After dissecting the vessel and separating it from the tumor, I can continue opening the capsule of the tumor and entering the brainstem so that I can find a plane of dissection between tumor and neural tissue. The tumor is removed in a piecemeal fashion now using the two suctions in a very controlled fashion. I can remove any residual tumor within the pons. In fact, there is a membrane of tissue that I actually removed carefully sent to the pathologist and they came back saying there was no tumor, so we obtained a complete tumor resection.
| 3.837891
| 0.763184
|
sec[0]/sec[1]/p[0]
|
en
| 0.999997
|
PMC9541825
|
https://doi.org/10.3171/2019.10.FocusVid.19421
|
[
"this",
"tumor",
"that",
"artery",
"dura",
"clinoid",
"sinus",
"cavernous",
"wall",
"nerve"
] |
[
{
"code": "4A01.03",
"title": "Transient hypogammaglobulinaemia of infancy"
},
{
"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": "8A80.Z",
"title": "Migraine, unspecified"
},
{
"code": "QA76",
"title": "Medication or substance that is known to be an allergen without injury or harm"
},
{
"code": "PL13.6",
"title": "Medication or substance that is known to be an allergen, as mode of injury or harm"
},
{
"code": "9C40.A0",
"title": "Papilloedema"
}
] |
=== ICD-11 CODES FOUND ===
[4A01.03] Transient hypogammaglobulinaemia of infancy
Also known as: Transient hypogammaglobulinaemia of infancy | immunoglobulin maturational delay | THI - [transient hypogammaglobulinaemia of infancy]
[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
[8A80.Z] Migraine, unspecified
Also known as: Migraine, unspecified | Migraine
[QA76] Medication or substance that is known to be an allergen without injury or harm
Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.
Also known as: Medication or substance that is known to be an allergen without injury or harm
Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance
[9C40.A0] Papilloedema
Definition: Optic disc swelling that results from increased intracranial pressure
Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure
Includes: Optic disc swelling that results from increased intracranial pressure
=== GRAPH WALKS ===
--- Walk 1 ---
[4A01.03] Transient hypogammaglobulinaemia of infancy
--PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects
Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...
--CHILD--> [4A01.01] Immunodeficiencies with severe reduction in at least two serum immunoglobulin isotypes with normal or low numbers of B cells
Def: This refers to a nonfamilial type of primary immune deficiency disease characterised by a reduction in at least two serum immunoglobulin isotypes. Circulating B cells may be normal or low....
--- Walk 2 ---
[4A01.03] Transient hypogammaglobulinaemia of infancy
--PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects
Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...
--CHILD--> [4A01.01] Immunodeficiencies with severe reduction in at least two serum immunoglobulin isotypes with normal or low numbers of B cells
Def: This refers to a nonfamilial type of primary immune deficiency disease characterised by a reduction in at least two serum immunoglobulin isotypes. Circulating B cells may be normal or low....
--- Walk 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--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- 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--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic 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....
--CHILD--> [?] Localised lymph node enlargement
--- 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--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--CHILD--> [?] Generalised lymph node enlargement
|
[
"[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.01] Immunodeficiencies with severe reduction in at least two serum immunoglobulin isotypes with normal or low numbers of B cells\n Def: This refers to a nonfamilial type of primary immune deficiency disease characterised by a reduction in at least two serum immunoglobulin isotypes. Circulating B cells may be normal or low....",
"[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.01] Immunodeficiencies with severe reduction in at least two serum immunoglobulin isotypes with normal or low numbers of B cells\n Def: This refers to a nonfamilial type of primary immune deficiency disease characterised by a reduction in at least two serum immunoglobulin isotypes. Circulating B cells may be normal or low....",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --CHILD--> [?] Localised lymph node enlargement",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....\n --CHILD--> [?] Generalised lymph node enlargement"
] |
4A01.03
|
Transient hypogammaglobulinaemia of infancy
|
[
{
"from_icd11": "4A01.03",
"icd10_code": "D807",
"icd10_title": "Transient hypogammaglobulinemia of infancy"
},
{
"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"
}
] |
D807
|
Transient hypogammaglobulinemia of infancy
|
A 43-year-old Tunisian woman with an unremarkable medical history presented with persistent right hypochondrium pain over a four-month period. The patient denied experiencing anorexia or weight loss. Upon clinical examination, she displayed a good general condition, with a performance status (PS) of 0 indicating excellent overall functional health. The patient had a BMI of 29 kg/m 2 and a non-tender 10 cm mass in the right hypochondrium. Laboratory tests showed cytolysis three times the normal and cholestasis four times the normal. Hydatic serology was negative, and tests for carcino-embryonic antigen (CEA), carbohydrate antigen 19–9 (CA 19–9), and α-fetoprotein were normal. Abdominal ultrasound identified an 18 × 11 cm cystic formation in the right liver lobe, suggestive of a type I hydatid cyst. CT imaging detailed a 17 cm multiloculated cystic mass with exophytic development, compressing the biliary ducts, portal bifurcation, and inferior vena cava, with no other lesions detected . Ascites was not observed. MRI findings supported a diagnosis of multiloculated cystadenoma or cystadenocarcinoma, based on high T2 signal, low T1 signal, and enhanced septa post-Gadolinium . A percutaneous liver biopsy was not carried out. Surgery was performed via a Makuchii incision, revealing a 17 cm multilobulated cystic mass straddling segments IV and V, resembling a hepatic cystadenoma . A right hepatectomy was performed. Gross examination of the hepatic mass revealed a cystic, multiloculated structure with a smooth, glistening white-tan lining, filled with clear fluid . Histological examination showed columnar biliary-type epithelium overlying a dense spindled stroma resembling ovarian tissue. No nuclear pseudostratification or mitotic figures were observed . Notable sheets of foamy histiocytes and foreign body granulomas were present within the cyst wall. The surrounding liver parenchyma displayed nodular regenerative hyperplasia, which manifested as the development of liver nodules interspersed with areas of atrophy, without the presence of fibrous septa. , and the portal and periportal areas showed numerous well-formed collections of epithelioid histiocytes known as epithelioid granulomas, accompanied by multinucleated giant cells and lymphocytes . Patchy inflammation was observed within the hepatic lobules, while fibrinoid necrosis or caseous necrosis were absent. Sarcoidosis and tuberculosis were ruled out based on laboratory tests, imaging, and clinical examination. In this case, laboratory investigations yielded normal results for specific sarcoidosis tests, indicating the absence of typical disease markers. Imaging studies, encompassing chest X-rays and CT scans, did not reveal anticipated tuberculosis features like cavitations or nodules, nor did they show sarcoidosis indicators such as bilateral hilar lymphadenopathy. Clinical examinations were meticulously performed to pinpoint key symptoms distinctive to these conditions, all of which were notably absent in the patient. The collective results, bolstered by negative biopsies of the accessory salivary glands devoid of granulomas or acid-fast bacilli, along with negative microbiological cultures, presented compelling evidence for confidently excluding tuberculosis and sarcoidosis in this clinical scenario. Therefore, the final diagnosis was a low-grade MCN of the liver associated with idiopathic granulomatous hepatitis. The postoperative recovery was smooth, with the resolution of abdominal pain, leading to the patient's discharge on the sixth day after surgery. During the two-month follow-up, the patient was well and free of symptoms. Fig. 1 A and B: Abdominal Computed Tomography Scan illustrating a 17 cm multiloculated cystic mass with exophytic growth, compressing the biliary ducts, portal bifurcation, and inferior vena cava. C: Magnetic Resonance Imaging showing a multiloculated cystic mass, on high T2 signal, low T1 signal, and enhanced septa post-Gadolinium. D: Intraoperative view revealing a 17 cm multilobulated cystic mass straddling segments IV and V. Fig. 1 Fig. 2 A and B: Macroscopic view of low-grade mucinous cystic neoplasm, highlighting its distinct multilocular configuration. Cut section of the cyst, revealing the well-defined multilocular structure of the hepatic mucinous cystic neoplasm. C: Multiloculated hepatic cyst with columnar epithelial cells and ovarian-type stroma, ( Hematoxylin and eosin, magnification × 100). D: Histological analysis of low-grade mucinous cystic neoplasm. Columnar biliary-type epithelium overlying dense spindled ovarian-type stroma, ( Hematoxylin and eosin, magnification × 100). Fig. 2 Fig. 3 A: The mucinous cystic neoplasm exhibits tall columnar mucinous epithelium lining the cyst, displaying small basally located nuclei. The epithelium overlies a distinctive ovarian-type stroma composed of densely packed spindle cells with round to oval nuclei and scant cytoplasm. ( Hematoxylin and eosin, magnification × 400). B: Nodular Regenerative Hyperplasia ( Hematoxylin and eosin, magnification × 100). C: The figure highlights the presence of a clustered granuloma within a portal tract, indicated by a blue discontinuous line encircling the area ( Hematoxylin and eosin, magnification × 100). D: The granuloma is composed of multinucleated giant cells and epithelioid cells. (Blue asterisk) ( Hematoxylin and eosin, magnification × 400). Fig. 3
| 4.15625
| 0.969238
|
sec[1]/p[0]
|
en
| 0.999997
|
39353310
|
https://doi.org/10.1016/j.ijscr.2024.110367
|
[
"cystic",
"type",
"multiloculated",
"hematoxylin",
"eosin",
"magnification",
"liver",
"cyst",
"hepatic",
"cells"
] |
[
{
"code": "CA25.Z",
"title": "Cystic fibrosis, unspecified"
},
{
"code": "CB40.Y",
"title": "Other specified diseases of the respiratory system"
},
{
"code": "GB71.0",
"title": "Calculus in bladder"
},
{
"code": "DB99.1Z",
"title": "Hepatic cyst, unspecified"
},
{
"code": "5A01.2",
"title": "Nontoxic multinodular goitre"
},
{
"code": "9C82.4",
"title": "Oculomotor apraxia"
},
{
"code": "ED50.Z",
"title": "Ichthyosis of unspecified type"
},
{
"code": "EH6Z",
"title": "Drug eruption of unspecified type"
},
{
"code": "5C51.3",
"title": "Glycogen storage disease"
},
{
"code": "LD20.1",
"title": "Syndromes with lissencephaly as a major feature"
}
] |
=== ICD-11 CODES FOUND ===
[CA25.Z] Cystic fibrosis, unspecified
Also known as: Cystic fibrosis, unspecified | Cystic fibrosis | mucoviscidosis | CF - [cystic fibrosis] | cystic fibrosis nos
[CB40.Y] Other specified diseases of the respiratory system
Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum
[GB71.0] Calculus in bladder
Definition: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is characterised by urinary calculi located in the bladder. This condition may also present with haematuria, dysuria, or pain in the flank, lower abdomen, or groin. Confirmation is by abdominal radiography, to determine the presence and location of calculi.
Also known as: Calculus in bladder | Urinary bladder stone | bladder calculi | bladder stone | urinary bladder calculus
Includes: Urinary bladder stone
Excludes: Calculus in a bowel segment for urinary diversion (e.g. neobladder, pouch) (NFBC)
[DB99.1Z] Hepatic cyst, unspecified
Also known as: Hepatic cyst, unspecified | Hepatic cyst | cyst of liver | cystic liver | liver cyst
[5A01.2] Nontoxic multinodular goitre
Definition: Multiple nodules of the thyroid gland due to follicular multiplication, unaccompanied by hyperthyroidism or thyrotoxicosis
Also known as: Nontoxic multinodular goitre | non-toxic multinodular goitre | multinodular nontoxic struma | cystic goitre | Cystic goitre NOS
[9C82.4] Oculomotor apraxia
Also known as: Oculomotor apraxia | Congenital ocular motor apraxia | Cogan’s congenital ocular motor apraxia | Saccadic palsy | Head thrust movement
[ED50.Z] Ichthyosis of unspecified type
Also known as: Ichthyosis of unspecified type | Ichthyoses
[EH6Z] Drug eruption of unspecified type
Also known as: Drug eruption of unspecified type | Drug-induced eruptions | drug eruption or rash of unspecified type | rash due to drug NOS | drug rash
[5C51.3] Glycogen storage disease
Definition: The term Glycogen storage disease characterises a group of heterogeneous diseases resulting from defects in the process of glycogen synthesis or breakdown within muscles, liver, and other cell types.
Also known as: Glycogen storage disease | Glycogenosis | GSD - [Glycogen storage disease] | glycogen thesaurismosis | diffuse glycogenosis
Includes: Glycogen storage disease due to LAMP-2 deficiency | Glycogen storage disease due to glycogen debranching enzyme deficiency | Glycogen storage disease due to muscle glycogen phosphorylase deficiency
[LD20.1] Syndromes with lissencephaly as a major feature
Definition: The term lissencephaly covers a group of rare malformations sharing the common feature of anomalies in the appearance of brain convolutions (characterised by simplification or absence of folding) associated with abnormal organisation of the cortical layers as a result of neuronal migration defects during embryogenesis. Children with lissencephaly have feeding and swallowing problems, muscle tone anomalies (early hypotonia and subsequently limb hypertonia), seizures (in particular, infantile spas
Also known as: Syndromes with lissencephaly as a major feature | Pachygyria | Agyria | Classic lissencephaly | Lissencephaly type 1
Includes: Agyria | Pachygyria
=== GRAPH WALKS ===
--- Walk 1 ---
[CA25.Z] Cystic fibrosis, unspecified
--PARENT--> [CA25] Cystic fibrosis
Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...
--CHILD--> [CA25.0] Classical cystic fibrosis
--- Walk 2 ---
[CA25.Z] Cystic fibrosis, unspecified
--PARENT--> [CA25] Cystic fibrosis
Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...
--CHILD--> [CA25.0] Classical cystic fibrosis
--- Walk 3 ---
[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 4 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--CHILD--> [CB40.1] Young syndrome
Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....
--- Walk 5 ---
[GB71.0] Calculus in bladder
Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...
--EXCLUDES--> [?] Calculus of bowel segments for urinary diversion
Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...
--CHILD--> [?] Suburethral calculus
--- Walk 6 ---
[GB71.0] Calculus in bladder
Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...
--EXCLUDES--> [?] Calculus of bowel segments for urinary diversion
Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...
--PARENT--> [?] Calculus of lower urinary tract
Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th...
|
[
"[CA25.Z] Cystic fibrosis, unspecified\n --PARENT--> [CA25] Cystic fibrosis\n Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...\n --CHILD--> [CA25.0] Classical cystic fibrosis",
"[CA25.Z] Cystic fibrosis, unspecified\n --PARENT--> [CA25] Cystic fibrosis\n Def: Cystic fibrosis (CF) is a genetic disorder characterised by the production of sweat with a high salt content and mucus secretions with an abnormal viscosity. The disease is chronic and generally progr...\n --CHILD--> [CA25.0] Classical cystic fibrosis",
"[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--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....",
"[GB71.0] Calculus in bladder\n Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...\n --EXCLUDES--> [?] Calculus of bowel segments for urinary diversion\n Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...\n --CHILD--> [?] Suburethral calculus",
"[GB71.0] Calculus in bladder\n Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...\n --EXCLUDES--> [?] Calculus of bowel segments for urinary diversion\n Def: A condition caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. This condition is charact...\n --PARENT--> [?] Calculus of lower urinary tract\n Def: A condition of the urinary system, caused by dehydration, decreased urine volume or fluid flow rates, or increased excretion of minerals such as calcium, oxalate, magnesium, cystine, and phosphate. Th..."
] |
CA25.Z
|
Cystic fibrosis, unspecified
|
[
{
"from_icd11": "CA25.Z",
"icd10_code": "E8419",
"icd10_title": "Cystic fibrosis with other intestinal manifestations"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E848",
"icd10_title": "Cystic fibrosis with other manifestations"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E849",
"icd10_title": "Cystic fibrosis, unspecified"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E84",
"icd10_title": "Cystic fibrosis"
},
{
"from_icd11": "CA25.Z",
"icd10_code": "E841",
"icd10_title": "Cystic fibrosis with intestinal manifestations"
},
{
"from_icd11": "GB71.0",
"icd10_code": "N210",
"icd10_title": "Calculus in bladder"
},
{
"from_icd11": "5A01.2",
"icd10_code": "E042",
"icd10_title": "Nontoxic multinodular goiter"
},
{
"from_icd11": "9C82.4",
"icd10_code": "H518",
"icd10_title": "Other specified disorders of binocular movement"
},
{
"from_icd11": "EH6Z",
"icd10_code": "L270",
"icd10_title": "Generalized skin eruption due to drugs and medicaments taken internally"
},
{
"from_icd11": "EH6Z",
"icd10_code": "L27",
"icd10_title": "Dermatitis due to substances taken internally"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7401",
"icd10_title": "von Gierke disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7404",
"icd10_title": "McArdle disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7402",
"icd10_title": "Pompe disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7403",
"icd10_title": "Cori disease"
},
{
"from_icd11": "5C51.3",
"icd10_code": "E7409",
"icd10_title": "Other glycogen storage disease"
}
] |
E8419
|
Cystic fibrosis with other intestinal manifestations
|
The patient is a 24 year-old African-American female with SCT who presented with a one month history of gross hematuria and intermittent right flank pain in December 2014. Computed tomography (CT) imaging revealed a well-defined solid mass with a central necrosis within the upper pole of the right kidney measuring 6.0 cm × 3.9 cm × 5.0 cm and two pulmonary nodules (3 and 2 mm in size) in the left lower lobe concerning for metastatic disease. Thus in January 2015, right radical nephrectomy was performed. Histological and Immunohistochemical (IHC) analysis revealed RMC. Further genetic study revealed SMARCB1 mutation as previously reported in RMC . Follow up imaging in February 2015 showed an interval increase in the size of the aforementioned pulmonary nodules to 7 mm and a new lesion in the upper left lobe. Unfortunately, two new nodules of 1 cm each were also detected in the post-surgical bed. Subsequently in March 2015, she was started on palliative chemotherapy consisting of cisplatin, paclitaxel and gemcitabine. Due to a grade 3 neutropenia she experienced after the first cycle, she only received cisplatin and gemcitabine for the remainder of the treatment. After the third cycle of the cisplatin and gemcitabine, a complete response was observed and at the end of the sixth cycle in July 2015, she remained free of disease. A follow up CT abdomen and pelvis performed in October 2015 showed an increased in disease burden with two pulmonary nodules in the left lower lobe and a 1.6 × 1.6 cm nodule within the right nephrectomy bed. IHC staining performed on the initial nephrectomy specimen revealed the expression of PD-L1 on 25% of tumor cells . As such, she was started on nivolumab 3 mg/kg every 2 weeks on October 19th 2015. She tolerated well the infusion of nivolumab except for mild nausea controlled with ondansetron. After completing 4 cycles of nivolumab, she presented at an outside hospital in December 2015 for UTI and was found to be 6 weeks pregnant prompting the nivolumab to be stopped. She elected to undergo a dilation and curettage in January 2016. From November 30th 2015 (date of her 4th cycle), to February 12th 2016 (5th cycle of nivolumab), she did not receive nivolumab. Prior to resuming the nivolumab, a CT scan showed a stable disease in the right nephrectomy bed and improved metastatic lung disease . She received 8 additional cycles of nivolumab before undergoing another PET scan in May 2016 which showed a slight increase in the recurrent lesion in the surgical bed and a persistent resolution in metastatic lesions to the left lower lung lobe. Despite the interval progression in the surgical bed, she remained asymptomatic. In July 2016 she presented to the emergency room with nausea, diarrhea and abdominal pain suggestive of colitis. An improvement was noted when with a course of prednisone. While she was recovering from the colitis, the nivolumab was stopped. She underwent a surgical resection of the recurrent lesion and resumed the nivolumab on July 21st 2016 (Cycle#13). After receiving 5 additional cycles, a PET scan in October 2016 revealed an increase in the disease burden. She received palliative radiation to the left mediastinal disease with 4400 cGy in 200 cGy fraction and to the left upper lung lobe lesion with 6000 cGy in 200 cGy fraction via intensity-modulated radiation therapy (IMRT) while continuing nivolumab. She completed the radiation therapy in December 2016 and continued to receive nivolumab. Since the initiation of nivolumab, the patient has completed 28 cycles and a follow up PET scan in February 2017 showed a decreased in tumor burden in the mediastinum but further progression outside of the radiation field with new lung and liver lesions and recurrence in the right nephrectomy bed . In light of disease progression, the decision was made to add ipilimumab to the nivolumab. At time of this submission, response assessment from this therapy is awaited (See Table 1 for a summary of chemotherapy and immunotherapy agents administered). Fig. 1 PD-L1 expression in patients with Renal medullary carcinoma (RMC). a Patient 1, PD-L1 SP142 (25% Immune cells stained (ICS); reference/Positive: ICS ≥ 5%). b Patient 2, PD-L1 IHC 28–8 (60% tumor cells stained (TCS); reference/Positive: TCS ≥ 1%) Fig. 2 Axial CT demonstrating interval improvement in the metastatic lung lesions in patient 1 after 5 cycles of Nivolumab. a Left lower lobe nodule #1 prior to Nivolumab. b Left lower lobe nodule #1 after Nivolumab. c Left lower lobe nodule #2 prior to Nivolumab. d Left lower lobe nodule #2 after Nivolumab Fig. 3 PET scan of patient 1 demonstrating disease progression. a Scan obtained in October 2016 showing prominent mediastinal lesions. b Latest scan in February 2017 after 28 cycles of nivolumab and palliative radiation to the mediastinum showing new metastatic lesions in the liver and lungs but resolution of medistanial disease Table 1 Summary chemotherapy and immunotherapy agents received by patient 1 Treatments Duration Cisplatin, paclitaxel a , gemcitabine Six cycles Nivolumab 28 cycles (56 weeks) b Ipilimumab 2 cycles (6 weeks) c a Paclitaxel was stopped after first cycle due to grade 3 toxicity b At the time of submission of this manuscript, 28 cycles were completed but nivolumab will be continued c At the time of submission of this manuscript, 2 cycles were given and will be continued for 2 more cycles
| 3.933594
| 0.977539
|
sec[1]/sec[0]/p[0]
|
en
| 0.999995
|
28807004
|
https://doi.org/10.1186/s40425-017-0267-9
|
[
"nivolumab",
"cycles",
"lobe",
"cycle",
"scan",
"metastatic",
"nephrectomy",
"nodule",
"lung",
"lesions"
] |
[
{
"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": "CB40.2",
"title": "Pulmonary collapse"
},
{
"code": "LA75.0",
"title": "Accessory lobe of lung"
},
{
"code": "MD41",
"title": "Clinical findings on diagnostic imaging of lung"
},
{
"code": "LA75.1",
"title": "Agenesis of lung"
},
{
"code": "JA8A.1",
"title": "Malformation of placenta"
}
] |
=== ICD-11 CODES FOUND ===
[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
[CB40.2] Pulmonary collapse
Also known as: Pulmonary collapse | Atelectasis | lung collapse | pulmonary atelectasis | pulmonary collapse with atelectasis
Includes: Atelectasis
Excludes: Primary atelectasis of newborn | tuberculous atelectasis, not confirmed | tuberculous atelectasis, confirmed
[LA75.0] Accessory lobe of lung
Definition: An extra lobe of lung beyond the 3 on the right and the 2 on the left
Also known as: Accessory lobe of lung | supernumerary lung lobe | azygos lobe of lung | azygos lobe fissure of lung | azygos lobe
[MD41] Clinical findings on diagnostic imaging of lung
Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging.
Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass
[LA75.1] Agenesis of lung
Definition: This refers to the absence or rudimentary residua of an undeveloped lung.
Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism
[JA8A.1] Malformation of placenta
Also known as: Malformation of placenta | variation of placenta form | deformity of placenta | placental deformity | Abnormal placenta NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[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--> [6A80.0] Prominent anxiety symptoms in mood episodes
Def: In the context of a current depressive, manic, mixed, or hypomanic episode, prominent and clinically significant anxiety symptoms (e.g., feeling nervous, anxious or on edge, not being able to control ...
--- 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 pedal cycle
--- 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 pedal cycle
--- 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--> [?] 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...
|
[
"[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--> [6A80.0] Prominent anxiety symptoms in mood episodes\n Def: In the context of a current depressive, manic, mixed, or hypomanic episode, prominent and clinically significant anxiety symptoms (e.g., feeling nervous, anxious or on edge, not being able to control ...",
"[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 pedal cycle",
"[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 pedal cycle",
"[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--> [?] 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..."
] |
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 nine-year-old girl presented for evaluation of progressively increased hair growth over androgen-dependent areas, deepening of voice, and abdominal distension. The patient had first episode of bleeding per vaginum at the age of 7 years and 6 months. Following it, she had an irregular menstrual bleeding pattern for the next five months. Subsequently, the bleeding episodes had ceased on its own without any drug intake, and she was amenorrhoeic for the last one year. However, no medical consultation or evaluation was done at that point of time for this precocious pubertal event. The parents had also noticed a significant height gain in comparison with her peers in the preceding one and half years. There was no history of any chronic drug intake or prior surgery. There was no history of a similar disorder in any family member. She was born out of a nonconsanguineous marriage and delivered at term by normal vaginal delivery. The perinatal period was uneventful. On clinical examination, the girl was thin built with muscular appearance. Her anthropometric parameters were as follows: height of 145 cm (>97 th percentile) and weight of 41 kg (90 th –97 th percentile). She had evidence of virilization characterized by a significant degree of hirsutism (Ferriman–Gallaway score of 16/36), clitoromegaly (clitoral length 16 mm and clitoral index 56 mm 2 ), and lack of breast development. No Turner syndrome stigmata were noted. Her vitals were within a normal range. On abdominal palpation, a mobile abdominal mass (around 10 cm × 10 cm) was noted in the right lower abdomen with the presence of shifting dullness and bulging flanks. Ultrasonography of the abdomen and pelvis revealed a large lobulated adnexal mass (around 11 cm × 6 cm × 9 cm) arising from the right ovary along with ascites. The left ovary was morphologically normal. A pubertal uterus (dimension of around 7.5 cm × 5 cm × 3.6 cm) with a normal endometrial echogenicity of 3 mm was also noted. Her bone age was advanced by two years in contrast to her chronological age. Contrast enhanced computed tomography revealed a large lobulated solid mass of size 11.9 cm × 6.5 cm × 9.4 cm arising from the right ovary, morphologically normal looking left ovary, and presence of gross ascites . The right ovarian mass was characterized by heterogeneous post-contrast enhancement and punctuate internal calcification along with multiple intratumor tortuous vascular channels . Serum lactate dehydrogenase (LDH) (361 U/L, normal: 140-280 U/L), serum beta human chorionic gonadotropin (hCG) (447.2 m·IU/ml, normal: <5.0 m·IU/ml), and CA-125 (56.93 U/ml, normal: <35 U/ml)) levels were elevated. Serum alpha-fetoprotein (AFP) level (4.2 ng/ml, normal: <5.8 ng/ml) was normal. Hormonal evaluation revealed significantly elevated levels of serum testosterone (12.51 ng/ml, normal: 0.06–0.52 ng/ml), low luteinizing hormone level (0.26 m·IU/ml, normal: >0.6 m·IU/ml for pubertal response), and slightly elevated estradiol level (30 pg/ml, normal: <20 pg/ml). Serum dehydroepiandrostenedione sulphate (DHEAS) levels were within a normal range. Karyotype analysis from peripheral blood sample revealed a normal female 46, XX pattern. Fluorescence in situ hybridization (FISH) from peripheral blood did not reveal any Y chromosome material. Based on the above clinical, biochemical, and supportive radiological findings, a diagnosis of virilizing ovarian tumor leading to contrasexual puberty was considered. Intraoperative findings revealed a 15 cm × 10 cm firm and lobulated mass arising from the right ovary whereas the left ovary appeared morphologically normal. The patient underwent right salpingo-oophorectomy, pelvic lymph node dissection, and infracolic omentectomy along with left ovarian biopsy . Around three liters of straw-coloured ascitic fluid was drained. The patient had an uneventful recovery in the postoperative period. Ascitic fluid cytology was negative for malignant cells. Histopathologic examination of excised tumor revealed greyish yellow tumor with focal areas of myxoid changes and haemorrhage with an intact capsule. The tumor cells were present in sheets and nests separated by fibrous septa with lymphoid infiltration. Occasional primordial follicles were also seen in between. The tumoral cells were large with prominent nucleoli and mitotic activity. At places, bizarre tumor cells with areas of calcification (suggestive of burned out gonadoblastoma) were seen. Regional lymph node assessment revealed reactive hyperplasia. Based on the above characteristic findings, a diagnosis of dysgerminoma associated with burned out gonadoblastoma was made . The left ovary biopsy sample revealed normal ovarian histology. Pathological staging was pT1aN0Mx. However, a cytogenetic study for assessing Y chromosome material from affected ovarian tumor tissue was not performed. The patient was started on chemotherapy comprising of bleomycin, etoposide, and cisplatin combination for four cycles. The virilization features decreased over the course of next three months with significant improvement in hirsutism, voice change, and other physical characteristics. The patient is on regular follow-up for the past one year with no evidence of tumor recurrence till now and menstrual cycles have not resumed. The hormonal evaluation revealed normalization of testosterone levels (0.2 ng/ml) and normal early pubertal gonadotropin levels.
| 4.023438
| 0.980469
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC9152346
|
https://doi.org/10.1155/2022/5666957
|
[
"ovary",
"tumor",
"ovarian",
"serum",
"pubertal",
"around",
"cells",
"areas",
"abdominal",
"bleeding"
] |
[
{
"code": "GA1Z&XA1QK0",
"title": "Noninflammatory disorders of ovary"
},
{
"code": "GA07.Z&XA1QK0",
"title": "Inflammation of ovary"
},
{
"code": "GA30.6",
"title": "Premature ovarian failure"
},
{
"code": "JA01.2",
"title": "Ovarian pregnancy"
},
{
"code": "QF01.10",
"title": "Acquired absence of female genital organs"
},
{
"code": "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 ===
[GA30.6] Premature ovarian failure
Definition: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conceiving and delivering a pregnancy. POF/POI occurs mostly without a known cause, but can be caused by the following conditions: numerical and structural chromosomal abnormalities, Fragile X (FMR1) premutations, autoimmune disorders, radiation therapy, chemotherapy, galactosemia, and other rare enzyme
Also known as: Premature ovarian failure | female hypergonadotropic hypogonadism | hypergonadotrophic ovarian failure | primary female hypogonadism | POF - [premature ovarian failure]
Excludes: Isolated gonadotropin deficiency | Postprocedural ovarian failure
[JA01.2] Ovarian pregnancy
Definition: A condition characterised by implantation of the embryo within the ovary during pregnancy.
Also known as: Ovarian pregnancy
[QF01.10] Acquired absence of female genital organs
Also known as: Acquired absence of female genital organs | Acquired absence of cervix | amputation of cervix | Acquired absence of the uterus | acquired uterine absence
[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 ---
[GA30.6] Premature ovarian failure
Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce...
--RELATED_TO--> [?] Secondary amenorrhoea
Def: In women who have menstruated previously, no menses for an interval of time equivalent to a total of at least 3 previous cycles, or 6 months...
--CHILD--> [?] Premature ovarian failure due to autoimmune oophoritis
Def: This refers to the loss of function of the ovaries before age 40, due to autoimmune inflammation of the ovaries....
--- Walk 2 ---
[GA30.6] Premature ovarian failure
Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce...
--RELATED_TO--> [?] Secondary amenorrhoea
Def: In women who have menstruated previously, no menses for an interval of time equivalent to a total of at least 3 previous cycles, or 6 months...
--CHILD--> [?] Premature ovarian failure due to autoimmune oophoritis
Def: This refers to the loss of function of the ovaries before age 40, due to autoimmune inflammation of the ovaries....
--- Walk 3 ---
[JA01.2] Ovarian pregnancy
Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....
--PARENT--> [JA01] Ectopic pregnancy
Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....
--CHILD--> [JA01.2] Ovarian pregnancy
Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....
--- Walk 4 ---
[JA01.2] Ovarian pregnancy
Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....
--PARENT--> [JA01] Ectopic pregnancy
Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....
--CHILD--> [JA01.1] Tubal pregnancy
Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....
--- Walk 5 ---
[QF01.10] Acquired absence of female genital organs
--RELATED_TO--> [?] Traumatic amputation of entire vulva
--PARENT--> [?] Acquired absence of female genital organs
--- Walk 6 ---
[QF01.10] Acquired absence of female genital organs
--RELATED_TO--> [?] Traumatic amputation of part of vulva
--PARENT--> [?] Traumatic amputation of external genital organs
|
[
"[GA30.6] Premature ovarian failure\n Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce...\n --RELATED_TO--> [?] Secondary amenorrhoea\n Def: In women who have menstruated previously, no menses for an interval of time equivalent to a total of at least 3 previous cycles, or 6 months...\n --CHILD--> [?] Premature ovarian failure due to autoimmune oophoritis\n Def: This refers to the loss of function of the ovaries before age 40, due to autoimmune inflammation of the ovaries....",
"[GA30.6] Premature ovarian failure\n Def: Menopause occurring spontaneously before 40 years of age, generally resulting in secondary amenorrhea although some women may exhibit intermittent ovarian function and ovulation, with a minority conce...\n --RELATED_TO--> [?] Secondary amenorrhoea\n Def: In women who have menstruated previously, no menses for an interval of time equivalent to a total of at least 3 previous cycles, or 6 months...\n --CHILD--> [?] Premature ovarian failure due to autoimmune oophoritis\n Def: This refers to the loss of function of the ovaries before age 40, due to autoimmune inflammation of the ovaries....",
"[JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --CHILD--> [JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....",
"[JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --CHILD--> [JA01.1] Tubal pregnancy\n Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....",
"[QF01.10] Acquired absence of female genital organs\n --RELATED_TO--> [?] Traumatic amputation of entire vulva\n --PARENT--> [?] Acquired absence of female genital organs",
"[QF01.10] Acquired absence of female genital organs\n --RELATED_TO--> [?] Traumatic amputation of part of vulva\n --PARENT--> [?] Traumatic amputation of external genital organs"
] |
GA1Z&XA1QK0
|
Noninflammatory disorders of ovary
|
[
{
"from_icd11": "GA30.6",
"icd10_code": "E2839",
"icd10_title": "Other primary ovarian failure"
},
{
"from_icd11": "GA30.6",
"icd10_code": "E28319",
"icd10_title": "Asymptomatic premature menopause"
},
{
"from_icd11": "GA30.6",
"icd10_code": "E28310",
"icd10_title": "Symptomatic premature menopause"
},
{
"from_icd11": "GA30.6",
"icd10_code": "E283",
"icd10_title": "Primary ovarian failure"
},
{
"from_icd11": "JA01.2",
"icd10_code": "O00201",
"icd10_title": "Right ovarian pregnancy without intrauterine pregnancy"
},
{
"from_icd11": "JA01.2",
"icd10_code": "O002",
"icd10_title": "Ovarian pregnancy"
},
{
"from_icd11": "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"
}
] |
E2839
|
Other primary ovarian failure
|
A previously healthy 29-year-old patient, while at work, was struck in the head by a steel pipe launched by a forklift. The patient who lost consciousness immediately with multiple sites of active bleeding on the head and face was transported to the nearest secondary hospital by the emergency services (120) promptly.. Upon arrival at the hospital's emergency department, the patient was comatose (GCS score of 3), with progressive bleeding from the head and face, a decreasing blood pressure, necessitating emergency tracheal intubation and mechanical ventilation. High doses of vasoactive drugs were administered to maintain blood pressure, along with tranexamic acid for hemostasis, blood transfusion, and fluid resuscitation. The CT result of the head revealed multiple skull fractures and brain contusions . Considering the critical condition, the patient received blood transfusion and was promptly transferred to a tertiary hospital one hour after injury. Upon arrival at the tertiary hospital's emergency department, physical examination indicated: heart rate of 25 beats per minute, blood pressure of 50/40 mmHg, unmeasurable SPO2, multiple skin lacerations on the head and face, durative staxis, periorbital ecchymosis, bleeding from the nose and mouth, GCS score of 3, tracheal intubation, cervical immobilization, fixed and dilated bilateral pupils measuring 5 mm with absent light reflexes. The patient's heart rate progressively decreased, prompting immediate cardiopulmonary resuscitation. Simultaneously, intravenous administration of epinephrine for cardiac support, sodium bicarbonate for correcting acidosis, emergency blood transfusion (at a ratio of red blood cells, plasma, and platelets in a 1:1:1 proportion), supplementation of fibrinogen, cryoprecipitate, crystalloid fluids, maintaining warmth, and wound closure of the head was provided as part of the treatment. A negative FAST bedside ultrasound was performed, arterial blood gas analysis indicated pH 7.16, PO2 69.3 mmHg, PCO2 19.8 mmHg, base excess (BEB) -19.8 mmol/l, lactate (LAC) 14.3 mmol/l, hemoglobin (Hb) 38 g/l, prothrombin time (PT) >120 s, activated partial thromboplastin time (APTT) >180 s, D-dimer >20 mg/l, fibrinogen (FG) <0.4 g/l. Based on the mechanism of injury, symptoms, and ancillary investigations, a tentative diagnosis included severe head trauma, traumatic cerebral hemorrhage, traumatic brain herniation, subarachnoid hemorrhage, multiple skull fractures, traumatic coagulopathy, hemorrhagic shock, and blunt cerebrovascular injury. Considering blunt cerebrovascular injury with active bleeding, immediate contact was made with the interventional radiology department for a planned DSA. After 27 min of resuscitation, the patient regained spontaneous heart rate and respiration, palpable arterial pulsations, and electrocardiogram showed sinus rhythm. The DSA procedure was performed successfully, revealing active bleeding mainly from multiple branches of the right external carotid artery (including the ascending pharyngeal artery, maxillary artery, superficial temporal artery, facial artery) . A small amount of carotid-cavernous fistula was observed in the right internal carotid artery, and active bleeding was indicated in the branches of the left external carotid artery (mainly superficial temporal artery and occipital artery) . Blood supply within the intracranial branches of both internal carotid arteries was sluggish. Microcatheters were selectively placed in the above-mentioned main arterial vessels and branches, and gelatin sponge particles were used for embolization. Post-procedure reimaging did not show clear signs of active bleeding. The patient was then admitted to the Intensive Care Unit for monitoring and treatment. Hemoglobin levels stabilized after embolization , and blood lactate levels progressively decreased . On the 5th day of admission, a follow-up head CT revealed significant brain tissue swelling, intraventricular and subarachnoid hemorrhage . On the 6th day of hospitalization, the patient was declared brain dead by specialist clinicians . Fig. 1 (A and B and C and D) Patient's injury scene, with a white arrow pointing to the steel pipe, and a black arrow pointing to the patient. Fig. 1 Fig. 2 (A and B)The three-dimensional reconstructed image of the first head CT scan upon the patient's admission. Fig. 2 Fig. 3 (A and B and C and D)The first head CT image upon the patient's admission. Fig. 3 Fig. 4 (A and B)The distal ends of multiple branches of the right external carotid artery show contrast agent accumulation. Fig. 4 Fig. 5 The right internal carotid artery shows a small carotid-cavernous fistula. There is contrast agent overflow observed in the distal end of the branches of the left external carotid artery (mainly superficial temporal artery and occipital artery). Fig. 5 Fig. 6 (A and B)Embolization performed by injecting gelatin sponge particles; post-procedure reimaging did not show clear signs of active bleeding. Fig. 6 Fig. 7 Patient's hemoglobin level trend chart. Fig. 7 Fig. 8 The patient's blood lactate level trend chart. Fig. 8 Fig. 9 (A and B and C)Imaging of the patient's follow-up head CT on the 5th day of admission. Fig. 9 Fig. 10 The patient's bedside electroencephalogram (EEG)and the report. Fig. 10 Fig. 11 Short-latency somatosensory evoked potentials(SLSEP). Fig. 11 Fig. 12 Transcranial Doppler (TCD) report. Fig. 12
| 3.912109
| 0.978027
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC11550016
|
https://doi.org/10.1016/j.ijscr.2024.110488
|
[
"artery",
"head",
"blood",
"carotid",
"bleeding",
"multiple",
"active",
"branches",
"emergency",
"injury"
] |
[
{
"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": "NA63",
"title": "Traumatic amputation at neck level"
},
{
"code": "MB4D",
"title": "Headache, not elsewhere classified"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "MB48.3",
"title": "Light-headedness"
},
{
"code": "FB3Z",
"title": "Disorders of muscles, unspecified"
}
] |
=== 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
[NA63] Traumatic amputation at neck level
Also known as: Traumatic amputation at neck level | complete head avulsion | Decapitation | decapitation of head at neck level | severed head
Includes: Decapitation
[MB4D] Headache, not elsewhere classified
Definition: 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.
Also known as: Headache, not elsewhere classified | cephalalgia | cephalgia | cephalodynia | pain in head NOS
Excludes: Trigeminal neuralgia | Atypical facial pain | Acute headache, not elsewhere classified
[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
[MB48.3] Light-headedness
Also known as: Light-headedness | light headed
[FB3Z] Disorders of muscles, unspecified
Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder
=== 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
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--- Walk 3 ---
[BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Acute arterial occlusion
--CHILD--> [?] Acute lower limb arterial occlusion
--- Walk 4 ---
[BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Acute arterial occlusion
--CHILD--> [?] Acute upper limb arterial occlusion
--- Walk 5 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--CHILD--> [?] Injuries to the thorax
--- Walk 6 ---
[BD52.3] Rupture of artery
--PARENT--> [BD52] Certain specified disorders of arteries or arterioles
--EXCLUDES--> [?] Leukocytoclastic vasculitis
Def: Leukocytoclastic vasculitis (hypersensitivity vasculitis; hypersensitivity angiitis) is a histopathological term commonly used to denote a small-vessel vasculitis. It may be localised to the skin or m...
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion",
"[BD5Z] Diseases of arteries or arterioles, unspecified\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...",
"[BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Acute arterial occlusion\n --CHILD--> [?] Acute lower limb arterial occlusion",
"[BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Acute arterial occlusion\n --CHILD--> [?] Acute upper limb arterial occlusion",
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --CHILD--> [?] Injuries to the thorax",
"[BD52.3] Rupture of artery\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles\n --EXCLUDES--> [?] Leukocytoclastic vasculitis\n Def: Leukocytoclastic vasculitis (hypersensitivity vasculitis; hypersensitivity angiitis) is a histopathological term commonly used to denote a small-vessel vasculitis. It may be localised to the skin or m..."
] |
BD5Z
|
Diseases of arteries or arterioles, unspecified
|
[
{
"from_icd11": "BD5Z",
"icd10_code": "I7389",
"icd10_title": "Other specified peripheral vascular diseases"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7419",
"icd10_title": "Embolism and thrombosis of other parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7411",
"icd10_title": "Embolism and thrombosis of thoracic aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7410",
"icd10_title": "Embolism and thrombosis of unspecified parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7381",
"icd10_title": "Erythromelalgia"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I745",
"icd10_title": "Embolism and thrombosis of iliac artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I789",
"icd10_title": "Disease of capillaries, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I748",
"icd10_title": "Embolism and thrombosis of other arteries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I749",
"icd10_title": "Embolism and thrombosis of unspecified artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I781",
"icd10_title": "Nevus, non-neoplastic"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I788",
"icd10_title": "Other diseases of capillaries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I744",
"icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I70-I79",
"icd10_title": ""
},
{
"from_icd11": "BD5Z",
"icd10_code": "I74",
"icd10_title": "Arterial embolism and thrombosis"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I73",
"icd10_title": "Other peripheral vascular diseases"
}
] |
I7389
|
Other specified peripheral vascular diseases
|
Subject 1810 had a fluctuating, asymmetric mixed hearing loss bilaterally. In the left ear, a slight-to-mild conductive hearing loss was limited to the low and mid frequencies. In the right ear, a moderate low frequency conductive loss and a moderate-to-severe, mid-to-high frequency mixed hearing loss that was primarily sensorineural was documented . Subject 1810 used bilateral hearing aids that were first prescribed when he was approximately four and a half years old. No evidence of middle ear pathology was identified by CT imaging of the temporal bones , audiologic immittance testing, or physical examination. His right and left vestibular aqueducts were enlarged with measured midpoint diameters of 6 and 3 mm, respectively. The lateral, posterior, and superior semicircular canals were morphologically normal bilaterally . The remainder of his medical and developmental phenotype was significant for prenatal and antenatal ultrasound examinations demonstrating a right ureterocele and torturous right ureter requiring endoscopic repair of ureteral obstruction and reimplantation of the ureter. He had a duplication of the right kidney requiring nephrectomy at 15 months of age, a history of episodic nausea, vomiting, and torticollis, a constellation of signs and symptoms which is commonly observed in infants with EVA, presumably due to inner ear vestibular dysfunction. He was first noted to independently ambulate at 21 months of age. Ophthalmologic evaluation at 5 years of age reported normal retinas. He had an adenoidectomy at 5.5 years of age for an “airway issue” but no evidence of choanal atresia by physical examination or CT imaging of the skull base. MR imaging of the brain at 5 years of age revealed relative hypoplasia of the inferior vermis of the cerebellum with concomitant mild enlargement of the fourth ventricle. He was reported to have a short systolic murmur heard best at the left sternal border and thought to be innocent in nature. FISH hybridization in the long arm of chromosome 22 (22q11.2) was normal. Physical examination at 6 years of age (by A.J.G.) was notable for a narrow face with mandibular and malar hypoplasia, dysmorphic soft pinnae, and a high-arched palate with a normal uvula. He had single transverse palmar creases bilaterally. Both his mother , father , and sister had normal hearing sensitivity at all frequencies in both ears . The father , 41 years, reported a history of rare episodes of otitis media and limited noise exposure. His medical history included mild environmental allergies, mild myopia and surgery for removal of a vascular malformation from his left forearm. No lesions, masses or signs of syndromic hearing loss were detected by a physical examination focused on the head and neck. Fig. 2 Audiograms for members of families 276 and 388. A Family 276: the audiogram of subject 1810 indicated a bilateral, asymmetric hearing loss. In the left ear, there was a slight-to-mild conductive hearing loss limited to the low-to-mid frequencies. In the right ear, he had a moderate low frequency conductive loss and a moderate-to-severe, mid-to-high frequency mixed hearing loss that was primarily sensorineural. Audiograms from subjects 1813, 1812 and 1811 indicated normal hearing sensitivity bilaterally. B For family 388: hearing sensitivity for subject 2105 was within normal limits. Subject 2106 had severe-to-profound mixed hearing loss in the low frequencies and no measurable hearing at 1000 Hz and above in her right ear. Her left ear was not tested as she had a cochlear implant. For subject 2107, his most recent audiogram before bilateral cochlear implantation is presented. There was a moderate-to-severe SNHL in the right ear. The left ear was not tested as previous testing had documented a profound SNHL in this ear. The audiogram of subject 2108 indicated a mild-to-moderately severe hearing loss in the right ear, that was mixed in the low frequencies and sensorineural in the mid and high frequencies. In the left ear, there was a severe low frequency mixed loss rising to a moderately severe high frequency SNHL. The age of each subject at the time of the audiogram is indicated in parenthesis. Arrows indicate no response at maximum audiometer output levels. Gray shaded area in the audiograms represents normal hearing range defined as air-conduction thresholds less than or equal to 15 dB HL for subjects less than 18 years, and less than or equal to 25 dB HL at 250 Hz to 8 kHz for adult subjects. y/o years old Fig. 3 Radiological images of temporal bones of affected individuals with p. and p. variants of CHD7 . Montage of axial computed tomography (CT) (rows 1–4) and magnetic resonance (MR) (row 5) temporal bone imaging in a cohort subject with normal labyrinths and vestibular aqueducts (row 1), and from subjects with CHD7 variant p. (row 2) and CHD7 variant p. (rows 3–5). In row 1, normal anatomy is shown for reference, including the lateral semicircular canals (white arrows), which are often hypoplastic or absent in patients with CHARGE syndrome, and the normal vestibular aqueducts (white arrowheads) with a midpoint diameter less than 1 mm. For each patient , the lateral semicircular canals are well-formed, indistinguishable from normal (row 1, white arrow) and the vestibular aqueducts are enlarged (rows 2–5, white arrowheads) measuring 3 to 6 mm at the midpoint in each case. R right ear, L left ear
| 4.148438
| 0.949707
|
sec[2]/sec[0]/sec[0]/p[1]
|
en
| 0.999996
|
37668839
|
https://doi.org/10.1007/s00439-023-02581-x
|
[
"hearing",
"loss",
"subject",
"mixed",
"frequencies",
"frequency",
"vestibular",
"bilaterally",
"conductive",
"that"
] |
[
{
"code": "AB52",
"title": "Deafness not otherwise specified"
},
{
"code": "QA00.7",
"title": "Examination of ears and hearing"
},
{
"code": "MC4Y",
"title": "Other specified symptoms or signs involving the ear or mastoid process"
},
{
"code": "AB54",
"title": "Presbycusis"
},
{
"code": "AB5Z",
"title": "Disorders with hearing impairment, unspecified"
},
{
"code": "FB32.Y",
"title": "Other specified disorders of muscles"
},
{
"code": "QE61.0",
"title": "Loss or death of child"
},
{
"code": "5C70.0",
"title": "Dehydration"
},
{
"code": "MB27.Z",
"title": "Symptoms or signs of perceptual disturbance, unspecified"
},
{
"code": "MG43.5",
"title": "Excessive weight loss"
}
] |
=== ICD-11 CODES FOUND ===
[AB52] Deafness not otherwise specified
Also known as: Deafness not otherwise specified | deaf | hearing loss NOS | hearing impairment | hearing loss
[QA00.7] Examination of ears and hearing
Also known as: Examination of ears and hearing | examination of ear | hearing examination | hearing test
[MC4Y] Other specified symptoms or signs involving the ear or mastoid process
Also known as: Other specified symptoms or signs involving the ear or mastoid process | Hearing complaint | Fear of ear disease
[AB54] Presbycusis
Definition: The term presbycusis refers to sensorineural hearing impairment in elderly individuals. Characteristically, presbycusis involves bilateral high-frequency hearing loss associated with difficulty in speech discrimination and central auditory processing of information.
Also known as: Presbycusis | Presbyacusia | age-related hearing loss | senile deafness | hard of hearing
Includes: Presbyacusia
[AB5Z] Disorders with hearing impairment, unspecified
Also known as: Disorders with hearing impairment, unspecified | disorders with hearing loss
[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
[QE61.0] Loss or death of child
Also known as: Loss or death of child | loss of child | death of child
Excludes: Prolonged grief disorder
[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
[MB27.Z] Symptoms or signs of perceptual disturbance, unspecified
Also known as: Symptoms or signs of perceptual disturbance, unspecified | Symptoms or signs involving perceptual disturbance | sensory loss
[MG43.5] Excessive weight loss
Definition: A reduction of total body mass, due to loss of fluid, body fat or adipose tissue, or lean (muscle) mass that is sufficient in quantity or rate to create risk to the individual’s health.
Also known as: Excessive weight loss | abnormal decrease in weight | abnormal weight loss | unintended weight loss | weight loss NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[AB52] Deafness not otherwise specified
--PARENT--> [?] Disorders with hearing impairment
--EXCLUDES--> [?] Otosclerosis
Def: Otosclerosis is a genetically mediated metabolic bone disease that affects the otic capsule and stapes. It is an autosomal dominant disorder with varying penetrance and expressivity. Usually symptomat...
--- Walk 2 ---
[AB52] Deafness not otherwise specified
--PARENT--> [?] Disorders with hearing impairment
--EXCLUDES--> [?] Otosclerosis
Def: Otosclerosis is a genetically mediated metabolic bone disease that affects the otic capsule and stapes. It is an autosomal dominant disorder with varying penetrance and expressivity. Usually symptomat...
--- Walk 3 ---
[QA00.7] Examination of ears and hearing
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--CHILD--> [QA00.2] Routine newborn health examination
Def: Health examination for infant under 29 days of age...
--- Walk 4 ---
[QA00.7] Examination of ears and hearing
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--EXCLUDES--> [?] Examination or encounter for administrative purposes
--- Walk 5 ---
[MC4Y] Other specified symptoms or signs involving the ear or mastoid process
--PARENT--> [?] Symptoms or signs involving the ear or mastoid process
--CHILD--> [MC40] Plugged feeling ear
--- Walk 6 ---
[MC4Y] Other specified symptoms or signs involving the ear or mastoid process
--PARENT--> [?] Symptoms or signs involving the ear or mastoid process
--CHILD--> [MC40] Plugged feeling ear
|
[
"[AB52] Deafness not otherwise specified\n --PARENT--> [?] Disorders with hearing impairment\n --EXCLUDES--> [?] Otosclerosis\n Def: Otosclerosis is a genetically mediated metabolic bone disease that affects the otic capsule and stapes. It is an autosomal dominant disorder with varying penetrance and expressivity. Usually symptomat...",
"[AB52] Deafness not otherwise specified\n --PARENT--> [?] Disorders with hearing impairment\n --EXCLUDES--> [?] Otosclerosis\n Def: Otosclerosis is a genetically mediated metabolic bone disease that affects the otic capsule and stapes. It is an autosomal dominant disorder with varying penetrance and expressivity. Usually symptomat...",
"[QA00.7] Examination of ears and hearing\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --CHILD--> [QA00.2] Routine newborn health examination\n Def: Health examination for infant under 29 days of age...",
"[QA00.7] Examination of ears and hearing\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --EXCLUDES--> [?] Examination or encounter for administrative purposes",
"[MC4Y] Other specified symptoms or signs involving the ear or mastoid process\n --PARENT--> [?] Symptoms or signs involving the ear or mastoid process\n --CHILD--> [MC40] Plugged feeling ear",
"[MC4Y] Other specified symptoms or signs involving the ear or mastoid process\n --PARENT--> [?] Symptoms or signs involving the ear or mastoid process\n --CHILD--> [MC40] Plugged feeling ear"
] |
AB52
|
Deafness not otherwise specified
|
[
{
"from_icd11": "AB52",
"icd10_code": "H9190",
"icd10_title": "Unspecified hearing loss, unspecified ear"
},
{
"from_icd11": "AB52",
"icd10_code": "H9193",
"icd10_title": "Unspecified hearing loss, bilateral"
},
{
"from_icd11": "QA00.7",
"icd10_code": "Z011",
"icd10_title": "Encounter for examination of ears and hearing"
},
{
"from_icd11": "AB54",
"icd10_code": "H9113",
"icd10_title": "Presbycusis, bilateral"
},
{
"from_icd11": "AB54",
"icd10_code": "H9110",
"icd10_title": "Presbycusis, unspecified ear"
},
{
"from_icd11": "AB54",
"icd10_code": "H911",
"icd10_title": "Presbycusis"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H9192",
"icd10_title": "Unspecified hearing loss, left ear"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H9191",
"icd10_title": "Unspecified hearing loss, right ear"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H9011",
"icd10_title": "Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H918X3",
"icd10_title": "Other specified hearing loss, bilateral"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H918X9",
"icd10_title": "Other specified hearing loss, unspecified ear"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H918X2",
"icd10_title": "Other specified hearing loss, left ear"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H918X1",
"icd10_title": "Other specified hearing loss, right ear"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H9012",
"icd10_title": "Conductive hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side"
},
{
"from_icd11": "AB5Z",
"icd10_code": "H913",
"icd10_title": "Deaf nonspeaking, not elsewhere classified"
}
] |
H9190
|
Unspecified hearing loss, unspecified ear
|
She was 147 cm tall and weighed 35 kg. Before esophagectomy, her respiratory function was normal and her echocardiography indicated disappearance of secondary pulmonary hypertension and subsequent increased left ventricular preload (Table 1 ). Chest radiography and CT showed normalized lung fields , but postoperative intrathoracic adhesions were suspected. Her preoperative blood examination detected no abnormal values except for a slightly elevated plasma creatinine concentration of 1.02 mg/dL and decreased hemoglobin concentration of 9.8 g/dL. And white blood cell (WBC) counts was 4100 /μL, and serum C-reactive protein (CRP) level was 0.1 mg/dL. She was treated with immunosuppressive agents including 1.6 mg/day of tacrolimus (blood concentration was 6.0 ng/mL), 500 mg/day of mycophenolate mofetil, and 5 mg/day of prednisolone, with 0.625 mg/day of bisoprolol for the suppression of right heart function. On the morning of surgery, she was administered 500 mg of methylprednisolone intravenously for the prevention of rejection and relative adrenal insufficiency. In the operating room, a thoracic epidural catheter was placed at the level of the T9–T10 intervertebral space. Before anesthesia induction, arterial catheter was inserted and then phenylephrine infusion (0.25 μg/kg/min) was initiated to prevent hypotension induced by anesthetic agents. After oxygenation, general anesthesia was induced by continuous infusion of remifentanil (0.5 μg/kg/min), intravenous bolus administrations of propofol (20 mg), and rocuronium (30 mg). She was orotracheally intubated with a 35 French double-lumen endobronchial tube. Due to the significant incidence of complications on bronchial anastomosis, endobronchial tube was positioned with fiberoptic bronchoscopic guidance. After intubation, central venous catheter was inserted via left basilic vein and the monitoring of central venous pressure (CVP) was started. During induction and intubation, hemodynamic and respiratory status remained stable. She received pressure-controlled ventilation with a fraction of inspired oxygen (F I O 2 ) of 0.3–0.45, positive end-expiratory pressure (PEEP) of 5 cmH 2 O, peak inspiratory pressure (PIP) of less than or equal to 18 cmH 2 O, and respiratory rate (RR) of 10–18/min. During two-lung ventilation, the dynamic compliance (Cdyn) and the arterial oxygen tension to F I O 2 ratio (P/F) of her lungs were approximately 30 mL/cmH 2 O and more than 500, respectively, and the CVP was 4–8 mmHg. Anesthesia was maintained by desflurane (3.5 %) and remifentanil (0.5–0.7 μg/kg/min), with continuous epidural analgesia using 0.25 % levobupivacaine (4 mL/h). Phenylephrine (0.1–0.4 μg/kg/min) and noradrenaline (0.03–0.04 μg/kg/min) infusion were used to prevent hypotension and overhydration, and sivelestat infusion (0.4 mg/kg/h) and carperitide infusion (10 ng/kg/min) were used to reduce lung injury and extravascular lung water. She was placed in the left lateral position and thoracoscopic esophagectomy with radical lymph node dissection was started. One-lung ventilation and an artificial pneumothorax, insufflating with carbon dioxide gas (CO 2 ) to promote lung collapse, were started, and then the CVP increased to 12–18 mmHg. During the thoracic procedure, the Cdyn and P/F of her lung were 15–20 mL/cmH 2 O and 273–421, respectively, with PaCO 2 and serum lactate level elevated up to 63 mmHg and 2.7 mg/dL, respectively. Artificial pneumothorax was prolonged (396 min), because of extensive intrathoracic adhesions, and a pulmonary air leak persisted after the thoracic procedure. After that, two-lung ventilation was resumed, and she was placed in the lithotomy position for abdominal and cervical procedure. Her CVP decreased to 4–7 mmHg. Hand-assisted laparoscopic gastric mobilization was started, which increased the CVP to 10–12 mmHg, transiently. Then, the gastric conduit was anastomosed with the cervical esophagus via the posterior mediastinum and a jejunostomy tube was placed for enteral feeding. One hour before the completion of the surgery, desflurane was discontinued, propofol (4 mg/kg/h) was started, and remifentanil was reduced to 0.3 μg/kg/min. After the completion of the surgery, bronchoscopy and arterial blood gases confirmed the preservation of bronchial blood flow and pulmonary function, and maintenance anesthetics and phenylephrine were discontinued. She recovered from the anesthesia and her tracheal tube was removed. Duration of the surgery and anesthesia were 669 min and 760 min, respectively. Blood loss and urine volume during anesthesia were 217 mL and 775 mL, respectively. We infused with 550 mL of 6 % hydroxyethyl starch 130/0.4 solution, 500 mL of amino acid solution, 650 mL of saline, and 120 mL of acetated Ringer’s solution during anesthesia. At the completion of the surgery, her serum creatinine and lacate values were 1.4 mg/dL and 2.1 mg/dL. Subsequently, she was transferred to the intensive care unit with continuous epidural analgesia of 4 mL/h of levobupivacaine 0.25 % + fentanyl 2.5 μg/mL and patient controlled epidural analgesia of bolus 3 mL (30-min lock out). Fig. 2 Chest radiography ( a ) and computed tomography ( b ) images of the patient before minimally invasive esophagectomy. a Normalized lung fields, and sternal wires and marking clips on mediastinal field are seen. b Normalized lung fields and marking clips on the esophagus are seen
| 4.054688
| 0.95459
|
sec[1]/p[2]
|
en
| 0.999996
|
29497670
|
https://doi.org/10.1186/s40981-016-0041-x
|
[
"lung",
"anesthesia",
"blood",
"infusion",
"respectively",
"mmhg",
"epidural",
"tube",
"pressure",
"ventilation"
] |
[
{
"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": "MB40.3",
"title": "Anaesthesia of skin"
},
{
"code": "9A78.6",
"title": "Anaesthesia of cornea"
},
{
"code": "MG30.5Z",
"title": "Chronic neuropathic pain, unspecified"
},
{
"code": "JA67.Z",
"title": "Complications of anaesthesia during pregnancy, unspecified"
},
{
"code": "JB43.Z",
"title": "Complications of anaesthesia during the puerperium, unspecified"
}
] |
=== 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
[MB40.3] Anaesthesia of skin
Definition: Partial or complete loss of sensation affecting the skin, most commonly affecting a circumscribed area and resulting from sensory nerve damage as from injury or leprosy.
Also known as: Anaesthesia of skin | Hypoaesthesia of skin | Loss of cutaneous sensation | Numbness of skin | Loss of sensation
Includes: Numbness of skin
[9A78.6] Anaesthesia of cornea
Definition: This is the condition of having sensation (including the feeling of pain) blocked or temporarily taken away, of the transparent front part of the eye that covers the iris, pupil, and anterior chamber.
Also known as: Anaesthesia of cornea | corneal anaesthesia
[MG30.5Z] Chronic neuropathic pain, unspecified
Also known as: Chronic neuropathic pain, unspecified | Chronic neuropathic pain | anaesthesia dolorosa | neuralgia | chronic neurogenic pain (deprecated)
[JA67.Z] Complications of anaesthesia during pregnancy, unspecified
Also known as: Complications of anaesthesia during pregnancy, unspecified | Complications of anaesthesia during pregnancy
[JB43.Z] Complications of anaesthesia during the puerperium, unspecified
Also known as: Complications of anaesthesia during the puerperium, unspecified | Complications of anaesthesia during the puerperium
=== GRAPH WALKS ===
--- Walk 1 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--CHILD--> [CB40.0] Ciliary dyskinesia
Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l...
--- Walk 2 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--CHILD--> [CB40.1] Young syndrome
Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....
--- Walk 3 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies of the respiratory system
--- Walk 4 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.1] 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--> [?] 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....
|
[
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.0] Ciliary dyskinesia\n Def: Defective function of the cilia lining the respiratory tract (lower and upper, sinuses, Eustachian tube, middle ear) resulting in altered mucociliary transport and manifesting as recurrent upper and l...",
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --CHILD--> [CB40.1] Young syndrome\n Def: Young syndrome is characterised by the association of obstructive azoospermia with recurrent sinobronchial infections....",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the respiratory system",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.1] 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--> [?] 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...."
] |
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 African American male with beta-thalassemia minor, diabetes mellitus, and hypertension was diagnosed with IgG Kappa multiple myeloma (MM) in 2008 after a minor mechanical fall resulted in a right femur fracture. His X-rays showed multiple lytic lesions of the right femur. Labs at diagnosis were significant for microcytic anemia with a hemoglobin of 12.3 g/dL and a mean corpuscular volume (MCV) of 67 fL, normal white blood cells (WBC) and platelet counts, an M-spike of 3.9 g/dL on his serum protein electrophoresis (SPEP) with the immunofixation significant for a monoclonal IgG Kappa, and a high Kappa/Lambda ratio. There was 70% involvement of the bone marrow with plasma cells and the cytogenetic analysis was significant for male karyotype with trisomy of chromosome 3 and deletion of Y chromosome in 4 out of 20 cells. The patient was treated with radiation to his femur after an orthopedic procedure and this was followed by five cycles of lenalidomide 25 mg daily on days 1–21 and dexamethasone 40 mg daily on days 1, 8, 15, and 22 every 4 weeks followed by bortezomib 1.3 mg/m 2 on days 1, 4, 8, and 11 every 3 weeks. The patient achieved stable disease with this regimen and he received no further treatment for almost four years. Meanwhile, he was being followed up regularly with clinical and laboratory assessments, serial serum protein electrophoresis with immunofixation, and free light chains. In 2012, four years after his initial diagnosis and treatment, the patient was found to have a relapse of his MM with an increase in his M-spike to >2 g/dL. Labs showed hemoglobin of 9.5 g/dL, WBC of 11.2 × 10 3 /mm 3 with a normal differential except for slightly elevated eosinophils, and platelet count of 509 × 10 3 /mm 3 . Skeletal survey showed increase in his myeloma lytic bone lesions. A bone marrow aspirate and biopsy was done which demonstrated a hypercellular marrow with trilineage hematopoiesis, increased myeloid cell series (M : E ratio 4 : 1) with eosinophilia, and 15–20% monoclonal plasmacytosis based on CD138 immunostaining . The cytogenetics showed 46 XY t(9;22) (q34;q11.2) in 8 out of 15 cells and the fluorescent in situ hybridization (FISH) was consistent with BCR/ABL translocation in 72.8% of cells. Interestingly, no trisomy of chromosome 3 or deletion of Y chromosome was detected in the cells examined—which could be explained by their low levels and the small number of metaphases examined. It was decided to control the patient's myeloma first prior to starting a tyrosine kinase inhibitor (TKI) for his CML as there was evidence of an aggressive myeloma progression with the sudden increase in his bony lesions, while his WBC was normal at the time. He was started again on lenalidomide 25 mg every 3 weeks and dexamethasone 20 mg weekly. Three months later, the patient presented with symptoms of fatigue, malaise, abdominal discomfort, and generalized weakness. The M spike was 1.8 g/dL, WBC count 42.7 10 3 /mm 3 , and platelet count of 2472 10 3 /mm 3 . There was an increased number of myelocytes, metamyelocytes, bands, mature neutrophils with rare blasts (approximately 1% of total cells), and increased basophils (4.2%). He underwent a bone marrow aspirate and biopsy that showed a hypercellular bone marrow with significantly increased myeloid progenitor population with a blast count of 37% in background of a myeloproliferative disorder, favoring transformation to acute myeloid leukemia . Unfortunately, the initial bone marrow biopsy from his MM diagnosis was not available to be examined for CML. A diagnosis of chronic myeloid leukemia in blast phase was made and cytoreductive treatment was started with hydration and hydroxyurea (up to 4 g/days) and subsequently he was started on dasatinib 140 mg daily. The patient reached major molecular response four months after treatment and complete molecular response four months after that. He was kept on maintenance treatment with dasatinib 100 mg daily. The treatment for the MM with lenalidomide was stopped when the patient presented in blast crisis. In 3 months, the patient had a quick progression of multiple myeloma with an increase of his M-spike to 2.5 g/dL and new diffuse lytic bone lesions. Treatment with weekly bortezomib 0.7 mg/m 2 which was later increased to 1.3 mg/m 2 weekly and dexamethasone 20 mg on days 1, 4, 8, and 11 of a 21-day cycle was restarted, concurrent with dasatinib. The patient tolerated the treatment combination of bortezomib and dasatinib well. He continued to show complete molecular response of his CML and he initially showed a good response of his MM as his M-spike stabilized around 1.9 g/dL transiently before increasing back to 2.3 g/dL again. One year from the start of dasatinib, the patient had an acute myocardial infarction. Dasatinib was continued while bortezomib and dexamethasone were discontinued which resulted in an improvement in his anemia while his M-spike remained stable. About five months later, he was admitted with pulmonary artery hypertension (PAH) with a mean pulmonary arterial pressure of 50–55 mm Hg on right heart catheterization. It was assumed that this was due to either the dasatinib or a diet pill that he admitted to taking over the counter or due to a combination of his comorbidities. Although dasatinib was stopped, he eventually succumbed to respiratory failure due to PAH 18 months after his CML diagnosis.
| 4.175781
| 0.96582
|
sec[1]/p[0]
|
en
| 0.999997
|
25544920
|
https://doi.org/10.1155/2014/962526
|
[
"dasatinib",
"cells",
"bone",
"spike",
"marrow",
"myeloma",
"lesions",
"chromosome",
"daily",
"dexamethasone"
] |
[
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "FB84.Z",
"title": "Osteomyelitis or osteitis, unspecified"
},
{
"code": "FB80.Z",
"title": "Disorder of bone density or structure, unspecified"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
},
{
"code": "FB86.1Z",
"title": "Bone hyperplasias, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS
[FB84.Z] Osteomyelitis or osteitis, unspecified
Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease
[FB80.Z] Disorder of bone density or structure, unspecified
Also known as: Disorder of bone density or structure, unspecified | Certain specified disorders of bone density or structure
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
[FB86.1Z] Bone hyperplasias, unspecified
Also known as: Bone hyperplasias, unspecified | Bone hyperplasias
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--CHILD--> [MF91] Bilirubinuria
Def: Bilirubinuria means the presence of any bile pigment in the urine....
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system
--- 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
--PARENT--> [5C56.2] Glycoproteinosis
Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....
--CHILD--> [5C56.2Y] Other specified glycoproteinosis
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.0] Sickle cell trait
Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF91] Bilirubinuria\n Def: Bilirubinuria means the presence of any bile pigment in the urine....",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Symptoms, signs or clinical findings of the genitourinary system",
"[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 --PARENT--> [5C56.2] Glycoproteinosis\n Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....\n --CHILD--> [5C56.2Y] Other specified glycoproteinosis",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.0] Sickle cell trait\n Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ..."
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "FC0Z",
"icd10_code": "XIII",
"icd10_title": ""
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86672",
"icd10_title": "Other chronic osteomyelitis, left ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86172",
"icd10_title": "Other acute osteomyelitis, left ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86171",
"icd10_title": "Other acute osteomyelitis, right ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86671",
"icd10_title": "Other chronic osteomyelitis, right ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X7",
"icd10_title": "Other osteomyelitis, ankle and foot"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X8",
"icd10_title": "Other osteomyelitis, other site"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X6",
"icd10_title": "Other osteomyelitis, lower leg"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M868X9",
"icd10_title": "Other osteomyelitis, unspecified sites"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M8668",
"icd10_title": "Other chronic osteomyelitis, other site"
},
{
"from_icd11": "FB84.Z",
"icd10_code": "M86662",
"icd10_title": "Other chronic osteomyelitis, left tibia and fibula"
}
] |
D571
|
Sickle-cell disease without crisis
|
The male infant was born at term by spontaneous vaginal delivery after a normal pregnancy. The child appeared well initially, but, within hours, experienced hypotonia and severe respiratory distress. He was immediately transferred to the neonatal intensive care unit where he was intubated for surfactant administration with little benefit. Routine laboratory testing revealed markedly elevated serum levels of total calcium corrected to albumin levels ( adj Ca, 3.75 mmol/L; normal range for age 2.10–2.55 mmol/L), ionized calcium (Ca 2+ , 1.96 mmol/L, normal range for age 1.13–1.32 mmol/L) and PTH (700 pg/mL; normal range for age 10.0–65.0 pg/mL). Other biochemical data were creatinine 0.16 mg/dl (normal range for age 0.31–0.88), phosphate 4.2 mg/dl (normal range for age 4.5–6.7 mg/dl), magnesium 2.5 mg/dl (normal range for age 1.8–2.4 mg/dl), alkaline phosphatase 363 U/l (normal range for age 100–400 U/l), 24-h urine calcium (24 hUCa) 34 mg/24 h. Both parents had calcium levels within the normal range and were unrelated, moreover the family history was unremarkable. NSHPT was confirmed by the finding of a previously reported heterozygous CaSR missense mutation at nucleotide position 554 (c.554G > A) in exon 4, leading to a substitution of arginine by glutamine at codon 185 [p.(Arg185Gln)] ( 14 – 17 ). This mutation was absent in both parents indicating a de novo mutation. For the management of the hypercalcemia, the patient initially received intravenous fluids and furosemide without significant improvement. Therefore, at 3 weeks of age , the patient underwent exploratory neck surgery with the aim of performing a subtotal parathyroidectomy. Pre-surgery parathyroid ultrasound showed two hypoechoic nodules of 3 and 4 mm compatible with lower parathyroids but only one hypercellulated parathyroid gland (left superior) without cellular atypia was removed. For the persistence of symptomatic hypercalcemia, after obtaining informed consent from the parents, cinacalcet was started (initially 20 mg/m 2 /day divided in two oral doses). Cinacalcet treatment led to reductions in both serum concentrations of adj Ca and Ca 2+ (3.1 and 1.55 mmol/L, respectively) with consequent clinical improvement. During hospitalization, cinacalcet was gradually increased up to 115 mg/m 2 /day divided into 2 doses until the calcium levels stabilized within the high-normal range. The only side effect that occurred was vomiting, progressively improved over time and definitively resolved with co-administration of thickened milk. The patient was discharged home at 5 months of life . During subsequent outpatient visits, therapy was gradually increased to maintain the daily dosage around 6–6.5 mg/kg/day with optimal biochemical control. The patient, previously evaluated elsewhere, came to our attention at the age of 2 . At that time, his therapy was cinacalcet 60 mg/day divided into 2 doses (6.1 mg/kg/day) with an adj Ca of 2.5 mmol/l, Ca 2+ 1.38 mmol/l (normal: 1.13–1.32 mmol/l), PTH 22.1 pg/ml (normal: 6.5–36.8 pg/ml) and 25-hydroxyvitamin D 27 ng/ml (25OHD, normal: 30–120 ng/ml) . The child presented normal motor, intellectual and relational abilities but parents complained about poor appetite and nausea in their son. The patient's weight and length-for-age were at the lower growth percentiles . Tests of thyroid function, growth hormone and celiac disease were unremarkable. An attempt to reduce the cinacalcet dose was performed with subsequent poor biochemical control and no improvement in gastrointestinal symptoms . A diet that provided the age-recommended daily amount of calcium was set and the patient was supplemented with cholecalciferol in order to normalize 25OHD levels. The patient was successfully and safely managed with cinacalcet through 8 years, with medical and biochemical controls every 6–12 months . During the course of this treatment, adj Ca and PTH levels were maintained close to the normal limits in the absence of specific symptoms of hypercalcemia , with progressive improvement in the auxologic parameters . However, from 6 years of age, the patient complained progressive increase in nausea and difficulties in taking tablets twice-daily. In consideration of these adverse symptoms and of the poor knowledge of the long-term effects of cinacalcet in children, parathyroid surgery was re-evaluated as definitive therapy. Finally, at 8 years of age , a new exploratory surgery of the neck was performed. The pre-surgery neck ultrasound showed a 20 mm right lesion compatible with a parathyroid gland. The surgical operation was challenging for the presence of multiple adhesions related to previous excision. A subtotal PTx was performed with removal of one hypercellulated parathyroid gland (right superior, 9 mm) without cellular atypia. Two days after surgery the patient developed asymptomatic hypocalcemia treated with calcium, calcitriol and cholecalciferol supplements. Surgery was complicated by transient bilateral recurrent laryngeal nerves injury, with bilateral median vocal cord paresis that completely recovered in 6 weeks after speech therapy. At 2 months from surgery, nausea was no longer present, appetite improved and the patient gained 1.3 kg. At 2 years follow up , hypoparathyroidism was permanent but therapeutic compliance was excellent with no hypocalcemic symptoms and no difficulties in taking calcium and calcitriol supplements.
| 4.203125
| 0.955078
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC8818680
|
https://doi.org/10.3389/fmed.2021.809067
|
[
"range",
"calcium",
"mmol",
"cinacalcet",
"parathyroid",
"biochemical",
"parents",
"improvement",
"that",
"initially"
] |
[
{
"code": "QA00.6Y",
"title": "Other specified examination of eyes or vision"
},
{
"code": "4B00.0Z",
"title": "Neutropaenia, unspecified"
},
{
"code": "3B63.1Z",
"title": "Acquired thrombocytosis, unspecified"
},
{
"code": "MA14.1C",
"title": "Raised antibody titre"
},
{
"code": "BD11.1",
"title": "Left ventricular failure with mid range ejection fraction"
},
{
"code": "5B5K.1Z",
"title": "Calcium deficiency, unspecified"
},
{
"code": "5B91.0",
"title": "Hypercalcaemia"
},
{
"code": "5B5K.1Y",
"title": "Other specified calcium deficiency"
},
{
"code": "5C64.5",
"title": "Disorders of calcium metabolism"
},
{
"code": "FB40.Y",
"title": "Other specified tenosynovitis"
}
] |
=== ICD-11 CODES FOUND ===
[QA00.6Y] Other specified examination of eyes or vision
Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia
[4B00.0Z] Neutropaenia, unspecified
Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range
[3B63.1Z] Acquired thrombocytosis, unspecified
Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia
[MA14.1C] Raised antibody titre
Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre
Excludes: isoimmunization, in pregnancy affecting fetus or newborn
[BD11.1] Left ventricular failure with mid range ejection fraction
Also known as: Left ventricular failure with mid range ejection fraction | HFmEF - [heart failure with mid range ejection fraction] | Left ventricular failure with mid range ejection fraction due to cardiomyopathy | Left ventricular failure with mid range ejection fraction due to coronary artery disease | Left ventricular failure with mid range ejection fraction due to myocarditis
[5B5K.1Z] Calcium deficiency, unspecified
Also known as: Calcium deficiency, unspecified | Calcium deficiency | hypocalcaemia NOS | disturbance of calcium absorption | disorder of calcium absorption
[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
[5B5K.1Y] Other specified calcium deficiency
Also known as: Other specified calcium deficiency | Dietary hypocalcaemia | dietary calcium deficiency
[5C64.5] Disorders of calcium metabolism
Definition: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important consequences for health.
Also known as: Disorders of calcium metabolism | Calcinosis | general calcification | heterotopic calcification | metastatic calcification
Excludes: Hyperparathyroidism | Chondrocalcinosis
[FB40.Y] Other specified tenosynovitis
Also known as: Other specified tenosynovitis | Other tenosynovitis or tendinitis | synovitis NOS | Bicipital tendinitis | biceps tendinitis
=== GRAPH WALKS ===
--- Walk 1 ---
[QA00.6Y] Other specified examination of eyes or vision
--PARENT--> [QA00.6] Examination of eyes or vision
--CHILD--> [QA00.61] Normal Visual Field
--- Walk 2 ---
[QA00.6Y] Other specified examination of eyes or vision
--PARENT--> [QA00.6] Examination of eyes or vision
--EXCLUDES--> [?] Examination for driving license
--- Walk 3 ---
[4B00.0Z] Neutropaenia, unspecified
--PARENT--> [4B00.0] Neutropenia
--RELATED_TO--> [?] Transient neonatal neutropaenia
Def: Neonatal neutropaenia can be due to underproduction of the marrow (e.g. hypoxemia due to placental insufficiency, congenital viral disease) or excessive utilization of white blood cells (bacterial sep...
--- Walk 4 ---
[4B00.0Z] Neutropaenia, unspecified
--PARENT--> [4B00.0] Neutropenia
--CHILD--> [4B00.0Z] Neutropaenia, unspecified
--- Walk 5 ---
[3B63.1Z] Acquired thrombocytosis, unspecified
--PARENT--> [3B63.1] Acquired thrombocytosis
Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...
--CHILD--> [3B63.10] Secondary thrombocytosis
--- Walk 6 ---
[3B63.1Z] Acquired thrombocytosis, unspecified
--PARENT--> [3B63.1] Acquired thrombocytosis
Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...
--CHILD--> [3B63.10] Secondary thrombocytosis
|
[
"[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --CHILD--> [QA00.61] Normal Visual Field",
"[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license",
"[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --RELATED_TO--> [?] Transient neonatal neutropaenia\n Def: Neonatal neutropaenia can be due to underproduction of the marrow (e.g. hypoxemia due to placental insufficiency, congenital viral disease) or excessive utilization of white blood cells (bacterial sep...",
"[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --CHILD--> [4B00.0Z] Neutropaenia, unspecified",
"[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.10] Secondary thrombocytosis",
"[3B63.1Z] Acquired thrombocytosis, unspecified\n --PARENT--> [3B63.1] Acquired thrombocytosis\n Def: A chronic myeloproliferative neoplasm that involves primarily the megakaryocytic lineage. It is characterised by sustained thrombocytosis in the blood, increased numbers of large, mature megakaryocyte...\n --CHILD--> [3B63.10] Secondary thrombocytosis"
] |
QA00.6Y
|
Other specified examination of eyes or vision
|
[
{
"from_icd11": "3B63.1Z",
"icd10_code": "D473",
"icd10_title": "Essential (hemorrhagic) thrombocythemia"
},
{
"from_icd11": "MA14.1C",
"icd10_code": "R760",
"icd10_title": "Raised antibody titer"
},
{
"from_icd11": "5B5K.1Z",
"icd10_code": "E58",
"icd10_title": "Dietary calcium deficiency"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8352",
"icd10_title": "Hypercalcemia"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8351",
"icd10_title": "Hypocalcemia"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8359",
"icd10_title": "Other disorders of calcium metabolism"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8350",
"icd10_title": "Unspecified disorder of calcium metabolism"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E835",
"icd10_title": "Disorders of calcium metabolism"
}
] |
D473
|
Essential (hemorrhagic) thrombocythemia
|
An 8-year-old Han Chinese girl was referred to our Sichuan Provincial People’s Hospital due to exotropia and diminished vision. Ophthalmologic evaluation revealed her best-corrected visual acuity to be 0.04 in her right eye (OD) with −1.50 defocus curve (DC) × 170° and 1.0 OS with −0.50DC × 175°. Intraocular pressure measured 11.2 mmHg in the right eye and 8.6 mmHg (1 mmHg = 0.133 kPa) in the left eye. She exhibited external strabismus in the right eye, but no ptosis or nystagmus was noted. The pupil diameter was 3 mm, it was reactive to light without iris defects, and both lenses and vitreous were normal. Fundus examination and photography indicated extensive choroidal colobomas affecting the macular in the right eye, with two distinct retinal vascular systems noted above the defect; a pseudo-double optic disc was observed in the left eye. The pseudo-optic disc, located approximately 6.5 mm beneath the true optic disc, was fed by a venous vessel from the nasal retina, accompanied by a distinct circular choroidal defect. B-ultrasound and orbital magnetic resonance imaging confirmed the presence of a single optic nerve in both eyes. UWF-SS-OCTA (VG200D, Intalight, Luoyang, China) and OCT analyses provided detailed insights into the double optic disc, allowing measurements of the colobomas’ dimensions in the right eye and revealing a thinning nerve fiber layer around the pseudo-optic disc, even getting though the optic disc, which showed the nerve breaking off and deep blood flow imaging. The left eye displayed a normal macular, but in the right eye, there was a partially developed macular fovea at the edge of the coloboma. Fundus fluorescein angiography (FFA) indicated the right eye’s optic disc of choroidal colobomas emitting two main arteries upwards and two below, with an arterial vessel connecting the two discs. The left eye’s inferior nasal retinal vein was observed converging into the pseudo-optic disc. No systemic abnormalities such as deafness, mental retardation, microtia, or skeletal anomalies were identified. The family denied any genetic or familial history. The diagnosis was uveal colobomas with pseudo-duplication of the optic disc in both eyes. This study received approval from the Ethics Committee of Sichuan Provincial People’s Hospital and complied with the Declaration of Helsinki. Fig. 1 Fundus photography of the right eye ( A ) and the left eye ( B ) Fig. 2 MRI ( A ) and B-ultrasound ( B ) of the eye showing a single optic nerve connected to both eyes Fig. 3 UWF-SS-OCTA image of the right eye fundus (29 mm × 24 mm). A (1) depicts the retinal nerve fiber layer as bundles descending through the upper optic disc, with blood flow signal (arrowhead) at the deep part of the optic disc. A (2) shows the B-scan image through the macula, featuring a central fovea structure (arrowhead); however, the macular area is at the margin of the colobomas and is partially affected. A (3) presents the B-scan image through the lower optic disc, where the star symbol denotes the detachment of the nerve fiber layer from the underlying sclera, and the arrow points to the thinning of the nerve fiber layer in an outward shape; the structure below the optic disc appears disordered. B En-face scan of the choroidal colobomas; B (1) shows a B-scan image through both optic discs, displaying the architecture of the optic tract in the upper optic disc, and a defective cavity area under the depression structure of the lower optic disc Fig. 4 UWF-SS-OCTA image of the left eye, with B-scan images displayed in Fig. A (1–6); A (1) depicts the true optic disc, where the arrow highlights the optic nerve fiber bundles and deep blood flow signals; A (2) shows a B-scan image through the structurally intact macular area, with the arrow indicating the macular fovea; A (3) illustrates the choroidal defect area, where the choroidal layer is absent, yet the sclera remains intact, with the retina closely adhering to the sclera; A (4) presents a B-scan though the pseudo-optic disc, with the star marking a defect area encased by the sclera; A (5) features a B-scan highlighting the thin optic nerve fiber layer and detachment, without any optic tract-like structures, showing a star-marked defect area and the sclera indicated by an arrow; A (6) displays a B-scan below the pseudo-optic disc, with the star denoting a defect area within the layered sclera. B Enface structure diagram of the left eye, where B (1) captures a B-scan image of the two optic discs, with the arrow pointing to the optic nerve fibers and an ectatic coloboma beneath the pseudo-optic disc, resembling an inverted “Ω” shape Fig. 5 A shows the arterial phase of fundus fluorescein angiography in the right eye, with the 12-second image revealing the lower optic disc emitting inferiorly and superiorly, the upper vessel supply projecting the main superior temporal arteries, and a vessel bridging the two optic discs. B illustrates the right eye’s fluorescent contrast arteriovenous phase at 27 seconds, featuring upper and lower vascular systems. C and D depict the arteriovenous phase of fluorescein fundus imaging in the left eye at 8 seconds and 5 minutes 16 seconds, respectively, showing the upper optic disc emitting to the upper temporal and nasal branches, and the infranasal and infratemporal branches, with the vessels of the lateral nasal vein converging into the pseudo-optic disc
| 4.125
| 0.950684
|
sec[1]/p[0]
|
en
| 0.999997
|
39129019
|
https://doi.org/10.1186/s13256-024-04676-z
|
[
"optic",
"disc",
"nerve",
"scan",
"pseudo",
"area",
"fundus",
"choroidal",
"colobomas",
"macular"
] |
[
{
"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": "FB1Y",
"title": "Other specified conditions associated with the spine"
},
{
"code": "LA13.73",
"title": "Optic disc dysplasia"
},
{
"code": "LA13.7Z",
"title": "Congenital malformation of optic disc, unspecified"
},
{
"code": "FA80.9",
"title": "Intervertebral disc degeneration of lumbar spine with prolapsed disc"
},
{
"code": "8C1Z",
"title": "Mononeuropathy of unspecified site"
}
] |
=== ICD-11 CODES FOUND ===
[9C40.BZ] Optic atrophy, unspecified
Also known as: Optic atrophy, unspecified | Optic atrophy | optic nerve atrophy | Primary optic atrophy | OA - [optic atrophy]
[9C40.Z] Disorder of the optic nerve, unspecified
Also known as: Disorder of the optic nerve, unspecified | Disorder of the optic nerve | disease of optic cranial nerve | disease of optic nerve | disease of second cranial nerve
[9C40.1Y] Other specified optic neuritis
Also known as: Other specified optic neuritis | Idiopathic inflammatory optic neuropathy | Idiopathic demyelinating optic neuropathy | optic nerve inflammation | optic nerve neuropathy
[9C40.B0] Congenital optic atrophy
Also known as: Congenital optic atrophy
[9C40.Y] Other specified disorder of the optic nerve
Also known as: Other specified disorder of the optic nerve | Nutritional optic neuropathy | nutritional amblyopia | Toxic optic neuropathy | Haemorrhage in optic nerve sheath
[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
[LA13.73] Optic disc dysplasia
Definition: deformed optic discs that fail to conform to any recognizable diagnostic category
Also known as: Optic disc dysplasia
[LA13.7Z] Congenital malformation of optic disc, unspecified
Also known as: Congenital malformation of optic disc, unspecified | Congenital malformation of optic disc | Congenital malformation of optic disc, not otherwise specified | anomaly of optic disc | cavity of optic papilla
[FA80.9] Intervertebral disc degeneration of lumbar spine with prolapsed disc
Also known as: Intervertebral disc degeneration of lumbar spine with prolapsed disc | lumbar disc prolapse NOS
Excludes: Intervertebral disc degeneration of lumbar spine with nervous system involvement
[8C1Z] Mononeuropathy of unspecified site
Also known as: Mononeuropathy of unspecified site | inflammation of nerve NOS | nerve condition NOS | neuritis NOS | nerve disease NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[9C40.BZ] Optic atrophy, unspecified
--PARENT--> [9C40.B] Optic atrophy
Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...
--CHILD--> [9C40.BZ] Optic atrophy, unspecified
--- Walk 2 ---
[9C40.BZ] Optic atrophy, unspecified
--PARENT--> [9C40.B] Optic atrophy
Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...
--RELATED_TO--> [?] Leber hereditary optic neuropathy
Def: Optic nerve disorders caused by mutations in mitochondrial DNA...
--- Walk 3 ---
[9C40.Z] Disorder of the optic nerve, unspecified
--PARENT--> [9C40] Disorder of the optic nerve
--CHILD--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--- Walk 4 ---
[9C40.Z] Disorder of the optic nerve, unspecified
--PARENT--> [9C40] Disorder of the optic nerve
--RELATED_TO--> [?] Injury of optic nerve, unilateral
--- Walk 5 ---
[9C40.1Y] Other specified optic neuritis
--PARENT--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--PARENT--> [9C40] Disorder of the optic nerve
--- Walk 6 ---
[9C40.1Y] Other specified optic neuritis
--PARENT--> [9C40.1] Optic neuritis
Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...
--CHILD--> [9C40.1Z] Optic neuritis, unspecified
|
[
"[9C40.BZ] Optic atrophy, unspecified\n --PARENT--> [9C40.B] Optic atrophy\n Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...\n --CHILD--> [9C40.BZ] Optic atrophy, unspecified",
"[9C40.BZ] Optic atrophy, unspecified\n --PARENT--> [9C40.B] Optic atrophy\n Def: Optic atrophies (OA) refer to a specific group of hereditary optic neuropathies in which the cause of the optic nerve dysfunction is inherited either in an autosomal dominant or autosomal recessive pa...\n --RELATED_TO--> [?] Leber hereditary optic neuropathy\n Def: Optic nerve disorders caused by mutations in mitochondrial DNA...",
"[9C40.Z] Disorder of the optic nerve, unspecified\n --PARENT--> [9C40] Disorder of the optic nerve\n --CHILD--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...",
"[9C40.Z] Disorder of the optic nerve, unspecified\n --PARENT--> [9C40] Disorder of the optic nerve\n --RELATED_TO--> [?] Injury of optic nerve, unilateral",
"[9C40.1Y] Other specified optic neuritis\n --PARENT--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...\n --PARENT--> [9C40] Disorder of the optic nerve",
"[9C40.1Y] Other specified optic neuritis\n --PARENT--> [9C40.1] Optic neuritis\n Def: Optic neuritis is a condition related to immune mediated inflammation of the optic nerve. It is commoner in women and can be the first presenting symptom of MS. The symptoms are those of blurred visio...\n --CHILD--> [9C40.1Z] Optic neuritis, unspecified"
] |
9C40.BZ
|
Optic atrophy, unspecified
|
[
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47213",
"icd10_title": "Primary optic atrophy, bilateral"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47291",
"icd10_title": "Other optic atrophy, right eye"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47292",
"icd10_title": "Other optic atrophy, left eye"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H4720",
"icd10_title": "Unspecified optic atrophy"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H4722",
"icd10_title": "Hereditary optic atrophy"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H47239",
"icd10_title": "Glaucomatous optic atrophy, unspecified eye"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H472",
"icd10_title": "Optic atrophy"
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H48",
"icd10_title": ""
},
{
"from_icd11": "9C40.BZ",
"icd10_code": "H480",
"icd10_title": ""
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47012",
"icd10_title": "Ischemic optic neuropathy, left eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47099",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47091",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, right eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47093",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, bilateral"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47019",
"icd10_title": "Ischemic optic neuropathy, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47013",
"icd10_title": "Ischemic optic neuropathy, bilateral"
}
] |
H47213
|
Primary optic atrophy, bilateral
|
In January 2019, in the context of severe pneumonia due to Influenza A (H1N1) virus infection, ongoing for 4 days, he developed hyperacute (onset in a few minutes) left peripheral facial palsy with prominent lower half predominance, dysphagia, dysphonia, cervical flexion paresis, sensory-motor dysfunction of the left arm and global worsening of his right leg motor deficit (now also affecting plantar flexion and knee extension), mimicking multifocal embolic and/or brainstem stroke . He was rapidly admitted in the emergency room and received full stroke protocol, including urgent cranial computer tomography (CT) scan and angio-CT, without any evidence of acute brain lesions. After 72 h, brain magnetic resonance imaging (MRi) was carried out, definitively excluding acute vascular injuries. CSF analysis was unremarkable, revealing no albuminocytologic dissociation. NCS/EMG were performed 9 days after the onset of the acute neurological dysfunction, confirming the neuropathic nature and revealing a new relapse, with electrophysiological criteria for asymmetric CIDP with bilateral facial involvement, with markedly increased facial distal motor latencies (DML), worse on the left as show in Tables 1 and 2 . The MRI images were reviewed and no signal changes of the cranial nerves were reported, although the absence of thin cuts of the infratentorial region limited cranial nerve assessment. He reached a minimum iRODS score of 07/48 during the peak of this relapse, indicating severe clinical disability. The patient was promptly started on oseltamivir on the first day of admission upon laboratorial confirmation of H1N1 virus RNA in the serum. Fortunately, improvement was noted soon after treatment initiation and the patient was able to eat small portions of pasty diet on day 2. The relapse episode swiftly evolved favorably in the following days almost returning to his basal condition after 6 days . The patient greatly recovered of the acute neurological deficits presented at admission, even without the use of IVIg, steroids or other immunomodulatory therapies, which were not started due to the favorable clinical course. His iRODS score greatly improved to 42/48 at the 3rd month of follow-up, although not fully to the previous status, and remains stable after 1 year . Fig. 1 Peripheral left facial nerve palsy at admision Table 1 Motor Nerve Conduction Studies Before and After Influenza A Infection Before H1N1 infection After H1N1 infection (after 9 days) Nerve DML AMP CV Δ AMP DML AMP CV Δ AMP Left Zygomatic NP NP 12.80 ms a 0.24 mV Right Zygomatic NP NP 5.63 ms a 1.97 mV Left Mandibular NP NP 12.10 ms a 0.34 mV Right Mandibular NP NP 3.61 ms a 2.10 mV Left Median Motor Nerve Wrist-APB 3.10 ms 2.4 mV 3.42 ms 1.87 mV Antecubital fossa-Wrist 14.2 ms 0.56 mV 21.6 m/s −76.7% 13.90 ms 0.58 mV 21.9 m/s −69.0% Right Median Motor Nerve Wrist-ABP 2.9 ms 9.2 mV 2.73 ms 9.5 mV Antecubital fossa-Wrist 9.5 ms 4.2 mV 37.1 m/s −54.3% 8.44 ms 6.1 mV 42.0 m/s −35.8% Left Ulnar Motor Nerve Wrist-ADM 2.03 ms 11.1 mV 2.72 ms 12.4 mV Bellow elbow-Wrist 8.25 ms 3.8 mV 37.0 m/s − 65.8% 9.02 ms 4.9 mV 36.5 m/s − 60.5% Above elbow-Bellow elbow 10.9 ms 3.2 mV 54.7 m/s −15.8% 11.00 ms 4.8 mV 50.5 m/s −2.0% Right Ulnar Motor Nerve Wrist-ADM 2.20 ms 15.1 mV 2.00 ms 13.5 mV Bellow elbow-Wrist 8.20 ms 9.2 mV 64.5 m/s −39.1% 5.85 ms 11.0 mV 58.4 m/s −18.5% Above elbow-Bellow elbow 6.0 ms 9.0 mV 59.1 m/s −2.2% 7.69 ms 10.8 mV 55.4 m/s −1.8% Left Tibial Motor Nerve Ankle-AH 3.78 ms 17.2 mV 3.97 ms 16.2 mV Popliteal Fossa-Ankle 11.4 ms 9.1 mV 51.8 m/s −47.1% 11.80 ms 10.0 mV 47.3 m/s −38.3% Right Tibial Motor Nerve Ankle-AH 4.62 ms 8.3 mV 5.89 ms 11.5 mV Popliteal Fossa-Ankle 14.2 ms 3.8 mV 40.7 m/s −54.2% 14.90 ms 4.2 mV 43.3 m/s −63.5% Left Deep Peroneal Motor Nerve Ankle-EDB 3.82 ms 0.41 mV 6.52 ms 0.91 mV Right Deep Peroneal Motor Nerve Ankle-EDB 0.00 ms 0.00 mV 0.00 ms 0.00 mV Since the criteria for demyelinating polyneuropathy with conduction blocks were obtained, more proximal nerve segments and other proximal nerves were not studied APB Abductor pollicis brevis, ADM Abductor digiti minimi, AH Abductor hallucis, AMP Amplitude, CV Conduction velocity, DML Distal motor latency, EDB Extensor digitorum brevis, ms Milisecond, mV Millivolt, NP Not performed a DML normal adult mean values: 3.40 ± 0.80 ms Table 2 Sensory Nerve Conduction Studies Before and After Influenza A Infection Before H1N1 infection After H1N1 infection (after 9 days) Nerve AMP CV AMP CV Left Median Sensory Nerve (Wrist-Dig II) 5.6uV 56.0 m/s 17.6uV 47.8 m/s Right Median Sensory Nerve (Wrist-Dig II) 34.0uV 47.9 m/s 26.1uV 55.0 m/s Left Superficial Radial Nerve (Lateral Forearm-Anatomical Snuffbox) 20.1uV 67.9 m/s 38.4uV 64.9 m/s Right Superficial Radial Nerve (Lateral Forearm-Anatomical Snuffbox) 0.0uV 0.0 m/s 0.0uV 0.0 m/s Left Ulnar Sensory Nerve (Wrist-Dig V) 27.0uV 63.8 m/s 29.2uV 50.7 m/s Right Ulnar Sensory Nerve (Wrist-Dig V) 20.0uV 55.0 m/s 28.8uV 62.8 m/s Left Superficial Peroneal Sensory Nerve 6.0uV 60.0 m/s 7.1uV 51.7 m/s Right Superficial Peroneal Sensory Nerve 0.0uV 0.0 m/s 0.0uV 0.0 m/s Left Sural Sensory Nerve 7.4uV 47.9 m/s 7.5uV 40.2 m/s Right Sural Sensory Nerve 4.1uV 38.6 m/s 5.3uV 36.2 m/s AMP Amplitude, CV Conduction velocity, Dig II Second finger, Dig V Fifth finger, ms Milisecond, uV Microvolt Fig. 2 Almost complete recovery of the facial palsy after 2 weeks
| 4.191406
| 0.951172
|
sec[1]/p[1]
|
en
| 0.999996
|
33234123
|
https://doi.org/10.1186/s12883-020-02008-4
|
[
"nerve",
"motor",
"wrist",
"sensory",
"infection",
"elbow",
"ankle",
"facial",
"conduction",
"median"
] |
[
{
"code": "8C1Z",
"title": "Mononeuropathy of unspecified site"
},
{
"code": "ND56.4",
"title": "Injury of nerve of unspecified body region"
},
{
"code": "8B80",
"title": "Disorders of olfactory nerve"
},
{
"code": "8C0Z",
"title": "Polyneuropathy, unspecified"
},
{
"code": "9C40.Z",
"title": "Disorder of the optic nerve, unspecified"
},
{
"code": "MB47.0",
"title": "Abnormal reflex"
},
{
"code": "PA2Z",
"title": "Unintentional land transport injury event unknown whether traffic or nontraffic injuring a user of unspecified transport"
},
{
"code": "DA21.Z",
"title": "Motility disorders of oesophagus, unspecified"
},
{
"code": "PA03",
"title": "Unintentional land transport traffic event injuring a motor cyclist"
},
{
"code": "PA20",
"title": "Unintentional land transport event unknown whether traffic or nontraffic injuring a pedestrian"
}
] |
=== ICD-11 CODES FOUND ===
[8C1Z] Mononeuropathy of unspecified site
Also known as: Mononeuropathy of unspecified site | inflammation of nerve NOS | nerve condition NOS | neuritis NOS | nerve disease NOS
[ND56.4] Injury of nerve of unspecified body region
Also known as: Injury of nerve of unspecified body region | injuries to nerves, nerve plexuses and roots | injury to nerves, unspecified site | nerve damage NOS | Injury of nerve NOS
Excludes: multiple injuries of nerves NOS
[8B80] Disorders of olfactory nerve
Also known as: Disorders of olfactory nerve | disorders of olfactory [1st] nerve | disorders of the first nerve | first cranial nerve disorder | disease of first cranial nerve
Includes: Disorder of 1st cranial nerve
Excludes: Idiopathic anosmia | Idiopathic parosmia
[8C0Z] Polyneuropathy, unspecified
Also known as: Polyneuropathy, unspecified | multiple neuropathy | peripheral neuropathy NOS | peripheral polyneuropathy | multiple peripheral neuritis
[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
[MB47.0] Abnormal reflex
Also known as: Abnormal reflex | reflex disorder | reflex disturbance | motor disturbance | motor disorder
Excludes: vasovagal reaction or syncope | hyperactive gag reflex | abnormal pupillary reflex
[PA2Z] Unintentional land transport injury event unknown whether traffic or nontraffic injuring a user of unspecified transport
Also known as: Unintentional land transport injury event unknown whether traffic or nontraffic injuring a user of unspecified transport | unintentional land transport injury event unknown whether on road or off-road | land transport accident NOS | motor vehicle accident NOS | MVA - [motor vehicle accident] NOS
[DA21.Z] Motility disorders of oesophagus, unspecified
Also known as: Motility disorders of oesophagus, unspecified | Motility disorders of oesophagus | Dyskinesia of oesophagus | oesophageal dysmotility | oesophageal motility disorder
[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
[PA20] Unintentional land transport event unknown whether traffic or nontraffic injuring a pedestrian
Also known as: Unintentional land transport event unknown whether traffic or nontraffic injuring a pedestrian | unintentional crash injuring a pedestrian, unknown whether on road | pedestrian accident NOS | pedestrian struck by motor vehicle | pedestrian struck by vehicle
=== GRAPH WALKS ===
--- Walk 1 ---
[8C1Z] Mononeuropathy of unspecified site
--PARENT--> [?] Mononeuropathy
--CHILD--> [8C11] Mononeuropathies of lower limb
Def: Damage to a single nerve or nerve group of the lower limb (not including central nervous structures such as the brain, brainstem or spinal cord), resulting in a loss of movement, sensation and/or auto...
--- Walk 2 ---
[8C1Z] Mononeuropathy of unspecified site
--PARENT--> [?] Mononeuropathy
--CHILD--> [8C12] Certain specified mononeuropathies
--- Walk 3 ---
[ND56.4] Injury of nerve of unspecified body region
--EXCLUDES--> [?] Injuries of nerves involving multiple body regions
--EXCLUDES--> [?] Injuries of nerves and spinal cord involving other multiple body regions
--- Walk 4 ---
[ND56.4] Injury of nerve of unspecified body region
--EXCLUDES--> [?] Injuries of nerves involving multiple body regions
--EXCLUDES--> [?] Injuries of nerves and spinal cord involving other multiple body regions
--- Walk 5 ---
[8B80] Disorders of olfactory nerve
--RELATED_TO--> [?] Injury of olfactory nerve
--PARENT--> [?] Injury of cranial nerves
--- Walk 6 ---
[8B80] Disorders of olfactory nerve
--EXCLUDES--> [?] Parosmia
--PARENT--> [?] Disturbances of smell or taste
Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste....
|
[
"[8C1Z] Mononeuropathy of unspecified site\n --PARENT--> [?] Mononeuropathy\n --CHILD--> [8C11] Mononeuropathies of lower limb\n Def: Damage to a single nerve or nerve group of the lower limb (not including central nervous structures such as the brain, brainstem or spinal cord), resulting in a loss of movement, sensation and/or auto...",
"[8C1Z] Mononeuropathy of unspecified site\n --PARENT--> [?] Mononeuropathy\n --CHILD--> [8C12] Certain specified mononeuropathies",
"[ND56.4] Injury of nerve of unspecified body region\n --EXCLUDES--> [?] Injuries of nerves involving multiple body regions\n --EXCLUDES--> [?] Injuries of nerves and spinal cord involving other multiple body regions",
"[ND56.4] Injury of nerve of unspecified body region\n --EXCLUDES--> [?] Injuries of nerves involving multiple body regions\n --EXCLUDES--> [?] Injuries of nerves and spinal cord involving other multiple body regions",
"[8B80] Disorders of olfactory nerve\n --RELATED_TO--> [?] Injury of olfactory nerve\n --PARENT--> [?] Injury of cranial nerves",
"[8B80] Disorders of olfactory nerve\n --EXCLUDES--> [?] Parosmia\n --PARENT--> [?] Disturbances of smell or taste\n Def: Disturbances of smell or taste include anosmia, parosmia, parageusia, and other disturbances of smell or taste...."
] |
8C1Z
|
Mononeuropathy of unspecified site
|
[
{
"from_icd11": "8C1Z",
"icd10_code": "G59",
"icd10_title": "Mononeuropathy in diseases classified elsewhere"
},
{
"from_icd11": "8C1Z",
"icd10_code": "G598",
"icd10_title": ""
},
{
"from_icd11": "ND56.4",
"icd10_code": "T144",
"icd10_title": ""
},
{
"from_icd11": "8B80",
"icd10_code": "G520",
"icd10_title": "Disorders of olfactory nerve"
},
{
"from_icd11": "8C0Z",
"icd10_code": "G629",
"icd10_title": "Polyneuropathy, unspecified"
},
{
"from_icd11": "8C0Z",
"icd10_code": "G53",
"icd10_title": "Cranial nerve disorders in diseases classified elsewhere"
},
{
"from_icd11": "8C0Z",
"icd10_code": "G538",
"icd10_title": ""
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47012",
"icd10_title": "Ischemic optic neuropathy, left eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47099",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47091",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, right eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47093",
"icd10_title": "Other disorders of optic nerve, not elsewhere classified, bilateral"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47019",
"icd10_title": "Ischemic optic neuropathy, unspecified eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47013",
"icd10_title": "Ischemic optic neuropathy, bilateral"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47011",
"icd10_title": "Ischemic optic neuropathy, right eye"
},
{
"from_icd11": "9C40.Z",
"icd10_code": "H47021",
"icd10_title": "Hemorrhage in optic nerve sheath, right eye"
}
] |
G59
|
Mononeuropathy in diseases classified elsewhere
|
A 62-year-old woman was diagnosed with stage IV colon cancer at hepatic flexure and lung metastasis according to the 7th edition of the American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) staging system two years ago , and have been treated with combined neoadjuvant chemotherapy (imatinib, folinic acid and fluorouracil) as the primary drug regimen. Three weeks later , she was admitted to the Department of Gastrointestinal Surgery for relieving her symptoms, during which tumor removal with palliative right hemi-colectomy was performed. Afterwards, FOLFIRI (5-fluorouracil, leucovorin, irinotecan) regimen which included leucovorin at 500 mg d1, fluorouracil at 500 mg d1, fluorouracil at 1700 mg civ/23h d1-2 Q2W, and irinotecan at 260 mg d1, was administered for 6 courses . However, she still manifested progressive cancer, lung metastasis was determined as right lung biopsy showed moderately differentiated intestinal adenocarcinoma with RAS (rat sarcoma virus) genetic mutations. Therefore, bevacizumab (anti-VEGF-A antibody) (400 d1 q3w) plus 8 courses of XELOX which included oxaliplatin at 150 mg d1 and capecitabine at 1500 mg bid d1-d14 was initiated after the abovementioned treatment. Radiotherapy for pulmonary metastasis was also carried out 28 times in 2 months . Nevertheless, the tumor was not able to be contained either and continued to progress. Thus, regorafenib(80 mg qd d1-d21) was added on Jan 11 th , 2018.In the beginning, she had normal renal function (serum creatinine, 45 μmol/L) without proteinuria or hypertension. Bevacizumab administration was performed for 8 courses spanning 8 months with transient liver dysfunction . After discontinuing bevacizumab, liver function returned to normal. However, serum creatinine gradually increased after regorafenib treatment initiation, her blood test showed hypercholesterolemia (7.11 mmol/L) and hypertriglyceridemia (2.04 mmol/L) . Moreover, she progressively developed nephrotic syndrome (serum creatinine, 91 μmol/L) in recent three months, and was thus transferred to the Department of Nephrology. On admission, her 24-hour urinary protein was 4.6 g/24h, and serum albumin was 29.1 g/L (Table 1 ). Regarding antibodies related to membranous nephropathy, anti-phospholipase A2 (PLA2) antibody was negative. While anti-thrombospondin type-1domain-containing 7A (THSD7A) antibody was positive. Coombs test, haptoglobin and also ADAMTS-13 activity were negative. Kidney biopsy showed fibrin thrombi in glomerular capillaries, endothelial injury with thickening, and mesangiolysis revealing TMA. Meanwhile, Immunofluorescence showed IgM, kappa and lambda deposition in glomerular mesangium and glomerular capillary loops with weak deposition of C4 and C1q. Electron microscopy revealed diffuse endothelial thickening with obliterated capillary lumina and ubendothelial fluffy materials or fibrin tactoids deposition . Pathological examination indicated a diagnosis of renal-limited TMA caused by anti-VEGF drugs. After careful consultation with oncologists, regorafenib therapy was suspended. Two years following discharge from our hospital, the patient received irbesartan treatment and responded with gradual improvement of her clinical manifestation, with urinary protein 2+ and serum albumin of 33.9 g/L (Table 1 ). Fig. 1 The clinical course of the patient. A Bevacizumab administration during an 8-month period . B Regorafenib administration during a 7-month period Table 1 Results of laboratory test Upon admission, , on admission and the latest follow-up Component Jan 16 th , 2018 (Upon admission) Oct 9 th , 2019 (On admission) May 27 th , 2021 (Latest follow-up) Urinalysis results Urinary protein negative 4+ 2+ 24-HTP ND 4.6 ND Peripheral blood HB (g/L) 143 138 98 WBC (×10 9 /L) 6.38 11.78 3.43 PLT (×10 9 /L) 169 126 65 Chemistries CREA (μmol/L) 45 91 106 BUN (mmol/L) 4.6 8.3 8.6 eGFR (ml/min/1.73 m 2 ) 104.6 58.7 48.3 Bilirubin (μmol/L) 14.7 7.6 6.2 LDH (IU/L) 197 249 298 TP (g/L) 74.5 51.7 56.9 ALB (g/L) 47.7 29.1 33.9 TG (mmol/L) ND 3.19 2.25 CHOL (mmol/L) ND 9.09 6.29 Other CRP (mg/L) ND 11.5 ND PCT (ng/ml) ND 0.16 ND Coombs Test ND negative ND ADAMTS-13 ND negative ND THSD7A ND negative ND Note : 24hHTP 24-hour urine protein, HB Hemoglobin, WBC White blood cell, PLT Platelets, CREA Creatinine, BUN Blood urea nitrogen, LDH Lactic dehydrogenase, TP Total protein, ALB Albumin, TG Triglyceride, CHOL Cholesterol, eGFR Estimate glomerular filtration rate, CRP C-reactive protein, PCT Procalcitonin, Coombs Test A test to detect non-agglutinating antibodies against erythrocytes by use of anti-antibodies (the Coombs’ reagent), ADAMTS-13 A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13, THSD7A Thrombospondin type 1 domain–containing 7A, ND No data Fig. 2 Pathological biopsy of glomerulus showing thrombotic microangiopathy. A Hematoxylin-eosin staining×200. B Periodic Acid–Schiff staining×200. C Masson’s Trichrom staining×200. D Periodic acid silver methenamine stain ×200. Scale bars=50μm Fig. 3 Immunofluorescence. Immunofluorescence for immunoglobulin M ( A ), kappa ( B ) and lambda ( C ) deposition in glomerular mesangium and glomerular capillary loops Fig. 4 Electron micrograph. Electron microscopy revealed diffuse endothelial thickening with obliterated capillary lumina and subendothelial fluffy materials or fibrin tactoids deposition
| 4.101563
| 0.963867
|
sec[1]/p[0]
|
en
| 0.999999
|
35305559
|
https://doi.org/10.1186/s12882-021-02656-9
|
[
"protein",
"glomerular",
"anti",
"serum",
"mmol",
"deposition",
"metastasis",
"fluorouracil",
"bevacizumab",
"regorafenib"
] |
[
{
"code": "5B71",
"title": "Protein deficiency"
},
{
"code": "5B7Z",
"title": "Unspecified undernutrition"
},
{
"code": "DA96.02",
"title": "Malabsorption or intolerance of specific nutrients"
},
{
"code": "MF96.Z",
"title": "Proteinuria, unspecified"
},
{
"code": "3B61.1",
"title": "Acquired thrombophilia"
},
{
"code": "GB4Z",
"title": "Glomerular diseases, unspecified"
},
{
"code": "GB4Y",
"title": "Other specified glomerular diseases"
},
{
"code": "GB40&XT5R",
"title": "Acute nephritic syndrome"
},
{
"code": "GB40&XT8W",
"title": "Chronic nephritic syndrome"
},
{
"code": "MF8Y",
"title": "Other specified clinical findings in specimens from the urinary system"
}
] |
=== ICD-11 CODES FOUND ===
[5B71] Protein deficiency
Also known as: Protein deficiency | protein deprivation
[5B7Z] Unspecified undernutrition
Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS
[DA96.02] Malabsorption or intolerance of specific nutrients
Definition: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken for food allergy, which is primarily involving the immune reaction against the food.
Also known as: Malabsorption or intolerance of specific nutrients | Carbohydrate intolerance other than lactose | disorder of carbohydrate absorption | Malabsorption due to intolerance to carbohydrate | carbohydrate intolerance
[MF96.Z] Proteinuria, unspecified
Also known as: Proteinuria, unspecified | Proteinuria | Albuminuria NOS | Proteinuria NOS
[3B61.1] Acquired thrombophilia
Definition: A disease caused by determinants arising after birth. This disease is characterised by abnormality of blood coagulation that increases the risk of thrombosis, clots in blood vessels. This disease may present with deep vein thrombosis or pulmonary embolism. Confirmation is identification of abnormal blood coagulation in a blood sample.
Also known as: Acquired thrombophilia | Gaisbock syndrome | polycythaemia due to stress | stress erythrocytosis | stress polycythaemia
[GB4Z] Glomerular diseases, unspecified
Also known as: Glomerular diseases, unspecified | Glomerular disease classified by aetiology | Idiopathic glomerular disease | primary glomerular disease | Glomerular disease associated with secondary causes or systemic conditions
[GB4Y] Other specified glomerular diseases
Also known as: Other specified glomerular diseases | Glomerular disease classified by clinical features or syndromes | Chronic proteinuria | Permanent proteinuria with focal and segmental hyalinosis without nephrotic syndrome | Recurrent or persistent glomerular haematuria
[MF8Y] Other specified clinical findings in specimens from the urinary system
Also known as: Other specified clinical findings in specimens from the urinary system | Glomerular disease with minor glomerular abnormality | Glomerular disease with minimal change disease | Secondary glomerular disease with minor glomerular abnormality | Glomerular disease with minor glomerular abnormality in diseases classified elsewhere
=== GRAPH WALKS ===
--- Walk 1 ---
[5B71] Protein deficiency
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--EXCLUDES--> [?] 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...
--- Walk 2 ---
[5B71] Protein deficiency
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--CHILD--> [5B51] Wasting in infants, children or adolescents
--- Walk 3 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--CHILD--> [5B50] Underweight in infants, children or adolescents
--- Walk 4 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--CHILD--> [5B51] Wasting in infants, children or adolescents
--- Walk 5 ---
[DA96.02] Malabsorption or intolerance of specific nutrients
Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...
--RELATED_TO--> [?] Lactose intolerance
Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...
--CHILD--> [?] Secondary lactase deficiency
Def: This form of lactase deficiency results from some sort of damage to the intestines either due to a disease or surgery....
--- Walk 6 ---
[DA96.02] Malabsorption or intolerance of specific nutrients
Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...
--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...
--RELATED_TO--> [?] Neonatal malabsorption syndromes
|
[
"[5B71] Protein deficiency\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --EXCLUDES--> [?] 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...",
"[5B71] Protein deficiency\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --CHILD--> [5B51] Wasting in infants, children or adolescents",
"[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --CHILD--> [5B50] Underweight in infants, children or adolescents",
"[5B7Z] Unspecified undernutrition\n --PARENT--> [?] Undernutrition\n Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...\n --CHILD--> [5B51] Wasting in infants, children or adolescents",
"[DA96.02] Malabsorption or intolerance of specific nutrients\n Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...\n --RELATED_TO--> [?] Lactose intolerance\n Def: Lactose intolerance is the inability to digest lactose, a sugar found in milk and some dairy products, due to a deficiency of lactase, the enzyme that metabolizes lactose. Lactose intolerance occurs w...\n --CHILD--> [?] Secondary lactase deficiency\n Def: This form of lactase deficiency results from some sort of damage to the intestines either due to a disease or surgery....",
"[DA96.02] Malabsorption or intolerance of specific nutrients\n Def: Food intolerance is a term used for difficulty in digesting a food due to various physiological responses associated with a particular food, or compound found. Food intolerance should not be mistaken ...\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 --RELATED_TO--> [?] Neonatal malabsorption syndromes"
] |
5B71
|
Protein deficiency
|
[
{
"from_icd11": "5B71",
"icd10_code": "E46",
"icd10_title": "Unspecified protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E440",
"icd10_title": "Moderate protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E441",
"icd10_title": "Mild protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E640",
"icd10_title": "Sequelae of protein-calorie malnutrition"
},
{
"from_icd11": "5B71",
"icd10_code": "E44",
"icd10_title": "Protein-calorie malnutrition of moderate and mild degree"
},
{
"from_icd11": "5B71",
"icd10_code": "E45",
"icd10_title": "Retarded development following protein-calorie malnutrition"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E43",
"icd10_title": "Unspecified severe protein-calorie malnutrition"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E538",
"icd10_title": "Deficiency of other specified B group vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E569",
"icd10_title": "Vitamin deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E638",
"icd10_title": "Other specified nutritional deficiencies"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E639",
"icd10_title": "Nutritional deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E41",
"icd10_title": "Nutritional marasmus"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E539",
"icd10_title": "Vitamin B deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E568",
"icd10_title": "Deficiency of other vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E649",
"icd10_title": "Sequelae of unspecified nutritional deficiency"
}
] |
E46
|
Unspecified protein-calorie malnutrition
|
Herein, we report the case of a 89-year old patient known for permanent atrial fibrillation who was implanted with a standard transvenous VVI pacemaker in 2003 for slow symptomatic atrial fibrillation. A generator replacement performed in November 2017 for elective replacement indicator was complicated by a pocket infection diagnosed 1 month later requiring percutaneous explantation of the system, without any complications. The patient was then not keen on having a new device implanted for the following years. On a recent Holter monitor, numerous significant symptomatic pauses reinforced the indication for a VVI pacemaker implantation. Because of the past infection and the need for ventricular pacing only, the decision was made to implant an Aveir VVI LPM. The preoperative echocardiography showed preserved left and right ventricular systolic function, no pulmonary hypertension, and light tricuspid regurgitation. This procedure was performed in February 2024 by a cardiologist experienced in LPM implantations. After venous access was obtained at the right femoral vein, an Aveir VVI LPM was successfully implanted in the interventricular septum using right anterior oblique 30° and left anterior oblique 45° projections along with contrast injections , with good electrical parameters (sensed R wave 12 mV, a rise in impedance regarding the one measured before screwing the device with a value of 520 ohms, and capture threshold at 0.75 V @ 0.4 ms with a good current of injury). Some difficulty was encountered while attempting to release the device from the tethers because of some resistance. Our hypothesis is that there was not enough tension between the tip of the delivery catheter and the device body during tether mode, preventing the 2 tethers from sliding apart and thus coming out easily from the body of the LPM, preventing easy separation. The device was finally still in place once freed, with the same parameters as previously described, with stable impedance but a slight elevation in the capture threshold at 2.5 V @ 0.4 ms. After a waiting time of 10 minutes, the threshold remained slightly elevated (1.75 V @ 0.8 ms). With the other parameters in perfect range and with no radiological dislodgment, the decision was made to leave it in place. The procedure duration was 60 minutes and fluoroscopy time 20 minutes. The patient went back to the ward, and LPM check, performed 4 hours later, showed good parameters with a trend toward a decrease in the capture threshold at 1.5 V @ 0.8 ms. The electrocardiogram showed good RV capture (low septal) . Twenty-four hours after implantation, ventricular capture and sensing were suddenly lost. A chest radiograph showed dislodgment of the device into an uncertain position. A computed tomography scan confirmed migration of the LPM to the proximal part of the coronary sinus (CS) in a stable position . The patient remained asymptomatic, and an echocardiogram showed no pericardial effusion. The patient was then transferred to the nearest tertiary center for explantation of the dislocated device. This procedure occurred 8 days later using the dedicated Abbott percutaneous retrieving catheter system via a single right venous femoral approach. By chance, the Aveir device was lodged in the CS such that the screw was oriented toward the distal CS with the docking button protruding into the right atrium. The tri-loop snare could eventually capture the docking button after a couple of attempts. The device was then pulled back by gentle manual traction, without any counterclockwise rotation, into the right atrium. The protective sleeve was then used to cover the device before its removal through the 27F introducer sheath. Visual inspection of the device showed integrity of the body and of the helix . The procedure duration was 45 minutes with an x-ray time of 7 minutes and dose of 70.83 mGy. An echocardiogram performed after the procedure showed no pericardial effusion. The patient declined a new LPM implantation and was discharged home the day after the procedure. Figure 1 A: Right anterior oblique (RAO) 30° projection after contrast injection through the delivering catheter showing right ventricular (RV) septal position before delivering the device. B: RAO 30° projection after liberation of the Aveir (Abbott, Abbott Park, IL) leadless pacemaker showing the same position in an RV septal location. C: Postprocedural electrocardiogram showing good RV capture (low septal). Figure 2 A: Lateral chest radiograph showing posterior dislodgment (in an uncertain position) of the Aveir (Abbott, Abbott Park, IL) leadless pacemaker (LPM). B: Computed tomography scan showing dislodgment of the Aveir LPM into the proximal part of the coronary sinus with the docking button protruding into the right atrium. Figure 3 A: Use of the tri-loop snare retrieving catheter via a right femoral venous access, to capture the docking button (protruding into the right atrium) of the Aveir (Abbott, Abbott Park, IL) leadless pacemaker (LPM) lodged into the proximal coronary sinus. B: The tri-loop snare is tightened to the docking button once grabbed. C: The device is pulled back by gentle manual traction, without any counterclockwise rotation, into the right atrium. D, E: Explantation of the Aveir LPM through the 27F introducer sheath. F: Visual inspection of the device showing integrity of the body and of the helix.
| 4.039063
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999997
|
39161915
|
https://doi.org/10.1016/j.hrcr.2024.05.011
|
[
"device",
"aveir",
"capture",
"abbott",
"pacemaker",
"good",
"minutes",
"position",
"docking",
"button"
] |
[
{
"code": "8A43.Z",
"title": "Neuromyelitis optica, unspecified"
},
{
"code": "QB5Z",
"title": "Presence of unspecified device"
},
{
"code": "PL12.0",
"title": "Structural device failure, as mode of injury or harm"
},
{
"code": "PL12.2",
"title": "Perforation or protrusion by device, as mode of injury or harm"
},
{
"code": "PL12.1",
"title": "Functional device failure, as mode of injury or harm"
},
{
"code": "NE82.1Y",
"title": "Other specified pacemaker or implantable cardioverter defibrillator dysfunction"
},
{
"code": "NE82.11",
"title": "Pacemaker syndrome"
},
{
"code": "QB30.20",
"title": "Adjustment or management of cardiac pacemaker"
},
{
"code": "BC9Y",
"title": "Other specified cardiac arrhythmia"
},
{
"code": "NE82.0Y",
"title": "Other specified pacemaker or implantable cardioverter defibrillator complication"
}
] |
=== ICD-11 CODES FOUND ===
[8A43.Z] Neuromyelitis optica, unspecified
Also known as: Neuromyelitis optica, unspecified | Neuromyelitis optica | Devic | Devic disease | Devic syndrome
[QB5Z] Presence of unspecified device
Also known as: Presence of unspecified device
[PL12.0] Structural device failure, as mode of injury or harm
Definition: Harm arising due to mechanical or material device failure not related to the installation of the device.
Also known as: Structural device failure, as mode of injury or harm | part failure of a structural device as a mode of injury | structural device component failure as a mode of injury | structural device design failure as a mode of injury | manufacturing fault of a structural device as a mode of injury
Includes: Leakage from device, as mode of injury or harm | Wear, breakage or breakdown of device, as mode of injury or harm | Breakdown of intraocular lens
Excludes: Wear of articular bearing surface of joint prosthesis | Combination or interaction of operator error and device failure, as mode of injury or harm | Structural device failure without injury or harm
[PL12.2] Perforation or protrusion by device, as mode of injury or harm
Also known as: Perforation or protrusion by device, as mode of injury or harm | protruding device | pierced by device | Ocular Implant Extrusion | Ocular Implant Exposure
Includes: Ocular Implant Extrusion | Ocular Implant Exposure
Excludes: Cut, puncture or tear, as mode of injury or harm
[PL12.1] Functional device failure, as mode of injury or harm
Also known as: Functional device failure, as mode of injury or harm | faulty device | jamming of device | device failure to activate | Battery failure before end of battery life
Excludes: Pacemaker or implantable cardioverter defibrillator dysfunction | Pacemaker or implantable cardioverter defibrillator battery at end of battery life | Combination or interaction of operator error and device failure, as mode of injury or harm
[NE82.1Y] Other specified pacemaker or implantable cardioverter defibrillator dysfunction
Also known as: Other specified pacemaker or implantable cardioverter defibrillator dysfunction | Implantable cardioverter defibrillator high voltage component dysfunction | Inappropriate withholding of implantable cardioverter defibrillator therapy | Implantable cardioverter or defibrillator generator dysfunction | Pacemaker or implantable cardioverter defibrillator output failure
[NE82.11] Pacemaker syndrome
Definition: Cardiovascular signs or symptoms following pacemaker implantation due to suboptimal atrioventricular synchrony, regardless of the pacing mode
Also known as: Pacemaker syndrome
[QB30.20] Adjustment or management of cardiac pacemaker
Also known as: Adjustment or management of cardiac pacemaker | change of pacemaker | checking of cardiac pacemaker | checking or testing of cardiac pulse generator battery | checking or testing of pulse generator
Excludes: Dysfunction or complication of pacemaker, pacemaker lead or implantable cardioverter defibrillator, not elsewhere classified
[BC9Y] Other specified cardiac arrhythmia
Also known as: Other specified cardiac arrhythmia | Ectopic arrhythmia | ectopic cardiac arrhythmia | ectopic atrial pacemaker | ectopic rhythm NOS
[NE82.0Y] Other specified pacemaker or implantable cardioverter defibrillator complication
Also known as: Other specified pacemaker or implantable cardioverter defibrillator complication | Pacemaker mediated tachycardia | Infection due to pacemaker or implantable cardioverter defibrillator | Infection due to implantable cardioverter defibrillator | Infection due to pacemaker
=== GRAPH WALKS ===
--- Walk 1 ---
[8A43.Z] Neuromyelitis optica, unspecified
--PARENT--> [8A43] Neuromyelitis optica
--CHILD--> [8A43.2] Single transverse myelitis aquaporin-4 antibody positive
Def: A single episode of transverse myelitis which is typically longitudinally extensive (>3 vertebral segments) associated with seropositivity for aquaporin-4 antibodies but without sufficient features to...
--- Walk 2 ---
[8A43.Z] Neuromyelitis optica, unspecified
--PARENT--> [8A43] Neuromyelitis optica
--RELATED_TO--> [?] Neuromyelitis optica myelin oligodendrocyte glycoprotein antibody-positive
Def: MOG antibody associated spectrum disorders are inflammatory demyelinating diseases of the central nervous system with a predilection for optic nerve that include a subgroup of patients with bilateral ...
--- Walk 3 ---
[QB5Z] Presence of unspecified device
--PARENT--> [?] Presence of device, implants or grafts
--CHILD--> [QB51] Presence of devices other than cardiac or vascular implants
--- Walk 4 ---
[QB5Z] Presence of unspecified device
--PARENT--> [?] Presence of device, implants or grafts
--CHILD--> [QB5Z] Presence of unspecified device
--- Walk 5 ---
[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....
--EXCLUDES--> [?] Combination or interaction of operator error and device failure, as mode of injury or harm
Def: Harm arising due to a combination of device failure and process/procedural error in device use or maintenance....
--EXCLUDES--> [?] 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 6 ---
[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....
--EXCLUDES--> [?] Combination or interaction of operator error and device failure, as mode of injury or harm
Def: Harm arising due to a combination of device failure and process/procedural error in device use or maintenance....
--PARENT--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft
|
[
"[8A43.Z] Neuromyelitis optica, unspecified\n --PARENT--> [8A43] Neuromyelitis optica\n --CHILD--> [8A43.2] Single transverse myelitis aquaporin-4 antibody positive\n Def: A single episode of transverse myelitis which is typically longitudinally extensive (>3 vertebral segments) associated with seropositivity for aquaporin-4 antibodies but without sufficient features to...",
"[8A43.Z] Neuromyelitis optica, unspecified\n --PARENT--> [8A43] Neuromyelitis optica\n --RELATED_TO--> [?] Neuromyelitis optica myelin oligodendrocyte glycoprotein antibody-positive\n Def: MOG antibody associated spectrum disorders are inflammatory demyelinating diseases of the central nervous system with a predilection for optic nerve that include a subgroup of patients with bilateral ...",
"[QB5Z] Presence of unspecified device\n --PARENT--> [?] Presence of device, implants or grafts\n --CHILD--> [QB51] Presence of devices other than cardiac or vascular implants",
"[QB5Z] Presence of unspecified device\n --PARENT--> [?] Presence of device, implants or grafts\n --CHILD--> [QB5Z] Presence of unspecified device",
"[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....\n --EXCLUDES--> [?] Combination or interaction of operator error and device failure, as mode of injury or harm\n Def: Harm arising due to a combination of device failure and process/procedural error in device use or maintenance....\n --EXCLUDES--> [?] 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....",
"[PL12.0] 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....\n --EXCLUDES--> [?] Combination or interaction of operator error and device failure, as mode of injury or harm\n Def: Harm arising due to a combination of device failure and process/procedural error in device use or maintenance....\n --PARENT--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft"
] |
8A43.Z
|
Neuromyelitis optica, unspecified
|
[
{
"from_icd11": "8A43.Z",
"icd10_code": "G360",
"icd10_title": "Neuromyelitis optica [Devic]"
},
{
"from_icd11": "QB5Z",
"icd10_code": "Z978",
"icd10_title": "Presence of other specified devices"
},
{
"from_icd11": "QB5Z",
"icd10_code": "XXI",
"icd10_title": ""
},
{
"from_icd11": "QB5Z",
"icd10_code": "Z97",
"icd10_title": "Presence of other devices"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82110A",
"icd10_title": "Breakdown (mechanical) of cardiac electrode, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82120A",
"icd10_title": "Displacement of cardiac electrode, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82190A",
"icd10_title": "Other mechanical complication of cardiac electrode, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82118A",
"icd10_title": "Breakdown (mechanical) of other cardiac electronic device, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82198A",
"icd10_title": "Other mechanical complication of other cardiac electronic device, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82128A",
"icd10_title": "Displacement of other cardiac electronic device, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82191A",
"icd10_title": "Other mechanical complication of cardiac pulse generator (battery), initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82119A",
"icd10_title": "Breakdown (mechanical) of unspecified cardiac electronic device, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82111A",
"icd10_title": "Breakdown (mechanical) of cardiac pulse generator (battery), initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82199A",
"icd10_title": "Other mechanical complication of unspecified cardiac device, initial encounter"
},
{
"from_icd11": "NE82.11",
"icd10_code": "T82121A",
"icd10_title": "Displacement of cardiac pulse generator (battery), initial encounter"
}
] |
G360
|
Neuromyelitis optica [Devic]
|
A 7-month-old male infant was referred to our tertiary-care hospital for evaluation of a one-month history of progressive painless abdominal distention. His prenatal and familial history was negative, and his personal medical history included a surgical correction of bilateral inguinal hernia and thalassemia minor diagnosis. He appeared well, and his growth and neurological development were appropriate for chronological age. Physical examination was normal except for a distended and tense abdomen, painless on deep palpation, with a positive fluid-thrill; there was no evidence of organomegaly or abdominal masses. There were no clinical, laboratory or imaging signs of portal hypertension or liver disease. Abdominal ultrasound examination (US) showed the presence of fluid in the Morison’s pouch, in the left upper abdominal quadrant, and Douglas space; the liquid appeared free in the abdomen in the absence of definite septation nor a multi-cystic appearance thus confirming the clinical impression of ascites. There were no abdominal masses or abdominal organ abnormalities. A comprehensive workup excluded hepatic, renal, cardiac, intestinal, pancreatic, inflammatory or infectious diseases, malignancy, and congenital metabolic diseases. The child had had in the past a mild pleuro-pericardic effusion during a febrile illness and a transient mild hyperkaliemia, evoking a possible stomatocytosis due to PIEZO1 mutation; the analysis of PIEZO1 gene was however found negative. As an interferon-gamma test (QuantiFERON®) was positive, peritoneal tuberculosis was suspected, but the chest x-ray and the Mantoux test of the patient and his parents were negative. Gram and acid-fast stain and culture of three gastric aspirates resulted negative. Furthermore, the repeated interferon gamma test was negative and atypical mycobacterial infections were also excluded. A MRI of the abdomen only confirmed an abundant collection of liquid in the abdomen, with centralization of the bowel loops and a normal aspect of all abdominal organs . Biochemical analysis of ascites revealed pale-yellow serous fluid with a normal value for the serum albumin-ascites gradient (gradient = 1.1). Triglycerides and total leukocytes counts were in the normal range (98% lymphocytes). At cytological examination, abdominal fluid appeared as a clear yellowish liquid that contained reactive lympho-monocytes, mesothelial cells, isolated foam cells and absence of malignant cells. Notably, the abdominal fluid rapidly re-accumulated just a few days after this first paracentesis. To promote a negative sodium balance and possibly reduce ascites production, symptomatic palliative diuretic management was started, by combining spironolactone (3 mg/Kg/daily) and furosemide (1 mg/Kg/daily). The child was then stable for a short time, but abdominal distension returned causing discomfort and breathing difficulty: multiple paracenteses were necessary during the following months. As repeated imaging and fluid analysis did not bring any new elements to orientate towards a precise diagnosis or treatment, a malformative pattern was also evoked and ruled out. Eighteen months after the onset of symptoms, in the absence of a positive diagnosis and of any improvement of the condition, and given the normality of all diagnostic tests, the initial diagnosis of ascites was reconsidered and pseudo-ascites was hypothesized. US and MRI studies were repeated but could not bring new elements, nor support the diagnosis of a PA . At that point, because the ascites was refractory to treatment with recurrent need for hospitalizations for paracentesis and associated with a poor quality of life, surgery was proposed. The plan was to proceed with a diagnostic laparoscopy to confirm the free ascites and the absence of any other precise condition, followed by the creation of a peritoneo-venous shunt if free and cryptogenic ascites was confirmed. Laparoscopy led to the identification of a benign giant cystic lymphangioma of the omentum, which was mobilized laparoscopically and radically resected through the umbilical site of the laparoscopy access. The cyst covered all abdominal organs but none was intimately involved and the resection was extended to an en-bloc resection of the great omentum . There was no free fluid in the abdomen. The resolution of symptoms was immediate, and there has been no recurrence of abdominal distention: the child is now doing fine one year after surgery. The anatomo-pathological study confirmed the surgical diagnosis. Fig. 1 Radiological signs evoking pseudo-ascites. a Initial MRI of the patient: Coronal aspect showing distribution of the abdominal fluid and the sparing of the hepatodiaphragmatic space. Note the centralization of the bowel and the confusing floating aspect of the bowel loops, and the partial septae. b MRI performed at a later stage in the patient: Coronal aspect showing an increased amount of fluid that distributes in the whole cavity and do not spare the hepato-diaphragmatic space. c as a comparison, CT coronal aspect of free massive ascites in a child with decompensated biliary cirrhosis. (White arrows pointing at the hepato-diaphragmatic space – Black arrows pointing at partial septae) Fig. 2 Intraoperative aspects. Intraoperative aspect of the cyst after its emptying, laparoscopic mobilization and exteriorization through the umbilical access site
| 4.15625
| 0.970215
|
sec[1]/p[0]
|
en
| 0.999998
|
31766989
|
https://doi.org/10.1186/s12887-019-1826-7
|
[
"abdominal",
"ascites",
"fluid",
"aspect",
"abdomen",
"free",
"space",
"absence",
"appeared",
"liquid"
] |
[
{
"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": "ME04.Y",
"title": "Other specified ascites"
},
{
"code": "DC51.0",
"title": "Chylous ascites"
},
{
"code": "2D91",
"title": "Malignant neoplasm metastasis in peritoneum"
},
{
"code": "1B12.7",
"title": "Tuberculosis of the digestive system"
},
{
"code": "FA36.Z",
"title": "Effusion of joint, 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
[ME04.Y] Other specified ascites
Also known as: Other specified ascites
[DC51.0] Chylous ascites
Definition: Chylous ascites is a rare form of ascites caused by accumulation of lymph in the peritoneal cavity, usually due to intra-abdominal malignancy, liver cirrhosis or abdominal surgery complications, and present with painless but progressive abdominal distension, dyspnoea and weight gain.
Also known as: Chylous ascites | chyloperitoneum
[2D91] Malignant neoplasm metastasis in peritoneum
Also known as: Malignant neoplasm metastasis in peritoneum | peritoneal metastases | peritoneal metastasis | carcinomatosis of peritoneal cavity | carcinomatosis peritonei
[1B12.7] Tuberculosis of the digestive system
Definition: Tuberculosis of the digestive tract or hepatobiliary system
Also known as: Tuberculosis of the digestive system | tuberculosis of gastrointestinal tract | Tuberculous duodenitis | Tuberculous gastritis | tuberculosis of stomach
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[MD81.3] Acute abdomen
Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...
--PARENT--> [MD81] Abdominal or pelvic pain
Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....
--EXCLUDES--> [?] Spinal pain
Def: This is a condition characterised by pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine....
--- Walk 2 ---
[MD81.3] Acute abdomen
Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...
--PARENT--> [MD81] Abdominal or pelvic pain
Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....
--EXCLUDES--> [?] Renal colic
Def: A severe paroxysmal pain in the flank radiating to the groin, scrotum or labia, caused by blockage of the renal pelvis or ureter most commonly by a renal stone. May be associated with nausea and vomit...
--- Walk 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--> [ME04.0] Fluid in peritoneal cavity
--- Walk 6 ---
[ME04.Z] Ascites, unspecified
--PARENT--> [ME04] Ascites
Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...
--CHILD--> [ME04.Z] Ascites, unspecified
|
[
"[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --EXCLUDES--> [?] Spinal pain\n Def: This is a condition characterised by pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine....",
"[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --EXCLUDES--> [?] Renal colic\n Def: A severe paroxysmal pain in the flank radiating to the groin, scrotum or labia, caused by blockage of the renal pelvis or ureter most commonly by a renal stone. May be associated with nausea and vomit...",
"[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--> [ME04.0] Fluid in peritoneal cavity",
"[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --CHILD--> [ME04.Z] Ascites, unspecified"
] |
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": "ME04.Y",
"icd10_code": "R188",
"icd10_title": "Other ascites"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A1883",
"icd10_title": "Tuberculosis of digestive tract organs, not elsewhere classified"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A1832",
"icd10_title": "Tuberculous enteritis"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A1884",
"icd10_title": "Tuberculosis of heart"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A1889",
"icd10_title": "Tuberculosis of other sites"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A1839",
"icd10_title": "Retroperitoneal tuberculosis"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A1831",
"icd10_title": "Tuberculous peritonitis"
},
{
"from_icd11": "1B12.7",
"icd10_code": "K67",
"icd10_title": "Disorders of peritoneum in infectious diseases classified elsewhere"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A183",
"icd10_title": "Tuberculosis of intestines, peritoneum and mesenteric glands"
},
{
"from_icd11": "1B12.7",
"icd10_code": "A188",
"icd10_title": "Tuberculosis of other specified organs"
}
] |
R100
|
Acute abdomen
|
The proband was the second child of healthy and nonconsanguineous Italian parents from Sicily. He was born preterm, at 28 + 6/7 weeks after a naturally conceived pregnancy, by cesarean section for premature rupture of membranes, chorioamnionitis and fetal distress. Apgar scores were 7 and 7, at 1 and 5 min, respectively. At birth, his weight was 1360 g (80th centile), length 40 cm (86th centile), and occipitofrontal circumference (OFC) 28.4 cm (89th centile). On physical examination, he showed dysmorphic features: prominent forehead, hypertelorism, broad nasal bridge, anteverted nares, flattened philtrum, thin upper lip, and high-arched palate. Neurological examination revealed, marked generalized hypotonia with presence of deep tendon reflexes, depressed neonatal reflexes, poor spontaneous motility, right exophoria, disconjugated eye movements and weak cry . Brain ultrasound (US) showed normal corpus callosum and mild dilatation of the left lateral ventricle. He had poor respiratory adaptation with tachypnea needing non-invasive ventilatory support from birth to 3 months CrA (15 days CA). From birth repeated Video-EEG monitoring showed sporadic spontaneous as well as provoked clonic and spontaneous motor paroxysms involving limbs, without concomitant EEG discharge . He necessitated of frequent oropharyngeal aspirations due to swallowing dysfunction, an early sign of incoordination of sucking-swallowing and breathing. These findings suggested, in relation to failure to thrive and frequent episodes of reflux associated with apnea, to convert to a nasogastric tube feeding regimen until insertion, at 4.5 months CrA, of a percutaneous endoscopic gastrostomy (PEG). At 5 months of CrA, corresponding to 2.5 months CA, a brain MRI revealed a mild diffuse cerebral atrophy, hypoplasia of the corpus callosum, cerebellar vermis hypoplasia and bilateral incomplete hippocampal inversion . Visual evoked potentials (VEP) recorded to binocular flash stimulation showed a delayed P100 latency (240 msec in right hemisphere, 270 msec in left hemisphere), and brainstem auditory evoked potentials (BAEP) showed increased hearing threshold (60 dB) in the right ear and absence response even at high-intensity stimulation (110 dB) in the left ear. Extended newborn screening for inherited metabolic disorders and aCGH were negative. Thus, on the basis of the clinical evolution suggesting a mitochondrial encephalopathy, a further metabolic diagnostic work-up was carried on. Plasma amino acids, acylcarnitines and biotinidase were normal, while urinary organic acids analysis showed marked increase of 4-OH phenylacetic acid, along with a moderate increase of phenylpyruvic and mild increase of ethylmalonic and fumaric acids. Thus, at 5 months CA, WES analysis was performed. The genomic sequencing, followed by direct sequencing, found and confirmed that the patient carried a compound heterozygous mutation in the LRPPRC gene, c.1921–7A > G and c.2056A > G (p.Ile686Val), splicing-site and missense variants, inherited from the mother and the father, respectively. The mutation of maternal origin and has not hitherto been described in the literature. Therefore, based on current knowledge, the variant can be classified as likely pathogenic (class IV). The second variant of paternal origin consisted in a replacement of an adenine with a guanine in position 2056 of the codon 686, determining the substitution of isoleucine with valine. This variant has not been described in the literature too, and according to current knowledge, can be classified of uncertain significance (class III). Parents refused any further invasive investigation for the execution of functional studies that could demonstrate COX activity deficit. Thus, to assess the functional effect of mRNA transcripts, we performed a reverse transcription-polymerase chain reaction (RT-PCR) that demonstrated the deletion of 45 base pairs in the exon 19 with a likely deletion of 15 amino acids in the encoded protein. He is currently 14 months CA, his weight is 5.500 g (− 5.4 SD), length 65 cm (− 5.2 SD) and OFC 40.6 cm (− 4.6 SD). Owing to the severe generalized hypotonia he has to lie in bed with nasal cannula O2 supplementation. He shows only sporadic movements of head rotation without focusing on a nearby object. Neither vocalization nor blinking reaction to bell and rattle are present. He is unable to move his limbs and maintains adducted thumbs in both hands . Nutritional supply with protein hydrolysate, MCT, Vitamin supplements, L-carnitine and glycopyrrolate for drooling are provided by PEG. However, he has never experienced to date episodes of acute ketosis, glycemic derangements, or any acute stroke like events. A home rehabilitation treatment has been started. Fig. 1 Neonatal dysmorphic facial features: prominent forehead, hypertelorism, broad nasal bridge, flattened philtrum, thin upper lip. Right exophoria is present Fig. 2 Awake video-EEG at 2.5 months CA: spontaneous motor paroxysm involving left harm without concomitant EEG discharge Fig. 3 Brain MRI T2 sagittal image: mild diffuse cerebral atrophy, hypoplasia of the corpus callosum (white arrow), cerebellar vermis hypoplasia (white circle) Fig. 4 Brain MRI T2 coronal image: incomplete bilateral hippocampal inversion (white arrows) and left lateral ventricle dilatation Fig. 5 Patient 14 months CA: Bilateral adducted thumbs
| 4.226563
| 0.958008
|
sec[1]/p[1]
|
en
| 0.999996
|
32972427
|
https://doi.org/10.1186/s13052-020-00903-7
|
[
"spontaneous",
"brain",
"hypoplasia",
"acids",
"birth",
"centile",
"nasal",
"corpus",
"callosum",
"without"
] |
[
{
"code": "PB1Z",
"title": "Unintentional exposure to unspecified thermal mechanism"
},
{
"code": "FB32.1",
"title": "Spontaneous rupture of muscle"
},
{
"code": "MB47.5",
"title": "Fasciculation"
},
{
"code": "FB41.2",
"title": "Spontaneous rupture of tendon"
},
{
"code": "GC01.3",
"title": "Rupture of bladder, nontraumatic"
},
{
"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 ===
[PB1Z] Unintentional exposure to unspecified thermal mechanism
Also known as: Unintentional exposure to unspecified thermal mechanism | thermal injuries and inhalation of products of combustion | Exposure to unspecified smoke, fire and flames | burning NOS | fire
[FB32.1] Spontaneous rupture of muscle
Definition: This is a spontaneous tearing or separation of muscle fibres from other muscle fibres and/or tendons in the absence of trauma.
Also known as: Spontaneous rupture of muscle | nontraumatic rupture of muscle | Spontaneous rupture of muscle, multiple sites | nontraumatic rupture of muscle, multiple sites | Spontaneous rupture of muscle, shoulder region
Excludes: rupture of tendon | traumatic rupture of muscle - see injury of muscle by body region
[MB47.5] Fasciculation
Also known as: Fasciculation | flickering muscles | fluttering muscles | muscle fasciculation | muscular fasciculation
[FB41.2] Spontaneous rupture of tendon
Also known as: Spontaneous rupture of tendon | spontaneous rupture of unspecified tendon, site unspecified | spontaneous tendon rupture | degenerative rupture of tendon | nontraumatic rupture of tendon
[GC01.3] Rupture of bladder, nontraumatic
Definition: A condition of the bladder, caused by determinants not attributable to wound or injury. This condition is characterised by rupture of the bladder.
Also known as: Rupture of bladder, nontraumatic | bladder rupture due to non-traumatic cause | spontaneous rupture of bladder | ruptured bladder NOS | Rupture of a reservoir for urinary diversion, non-traumatic
[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 ---
[PB1Z] Unintentional exposure to unspecified thermal mechanism
--PARENT--> [?] Unintentional exposure to thermal mechanism
--PARENT--> [?] Unintentional causes
--- Walk 2 ---
[PB1Z] Unintentional exposure to unspecified thermal mechanism
--PARENT--> [?] Unintentional exposure to thermal mechanism
--PARENT--> [?] Unintentional causes
--- Walk 3 ---
[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....
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--EXCLUDES--> [?] Pathological fracture
--- Walk 4 ---
[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....
--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....
--PARENT--> [?] Disorders of muscles
--- Walk 5 ---
[MB47.5] Fasciculation
--PARENT--> [MB47] Abnormality of tonus or reflex
--PARENT--> [?] Symptoms or signs involving the nervous system
--- Walk 6 ---
[MB47.5] Fasciculation
--PARENT--> [MB47] Abnormality of tonus or reflex
--CHILD--> [MB47.1] Abnormal posture
|
[
"[PB1Z] Unintentional exposure to unspecified thermal mechanism\n --PARENT--> [?] Unintentional exposure to thermal mechanism\n --PARENT--> [?] Unintentional causes",
"[PB1Z] Unintentional exposure to unspecified thermal mechanism\n --PARENT--> [?] Unintentional exposure to thermal mechanism\n --PARENT--> [?] Unintentional causes",
"[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....\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",
"[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....\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 --PARENT--> [?] Disorders of muscles",
"[MB47.5] Fasciculation\n --PARENT--> [MB47] Abnormality of tonus or reflex\n --PARENT--> [?] Symptoms or signs involving the nervous system",
"[MB47.5] Fasciculation\n --PARENT--> [MB47] Abnormality of tonus or reflex\n --CHILD--> [MB47.1] Abnormal posture"
] |
PB1Z
|
Unintentional exposure to unspecified thermal mechanism
|
[
{
"from_icd11": "PB1Z",
"icd10_code": "X088XXD",
"icd10_title": "Exposure to other specified smoke, fire and flames, subsequent encounter"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X088XXS",
"icd10_title": "Exposure to other specified smoke, fire and flames, sequela"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X19XXXA",
"icd10_title": "Contact with other heat and hot substances, initial encounter"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X088XXA",
"icd10_title": "Exposure to other specified smoke, fire and flames, initial encounter"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X19XXXS",
"icd10_title": "Contact with other heat and hot substances, sequela"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X0819XA",
"icd10_title": "Exposure to sofa fire due to other burning material, initial encounter"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X00-X09",
"icd10_title": ""
},
{
"from_icd11": "PB1Z",
"icd10_code": "X09",
"icd10_title": ""
},
{
"from_icd11": "PB1Z",
"icd10_code": "X10-X19",
"icd10_title": ""
},
{
"from_icd11": "PB1Z",
"icd10_code": "X19",
"icd10_title": "Contact with other heat and hot substances"
},
{
"from_icd11": "PB1Z",
"icd10_code": "X08",
"icd10_title": "Exposure to other specified smoke, fire and flames"
},
{
"from_icd11": "FB32.1",
"icd10_code": "M62152",
"icd10_title": "Other rupture of muscle (nontraumatic), left thigh"
},
{
"from_icd11": "FB32.1",
"icd10_code": "M62161",
"icd10_title": "Other rupture of muscle (nontraumatic), right lower leg"
},
{
"from_icd11": "FB32.1",
"icd10_code": "M6210",
"icd10_title": "Other rupture of muscle (nontraumatic), unspecified site"
},
{
"from_icd11": "FB32.1",
"icd10_code": "M621",
"icd10_title": "Other rupture of muscle (nontraumatic)"
}
] |
X088XXD
|
Exposure to other specified smoke, fire and flames, subsequent encounter
|
We followed this young male patient with bilateral exudative retinal detachment with APMPPE for a long time and observed the changing retinal and choroidal features by multimodal imaging. FFA of the patient at the early of onset showed late venous manifestations of multiple placoid hypofluorescent areas in the posterior pole, and late images showed hyperfluorescence consistent with placoid lesions with subretinal dye aggregation and lesions as far as the equatorial retina. Due to optic discitis in the left eye, resulting in optic disc staining , localized retinal capillary dilation in the temporal periphery of the right eye, with fluorescence staining of small vessel walls; over time, the lesions continued to progress and were widely distributed, with lesions visible at different times in images of the same period . The fundus photography (AFC-330; Nidek, Japan) showed that progressed from limited yellow/white lesions in the acute phase to yellow/white lesions coexistence with pigment proliferation, and widespread distribution of lesions and pigmentation over time . Changes in fundus autofluorescence (FAF) were shown to lag behind the placoid APMPPE lesions seen on clinical examination during follow-up and were less numerous. As disease activity diminished, the same areas showed enhanced autofluorescence, with low autofluorescence persisting within the lesion and at the lesion margin. Over time, the high autofluorescence within the lesion and surrounding areas became more discrete, with decreased fluorescence intensity and increased areas of low autofluorescence . OCT showed fluid accumulating between the neurosensory retina and RPE of this case, at the onset. After glucocorticoid treatment, the subfoveal fluid accumulation was resorbed, and some hyperreflective signals were visible in the outer retina layer, suggesting the presence of inflammatory deposits. With the absorption of inflammatory deposits, the outer retinal strips were interrupted, the outer nuclear layer was thinned, the outer plexiform layer seemed to be directly connected to the outer membrane and RPE layer, and the myoid band, ellipsoid band and photoreceptor outer segments were missing. With the prolongation of the disease, the outer retinal structures were further reorganized and normalized, the outer nuclear layer gradually regained its normal hyporeflectivity, the ellipsoidal body band at the fovea was partially reappearing with the outer segmental membrane disc light band, and the connection with the RPE was undergoing reorganization . Fig. 1 Fluorescence angiography image of the patient. The fluorescence angiogram at the early stage of the disease showed multiple placoid hypofluorescent areas in the posterior pole of the vein at the late stage, and the advanced image showed hyperfluorescence consistent with placoid lesions with subretinal dye aggregation and optic disc staining in the left eye; at the 18-month follow-up, new fluorescent changes in different locations could be seen on fluorescence angiography, and these lesions stabilized after treatment Fig. 2 Color photograph of the patient's fundus. Retinal edema with limited neuroepithelial detachment in the early stage of the disease, with optic papilla edema in the left eye and multiple deep yellow-white lesions visible near the macula; over time, the lesions became widely distributed and pigmented Fig. 3 Autofluorescence images of the patient's bilateral fundus. the FAF shows a gradual increase in the extent of the lesion over the course of follow-up, with the same areas showing increased autofluorescence as the disease activity diminishes, and low autofluorescence persisting within the lesion and at the edge of the lesion. Over time, the high autofluorescence within the lesion and surrounding areas became more discrete, with a decrease in fluorescence intensity and an increase in areas of low autofluorescence Fig. 4 a , b OCT images of both eyes of the patient. OCT at the initial visit showed a fluid accumulating between the neurosensory retina and RPE. In addition, membranous structure and cystoid spaces were found in the left eye; c , d One week after glucocorticoid treatment, the fluid was resorbed, the inflammatory interval faded, the subretinal fluid in the macular area of the left eye was resorbed, some hyperreflective signals were visible in the outer retina, and similar retinal changes were also seen in the right eye; e , f OCT showed absorption of subretinal fluid and inflammatory deposits in the macular area of the left eye, disruption of the outer retinal strips, thinning of the outer nuclear layer, the outer plexiform layer appeared to be directly connected to the outer membrane and RPE layer, absence of the myoid band, ellipsoid band and outer photoreceptor segments, similar outer retinal lesions, also seen in the temporal side of the right eye, at 18-month follow-up visit; g , h OCT showed further reorganization and normalization of the outer retinal structures, whose outer nuclear layer had regained its normal hyporeflectivity, with partial reappearance of the ellipsoid band outer segmental membrane disc light band at the fovea, and ongoing reorganization at the connection with the RPE; the ellipsoid band was still missing in the temporal side of the right eye, but the outer retinal layer at the lesion was being reorganized, at 28-month follow-up visit
| 4.265625
| 0.783691
|
sec[1]/p[1]
|
en
| 0.999997
|
PMC9547405
|
https://doi.org/10.1186/s12886-022-02624-3
|
[
"outer",
"lesions",
"retinal",
"autofluorescence",
"layer",
"band",
"areas",
"lesion",
"time",
"fluorescence"
] |
[
{
"code": "9B65.1",
"title": "Infectious posterior uveitis"
},
{
"code": "2C6Z",
"title": "Malignant neoplasms of breast, unspecified"
},
{
"code": "9B65.0",
"title": "Noninfectious posterior uveitis"
},
{
"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": "9B7Z",
"title": "Disorders of the retina, unspecified"
},
{
"code": "9B74.Z",
"title": "Retinal vascular occlusions, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[9B65.1] Infectious posterior uveitis
Also known as: Infectious posterior uveitis | infectious choroiditis | Herpesvirus retinitis | Acute retinal necrosis | Progressive outer retinal necrosis
[2C6Z] Malignant neoplasms of breast, unspecified
Also known as: Malignant neoplasms of breast, unspecified | breast cancer | primary breast cancer | cancer of breast | malignant neoplasm of connective tissue of breast
[9B65.0] Noninfectious posterior uveitis
Also known as: Noninfectious posterior uveitis | noninfectious choroiditis | Posterior uveitis due to Vogt Koyanagi Harada syndrome | Sympathetic Ophthalmia | sympathetic ophthalmitis
[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
[9B7Z] Disorders of the retina, unspecified
Also known as: Disorders of the retina, unspecified | retinal disease | retinal lesion NOS
[9B74.Z] Retinal vascular occlusions, unspecified
Also known as: Retinal vascular occlusions, unspecified | Retinal vascular occlusions | occlusion of retinal vessels | retinal obstruction
=== GRAPH WALKS ===
--- Walk 1 ---
[9B65.1] Infectious posterior uveitis
--RELATED_TO--> [?] Viral retinitis
--CHILD--> [?] HIV retinitis
--- Walk 2 ---
[9B65.1] Infectious posterior uveitis
--RELATED_TO--> [?] Viral retinitis
--PARENT--> [?] Infectious posterior uveitis
--- Walk 3 ---
[2C6Z] Malignant neoplasms of breast, unspecified
--PARENT--> [?] Malignant neoplasms of breast
Def: The category refers to primary malignant neoplasms of parenchyma, connective, and soft tissue of the breast, including nipple and areola....
--EXCLUDES--> [?] Malignant neoplasms of skin
Def: A primary or metastatic tumour involving the skin. Primary malignant skin tumours most often are carcinomas (either basal cell or squamous cell carcinomas that arise from cells in the epidermis) or me...
--- Walk 4 ---
[2C6Z] Malignant neoplasms of breast, unspecified
--PARENT--> [?] Malignant neoplasms of breast
Def: The category refers to primary malignant neoplasms of parenchyma, connective, and soft tissue of the breast, including nipple and areola....
--EXCLUDES--> [?] Malignant mesenchymal neoplasms
Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...
--- Walk 5 ---
[9B65.0] Noninfectious posterior uveitis
--RELATED_TO--> [?] Ocular Behçet disease
--PARENT--> [?] Behçet disease
Def: Behçet disease is a disease of incompletely understood aetiopathogenesis characterised by recurrent oral and/or genital aphthous ulcers accompanied by cutaneous, ocular, articular, gastrointestinal, a...
--- Walk 6 ---
[9B65.0] Noninfectious posterior uveitis
--RELATED_TO--> [?] Ocular Behçet disease
--PARENT--> [?] Noninfectious posterior uveitis
|
[
"[9B65.1] Infectious posterior uveitis\n --RELATED_TO--> [?] Viral retinitis\n --CHILD--> [?] HIV retinitis",
"[9B65.1] Infectious posterior uveitis\n --RELATED_TO--> [?] Viral retinitis\n --PARENT--> [?] Infectious posterior uveitis",
"[2C6Z] Malignant neoplasms of breast, unspecified\n --PARENT--> [?] Malignant neoplasms of breast\n Def: The category refers to primary malignant neoplasms of parenchyma, connective, and soft tissue of the breast, including nipple and areola....\n --EXCLUDES--> [?] Malignant neoplasms of skin\n Def: A primary or metastatic tumour involving the skin. Primary malignant skin tumours most often are carcinomas (either basal cell or squamous cell carcinomas that arise from cells in the epidermis) or me...",
"[2C6Z] Malignant neoplasms of breast, unspecified\n --PARENT--> [?] Malignant neoplasms of breast\n Def: The category refers to primary malignant neoplasms of parenchyma, connective, and soft tissue of the breast, including nipple and areola....\n --EXCLUDES--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...",
"[9B65.0] Noninfectious posterior uveitis\n --RELATED_TO--> [?] Ocular Behçet disease\n --PARENT--> [?] Behçet disease\n Def: Behçet disease is a disease of incompletely understood aetiopathogenesis characterised by recurrent oral and/or genital aphthous ulcers accompanied by cutaneous, ocular, articular, gastrointestinal, a...",
"[9B65.0] Noninfectious posterior uveitis\n --RELATED_TO--> [?] Ocular Behçet disease\n --PARENT--> [?] Noninfectious posterior uveitis"
] |
9B65.1
|
Infectious posterior uveitis
|
[
{
"from_icd11": "2C6Z",
"icd10_code": "C50111",
"icd10_title": "Malignant neoplasm of central portion of right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50811",
"icd10_title": "Malignant neoplasm of overlapping sites of right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50212",
"icd10_title": "Malignant neoplasm of upper-inner quadrant of left female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50611",
"icd10_title": "Malignant neoplasm of axillary tail of right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50311",
"icd10_title": "Malignant neoplasm of lower-inner quadrant of right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50112",
"icd10_title": "Malignant neoplasm of central portion of left female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50512",
"icd10_title": "Malignant neoplasm of lower-outer quadrant of left female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50812",
"icd10_title": "Malignant neoplasm of overlapping sites of left female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50211",
"icd10_title": "Malignant neoplasm of upper-inner quadrant of right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50011",
"icd10_title": "Malignant neoplasm of nipple and areola, right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50511",
"icd10_title": "Malignant neoplasm of lower-outer quadrant of right female breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50822",
"icd10_title": "Malignant neoplasm of overlapping sites of left male breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50921",
"icd10_title": "Malignant neoplasm of unspecified site of right male breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50121",
"icd10_title": "Malignant neoplasm of central portion of right male breast"
},
{
"from_icd11": "2C6Z",
"icd10_code": "C50012",
"icd10_title": "Malignant neoplasm of nipple and areola, left female breast"
}
] |
C50111
|
Malignant neoplasm of central portion of right female breast
|
Several teaching points can be made in this case. A peritoneal involvement of gastric adenocarcinoma can cause bilateral ureteral obstruction. Our patient had a rare presentation of gastric cancer with urinary tract obstruction causing acute kidney injury. Urinary tract obstruction is a rare cause of acute kidney injury in adults. However, it is a common cause of acute kidney injury in patients with cancer, especially those with malignancies of the bladder, prostate, uterus, or cervix, but exceptionally gastric cancer. Our patient presented with acute kidney injury and anuria with no significant electrolytes or acid–base imbalance and was not known to have neoplasia at presentation. Gastric cancer is one of the most common cancers worldwide. 6 It may spread to the urinary tract by hematogenous or lymphatic channels or involve these structures by direct extension and likely compress rather than invade them. 7 Signs and symptoms of metastatic disease to the urinary tract usually appear late in the course of gastric cancer and may only be recognized preterminal or at autopsy. Acute kidney injury caused by obstructive uropathy secondary to gastric cancer is rare. It occurred mainly during treatment of the cancerous malignancy 8 – 13 but rarely at presentation (only in 17% of cases), as in our patient. 14 Acute renal injury as a presentation of gastric cancer is mainly an obstructive injury rather than a renal injury caused by crescent glomerulonephritis. 15 Acute kidney injury caused by obstructive uropathy is mainly due to intratubular obstruction of uric acid crystals in uric acid nephropathy, light chain casts in cast nephropathy, xanthine, hypoxanthine, calcium phosphate, or crystallization of certain drugs such as high-dose methotrexate. 16 , 17 It is less likely secondary to extrinsic compression of the urinary tract from metastatic abdominal malignancies, which can result from peritoneal involvement, as in our patient, 14 metastasis to the bladder, 18 , 19 metastasis to the uterine cervix, 19 or retroperitoneal fibrosis. 20 Urinary tract obstruction secondary to gastric cancer can occur anywhere along the urinary tract, at one or multiple sites. 14 It is symptomatic in half of the cases. 5 Urinary tract obstruction is an occasional complication in patients with gastric cancer. It is rarely complicated by acute kidney injury, observed only in 8% of the cases, and due to bilateral obstruction in most patients as in our patient. 5 , 21 Obstruction is less likely unilateral and occurs if the contralateral kidney is absent or has lesions such as acute tubular necrosis or in the presence of underlying kidney disease. 22 Acute kidney injury is a result of decreased renal blood flow and glomerular filtration rate due to the activation of the renin–angiotensin system, prostaglandins, thromboxane, and kinin–kallikrein system. 23 The clinicobiological spectrum of acute obstructive renal failure is a rise in renal function tests and acute urine retention, resulting in oligo anuria, as in our patient upon presentation. Acute urine retention can result in the inability to pass urine voluntarily. The patient can have abdominal or flank pain, frequently observed in 40% of the cases, and this was not observed in our patient. 5 On physical examination, we can find a palpable bladder that is percussible and sensitive to pain when the patient is unable to pass urine or there was costovertebral angle tenderness. However, these symptoms are not always seen, as in our case. Estimating and measuring the glomerular filtration rate in patients with acute kidney injury are not recommended. 24 An increase in cystatin C level demonstrates better performance compared with creatinine as a better indicator of the severity of obstructive uropathy. 25 The diagnosis of urinary tract obstruction is usually established by imaging studies, which should be performed in all patients who present with acute kidney injury of unknown cause. They typically show hydronephrosis and can be characteristic of urinary tract involvement secondary to gastric cancer. 26 Hydronephrosis is an anatomical diagnosis, which is characterized by the dilation of the urinary tract caused by gastric cancer-induced extrinsic compression of the ureter, culminating in urine retention that expands the upper urinary tract. 27 It is likely bilateral, as in our patient. 5 , 21 In some cases, it is unilateral, resulting in unilateral obstruction with an absent contralateral kidney, lesions such as acute tubular necrosis, or underlying kidney disease. 22 Ultrasonography is the preferred imaging test for most patients with acute renal injury caused by obstructive uropathy, as it is safe, relatively inexpensive with a negative predictive value of 98%, and a positive predictive value reaching 70%, 28 but it can be as low as 6% for mild hydronephrosis as an incidental finding. 28 , 29 The dilation of the upper urinary tract appears as a hypoechoic area inside the renal cortex. 28 Kidneys appear to be large. 30 Visualizing the bladder is important when establishing hydronephrosis; if the urinary post-void volume exceeds 150 mL, it suggests urinary retention. 31 Doppler ultrasonography can often detect the pulsatile movement of the urine into the bladder (ureteral jets) by B-mode sonography, and the absence or decreased frequency of these indicates urinary obstruction. 32
| 4.328125
| 0.829102
|
sec[2]/p[0]
|
en
| 0.999997
|
PMC8900715
|
https://doi.org/10.5339/qmj.2022.15
|
[
"urinary",
"kidney",
"injury",
"tract",
"gastric",
"obstruction",
"cancer",
"renal",
"patients",
"obstructive"
] |
[
{
"code": "GB6Z",
"title": "Kidney failure, unspecified"
},
{
"code": "GC04.Z",
"title": "Fistula of the genitourinary tract, unspecified"
},
{
"code": "MF51",
"title": "Anuria or oliguria"
},
{
"code": "GB70.Z",
"title": "Calculus of upper urinary tract, unspecified"
},
{
"code": "GC2Z",
"title": "Diseases of the urinary system, unspecified"
},
{
"code": "GC2Z&XA6KU8",
"title": "Disease of kidney, not elsewhere classified"
},
{
"code": "LB30.1",
"title": "Renal dysplasia"
},
{
"code": "NB92.0Y",
"title": "Other specified injury of kidney"
},
{
"code": "LB30.7",
"title": "Ectopic or pelvic kidney"
},
{
"code": "ND56.Z",
"title": "Unspecified injury to unspecified part of trunk, limb or body region"
}
] |
=== ICD-11 CODES FOUND ===
[GB6Z] Kidney failure, unspecified
Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS
[GC04.Z] Fistula of the genitourinary tract, unspecified
Also known as: Fistula of the genitourinary tract, unspecified | Fistula of the genitourinary tract | persistent urinary fistula | persistent urinary tract fistula | recurrent urinary fistula
[MF51] Anuria or oliguria
Definition: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 300-500ml/day.
Also known as: Anuria or oliguria | Anuria | suppression of urinary secretion | ischuria | Oliguria
Excludes: Maternal care for other conditions predominantly related to pregnancy
[GB70.Z] Calculus of upper urinary tract, unspecified
Also known as: Calculus of upper urinary tract, unspecified | Calculus of upper urinary tract | calculus of urinary tract NOS | urinary calculi | urinary calculus, unspecified
[GC2Z] Diseases of the urinary system, unspecified
Also known as: Diseases of the urinary system, unspecified | urinary tract disease NOS | Abnormal renal function | kidney dysfunction NOS | kidney hypofunction
[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
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--EXCLUDES--> [?] Hypertensive renal disease
Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....
--- Walk 2 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--RELATED_TO--> [?] Congenital renal failure
Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,...
--- Walk 3 ---
[GC04.Z] Fistula of the genitourinary tract, unspecified
--PARENT--> [GC04] Fistula of the genitourinary tract
Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within...
--CHILD--> [GC04.2] Ureteral fistula
Def: Abnormal passage or communication between the ureter and another body organ or cavity or the body surface....
--- Walk 4 ---
[GC04.Z] Fistula of the genitourinary tract, unspecified
--PARENT--> [GC04] Fistula of the genitourinary tract
Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within...
--CHILD--> [GC04.0] Urethral fistula
Def: A condition of the urethra, caused by surgery, infection, trauma, or congenital factors. This condition is characterised by the formation of an abnormal passage between the urethra and adjacent organs...
--- Walk 5 ---
[MF51] Anuria or oliguria
Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3...
--EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy
Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....
--CHILD--> [?] Excessive weight gain in pregnancy
Def: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy....
--- Walk 6 ---
[MF51] Anuria or oliguria
Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3...
--EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy
Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....
--CHILD--> [?] 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....
|
[
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --EXCLUDES--> [?] Hypertensive renal disease\n Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....",
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --RELATED_TO--> [?] Congenital renal failure\n Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,...",
"[GC04.Z] Fistula of the genitourinary tract, unspecified\n --PARENT--> [GC04] Fistula of the genitourinary tract\n Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within...\n --CHILD--> [GC04.2] Ureteral fistula\n Def: Abnormal passage or communication between the ureter and another body organ or cavity or the body surface....",
"[GC04.Z] Fistula of the genitourinary tract, unspecified\n --PARENT--> [GC04] Fistula of the genitourinary tract\n Def: Any condition caused by trauma, medical intervention, infection, cancer, or congenital factors. This condition is characterised by the formation of an abnormal passage between any two locations within...\n --CHILD--> [GC04.0] Urethral fistula\n Def: A condition of the urethra, caused by surgery, infection, trauma, or congenital factors. This condition is characterised by the formation of an abnormal passage between the urethra and adjacent organs...",
"[MF51] Anuria or oliguria\n Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3...\n --EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....\n --CHILD--> [?] Excessive weight gain in pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for excessive weight gain during pregnancy....",
"[MF51] Anuria or oliguria\n Def: Anuria means nonpassage of urine, in practice is defined as passage of less than 50 millilitres of urine in a day. Oliguria is the low output of urine. It is clinically classified as an output below 3...\n --EXCLUDES--> [?] Maternal care for other conditions predominantly related to pregnancy\n Def: Any reason for encounter to assess (or care for) a mother for other conditions predominantly related to pregnancy....\n --CHILD--> [?] 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...."
] |
GB6Z
|
Kidney failure, unspecified
|
[
{
"from_icd11": "GB6Z",
"icd10_code": "N19",
"icd10_title": "Unspecified kidney failure"
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17-N19",
"icd10_title": ""
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17",
"icd10_title": "Acute kidney failure"
},
{
"from_icd11": "GC04.Z",
"icd10_code": "N321",
"icd10_title": "Vesicointestinal fistula"
},
{
"from_icd11": "MF51",
"icd10_code": "R34",
"icd10_title": "Anuria and oliguria"
},
{
"from_icd11": "GB70.Z",
"icd10_code": "N202",
"icd10_title": "Calculus of kidney with calculus of ureter"
},
{
"from_icd11": "GB70.Z",
"icd10_code": "N209",
"icd10_title": "Urinary calculus, unspecified"
},
{
"from_icd11": "GB70.Z",
"icd10_code": "N20",
"icd10_title": "Calculus of kidney and ureter"
},
{
"from_icd11": "LB30.1",
"icd10_code": "Q614",
"icd10_title": "Renal dysplasia"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q632",
"icd10_title": "Ectopic kidney"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q63",
"icd10_title": "Other congenital malformations of kidney"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1491XA",
"icd10_title": "Suicide attempt, initial encounter"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1490XS",
"icd10_title": "Injury, unspecified, sequela"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1490",
"icd10_title": "Injury, unspecified"
},
{
"from_icd11": "ND56.Z",
"icd10_code": "T1491",
"icd10_title": "Suicide attempt"
}
] |
N19
|
Unspecified kidney failure
|
A 28-year-old male complained of a sudden loss of vision in the left eye for 1 week when presented to our hospital. He had hypertension for more than 3 years without regular treatment but had no history of any other systemic illness, drug use, myopia, and trauma. Three weeks ago, he was admitted to other hospital due to sudden severe pain and blurred vision of the left eye for 1 h. At the time of admission, the blood pressure was 230/120 mmHg, the intraocular pressure was 69 mmHg, there were conjunctival hyperemia and corneal edema, the pupil diameter was 2.5 mm. Skull CT and MRI detected abnormal signal shadows in the left eye and no abnormalities in the brain. B-ultrasonography indicated an occupying lesion in the left eye. The hospital considered the diagnosis of glaucoma and choroidal occupying lesion. The patient was given symptomatic treatment to reduce the intraocular and blood pressure, including mannitol by intravenous drip, Catinolol Hydrochloride and Brinzolamide eye drops, oral antihypertensives. Due to which, the symptoms improved. However, after 2 weeks, the patient came to our hospital for treatment due to the sudden loss of vision in the left eye. Further examination revealed the following: the blood pressure was 200/120 mmHg, best-corrected visual acuity was 20/20 in the right eye and hand motion in the left eye, and the anterior segment was normal, there were no hyperemia, corneal edema and mydriasis, the intraocular pressure was normal. Fundus camera displayed disc hemorrhage near the optic disc and hard and soft exudates at posterior pole in the right eye; fundus details could not be evaluated in the left eye because of hemorrhage in the vitreous cavity. B-ultrasonography of the left eye revealed a dense, diffuse intravitreal hemorrhage. Skull MRI revealed abnormal signal shadow in the left eyeball (beside the lateral wall), considering the possibility of intraocular hemorrhage. Laboratory examination showed that serum creatinine was 178.0 (53–106 mol/L), and total cholesterol was 6.63 (2.83–5.20 mmol/L). The blood routine and coagulation function were normal, serum infection and immune tests were within normal limits, tumor marker were negative, and no abnormality was found on chest CT or abdominal ultrasound. Thus, the following diagnosis was considered: left eye vitreous hemorrhage, right eye hypertensive retinopathy, hypertension combined with hypertensive crisis, and hyperlipidemia. We recommended a medical consultation for blood pressure reduction, kidney protection, lipid regulation, and other treatments. After the blood pressure was stabilized, vitrectomy combined with silicone oil tamponade of the left eye was performed, retinal vascular abnormalities were ruled out in the vitrectomy performed. In order to keep the refractive medium transparent, silicone oil was used as an endotamponade. The intraoperative finding was an inferotemporal subretinal focal elevated lesion with distinct boundary and yellow color. Since the nature of the elevated lesion could not be determined, it was not treated. No abnormal cells were found in the pathology of vitreous fluid during the operation. Any obvious abnormality was not observed in the macular optical coherence tomography (OCT) of the left eye after surgery. Infrared photography showed a dome-shaped bulge in the peripheral part of the inferotemporal region of the left eye. ICGA showed low fluorescence occlusion and no abnormal fluorescence leakage in the elevated lesion. Combined with the results of systemic and ocular examination, SSRH in the left eye was considered. After close follow-up, the SSRH was found to be gradually reabsorbed, albeit at a slower rate, best-corrected visual acuity was 20/20 in the right eye and 20/25 in the left eye at 1 month after the operation, silicone oil was removed 9 months after surgery. The SSRH was mostly absorbed in his last follow-up visit (1 year after the vitrectomy) . Fig. 1 a Skull CT and MRI (other hospital). Abnormal signal shadow in the left eyeball (beside the lateral wall). b B-ultrasonography (other hospital). A dome-shaped retinal detachment of the left eye. c Fundus camera. Disc hemorrhage near the optic disc and yellow and white exudation at posterior pole in the right eye; fundus details could not be evaluated in the left eye because of hemorrhage in the vitreous cavity. d B-ultrasonography. A dense, diffuse intravitreal hemorrhage of the left eye. e Skull MRI. Abnormal signal shadow in the left eyeball (beside the lateral wall), considering the possibility of intraocular hemorrhage. f Intraoperative findings: inferotemporal subretinal focal elevated lesion with clear boundary and yellow color. g Three days OCT after the operation. Any obvious abnormality was not observed in the macular of the left eye. h Three days of infrared photography after the operation. A dome-shaped bulge in the peripheral part of the inferotemporal region of the left eye. i Three days ICGA after the operation. Low fluorescence occlusion and no abnormal fluorescence leakage in the elevated lesion. j Half a year ICGA after the operation. The hypofluorescence occlusion area under the retina of the left eye was significantly smaller than before. k Scanning laser ophthalmoscopy at 3 days, 3 months, 6 months, and 1.5 years after the operation. Subretinal elevated lesion was gradually reabsorbed of the left eye
| 3.871094
| 0.98291
|
sec[1]/p[0]
|
en
| 0.999998
|
32962682
|
https://doi.org/10.1186/s12886-020-01634-3
|
[
"hemorrhage",
"lesion",
"pressure",
"blood",
"intraocular",
"three",
"skull",
"signal",
"ultrasonography",
"fundus"
] |
[
{
"code": "MG27",
"title": "Haemorrhage, not elsewhere classified"
},
{
"code": "3B6Z",
"title": "Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified"
},
{
"code": "FB32.Y",
"title": "Other specified disorders of muscles"
},
{
"code": "FA36.0",
"title": "Effusion of joint containing blood"
},
{
"code": "JA41.Z",
"title": "Antepartum haemorrhage, unspecified"
},
{
"code": "FA5Z",
"title": "Arthropathies, unspecified"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "MD41",
"title": "Clinical findings on diagnostic imaging of lung"
},
{
"code": "GC2Z&XA6KU8",
"title": "Disease of kidney, not elsewhere classified"
}
] |
=== ICD-11 CODES FOUND ===
[MG27] Haemorrhage, not elsewhere classified
Definition: Bleeding or escape of blood from a vessel.
Also known as: Haemorrhage, not elsewhere classified | arterial haemorrhage | bleeding | extravasation of blood | Haemorrhage NOS
Excludes: Obstetric haemorrhage | Haemorrhage or haematoma complicating a procedure, not elsewhere classified | Fetal blood loss
[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
[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
[FA36.0] Effusion of joint containing blood
Also known as: Effusion of joint containing blood | bleeding into joint | hemarthrosis, site unspecified | haemarthrosis | joint haemorrhage
Includes: haemarthrosis
Excludes: Dislocation or strain or sprain of unspecified body region
[JA41.Z] Antepartum haemorrhage, unspecified
Also known as: Antepartum haemorrhage, unspecified | Antepartum haemorrhage | accidental antepartum haemorrhage | antepartum haemorrhage NOS | APH - [antepartum haemorrhage]
[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 ---
[MG27] Haemorrhage, not elsewhere classified
Def: Bleeding or escape of blood from a vessel....
--EXCLUDES--> [?] Obstetric haemorrhage
--CHILD--> [?] Intrapartum haemorrhage
--- Walk 2 ---
[MG27] Haemorrhage, not elsewhere classified
Def: Bleeding or escape of blood from a vessel....
--PARENT--> [?] General symptoms
--RELATED_TO--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
--- Walk 3 ---
[3B6Z] Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified
--PARENT--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions
Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...
--CHILD--> [?] 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...
--- Walk 4 ---
[3B6Z] Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified
--PARENT--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions
Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...
--CHILD--> [?] 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...
--- Walk 5 ---
[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--> [?] Myalgia
Def: This is a disorder characterised by pain in a muscle or group of muscles....
--- Walk 6 ---
[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--> [?] Myalgia
Def: This is a disorder characterised by pain in a muscle or group of muscles....
|
[
"[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --EXCLUDES--> [?] Obstetric haemorrhage\n --CHILD--> [?] Intrapartum haemorrhage",
"[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --PARENT--> [?] General symptoms\n --RELATED_TO--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....",
"[3B6Z] Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified\n --PARENT--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions\n Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...\n --CHILD--> [?] 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...",
"[3B6Z] Coagulation defects, purpura or other haemorrhagic or related conditions, unspecified\n --PARENT--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions\n Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...\n --CHILD--> [?] 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...",
"[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--> [?] Myalgia\n Def: This is a disorder characterised by pain in a muscle or group of muscles....",
"[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--> [?] Myalgia\n Def: This is a disorder characterised by pain in a muscle or group of muscles...."
] |
MG27
|
Haemorrhage, not elsewhere classified
|
[
{
"from_icd11": "MG27",
"icd10_code": "R58",
"icd10_title": "Hemorrhage, not elsewhere classified"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D684",
"icd10_title": "Acquired coagulation factor deficiency"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D6861",
"icd10_title": "Antiphospholipid syndrome"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D6869",
"icd10_title": "Other thrombophilia"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D6862",
"icd10_title": "Lupus anticoagulant syndrome"
},
{
"from_icd11": "3B6Z",
"icd10_code": "M311",
"icd10_title": "Thrombotic microangiopathy"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D699",
"icd10_title": "Hemorrhagic condition, unspecified"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D65-D69",
"icd10_title": ""
},
{
"from_icd11": "3B6Z",
"icd10_code": "D69",
"icd10_title": "Purpura and other hemorrhagic conditions"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D68",
"icd10_title": "Other coagulation defects"
},
{
"from_icd11": "3B6Z",
"icd10_code": "D686",
"icd10_title": "Other thrombophilia"
},
{
"from_icd11": "FB32.Y",
"icd10_code": "M6281",
"icd10_title": "Muscle weakness (generalized)"
},
{
"from_icd11": "FA36.0",
"icd10_code": "M25062",
"icd10_title": "Hemarthrosis, left knee"
},
{
"from_icd11": "FA36.0",
"icd10_code": "M25012",
"icd10_title": "Hemarthrosis, left shoulder"
}
] |
R58
|
Hemorrhage, not elsewhere classified
|
Our patient had type I cryoglobulinemia, but the renal biopsy exclude cryoglobulinemia-related renal injury. Instead, the renal biopsy revealed crystalline podocytopathy, tubulopathy, and secondary focal segmental glomerulosclerosis (FSGS). Thirteen similar previously reported cases are summarized in Table 1 [ 3 – 15 ]. Most patients (6/13) had a glomerular FSGS pattern or, rarely, collapsing FSGS (especially MM patients treated with pamidronate). The FSGS pattern in these patients is mostly likely secondary FSGS due to crystal deposition-induced podocyte injury, and most of the patients (11/13 patients) had mild to moderate proteinuria, which is similar to our case. However, our patient had a 4-year history of hypertension. The current renal biopsy revealed 12/29 globally sclerosed glomeruli with ischemic change and mild arteriolar and arterial sclerosis, which suggested that hypertension may also have contributed to the renal injury in this patient. In previous reports, ten patients had renal insufficiency and Fanconi syndrome was present in only 2 patients. Majority of the patients (11/13) had myeloma, and all patients including this case were monoclonal IgGκ. Mostly importantly, in crystal-storing renal injury, the IF staining of the light chain on frozen tissue was negative, which may be due to the light chain epitope hiding in the crystal pattern. However, immunostaining for light chains on paraffin tissue after antigenic retrieval and immuno-electron microscopy study can show monoclonal light chain deposition in the crystals, which is very important for the diagnosis. Table 1 Previous reports of crystalline podocytopathy and tubulopathy Sex/age Duration of onset to presentation Clinical renal manifestation Plasma cell dyscrasia Glomerular pathology Crystal distribution IHC Treatment Prognosis M/29 12 months Recurrent proteinuria after two kidney allografts, PCR 6 g/g, SCr 2.3 mg/dl MGUS→IgG-κ MM Recurrent FSGS Podocytes, proximal TEC IF/IHC:Positive for κ in TEC, λ negative Bortezomib, lenalidomide, dexamethasone Lacking F/66 During evaluation for back pain SCr 1.7 mg/dl, Fanconi syndrome, albumin 29 g/L, PCR 3.11μg/mgCr IgG-κ MM Non-specific Podocytes, MC, GEC, TEC, tubular lumen,histiocytes IF:Positive for κ; negative for λ Bortezomib, melphalan, prednisolone Overall improvement in her myeloma related laboratory results F/52 Routine health examination Proteinuria 2.62 g/d, SCr 1.3 mg/dl IgG-κ MM FSGS Podocytes, proximal TEC IHC: κ positive in TEC, λ negative Lacking Lacking M/45 Routine annual physical examination SCr 1.85 mg/dl, proteinuria 7.925 g/d, glycosuria IgG-κ MM Collapsing FSGS Podocytes,MC, TEC IF/IHC: negative for κ and λ in crystal areas Therapy, details lacking 2 m later, SCr 1.5 mg/dl, proteinuria 3.627 g/d M/53 78 months of MGUS SCr 1.3 mg/dl, proteinuria 1.18 g/d, albumin 38 g/L IgG-κ MGUS Foamy substance in podocytes Podocytes and TEC IF: κ TEC positive; λ negative 4 cycles of DF and lenalidomide SCr returned to 1.0 mg/dl F/54 24 months of MM, 19 months of proteinuria SCr1.0 → 3.9 mg/dl(2 yrs), proteinuria0.3 → 14.4 g/d (2 yrs., pamidronate), albumin 29 g/L IgG-κ MM Collapsing FSGS and LCN Proximal TECs, podocytes,tubular casts IF: Negative for κ and λ;IHC: Positive for κ, negative for λ DF, CYC, thalidomide, bortezomib, HCT SCr 1.8 mg/dl M/56 < 1 month SCr1.2 → 9.2 mg/dl (3 m), proteinuria 5 g/L IgG-κ MM NA, ATN Podocytes, TEC, interstitial macrophages, tubular lumen,BM, urine IF: Negative for both κ and λ Vincristine, doxorubicin, DF, HCT SCr 6.3 mg/dl F/46 Unknown Renal dysfunction IgG-κ MM NA Podocytes, TECs, Interstitial histiocytes IF: Positive for IgG-κ Chemotherapy followed by HCT SCr↓, crystalline- containing podocyte ↓ M/51 6 months Bence–Jones proteinuria 1.54 g/L, albumin 41.8 g/L IgG-κ MM Nonspecific Podocytes, GEC, MC, TEC, Interstitial histiocytes,, MCs, hepatocytes and macrophages in liver NA Chemotherapy deferred due to lung carcinoma surgery Died shortly after lung surgery due to multi- organ failure F/52 60 months SCr 1.8 → 2.0 mg/dl (5 yrs), Proteinuria 1.3 → 5 g/d(5 yrs), albumin 34 g/L IgG-κ MM 3/5 G sclerosed Podocytes, PEC, TEC, interstitial histiocytes IF: Negative for κ and λ;IHC: Positive for κ, negative for λ NA NA F/40 14 months Proteinuria 14.3 g/d, albumin 30 g/L, SCr 1.8 mg/dl IgG-κ MGUS FSGS Podocytes, PEC, distal TECs, tubular lumina, BM IHC: Positive for κ, negative for λ NA NA M/75 60 months of MM Proteinuria;chronic renal failure IgG-κ MM NA Podocytes, PEC, TEC, interstitial histiocytes, cornea, myeloma cell, choroid plexus IHC: Positive for κ and γ NA NA M/57 6 months SCr 3.2 mg/dl, Proteinuria 2 g/d IgG-κ MM FSGS Podocytes, MC, GEC, PEC, proximal TEC, histiocytes and fibroblasts in the interstitium, synovium and BM IF: Negative Cytoxan, carmustine and prednisone, discontinued due to complications 1.5 years later SCr 3.9 mg/dl, died due to cardiac arrest Abbreviation: FSGS focal segmental glomerulosclerosis, MM multiple myeloma, MGUS monoclonal gammopathy of undetermined significance, SCr serum creatinine, GEC glomerular endothelial cell, TEC tubular epithelial cell, MC mesangial cell, PEC parietal epithelial cell, BM bone marrow, NA not available, HCT autologous hematopoietic cell transplantation, ATN acute tubular necrosis, DF dexamethasone, IHC immunohistochemistry, PCR protein/creatinine ratio, LCN light chain cast nephropathy
| 4.3125
| 0.486572
|
sec[2]/p[2]
|
en
| 0.999994
|
30419839
|
https://doi.org/10.1186/s12882-018-1108-x
|
[
"podocytes",
"proteinuria",
"fsgs",
"renal",
"patients",
"cell",
"albumin",
"tubular",
"histiocytes",
"crystal"
] |
[
{
"code": "MF96.Z",
"title": "Proteinuria, unspecified"
},
{
"code": "MF96.Y",
"title": "Other specified proteinuria"
},
{
"code": "GB4Y",
"title": "Other specified glomerular diseases"
},
{
"code": "MF96.0",
"title": "Orthostatic proteinuria"
},
{
"code": "JA22.0",
"title": "Gestational proteinuria without hypertension"
},
{
"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 ===
[MF96.Z] Proteinuria, unspecified
Also known as: Proteinuria, unspecified | Proteinuria | Albuminuria NOS | Proteinuria NOS
[MF96.Y] Other specified proteinuria
Also known as: Other specified proteinuria
[GB4Y] Other specified glomerular diseases
Also known as: Other specified glomerular diseases | Glomerular disease classified by clinical features or syndromes | Chronic proteinuria | Permanent proteinuria with focal and segmental hyalinosis without nephrotic syndrome | Recurrent or persistent glomerular haematuria
[MF96.0] Orthostatic proteinuria
Definition: A condition characterised by an elevated protein excretion while in the upright position and normal protein excretion in a supine or recumbent position.
Also known as: Orthostatic proteinuria | benign postural proteinuria | orthostatic albuminuria | postural albuminuria | postural proteinuria
[JA22.0] Gestational proteinuria without hypertension
Also known as: Gestational proteinuria without hypertension | proteinuria complicating pregnancy | puerperal albuminuria | Gestational proteinuria, intermittent | Gestational proteinuria, persistent
[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 ---
[MF96.Z] Proteinuria, unspecified
--PARENT--> [MF96] 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...
--RELATED_TO--> [?] Gestational proteinuria without hypertension
--- Walk 2 ---
[MF96.Z] Proteinuria, unspecified
--PARENT--> [MF96] 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...
--CHILD--> [MF96.Y] Other specified proteinuria
--- Walk 3 ---
[MF96.Y] Other specified proteinuria
--PARENT--> [MF96] 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...
--RELATED_TO--> [?] Gestational proteinuria without hypertension
--- Walk 4 ---
[MF96.Y] Other specified proteinuria
--PARENT--> [MF96] 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...
--RELATED_TO--> [?] Gestational proteinuria without hypertension
--- Walk 5 ---
[GB4Y] Other specified glomerular diseases
--PARENT--> [?] Glomerular diseases
Def: Any disease characterised by pathological changes to the glomerulus....
--RELATED_TO--> [?] Plasmodium malariae malaria with nephropathy
Def: Quartan malarial nephropathy is a rare complication of malariae (quartan) malaria, especially occurring in children; it is a glomerulonephritis, usually fatal....
--- Walk 6 ---
[GB4Y] Other specified glomerular diseases
--PARENT--> [?] Glomerular diseases
Def: Any disease characterised by pathological changes to the glomerulus....
--RELATED_TO--> [?] Clinical findings in specimens from the urinary system
|
[
"[MF96.Z] Proteinuria, unspecified\n --PARENT--> [MF96] 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...\n --RELATED_TO--> [?] Gestational proteinuria without hypertension",
"[MF96.Z] Proteinuria, unspecified\n --PARENT--> [MF96] 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...\n --CHILD--> [MF96.Y] Other specified proteinuria",
"[MF96.Y] Other specified proteinuria\n --PARENT--> [MF96] 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...\n --RELATED_TO--> [?] Gestational proteinuria without hypertension",
"[MF96.Y] Other specified proteinuria\n --PARENT--> [MF96] 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...\n --RELATED_TO--> [?] Gestational proteinuria without hypertension",
"[GB4Y] Other specified glomerular diseases\n --PARENT--> [?] Glomerular diseases\n Def: Any disease characterised by pathological changes to the glomerulus....\n --RELATED_TO--> [?] Plasmodium malariae malaria with nephropathy\n Def: Quartan malarial nephropathy is a rare complication of malariae (quartan) malaria, especially occurring in children; it is a glomerulonephritis, usually fatal....",
"[GB4Y] Other specified glomerular diseases\n --PARENT--> [?] Glomerular diseases\n Def: Any disease characterised by pathological changes to the glomerulus....\n --RELATED_TO--> [?] Clinical findings in specimens from the urinary system"
] |
MF96.Z
|
Proteinuria, unspecified
|
[
{
"from_icd11": "MF96.Z",
"icd10_code": "R809",
"icd10_title": "Proteinuria, unspecified"
},
{
"from_icd11": "MF96.Z",
"icd10_code": "R803",
"icd10_title": "Bence Jones proteinuria"
},
{
"from_icd11": "MF96.Z",
"icd10_code": "R808",
"icd10_title": "Other proteinuria"
},
{
"from_icd11": "MF96.Z",
"icd10_code": "R801",
"icd10_title": "Persistent proteinuria, unspecified"
},
{
"from_icd11": "MF96.Z",
"icd10_code": "N391",
"icd10_title": ""
},
{
"from_icd11": "MF96.Z",
"icd10_code": "R80",
"icd10_title": "Proteinuria"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N2889",
"icd10_title": "Other specified disorders of kidney and ureter"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N2882",
"icd10_title": "Megaloureter"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N2886",
"icd10_title": "Ureteritis cystica"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N2881",
"icd10_title": "Hypertrophy of kidney"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N2884",
"icd10_title": "Pyelitis cystica"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N2885",
"icd10_title": "Pyeloureteritis cystica"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N288",
"icd10_title": "Other specified disorders of kidney and ureter"
},
{
"from_icd11": "MF96.0",
"icd10_code": "N392",
"icd10_title": ""
},
{
"from_icd11": "JA22.0",
"icd10_code": "O1213",
"icd10_title": "Gestational proteinuria, third trimester"
}
] |
R809
|
Proteinuria, unspecified
|
A 19-year-old man presented to our otolaryngology department in August 2017 with a table tennis-sized lump in his left chest wall and right axilla and pain in right rib that lasted for 1 month. The patient’s history was free of relevant diseases. The patient’s family history and genetic history are free of genetically related diseases and free of hematologic disorders such as lymphoma. Chest computed tomography (CT) showed enlargement of the right axillary lymph nodes, indicating neoplastic lesions and destruction of the right eighth rib bone. The diagnosis of ALCL was confirmed using a right axillary lymph node biopsy and immunohistochemical analysis . Immunohistochemical staining revealed that the tumor cells were positive for ALK and CD30. The Ki-67 proliferation index was 90%. The patient was diagnosed with stage IV ALCL and had an international prognostic index (PI) score of 3. The patient received induction chemotherapy, including 8 courses of cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisolone (CHOEP). The patient underwent clinical evaluation after completing 8 cycles of chemotherapy. Positron emission tomography–computed tomography (PET–CT) revealed bilateral neck and axillary lymph node enlargement and increased metabolism. Subsequently, the patient underwent neck and axillary sensitization radiotherapy . Three months later, a substantial subcutaneous mass measuring approximately 1 cm was palpated in the left lower abdomen. The patient was diagnosed with relapsed/refractory ALCL after an abdominal mass biopsy . PET–CT demonstrated multiple mediastinal, abdominal, and retroperitoneal lymph node enlargement that were partially fused. The largest one was approximately 4.9 ×3.3 cm, and the SUVmax was 19.6. Right pleural thickening, a slightly low-density shadow in the left kidney, multiple muscles, and subcutaneously increased metabolism were also observed. These new changes were considered lymphoma infiltration. The bilateral cervical and axillary lymph nodes increased in size, and metabolism was enhanced. Increased local metabolism of the stomach, small intestine, and transverse colon was also observed. One cycle of dexamethasone, high-dose cytosine arabinoside, cisplatin (DHAP) chemotherapy was initiated on September 4, 2019. The patient presented with abdominal pain on September 23, 2019. Abdominal imaging revealed a significant increase and enlargement of the peripancreatic, retroperitoneal, and mesenteric root lymph nodes, indicating tumor progression. New flaky low-density shadows appeared in the left kidney, indicating a potential tumor invasion. Imaging assessment of the retroperitoneal mass showed that the stable disease (SD) developed into progressive disease (PD). The patient began taking crizotinib (250 mg twice daily) on October 1, 2019, for 1 month. BV at a dose of 100 mg was administered to the patient on October 29, 2019. On the day of BV infusion, the patient underwent an abdominal CT examination. Compared with the previous abdominal images , the number of enlarged retroperitoneal and mesenteric lymph nodes was significantly reduced. The range of patchy, low-density lesions in the left kidney also decreased significantly. Abdominal imaging findings were evaluated as partial remission (PR). The patient learned of the clinical trial of tandem ASCT and CAR30 T cell infusion in r/r CD30 + lymphoma being conducted at our hospital, to further enhance the curative effect, he volunteered to participate in the clinical trial. The trial was approved by the Institutional Review Board of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, and the study was registered with the Chinese Clinical Trial Registry . Informed consent was obtained by the patient and her family according to the Declaration of Helsinki. On December 21, doxorubicin hydrochloride liposome with the BEAM regimen pretreatment was performed. Autologous hematopoietic stem cells (4.94 × 10 6 /kg CD34+ cells) were infused on December 28, and CD30 (24.00 × 10 6 /kg) CAR-T cells were infused three times. The three infusion doses of CD30 CAR-T were 5 × 10 6 /kg, 5 × 10 6 /kg and 1.4 × 10 7 /kg respectively . The structure is as shown in Figure 2A . CAR30 transgene copy numbers in the peripheral blood was detected by droplet digital polymerase chain reaction (ddPCR) . After infusion of anti-CD30 CAR T-cells, grade 1 cytokine release syndrome (CRS) was observed, and immune effector cell-associated neurotoxicity syndrome (ICANS) was not occur. The serum ferritin and interleukin-6 levels were assessed after cell infusion . The engraftment times of neutrophil and platelet after hematopoietic stem cells infusion were both 14 days. The results of the PET–CT evaluation 3 months after treatment showed that the retroperitoneal soft tissue focus was significantly reduced or had disappeared . PET–CT assessments at 3, 6, and 12 months after autologous stem-cell transplantation (ASCT) and CAR T-cell therapy showed sustained complete remission (CR). The latest PET–CT showed that the size of the lymph nodes in the left neck IIA region was similar, and metabolism was slightly reduced compared to previous PET–CT images . Approximately 4 years after ASCT and CAR T-cell therapy, the patient was disease-free. The timeline of clinical treatment and disease status is shown in Figure 4 .
| 3.984375
| 0.978516
|
sec[1]/p[0]
|
en
| 0.999998
|
38375471
|
https://doi.org/10.3389/fimmu.2024.1346001
|
[
"lymph",
"abdominal",
"that",
"cells",
"infusion",
"cell",
"axillary",
"nodes",
"metabolism",
"retroperitoneal"
] |
[
{
"code": "BD9Z",
"title": "Disorders of lymphatic vessels or lymph nodes, unspecified"
},
{
"code": "BD90.Z",
"title": "Lymphadenitis, unspecified"
},
{
"code": "BD90.Y",
"title": "Other specified lymphadenitis"
},
{
"code": "BD9Y",
"title": "Other specified disorders of lymphatic vessels or lymph nodes"
},
{
"code": "MA01.Z",
"title": "Enlarged lymph nodes, unspecified"
},
{
"code": "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 ===
[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
[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 ---
[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified
--PARENT--> [?] Disorders of lymphatic vessels or lymph nodes
Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....
--CHILD--> [BD92] Lymphangiectasia
--- Walk 2 ---
[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified
--PARENT--> [?] Disorders of lymphatic vessels or lymph nodes
Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....
--CHILD--> [BD91] Lymphangitis
Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells....
--- Walk 3 ---
[BD90.Z] Lymphadenitis, unspecified
--PARENT--> [BD90] Lymphadenitis
--PARENT--> [?] Disorders of lymphatic vessels or lymph nodes
Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....
--- Walk 4 ---
[BD90.Z] Lymphadenitis, unspecified
--PARENT--> [BD90] Lymphadenitis
--EXCLUDES--> [?] Human immunodeficiency virus disease
Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...
--- Walk 5 ---
[BD90.Y] Other specified lymphadenitis
--PARENT--> [BD90] Lymphadenitis
--CHILD--> [BD90.0] Acute lymphadenitis
--- Walk 6 ---
[BD90.Y] Other specified lymphadenitis
--PARENT--> [BD90] Lymphadenitis
--EXCLUDES--> [?] Enlarged lymph nodes
Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes....
|
[
"[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --CHILD--> [BD92] Lymphangiectasia",
"[BD9Z] Disorders of lymphatic vessels or lymph nodes, unspecified\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....\n --CHILD--> [BD91] Lymphangitis\n Def: Lymphangitis is an inflammation of lymphatic vessels. It is most often caused by infection from bacteria, virus or fungus or infiltration by cancer cells....",
"[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --PARENT--> [?] Disorders of lymphatic vessels or lymph nodes\n Def: Disorders due to developmental and acquired disturbances of lymph circulation and drainage and to infective disorders of lymph vessels and nodes....",
"[BD90.Z] Lymphadenitis, unspecified\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Human immunodeficiency virus disease\n Def: A case of HIV infection is defined as an individual with HIV infection irrespective of clinical stage including severe or stage 4 clinical disease (also known as AIDS) confirmed by laboratory criteria...",
"[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --CHILD--> [BD90.0] Acute lymphadenitis",
"[BD90.Y] Other specified lymphadenitis\n --PARENT--> [BD90] Lymphadenitis\n --EXCLUDES--> [?] Enlarged lymph nodes\n Def: Enlarged lymph node is called lymphadenopathy which means the abnormal enlargement of lymph nodes...."
] |
BD9Z
|
Disorders of lymphatic vessels or lymph nodes, unspecified
|
[
{
"from_icd11": "BD9Z",
"icd10_code": "I898",
"icd10_title": "Other specified noninfective disorders of lymphatic vessels and lymph nodes"
},
{
"from_icd11": "BD9Z",
"icd10_code": "I899",
"icd10_title": "Noninfective disorder of lymphatic vessels and lymph nodes, unspecified"
},
{
"from_icd11": "BD9Z",
"icd10_code": "I89",
"icd10_title": "Other noninfective disorders of lymphatic vessels and lymph nodes"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I889",
"icd10_title": "Nonspecific lymphadenitis, unspecified"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I88",
"icd10_title": "Nonspecific lymphadenitis"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "I888",
"icd10_title": "Other nonspecific lymphadenitis"
},
{
"from_icd11": "BD90.Z",
"icd10_code": "L00-L08",
"icd10_title": ""
},
{
"from_icd11": "MA01.Z",
"icd10_code": "R599",
"icd10_title": "Enlarged lymph nodes, unspecified"
},
{
"from_icd11": "MA01.Z",
"icd10_code": "R59",
"icd10_title": "Enlarged lymph nodes"
},
{
"from_icd11": "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"
}
] |
I898
|
Other specified noninfective disorders of lymphatic vessels and lymph nodes
|
A 62-year-old woman presented with complaints of epigastric pain and vomiting for a few weeks. She had a history of traffic trauma followed by a brain abscess and had also undergone a total hysterectomy for a uterine myoma. She was given an antiepileptic agent, a non-steroidal anti-inflammatory drug and a proton pump inhibitor at a local hospital. She had no history of smoking or alcohol consumption. On physical examination, her blood pressure was 123/65 mmHg, her temperature 36.8 °C, her respiratory rate 18/min, and her heart rate 56 beats per minute. There was epigastric tenderness on palpation. Laboratory results indicated a white blood cell count of 7090/mm 3 (67.5% neutrophils and 0.8% eosinophils), a hemoglobin level of 12.6 mg/dl, and a platelet count of 275,000/mm 3 . Other blood biochemistry data were normal. Serum anti- Helicobacter pylori ( H. pylori ) immunoglobulin G antibody was negative (4 IU/ml, < 10 cut-off). Computed tomography (CT) showed a 27-mm, hyper-enhancing tumor in the submucosa of the prepyloric antrum as well as thickening of the muscularis propria layer and a hyper-enhancing lesion in the subserosa . Upper endoscopy also showed a submucosal tumor originating from the posterior wall of the prepyloric antrum . The tumor caused subtotal obstruction of the gastric outlet. Multiple biopsy specimens obtained from the surface of the submucosal tumor revealed infiltration of inflammatory cells. To obtain further histopathological information, endoscopic ultrasound-guided fine-needle aspiration was conducted. The endoscopic ultrasound showed a hypoechoic tumor with slightly heterogeneous internal echoes originating from the submucosal area . The tumor was punctured using a 22 G needle. The results indicated a small number of spindle cells, but a definitive diagnosis was not made. Considering her clinical findings, a diagnosis of GIST was suspected. Thus, distal gastrectomy was performed. The resected specimen revealed thickening of the submucosal layer and the muscularis propria layer at the antrum . Histopathological examination revealed a submucosal tumor containing proliferating bland fibroblast-like spindle cells with inflammatory infiltrates . There was also a proliferation of small blood vessels. The inflammatory infiltrate contained lymphocytes and plasma cells. The spindle cells invaded the muscularis propria layer and extended to the subserosal layer . Regional lymph node metastasis was not detected. Immunohistochemical examination revealed that the spindle cells were diffusely positive for CD34, focally positive for alpha-smooth muscle actin and CD68, and negative for CD117, discovered on GIST-1 (DOG-1), S100 protein, desmin, cytokeratin AE1/AE3 and anaplastic lymphoma kinase (ALK). The Ki-67 (MIB-1) labeling index in the spindle cells was less than 1% . Nuclear positivity for beta-catenin was not observed. IgG4-positive plasma cells were rare in the lesion. For mutational analysis, the tumor tissue was scraped from unstained slides, and DNA was extracted using a QIAamp DNA FFPE Tissue Kit (Qiagen, Hilden, Germany). The PDGFRA gene (exons 12, 14 and 18) was amplified by PCR using KOD FX Neo (Toyobo, Osaka, Japan). The PCR products were separated by electrophoresis and purified with a QIAquick Gel Extraction Kit (Qiagen). The purified PCR products were sequenced using an ABI 3130xl Genetic Analyzer (Applied Biosystems, Foster City, CA, USA). The results indicated the lack of mutations in the PDGFRA gene. While the invasive characteristics were atypical, the histopathological and immunohistochemical findings were consistent with an IFP. Thus, we finally diagnosed the tumor as an IFP. After resection, the patient’s clinical course was good: she has been closely followed up and has shown no recurrence. Fig. 1 Computed tomography (CT) findings. a Axial view. b Coronal view. c Sagittal view. CT image showing a hyper-enhancing tumor in the submucosa of the prepyloric antrum ( arrows ). CT showing a thickening of the muscularis propria layer and a hyper-enhancing lesion in the subserosa of the gastric antrum ( arrow heads ) Fig. 2 Endoscopic findings. a Upper endoscopy showing a submucosal tumor at the prepyloric antrum causing obstruction of the gastric outlet. b Endoscopic ultrasound showing a hypoechoic tumor located in the submucosal layer Fig. 3 Macroscopic findings. The resected specimen revealed circumferential wall thickening of the prepyloric antrum ( red line : cut line). Cut-section reveals thickening of the submucosal layer and the muscularis propria layer Fig. 4 Microscopic findings. a Histopathological view through a low-power microscope. b-e Histopathological view through a medium-power microscope. Microscopic findings reveal spindle cell proliferation and infiltration of lymphocytes and plasma cells in the submucosal layer. Cells invading the muscularis propria layer ( arrows ) and extending to the subserosal layer ( arrowheads ) Fig. 5 Immunohistochemical findings. Immunohistochemical findings revealing spindle cells stained positive for CD34 and smooth muscle actin but negative for CD117, DOG-1 and S100 protein. The Ki-67 labeling index was less than 1%. Scattered mast cells stained positive for CD117, but the spindle cells stained negative. Adipose tissue engulfed by the lesion stained positive for S100 protein, but the spindle cells stained negative
| 4.089844
| 0.974609
|
sec[1]/p[0]
|
en
| 0.999997
|
29855265
|
https://doi.org/10.1186/s12876-018-0808-9
|
[
"cells",
"tumor",
"layer",
"submucosal",
"spindle",
"antrum",
"muscularis",
"propria",
"prepyloric",
"thickening"
] |
[
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
},
{
"code": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
}
] |
=== ICD-11 CODES FOUND ===
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
[2F9Z] Neoplasms of unknown behaviour of unspecified site
Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature
Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules
Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung
Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site
[2F92] Neoplasms of unknown behaviour of skin
Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of carbohydrate metabolism
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--CHILD--> [MF91] Bilirubinuria
Def: Bilirubinuria means the presence of any bile pigment 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
--PARENT--> [5C56.2] Glycoproteinosis
Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....
--CHILD--> [5C56.21] Oligosaccharidosis
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--PARENT--> [?] Anaemias or other erythrocyte disorders
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF91] Bilirubinuria\n Def: Bilirubinuria means the presence of any bile pigment 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 --PARENT--> [5C56.2] Glycoproteinosis\n Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....\n --CHILD--> [5C56.21] Oligosaccharidosis",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --PARENT--> [?] Anaemias or other erythrocyte disorders",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.1] 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": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
}
] |
D571
|
Sickle-cell disease without crisis
|
A 28-year-old Caucasian woman, gravida 4, para 1, was referred to our high-risk obstetric unit at 24 weeks' gestation for fetal ascites detected during a routine ultrasound examination. Her personal and family history did not reveal any pathology of note. Her first pregnancy ended with an intra-uterine death at 23 weeks' gestation caused by chorioamnionitis. In the second pregnancy, a live baby girl was delivered at 40 weeks' gestation. Four years later our patient had a spontaneous miscarriage. Our patient denied any fever, rash, cold symptoms, or joint pain before and during pregnancy. She did not refer to any vaginal bleeding. Laboratory tests for Toxoplasma and rubeola showed negative immunoglobulin M (IgM). An ultrasound examination performed during the consultation confirmed the presence of abdominal ascites . A borderline monolateral dilation of the cerebral ventricle was also seen. Biometry of the fetal limbs was below the mean in relation to gestational age, while cephalic measurements were normal. No other fetal anomalies were observed. Amniotic fluid was present in adequate quantity, but fetal movements were poor. For these reasons, the woman was admitted to our institution for close pregnancy monitoring. During hospitalization, her blood pressure and heart frequency were measured several times during the day, while cardiotocography was performed twice a day. Maternal blood pressure was normal, and there was no proteinuria. Investigation about the etiology of the fetal ascites were carried out, and a fetal paracentesis was also performed. Both parents had normal mean corpuscular erythrocyte volume with no sign of microcythemia and they both had positive blood group Rh without any pathologic antibodies. A routine blood laboratory assessment did not show any kind of abnormalities. Viral serology markers (cytomegalovirus IgG and IgM, parvovirus IgG and IgM) were negative in the maternal blood, and no viral genome was isolated in her amniotic fluid or the fetal ascites sample. The fetal karyotype was normal (46, XY). A Kleihauer-Betke test showed no evidence of fetal erythrocytes in the maternal circulation. Immunologic markers, lupus anticoagulant anticardiolipin, antinuclear, and anti-RO antibodies were negative; G6PD was also excluded. There was no evidence regarding the cause of fetal ascites (then considered non-immune or hydiopatic). Only a mild increase in inflammation indices was noted (VES 40, PCR 7.325); an antibiotic preventive treatment was performed for five days (sulbactam/ampicillin 1.5 mg three times daily, gentamicin 80 mg three times daily, metronidazole 500 mg three times daily). During hospitalization, detailed ultrasound scans were performed at least every two days to monitor the ascites and general condition of the fetus. Fetal middle cerebral artery peak systolic velocity (PSV) was measured to diagnose fetal anemia. Pulsatility index (PI) of either the umbilical artery (UA) or the MCA as well as the resistance index of uterine arteries were assessed to better evaluate the materno-fetal perfusion. Monitoring scans showed a deterioration of fetal condition. Paracentesis was performed at 25 weeks' gestation, but two days later the fetal ascites occurred again. A restriction of fetal growth and progressive reduction of amniotic fluid were also registered. The value of PSV in the MCA was borderline for moderate to severe anemia according to Mari's chart , whereas fetal Doppler ultrasound parameters were normal. At 27 weeks' gestation, a reverse end-diastolic flow in the MCA occurred . This abnormal waveform pattern persisted for all the ultrasound examinations, and it was not associated with other Doppler abnormalities (PI UA 1.15, PI MCA 1.54). The condition was interpreted as 'at risk', and our patient was submitted to closer monitoring. Fetal echocardiography showed cardiomegaly without significant abnormality of heart structures and a mild tricuspid regurgitation. Cardiotocography monitoring showed fetal bradycardia (fetal heart rate 100 beats per minute). Our patient was submitted to fetal magnetic resonance imaging to investigate in particular the brain edema, and this confirmed the presence of fetal ascites without showing any abnormality of fetal cerebral tissue or signs of hypoxia. Corticosteroid treatment (betamethasone 12 mg for two days) was started because of a high risk for preterm delivery. After one week, ultrasound parameters showed a severe decrease in fetal weight (<fifth percentile), an increase in fetal ascites, and subcutaneous edema. The reversed end-diastolic flow in the MCA persisted, and an increase of PI UA was detected. Alterations of ductus venosus waveform appeared, and an inversion of "a" wave was identified. The amniotic fluid index was below the mean for gestational age. The biophysical profile examination was unsatisfactory. The severe prognosis was explained to the couple, and an active intervention was ruled out. The fetus was in breech presentation at this time. Our patient was submitted to an emergency cesarean section at 28 weeks' gestation. A live baby boy in poor general condition was delivered. The Apgar score was one and five. Intubation was necessary, but despite neonatal intensive care, the baby died a few hours after birth. An autopsy revealed a rare malformation of IHBDs known as DPM. No other anomaly was identified.
| 4.023438
| 0.978516
|
sec[1]/p[0]
|
en
| 0.999997
|
21272301
|
https://doi.org/10.1186/1752-1947-5-37
|
[
"fetal",
"ascites",
"gestation",
"ultrasound",
"blood",
"pregnancy",
"amniotic",
"fluid",
"monitoring",
"times"
] |
[
{
"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": "ME04.Z",
"title": "Ascites, unspecified"
},
{
"code": "ME04.Y",
"title": "Other specified ascites"
},
{
"code": "DC51.0",
"title": "Chylous ascites"
},
{
"code": "2D91",
"title": "Malignant neoplasm metastasis in peritoneum"
},
{
"code": "1B12.7",
"title": "Tuberculosis of the digestive system"
}
] |
=== ICD-11 CODES FOUND ===
[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
[ME04.Z] Ascites, unspecified
Also known as: Ascites, unspecified | Ascites | abdominal dropsy | hydrops abdominis | ascites NOS
[ME04.Y] Other specified ascites
Also known as: Other specified ascites
[DC51.0] Chylous ascites
Definition: Chylous ascites is a rare form of ascites caused by accumulation of lymph in the peritoneal cavity, usually due to intra-abdominal malignancy, liver cirrhosis or abdominal surgery complications, and present with painless but progressive abdominal distension, dyspnoea and weight gain.
Also known as: Chylous ascites | chyloperitoneum
[2D91] Malignant neoplasm metastasis in peritoneum
Also known as: Malignant neoplasm metastasis in peritoneum | peritoneal metastases | peritoneal metastasis | carcinomatosis of peritoneal cavity | carcinomatosis peritonei
[1B12.7] Tuberculosis of the digestive system
Definition: Tuberculosis of the digestive tract or hepatobiliary system
Also known as: Tuberculosis of the digestive system | tuberculosis of gastrointestinal tract | Tuberculous duodenitis | Tuberculous gastritis | tuberculosis of stomach
=== GRAPH WALKS ===
--- Walk 1 ---
[LD9Z] Developmental anomalies, unspecified
--PARENT--> [20] Developmental anomalies
Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....
--EXCLUDES--> [?] Inborn errors of metabolism
Def: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversi...
--- Walk 2 ---
[LD9Z] Developmental anomalies, unspecified
--PARENT--> [20] Developmental anomalies
Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....
--EXCLUDES--> [?] Inborn errors of metabolism
Def: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversi...
--- Walk 3 ---
[KB20.Z] Intrauterine hypoxia, unspecified
--PARENT--> [KB20] Intrauterine hypoxia
Def: Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. This may occur with prolapse or occlusion of the umbilical cord, placental infarction and maternal smoking. This...
--EXCLUDES--> [?] Intracranial nontraumatic haemorrhage of fetus or newborn
Def: Intraventricular (nontraumatic) haemorrhage of the fetus and newborn is a condition characterised by bleeding within the skull of a newborn that is not due to injury causing physical damage....
--- Walk 4 ---
[KB20.Z] Intrauterine hypoxia, unspecified
--PARENT--> [KB20] Intrauterine hypoxia
Def: Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. This may occur with prolapse or occlusion of the umbilical cord, placental infarction and maternal smoking. This...
--EXCLUDES--> [?] Metabolic acidaemia in newborn
Def: Metabolic acidaemia represents an increase in hydrogen ion concentration, usually due to the production of lactic acid following hypoxia or ischemia induced anaerobic metabolism. Acidaemia can also re...
--- Walk 5 ---
[3A50.4] Hereditary persistence of fetal haemoglobin
Def: 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-containin...
--PARENT--> [3A50] Thalassaemias
Def: A disease caused by genetically inherited autosomal recessive mutations leading to abnormal production of haemoglobin. This disease is characterised by destruction of red blood cells leading to anaemi...
--CHILD--> [3A50.1] Alpha thalassaemia related syndromes
Def: Alpha-thalassemia-related diseases refers to a group of diseases characterised by alpha-thalassemia and an associated disorder. Three conditions are included in this group: alpha-thalassemia-intellect...
--- Walk 6 ---
[3A50.4] Hereditary persistence of fetal haemoglobin
Def: 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-containin...
--PARENT--> [3A50] Thalassaemias
Def: A disease caused by genetically inherited autosomal recessive mutations leading to abnormal production of haemoglobin. This disease is characterised by destruction of red blood cells leading to anaemi...
--CHILD--> [3A50.0] Alpha thalassaemia
Def: Alpha-thalassemia is an inherited haemoglobinopathy characterised by impaired synthesis of alpha-globin chains leading to a variable clinical picture depending on the number of affected alleles, and e...
|
[
"[LD9Z] Developmental anomalies, unspecified\n --PARENT--> [20] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....\n --EXCLUDES--> [?] Inborn errors of metabolism\n Def: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversi...",
"[LD9Z] Developmental anomalies, unspecified\n --PARENT--> [20] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....\n --EXCLUDES--> [?] Inborn errors of metabolism\n Def: Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. The majority are due to defects of single genes that code for enzymes that facilitate conversi...",
"[KB20.Z] Intrauterine hypoxia, unspecified\n --PARENT--> [KB20] Intrauterine hypoxia\n Def: Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. This may occur with prolapse or occlusion of the umbilical cord, placental infarction and maternal smoking. This...\n --EXCLUDES--> [?] Intracranial nontraumatic haemorrhage of fetus or newborn\n Def: Intraventricular (nontraumatic) haemorrhage of the fetus and newborn is a condition characterised by bleeding within the skull of a newborn that is not due to injury causing physical damage....",
"[KB20.Z] Intrauterine hypoxia, unspecified\n --PARENT--> [KB20] Intrauterine hypoxia\n Def: Intrauterine hypoxia occurs when the fetus is deprived of an adequate supply of oxygen. This may occur with prolapse or occlusion of the umbilical cord, placental infarction and maternal smoking. This...\n --EXCLUDES--> [?] Metabolic acidaemia in newborn\n Def: Metabolic acidaemia represents an increase in hydrogen ion concentration, usually due to the production of lactic acid following hypoxia or ischemia induced anaerobic metabolism. Acidaemia can also re...",
"[3A50.4] Hereditary persistence of fetal haemoglobin\n Def: 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-containin...\n --PARENT--> [3A50] Thalassaemias\n Def: A disease caused by genetically inherited autosomal recessive mutations leading to abnormal production of haemoglobin. This disease is characterised by destruction of red blood cells leading to anaemi...\n --CHILD--> [3A50.1] Alpha thalassaemia related syndromes\n Def: Alpha-thalassemia-related diseases refers to a group of diseases characterised by alpha-thalassemia and an associated disorder. Three conditions are included in this group: alpha-thalassemia-intellect...",
"[3A50.4] Hereditary persistence of fetal haemoglobin\n Def: 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-containin...\n --PARENT--> [3A50] Thalassaemias\n Def: A disease caused by genetically inherited autosomal recessive mutations leading to abnormal production of haemoglobin. This disease is characterised by destruction of red blood cells leading to anaemi...\n --CHILD--> [3A50.0] Alpha thalassaemia\n Def: Alpha-thalassemia is an inherited haemoglobinopathy characterised by impaired synthesis of alpha-globin chains leading to a variable clinical picture depending on the number of affected alleles, and e..."
] |
LD9Z
|
Developmental anomalies, unspecified
|
[
{
"from_icd11": "LD9Z",
"icd10_code": "Q898",
"icd10_title": "Other specified congenital malformations"
},
{
"from_icd11": "LD9Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "LD9Z",
"icd10_code": "Q89",
"icd10_title": "Other congenital malformations, not elsewhere classified"
},
{
"from_icd11": "LD9Z",
"icd10_code": "XVII",
"icd10_title": ""
},
{
"from_icd11": "LD9Z",
"icd10_code": "Q10-Q18",
"icd10_title": ""
},
{
"from_icd11": "LD9Z",
"icd10_code": "Q38-Q45",
"icd10_title": ""
},
{
"from_icd11": "LD9Z",
"icd10_code": "Q80-Q89",
"icd10_title": ""
},
{
"from_icd11": "KB20.Z",
"icd10_code": "P20",
"icd10_title": ""
},
{
"from_icd11": "KB20.Z",
"icd10_code": "P209",
"icd10_title": ""
},
{
"from_icd11": "3A50.4",
"icd10_code": "D564",
"icd10_title": "Hereditary persistence of fetal hemoglobin [HPFH]"
},
{
"from_icd11": "KB42",
"icd10_code": "P293",
"icd10_title": "Persistent fetal circulation"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q8789",
"icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q8781",
"icd10_title": "Alport syndrome"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q871",
"icd10_title": "Congenital malformation syndromes predominantly associated with short stature"
},
{
"from_icd11": "LD2Z",
"icd10_code": "Q872",
"icd10_title": "Congenital malformation syndromes predominantly involving limbs"
}
] |
Q898
|
Other specified congenital malformations
|
A 61-year-old male was initially diagnosed with a melanoma involving his left neck in 1991 and treated with a parotidectomy and neck dissection followed by adjuvant radiation therapy. In July 2009, he was diagnosed with UC, initially treated with infliximab, a chimeric TNF-α monoclonal antibody for 6 weeks and then transitioned to a purine analogue, azathioprine. In May of 2012, he presented with a second primary melanoma involving his left jaw. After a whole body PET revealed no evidence of metastatic disease he underwent a radical neck dissection with pathology revealing invasive malignant melanoma characterized by an ulcerated Clark Level 5 lesion with a Breslow thickness of 5.5 mm and 15 mitotic figures/mm 2 . In August of 2012, PET CT re-staging showed FDG-avid cervical lymph nodes concerning for recurrent disease and a left parotidectomy revealed a 1.8 cm lymph node deposit of malignant melanoma. Surveillance PET imaging in December 2012 demonstrated evidence of further recurrence in bilateral cervical lymph nodes. A right modified neck dissection was positive for 1 of 6 lymph nodes notable for a melanoma deposit up to a diameter of 2 cm. Further surveillance PET CT imaging in May 2013 showed an interval increase in metabolic activity within the lesions in his neck, with additional metastasis to his chest, manubrium, and T5 vertebra . Brain MRI was negative. Given his limited treatment options at the time and after a thorough discussion regarding the potential toxicities in the setting of known UC, it was decided to pursue ipilimumab immunotherapy. Cycle 1 was initiated in June of 2013. Six weeks later he was eventually hospitalized for steroid-refractory colitis characterized by colonoscopy as a moderate colitis with diffuse erosions, ulcerations, and pseudopolyps which resolved with a single dose of infliximab therapy. Further ipilimumab was held and the patient was followed for an additional two months before he was re-admitted for colitis and re-started on azathioprine and IV methylprednisolone followed by a slow prednisone taper in late September 2013. The patient did well until mid-November 2013 when he experienced an episode of acute abdominal pain prompting a diagnosis of colonic perforation and an urgent laparoscopic colectomy. Pathology showed extensive ulcerative colitis with evidence of a sigmoid perforation. Notably, PET CT imaging following his initial hospitalization showed an overall improvement in the FDG avidity of multiple sites of melanoma involving his chest wall as well as various osseous structures including the manubrium, right clavicle, and the T5 vertebral body . After recovering from his surgery and receiving two monthly denosumab injections at 120 mg via subcutaneous delivery, he underwent additional re-staging with a PET CT showing evidence of disease progression . After extensive discussion of potential toxicities including the development of proctitis and/or other autoimmune manifestations involving the hepatobiliary tract such as primary sclerosing cholangitis (PSC), it was determined in April of 2014 that re-induction therapy with ipilimumab in the setting of a total colectomy would be reasonable. He did well until 2 weeks after his second dose of ipilimumab when he reported a grade I limited pruritic rash and persistent dry cough for which he was started on mometasone inhaler and chlorpheniramine/hydrocodone. By five weeks into his ipilimumab regimen, the patient reported the development of a dry cough and two weeks following his fourth dose of therapy, he reported extreme fatigue and a reduction in stamina. Morning labs were drawn and found to be consistent with anterior panhypopituitarism prompting the initiation of hydrocortisone replacement therapy. Although his fatigue improved dramatically, he continued to report a persistent dry cough that was interfering with his sleep. His initial 4 week re-staging PET CT following therapy showed interval complete resolution of prior hypermetabolic FDG activity within the left level II cervical lymph node, the chest wall nodule, and foci in his manubrium, right clavicular head and T5 vertebral body with diminished FDG activity in a right level IV lymph node. At that time he was also found to have FDG activity along the length of the trachea consistent with a tracheobronchitis . With this finding, he was placed on a 10 day prednisone taper which completely resolved his cough. He continued on monthly denosumab therapy until he underwent re-staging in October 2014 demonstrating a complete response (CR) to therapy. Figure 1 Ipilimumab Treatment Course of Patient with UC. A . re-staging chest axial PET CT imaging of patient at different time points. (1) prior to initial dose of ipilimumab, (2) following first dose of ipilimumab and ipilimumab-induced grade III colitis, (3) following total colectomy and prior to re-treatment with ipilimumab, (4) complete disease resolution following a four-dose regimen of ipilimumab. B . Time line of clinical events. Figure 2 Induction of Tracheobronchitis and Elevation in Absolute Lymphocyte Count Following Treatment of UC Patient with Ipilimumab. A . PET CT evidence of ipilimumab-induced tracheobronchitis in a patient with UC (arrow). B . Absolute lymphocyte count (ALC) versus treatment day in a UC patient undergoing ipilimumab immunotherapy. Arrows indicate ipilimumab dosing.
| 3.925781
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999997
|
25992290
|
https://doi.org/10.1186/s40425-015-0064-2
|
[
"ipilimumab",
"melanoma",
"lymph",
"neck",
"evidence",
"staging",
"colitis",
"involving",
"imaging",
"activity"
] |
[
{
"code": "2C30.Z",
"title": "Melanoma of skin, unspecified"
},
{
"code": "2B70.Y&XH4846",
"title": "Melanoma of oesophagus"
},
{
"code": "2C30.Y",
"title": "Other specified melanoma of skin"
},
{
"code": "2D0Y&XA4MT3",
"title": "Melanoma of uvea"
},
{
"code": "2D04",
"title": "Malignant neoplasm of orbit"
},
{
"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 ===
[2C30.Z] Melanoma of skin, unspecified
Also known as: Melanoma of skin, unspecified | Melanoma of skin | Malignant melanoma of skin | cutaneous melanoma | melanoma NOS
[2C30.Y] Other specified melanoma of skin
Also known as: Other specified melanoma of skin | Naevoid melanoma, primary | Spitzoid malignant melanoma | Naevoid malignant melanoma | Small cell melanoma
[2D04] Malignant neoplasm of orbit
Definition: A primary or metastatic malignant neoplasm involving the orbit.
Also known as: Malignant neoplasm of orbit | orbital cancer | primary malignant neoplasm of orbit | intraorbital cancer | Malignant neuroepithelial tumours of orbit
Excludes: Benign neoplasm of orbital bone | malignant neoplasm of orbital bone
[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 ---
[2C30.Z] Melanoma of skin, unspecified
--PARENT--> [2C30] Melanoma of skin
Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...
--CHILD--> [2C30.2] Lentigo maligna melanoma, primary
Def: Lentigo maligna malignant melanoma is a form of melanoma which occurs within a lentigo maligna when neoplastic cells no longer remain confined to the epidermis (in situ radial growth) but invade the d...
--- Walk 2 ---
[2C30.Z] Melanoma of skin, unspecified
--PARENT--> [2C30] Melanoma of skin
Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...
--CHILD--> [2C30.1] Nodular melanoma, primary
Def: Variant of melanoma carrying a poor prognosis due to the fact that there is little or no prodromal radial (superficial) growth phase before deep invasion (vertical growth). The lesion presents as an e...
--- Walk 3 ---
[2C30.Y] Other specified melanoma of skin
--PARENT--> [2C30] Melanoma of skin
Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...
--EXCLUDES--> [?] Melanoma of vulva
--- Walk 4 ---
[2C30.Y] Other specified melanoma of skin
--PARENT--> [2C30] Melanoma of skin
Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...
--EXCLUDES--> [?] Melanoma of vulva
--- Walk 5 ---
[2D04] Malignant neoplasm of orbit
Def: A primary or metastatic malignant neoplasm involving the orbit....
--EXCLUDES--> [?] Benign osteogenic tumours of bone or articular cartilage of skull or face
--CHILD--> [?] Benign neoplasm of craniofacial bones
--- Walk 6 ---
[2D04] Malignant neoplasm of orbit
Def: A primary or metastatic malignant neoplasm involving the orbit....
--EXCLUDES--> [?] Benign osteogenic tumours of bone or articular cartilage of skull or face
--CHILD--> [?] Benign neoplasm of bone of skull
|
[
"[2C30.Z] Melanoma of skin, unspecified\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --CHILD--> [2C30.2] Lentigo maligna melanoma, primary\n Def: Lentigo maligna malignant melanoma is a form of melanoma which occurs within a lentigo maligna when neoplastic cells no longer remain confined to the epidermis (in situ radial growth) but invade the d...",
"[2C30.Z] Melanoma of skin, unspecified\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --CHILD--> [2C30.1] Nodular melanoma, primary\n Def: Variant of melanoma carrying a poor prognosis due to the fact that there is little or no prodromal radial (superficial) growth phase before deep invasion (vertical growth). The lesion presents as an e...",
"[2C30.Y] Other specified melanoma of skin\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --EXCLUDES--> [?] Melanoma of vulva",
"[2C30.Y] Other specified melanoma of skin\n --PARENT--> [2C30] Melanoma of skin\n Def: A primary melanoma arising from atypical melanocytes in the skin. Precursor lesions include acquired and congenital melanocytic nevi, and dysplastic nevi. Several histologic variants have been recogni...\n --EXCLUDES--> [?] Melanoma of vulva",
"[2D04] Malignant neoplasm of orbit\n Def: A primary or metastatic malignant neoplasm involving the orbit....\n --EXCLUDES--> [?] Benign osteogenic tumours of bone or articular cartilage of skull or face\n --CHILD--> [?] Benign neoplasm of craniofacial bones",
"[2D04] Malignant neoplasm of orbit\n Def: A primary or metastatic malignant neoplasm involving the orbit....\n --EXCLUDES--> [?] Benign osteogenic tumours of bone or articular cartilage of skull or face\n --CHILD--> [?] Benign neoplasm of bone of skull"
] |
2C30.Z
|
Melanoma of skin, unspecified
|
[
{
"from_icd11": "2C30.Z",
"icd10_code": "C4359",
"icd10_title": "Malignant melanoma of other part of trunk"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4372",
"icd10_title": "Malignant melanoma of left lower limb, including hip"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4339",
"icd10_title": "Malignant melanoma of other parts of face"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4331",
"icd10_title": "Malignant melanoma of nose"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4371",
"icd10_title": "Malignant melanoma of right lower limb, including hip"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4352",
"icd10_title": "Malignant melanoma of skin of breast"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4322",
"icd10_title": "Malignant melanoma of left ear and external auricular canal"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4362",
"icd10_title": "Malignant melanoma of left upper limb, including shoulder"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C43112",
"icd10_title": "Malignant melanoma of right lower eyelid, including canthus"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4330",
"icd10_title": "Malignant melanoma of unspecified part of face"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4351",
"icd10_title": "Malignant melanoma of anal skin"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4370",
"icd10_title": "Malignant melanoma of unspecified lower limb, including hip"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4360",
"icd10_title": "Malignant melanoma of unspecified upper limb, including shoulder"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C4320",
"icd10_title": "Malignant melanoma of unspecified ear and external auricular canal"
},
{
"from_icd11": "2C30.Z",
"icd10_code": "C439",
"icd10_title": "Malignant melanoma of skin, unspecified"
}
] |
C4359
|
Malignant melanoma of other part of trunk
|
The child was admitted and an empiric treatment with IV cefotaxin was started. On the 2 nd day of admission, the child was still febrile (39.5 °C) with increased irritability, abdominal distension and cold extremities and rash spread to the face and trunk. Swelling and redness of the hands and feet, lips and oral mucosa redness (strawberry tongue), bilateral conjunctivitis and perioral redness became evident, as shown in Fig. 1 a-e. Repeated blood tests revealed raised pro-calcitonin (7.676 ng/mL), slightly increased liver enzymes (ALT 89 U/L, AST 44 U/L) and mild hypoalbuminemia (30.6 g/L). Leukocyturia (white blood cells 3 +) and proteinuria (582.6 ul) were evident at urine analysis. The main infective causes were excluded, including TORCH, EBV, gastrointestinal infection (normal stool culture and viral investigations), upper respiratory tract infection (negative pharyngeal swab). COVID serology was negative, such as blood and urine cultures. Mild signs of pulmonary inflammation were found on chest X-ray. Antibiotic treatment was switched to ceftriaxone to increase the spectrum and glycyrrhizin was introduced for liver protection. Three days after admission, blood analyses showed increased leukocytosis and clotting derangement (Fibrinogen: 6.08 g/L, Fibrin degradation products: 25.6 mg/L, D-dimer 9.62 mg/L). An echocardiogram showed normal diameter of the left main coronary artery (1.9 mm, z-score: 1.17, LCA/AO = 0.21), left anterior descending branch dilatation (1.8 mm, z-score: 2.08, LAD/AO = 0.20), and presence of a coronary aneurysm at the proximal right coronary artery (3.6 mm, z-score: 6.98, RCA/AO = 0.40) , with intra-aneurysmatic non-occlusive thrombosis . Despite the young age and the short history of symptoms, a diagnosis of KD was considered. After obtaining parental informed consent, treatment with intravenous human immunoglobulin (IVIG, 2 g/Kg) was immediately given to block the immune response process and reduce further coronary damage. At the same time, a combination of anticoagulant therapies including oral aspirin (100 mg bid) and dipyridamole (12.5 mg bid) was prescribed. Despite a transient relief of symptoms for one day, 24 h after IVIG administration, fever, rash and the other clinical manifestations and biochemical signs recurred. A second dose of IVIG (2 g/Kg) was infused, along with intravenous steroids (methylprednisolone, 2 mg/kg). Following this treatment, symptoms rapidly disappeared, with an increase in platelet count to (770 × 10 9 /L) and evidence of hands and feet desquamation . A second echocardiography repeated after one week showed stable findings. The patient was clinically stable and therefore discharged from hospital on day 14 after a 3 rd echocardiography showing a mild improvement (LCA z-score: 0.86, LAD z-score: 0.43, RCA z-score: 6.01) and a regular follow-up was conducted after discharge according to the management plan (formulated by the Kawasaki Disease Cooperation Group of the Pediatric Branch of the Chinese Medical Association and the relevant guidelines of Japan and the United States) . Two weeks post-discharge, the echocardiography showed no significant improvement in the coronary artery lesion and the thrombosis measures. Liver enzymes were significantly increased (ALT 119 U/L, AST 54 U/L). Therefore, warfarin treatment (0.09 mg/kg) was introduced, maintaining prothrombin international normalized ratio (INR) between 2 and 3 and aspirin and dypiridamole were stopped. Liver enzymes normalized after one week. At 4 weeks from discharge (day 46) the child was clinically well, weight was 6.7 kg and length was 66 cm. The echocardiography did not show evidence of thrombosis and dilatation of coronary artery was markedly improved ((LCA 1.6 mm, z-score: 0.12, LAD: 1.8 mm, z-score: 1.95, RCA 1.6 mm, z-score: 0.79). The results of echocardiography on the 46 th day of disease are shown in Fig. 3 . At final follow-up (7 weeks post-discharge), the echocardiogram showed LCA 2.0 mm, z-score 1.47and RCA 1.6 mm,z-score: 0.79. Platelet count progressively normalized during observation and other blood tests were repeatedly normal (Table 1 ). Fig. 1 Initial and late clinical signs of disease course. a and b . Sprinkled skin rash on the abdomen, trunk and limbs c . edema of the fingers d . bilateral conjuntivitis, red and dry lips, red bayberry tongue e . perianal redness f . hands desquamation g . feet desquamation Fig. 2 Echocardiography on day 4 of course of disease. a Apical five chamber view showing dimensions of the right coronary artery. b Parasternal short axis view showing left anterior descending branch. c Apical five chamber view showing dimensions of the proximal right coronary artery. d Apical five chamber view showing the intramural throbosis Fig. 3 Echocardiography on the 46th day of disease course. Ultrasound examination of the heart showed that coronary artery dilation was improved. a Five chamber view showing dimensions of right coronary artery. b Parasternal short axis view showing left coronary artery (4a and 4b) Table 1 Full blood count results at different time points WBC(× 10 9 /L) NEU(× 10 9 /L) RBC(× 10 12 /L) HB(g/L) PLT(× 10 9 /L) Day 1 12.73 7.5 4.81 133 199 Day 4 12.76 8.25 3.67 96 277 Day 8 16.66 6.4 3.41 89 367 Day 14 10.23 03.2 3.5 94 770 Day 26 8.87 1.21 4.24 111 568 Day 41 7.66 0.94 4.13 109 412 Day 46 5.73 0.7 4.18 109 225
| 4.015625
| 0.976563
|
sec[1]/p[3]
|
en
| 0.999998
|
37270515
|
https://doi.org/10.1186/s13052-023-01478-9
|
[
"coronary",
"score",
"artery",
"echocardiography",
"blood",
"view",
"redness",
"liver",
"five",
"chamber"
] |
[
{
"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": "MB20.1&XC87",
"title": "Glasgow Coma Scale, eyes opening, never"
},
{
"code": "KD30.0",
"title": "Birth depression with 5 minute Apgar score 0-3"
},
{
"code": "KD30.1",
"title": "Birth depression with 5 minute Apgar score 4-6"
},
{
"code": "MB20.1",
"title": "Coma"
},
{
"code": "KB21.0",
"title": "Severe birth asphyxia"
}
] |
=== ICD-11 CODES FOUND ===
[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
[KD30.0] Birth depression with 5 minute Apgar score 0-3
Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.
Also known as: Birth depression with 5 minute Apgar score 0-3
[KD30.1] Birth depression with 5 minute Apgar score 4-6
Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.
Also known as: Birth depression with 5 minute Apgar score 4-6
[MB20.1] Coma
Definition: Acute state lasting more than one hour and usually less than a month. The comatose patient is unresponsive, lying with their eyes closed and cannot be aroused even by vigorous and noxious stimuli. Motor responses to noxious stimulation are limited to reflexive behaviour. Etiologies include but are not limited to traumatic, anoxic, infectious, neoplastic, vascular, inflammatory and metabolic brain injuries.
Also known as: Coma | comatose | exanimation | Coma, NOS | Unconsciousness, NOS
Excludes: Diabetic coma | Hepatic coma | Neonatal coma
[KB21.0] Severe birth asphyxia
Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent.
Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia
=== GRAPH WALKS ===
--- Walk 1 ---
[BA8Z] Diseases of coronary artery, unspecified
--PARENT--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--CHILD--> [BA81] Coronary artery aneurysm
Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....
--- Walk 2 ---
[BA8Z] Diseases of coronary artery, unspecified
--PARENT--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--CHILD--> [BA81] Coronary artery aneurysm
Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....
--- Walk 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
--PARENT--> [?] Ischaemic heart diseases
--- 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...
--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 6 ---
[BA41.Z] Acute myocardial infarction, unspecified
--PARENT--> [BA41] Acute myocardial infarction
Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...
--EXCLUDES--> [?] Certain current complications following acute myocardial infarction
Def: Secondary conditions which may occur in the course after the heart attack. They include pericarditis, arrhythmia, cardiogenic shock, heart failure, ventricular rupture, ventricular aneurysm (with thro...
|
[
"[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --CHILD--> [BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....",
"[BA8Z] Diseases of coronary artery, unspecified\n --PARENT--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....\n --CHILD--> [BA81] Coronary artery aneurysm\n Def: Coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times....",
"[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 --PARENT--> [?] Ischaemic heart diseases",
"[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...",
"[BA41.Z] Acute myocardial infarction, unspecified\n --PARENT--> [BA41] Acute myocardial infarction\n Def: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Under these conditions any one o...\n --EXCLUDES--> [?] Certain current complications following acute myocardial infarction\n Def: Secondary conditions which may occur in the course after the heart attack. They include pericarditis, arrhythmia, cardiogenic shock, heart failure, ventricular rupture, ventricular aneurysm (with thro..."
] |
BA8Z
|
Diseases of coronary artery, unspecified
|
[
{
"from_icd11": "BA4Z",
"icd10_code": "I248",
"icd10_title": "Other forms of acute ischemic heart disease"
},
{
"from_icd11": "BA4Z",
"icd10_code": "I256",
"icd10_title": "Silent myocardial ischemia"
},
{
"from_icd11": "BA4Z",
"icd10_code": "I249",
"icd10_title": "Acute ischemic heart disease, unspecified"
},
{
"from_icd11": "BA4Z",
"icd10_code": "I24",
"icd10_title": "Other acute ischemic heart diseases"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A1",
"icd10_title": "Myocardial infarction type 2"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A9",
"icd10_title": "Other myocardial infarction type"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2109",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2119",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2111",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2102",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2129",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2121",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2101",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I214",
"icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I213",
"icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site"
}
] |
I248
|
Other forms of acute ischemic heart disease
|
In cases of such congenital liver anomalies, the gallbladder is often placed on the right side of the liver against the diaphragm in a retrohepatic or suprahepatic location . In our case, the gallbladder is also on the right side of the liver, in a vertical position between the right costal arch and the right dome of the diaphragm. In the case of an atypically located gallbladder, the inferior vena cava can be used instead as another landmark. Although the right hepatic lobe is absent, the inferior vena cava keeps its usual position in contact with the posterior visceral surface of the medial segment of the left hepatic lobe . Previous studies have revealed that the congenital agenesis of the liver lobe affects the left lobe more than the right lobe, and the agenesis of the right lobe occurs slightly more often in men . However, in our case, this rare anomaly occurred in the right lobe and was an incidental finding noticed in a female patient with a complaint of right upper quadrant pain (Table 1 ). Table 1 Reported cases of hepatic agenesis Authors Year of publication Patients clinical presentation Investigations Objective of the paper Masayuki Kanematsu et al . Published in 1991 A 48-year-old man presented with epigastric pain, white watery diarrhea but no jaundice The laboratory studies showed normal results Computed tomography (CT) revealed an absence of the right lobe and the caudate lobe of the liver with glossy enlarged left hepatic lobe This paper describes a rare case of agenesis of the right liver lobe, which was diagnosed using computed tomography (CT), liver scintigraphy, and angiography. The radiological findings and differential diagnosis are reviewed Soo Jeong Lee et al . Published in July 1993 A 36-year-old man presented with colicky right upper quadrant pain Normal laboratory studies CT scan showed absent right lobe of the liver with displaced gallbladder forming a blunt angle between the long axis of the gallbladder and CBD This report describes a patient with agenesis of the right liver lobe, emphasizing the rarity of this congenital anomaly and the limited number of reported cases Karaman et al . Published in 1997 An obese 55-year-old woman was admitted with abdominal pain, nausea, and vomiting All laboratory tests were normal CT scan showed total agenesis of the right lobe of the liver and compensatory hypertrophy of the left lobe plus hydatid cyst The paper presents a case report of a rare congenital anomaly called agenesis of the right lobe of the liver, which is usually accompanied by additional anomalies such as a retrohepatically or suprahepatically located gallbladder. The case report includes a patient with agenesis of the right lobe of the liver with Chilaiditi syndrome and a subdiaphragmatic hydatid cyst Norihiro Sato et al . Published in 1998 An 84-year-old woman presented with vomiting and weight loss Normal laboratory tests CT scan showed absence of the right lobe of the liver and an enlargement of the left lobe plus gastric cancer The paper reports a case of congenital agenesis of the right lobe of the liver detected in a patient with gastric cancer. The diagnosis was established using computed tomography, abdominal angiography, and operative findings. The importance of recognizing this condition is stressed, and the clinical presentation, radiographic appearance, and differential diagnosis are also discussed Geeta Gathwala et al . February 2003 A 10-year-old male child presented with swelling on the left side of abdomen All laboratory test were within normal range CT scan showed agenesis of the right lobe of liver with portal hypertension This article reports a case of agenesis of the right lobe of the liver and provides a brief review of the literature, discussing the diagnosis and differential diagnosis of this condition Antonio Iannelli et al . Published in May 2005 A 70-year-old woman was admitted with abdominal pain in the epigastrium and upper right abdominal quadrant, nausea, and vomiting The ultrasound (US) revealed gallbladder stones and ruled out other anomalies This study focuses on the challenges encountered during laparoscopic cholecystectomy in a patient with congenital agenesis of the right liver. It highlights the importance of preoperative planning and awareness of anatomical variations Lucas Souto Nacif et al . Published in March 2012 A 32-year-old male patient presented with abdominal discomfort and loss of appetite but no jaundice or urine color change Laboratory tests and tumor markers were all normal CT scan revealed the absence of the right hepatic lobe, hypertrophied left hepatic segments This article discusses a case of biliary injury after laparoscopic cholecystectomy in a patient with right liver agenesis. It highlights the challenges and considerations in surgical management Our case A 35-year-old woman presented with right upper quadrant pain and fatty food intolerance Her laboratory studies were within the normal range CT scan showed absence of right hepatic lobe with compensatory hypertrophy of the left hepatic lobe and caudate lobe plus gallstone The abstract of the paper briefly describes the importance of understanding anatomical anomalies for surgical planning and postoperative therapy. It also reports a case of a rare congenital anomaly, right hepatic lobe agenesis, and cholelithiasis in a 35-year-old female patient
| 4.144531
| 0.833008
|
sec[2]/p[3]
|
en
| 0.999997
|
38225604
|
https://doi.org/10.1186/s13256-023-04328-8
|
[
"lobe",
"liver",
"agenesis",
"hepatic",
"this",
"congenital",
"gallbladder",
"laboratory",
"pain",
"published"
] |
[
{
"code": "CB40.2",
"title": "Pulmonary collapse"
},
{
"code": "LA75.0",
"title": "Accessory lobe of lung"
},
{
"code": "MD41",
"title": "Clinical findings on diagnostic imaging of lung"
},
{
"code": "LA75.1",
"title": "Agenesis of lung"
},
{
"code": "JA8A.1",
"title": "Malformation of placenta"
},
{
"code": "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 ===
[CB40.2] Pulmonary collapse
Also known as: Pulmonary collapse | Atelectasis | lung collapse | pulmonary atelectasis | pulmonary collapse with atelectasis
Includes: Atelectasis
Excludes: Primary atelectasis of newborn | tuberculous atelectasis, not confirmed | tuberculous atelectasis, confirmed
[LA75.0] Accessory lobe of lung
Definition: An extra lobe of lung beyond the 3 on the right and the 2 on the left
Also known as: Accessory lobe of lung | supernumerary lung lobe | azygos lobe of lung | azygos lobe fissure of lung | azygos lobe
[MD41] Clinical findings on diagnostic imaging of lung
Definition: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors use to look inside body for clues about a medical condition. X-rays, CT scans, nuclear medicine scans, MRI scans and ultrasound are all types of diagnostic imaging.
Also known as: Clinical findings on diagnostic imaging of lung | abnormal diagnostic imaging of lung | Hyperinflation of lung | Lung mass | Pulmonary lobe mass
[LA75.1] Agenesis of lung
Definition: This refers to the absence or rudimentary residua of an undeveloped lung.
Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism
[JA8A.1] Malformation of placenta
Also known as: Malformation of placenta | variation of placenta form | deformity of placenta | placental deformity | Abnormal placenta NOS
[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 ---
[CB40.2] Pulmonary collapse
--EXCLUDES--> [?] Respiratory tuberculosis, not confirmed
Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has not been confirmed. This disease is characterised by a chronic cough, and sputum prod...
--PARENT--> [?] Tuberculosis of the respiratory system
Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....
--- Walk 2 ---
[CB40.2] Pulmonary collapse
--EXCLUDES--> [?] Respiratory tuberculosis, confirmed
Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,...
--CHILD--> [?] Tuberculosis of lung, confirmed by culture only
Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is confirmed by culture only....
--- Walk 3 ---
[LA75.0] Accessory lobe of lung
Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--- Walk 4 ---
[LA75.0] Accessory lobe of lung
Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.2] Congenital hypoplasia of lung
--- Walk 5 ---
[MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
--PARENT--> [?] Clinical findings in the respiratory system
--CHILD--> [MD42] Results of function studies of the respiratory system
--- Walk 6 ---
[MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
--PARENT--> [?] Clinical findings in the respiratory system
--CHILD--> [MD42] Results of function studies of the respiratory system
|
[
"[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Respiratory tuberculosis, not confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has not been confirmed. This disease is characterised by a chronic cough, and sputum prod...\n --PARENT--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....",
"[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Respiratory tuberculosis, confirmed\n Def: A disease of the respiratory tract, caused by an infection with the bacteria Mycobacterium tuberculosis, which has been confirmed by laboratory testing. This disease is characterised by chronic cough,...\n --CHILD--> [?] Tuberculosis of lung, confirmed by culture only\n Def: This is a common, and in many cases lethal, infectious disease of the lung caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is confirmed by culture only....",
"[LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....",
"[LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung",
"[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD42] Results of function studies of the respiratory system",
"[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --CHILD--> [MD42] Results of function studies of the respiratory system"
] |
CB40.2
|
Pulmonary collapse
|
[
{
"from_icd11": "CB40.2",
"icd10_code": "J9811",
"icd10_title": "Atelectasis"
},
{
"from_icd11": "CB40.2",
"icd10_code": "J9819",
"icd10_title": "Other pulmonary collapse"
},
{
"from_icd11": "CB40.2",
"icd10_code": "J981",
"icd10_title": "Pulmonary collapse"
},
{
"from_icd11": "LA75.0",
"icd10_code": "Q331",
"icd10_title": "Accessory lobe of lung"
},
{
"from_icd11": "MD41",
"icd10_code": "R911",
"icd10_title": "Solitary pulmonary nodule"
},
{
"from_icd11": "MD41",
"icd10_code": "R91",
"icd10_title": "Abnormal findings on diagnostic imaging of lung"
},
{
"from_icd11": "LA75.1",
"icd10_code": "Q333",
"icd10_title": "Agenesis of lung"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43123",
"icd10_title": "Velamentous insertion of umbilical cord, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43193",
"icd10_title": "Other malformation of placenta, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43122",
"icd10_title": "Velamentous insertion of umbilical cord, second trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43113",
"icd10_title": "Circumvallate placenta, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43192",
"icd10_title": "Other malformation of placenta, second trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43103",
"icd10_title": "Malformation of placenta, unspecified, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43101",
"icd10_title": "Malformation of placenta, unspecified, first trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43102",
"icd10_title": "Malformation of placenta, unspecified, second trimester"
}
] |
J9811
|
Atelectasis
|
A 13-month-old Hispanic boy presented with a sudden-onset papular eruption affecting the face, trunk, and extremities that progressively worsened over 2 months . Prior medical history was only significant for heterochromia of the right eye (also present in the mother). The mother had no known history of NOD2 mutation or sarcoidosis. The patient was experiencing frequent falls, conjunctival injection, and apparent joint and eye pain. He had no history of difficulty breathing, cough, wheezing, blurry vision, international travel, or frequent infections. On physical exam, he had innumerable erythematous to skin-colored papules coalescing into plaques over the arms, back, legs, and face. Laboratory evaluation revealed an immunoglobulin panel with normal IgG at 799 mg/dL (normal range 480–965 mg/dL), low IgA at <50 mg/dL (normal range 52–141 mg/dL), and high IgM levels at 203 mg/dL (normal range 34–120 mg/dL). T-spot was negative. The angiotensin converting enzyme (ACE) level was elevated to 145 μg/L (ref: 18–95 μg/L). Biopsy of skin from the right shoulder was performed and revealed rounded aggregates of epithelioid histocytes and multinucleated giant cells without a significant lymphocytic component (“naked” granulomas) . Histiocytes were negative for S100 and CD1a, arguing against a Langerhans cell histiocytosis. Histocytes were diffusely positive for CD163. Special stains to rule out infection were performed, including Gram stain, acid fast stain (Ziehl–Neelsen), and Fite stain, which were negative for bacteria and mycobacteria. The patient was referred to an ophthalmologist who directly visualized subconjunctival nodules (patient could not tolerate slit lamp examination). Given the arthritis, subconjunctival nodules, and sarcoidal granulomas on skin biopsy, the patient underwent genetic testing. A mutation in codon 1000 C > T (protein R334W) in the NOD2 gene was discovered. Testing for other immunodeficiency-related genes (more than 95 other genes) showed negative results. The patient was started on prednisolone 2 mg/kg/day for 8 weeks. The patient experienced reduction in skin papules to erythematous to light-brown macules and reduction in joint swelling (assessed via inspection and palpation as well as functional improvement in mobility) and reduction in conjunctival injection and appearance of subconjunctival nodules (assessed via visual inspection) after 8 weeks of the prednisolone therapy. Two months after stopping this initial round of steroids, the patient redeveloped erythematous papules coalescing into plaques, bogginess within joints with swelling and impaired range of motion, and conjunctival injection consistent with uveitis. At this time, a second trial of repeated prednisolone 2 mg/kg/day for another 8 weeks resulting again in improvement in papular skin eruption (assessed via visual inspection), bogginess to joints and impaired range of motion (assessed via inspection and palpation by dermatology and rheumatology), and uveitis (assessed via visual inspection by dermatology and ophthalmology). Upon finishing the second round of 8 weeks of 2 mg/kg/day of prednisolone, a tapering process was performed over the next 2 weeks (10 mg daily for 7 days, then 5 mg daily for 7 days), at which time he was started on methotrexate 7.5 mg subcutaneously weekly with 1 mg folic acid orally daily. After 8 weeks, the patient experienced an improvement in his papular skin eruption to faint brown macules but continued to have significant joint swelling and arthritis (assessed on joint palpation of knees and ankles and reports by parents of persistence in difficulty with mobility) and extreme pruritus (per reports from parents) and persistent mild conjunctival erythema (assessed via visual inspection). Although pruritus is not a specifically recognized symptom of Blau syndrome, the authors assessed that the pruritus was likely a secondary symptom in response to the inflammation present within the skin, triggering the sensation of itch as is commonly experienced in a variety of dermatitides, including atopic dermatitis, psoriasis, and autoimmune connective tissue disease patients, for example. In the authors’ experience, hydroxychloroquine has helped suppress a variety of cutaneous inflammatory processes correlating with a reduction in pruritus. In consultation with rheumatology, the patient was started on hydroxychloroquine 75 mg orally daily in combination with 7.5 mg methotrexate subcutaneously weekly in combination for 8 weeks, leading to complete resolution of dermatitis (assessed via visual inspection) , pruritus (per parents' reports), arthritis (assessed via visual inspection and palpation by dermatology and rheumatology) and uveitis (assessed via visual inspection by dermatology and ophthalmology). In discussion with the ophthalmologist, hydroxychloroquine was discontinued after the 8 weeks due to concern for risk of macular toxicity or other ocular complications and with the hope that methotrexate alone would continue to control the disease relapse from that point forward. As of the time of writing of this report, the patient continues on methotrexate 7.5 mg subcutaneously weekly with 1 mg folic acid orally daily, with appropriate follow-up with the dermatologist, rheumatologist, and ophthalmologist. The timeline of his disease status and treatment course is included in Table 1 .
| 4.085938
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC10585138
|
https://doi.org/10.3389/fimmu.2023.1279329
|
[
"assessed",
"inspection",
"skin",
"visual",
"range",
"daily",
"pruritus",
"that",
"conjunctival",
"joint"
] |
[
{
"code": "QA0B",
"title": "Preprocedural examination"
},
{
"code": "PK93.0",
"title": "Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices"
},
{
"code": "NA07.06",
"title": "Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment"
},
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "ME66.Y",
"title": "Other specified skin changes"
},
{
"code": "EM0Y",
"title": "Other specified diseases of the skin"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "ME66.1",
"title": "Changes in skin texture"
},
{
"code": "9E1Z",
"title": "Diseases of the visual system, unspecified"
},
{
"code": "MC1Y",
"title": "Other specified symptoms or signs involving the visual system"
}
] |
=== ICD-11 CODES FOUND ===
[QA0B] Preprocedural examination
Definition: Evaluation and testing for assessment and proactive management of risks of perioperative morbidity and mortality and implements measurements to minimize risks.
Also known as: Preprocedural examination | Encounter for preoperative examinations | Preprocedural general examination | Encounter for preprocedural examination NOS | preoperative assessment
[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
[NA07.06] Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment
Also known as: Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[ME66.Y] Other specified skin changes
Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta
[EM0Y] Other specified diseases of the skin
Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures
[ME60.Z] Skin lesion of unspecified nature
Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature
[ME66.1] Changes in skin texture
Definition: Alterations in skin texture of unspecified cause.
Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis
[9E1Z] Diseases of the visual system, unspecified
Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder
[MC1Y] Other specified symptoms or signs involving the visual system
Also known as: Other specified symptoms or signs involving the visual system | Erythema of eyelid | Visual disturbances | disturbances of vision | difficulty seeing
=== GRAPH WALKS ===
--- Walk 1 ---
[QA0B] Preprocedural examination
Def: Evaluation and testing for assessment and proactive management of risks of perioperative morbidity and mortality and implements measurements to minimize risks....
--PARENT--> [?] Contact with health services for purposes of examination or investigation
--EXCLUDES--> [?] Contact with health services for reasons associated with reproduction
--- Walk 2 ---
[QA0B] Preprocedural examination
Def: Evaluation and testing for assessment and proactive management of risks of perioperative morbidity and mortality and implements measurements to minimize risks....
--PARENT--> [?] Contact with health services for purposes of examination or investigation
--EXCLUDES--> [?] Clinical findings in blood, blood-forming organs, or the immune system
--- Walk 3 ---
[PK93.0] Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm
Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....
--- Walk 4 ---
[PK93.0] Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft
--- Walk 5 ---
[NA07.06] Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment
--PARENT--> [NA07.0] Concussion
Def: Loss or diminution of consciousness due to injury....
--CHILD--> [NA07.02] Concussion with loss of consciousness, short duration of less than 30 minutes
--- Walk 6 ---
[NA07.06] Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment
--PARENT--> [NA07.0] Concussion
Def: Loss or diminution of consciousness due to injury....
--CHILD--> [NA07.00] Concussion with incomplete loss of consciousness with amnesia
|
[
"[QA0B] Preprocedural examination\n Def: Evaluation and testing for assessment and proactive management of risks of perioperative morbidity and mortality and implements measurements to minimize risks....\n --PARENT--> [?] Contact with health services for purposes of examination or investigation\n --EXCLUDES--> [?] Contact with health services for reasons associated with reproduction",
"[QA0B] Preprocedural examination\n Def: Evaluation and testing for assessment and proactive management of risks of perioperative morbidity and mortality and implements measurements to minimize risks....\n --PARENT--> [?] Contact with health services for purposes of examination or investigation\n --EXCLUDES--> [?] Clinical findings in blood, blood-forming organs, or the immune system",
"[PK93.0] Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --CHILD--> [?] Dislodgement, misconnection or de-attachment of a surgical or medical device without injury or harm\n Def: A device that has moved out of place, become disconnected, loosened or unstable, but without documented injury or harm....",
"[PK93.0] Gastroenterology or urology devices associated with injury or harm, diagnostic or monitoring devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft",
"[NA07.06] Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment\n --PARENT--> [NA07.0] Concussion\n Def: Loss or diminution of consciousness due to injury....\n --CHILD--> [NA07.02] Concussion with loss of consciousness, short duration of less than 30 minutes",
"[NA07.06] Concussion with loss of consciousness, persisting longer than 24 hours or until discharge or latest assessment\n --PARENT--> [NA07.0] Concussion\n Def: Loss or diminution of consciousness due to injury....\n --CHILD--> [NA07.00] Concussion with incomplete loss of consciousness with amnesia"
] |
QA0B
|
Preprocedural examination
|
[
{
"from_icd11": "QA0B",
"icd10_code": "Z01818",
"icd10_title": "Encounter for other preprocedural examination"
},
{
"from_icd11": "QA0B",
"icd10_code": "Z01810",
"icd10_title": "Encounter for preprocedural cardiovascular examination"
},
{
"from_icd11": "QA0B",
"icd10_code": "Z01812",
"icd10_title": "Encounter for preprocedural laboratory examination"
},
{
"from_icd11": "PK93.0",
"icd10_code": "Y730",
"icd10_title": "Diagnostic and monitoring gastroenterology and urology devices associated with adverse incidents"
},
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "ME66.Y",
"icd10_code": "L578",
"icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L918",
"icd10_title": "Other hypertrophic disorders of the skin"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L988",
"icd10_title": "Other specified disorders of the skin and subcutaneous tissue"
},
{
"from_icd11": "ME66.1",
"icd10_code": "R234",
"icd10_title": "Changes in skin texture"
},
{
"from_icd11": "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"
}
] |
Z01818
|
Encounter for other preprocedural examination
|
Under general anesthesia, the patient was positioned supine on horse shoe which should be as near as possible to operating table in order to make the endoscopic sheaths, attached to the holding arms, reach our targets easily without any minimal tension, the head elevated at 30° and slightly flexed. The proximal holding arm is used for the first trajectory and the distal one for the second trajectory. After registration of the patient, two trajectories were marked by the mean of navigation. The first trajectory was for third ventriculostomy (pre-coronal burr hole and 2.5 cm lateral to MEDLINE, via the right lateral ventricle and the right foramen of Monro towards the target point in the midline of the floor of the third ventricle, 3 mm in front of the mamillary bodies), and the second trajectory was for tumor biopsy (posterior to hair line if it is possible and 2.5–3 cm lateral to MEDLINE, via the right frontal horn and the right foramen of Monro towards the midpoint of the tumor . After routine preparation of the surgical site, two endoscopic mechanical holders were applied on the operative table (ipsilateral to surgical side, in our cases on the right side of the table). Two burr holes were made over the planned trajectories. The right frontal horn was tapped, using the operating sheath with obturator, stopped just when it passed the ependymal wall of lateral ventricle, then the obturator was changed for a video camera-equipped endoscope (outer diameter, 2.3 mm). CSF was taken for cytological and biochemical analyses. The same steps were applied on the other trajectory with new sheath and obturator and the same rigid endoscope. After confirmation that we are in lateral ventricle, we reput the obturator again and we come back to the first trajectory to realize the ETV and we always start with ETV first in order to avoid any bleeding could happen from the tumor. The ventriculoscope was advanced through opening of the foramen of Monro . Opening of the floor of the third ventricle in the midline just in front of the mamillary bodies was performed with endoscopic forceps through the working channel under pressure-controlled constant irrigation via the irrigation channels . The opening of the ventricle floor was enlarged by inflation of a 3-French Fogarty catheter. Further advancement of the endoscope was performed to open The Liliequist membrane . CSF flow towards the basal cisterns and pulsation of the floor of the third ventricle were immediately observed. The ventriculoscope was then withdrawn to the lateral ventricle, the obturator was introduced again into the sheath, and the endoscope was moved to the 2nd trajectory in order to take a biopsy. The damage to the structures of the foramen could be avoided by the straight trajectory when the second burr hole was put on or just posterior to hairline. In the posterior part of third ventricle, a large reddish tumor was visualized . Multiple endoscopic biopsies were taken by tumor forceps and hemostais was achieved by monopolar and controlled irrigations with ringer’s lactate solution . As the possibility of tumors with mixed histology existed, attempts were made to obtain a sufficient quantity of tissue for pathological investigation. It is worth mentioning that there were no recorded changes in heart rate or blood pressure throughout the procedure, which may be due to the multiple outlet channels provided by both endoscopic sheaths, which allow drainage of the irrigating fluid without affecting the physiological intracranial pressure. Once we get a confirmation of the frozen section histopathology and we reach good hemostasis and clear CSF, the obturator removed from first trajectory endoscopic sheath and the EVD was introduced under direct endoscopic vision of the second trajectory, the sheath then was removed. Finally, we remove the whole endoscope from the second trajectory and we cover the burr holes with small pieces of gelfoam and skin was closed. The EVD was kept closed. No further measures were taken. The patient was mobilized on the next day and postoperative CT was done and showed improvement in ventricular size; as a result, the EVD was removed and patient discharged from the hospital on the 3rd day. He made an uneventful recovery, and a flow-sensitive MRI 1 week later confirmed ventriculostomy patency . Fig. 2 A two burr hole. B , C Two endoscopes fixed in mechanical holder Fig. 3 A , B Operative view through the second endoscope while advancing the first one into foramen of monro. C – F Operative view through the first ventriculoscope. C Floor of 3rd ventricle. D Endoscopic forceps performing the ostium. E The ventriculostomy opening. F Liliequist membrane after opening Fig. 4 Operative view through the second endoscope, the tip of which is positioned in the posterior part of third ventricle. A A large reddish tumor is visualized. B Biopsy is taken by endoscopic forceps. C Bleeding from biopsy site. D Hemostasis by monopolar. E Biopsy site after hemostasis. F – G An EVD is inserted under guidance of the second ventriculoscope. H The site of the 2 burr holes Fig. 5 A Postoperative CT brain showing the EVD tip (white arrow) passing through foramen of monro. B A flow-sensitive MRI showing patent ventriculostomy ostium (white arrow) black signal in MRI with CSF flowmetry due to turbulance of CSF across the ventriculostomy site
| 4.023438
| 0.665039
|
sec[1]/sec[1]/p[0]
|
en
| 0.999995
|
36624512
|
https://doi.org/10.1186/s41016-022-00313-0
|
[
"trajectory",
"ventricle",
"endoscopic",
"endoscope",
"burr",
"foramen",
"tumor",
"obturator",
"ventriculostomy",
"monro"
] |
[
{
"code": "LA89.Z",
"title": "Functionally univentricular heart, unspecified"
},
{
"code": "BC45",
"title": "Cardiomegaly"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "BC46&XA7XU8",
"title": "Ventricular thrombosis"
},
{
"code": "BD1Z&XT5R",
"title": "Acute heart failure"
},
{
"code": "DA25.3Y/PK80.32",
"title": "Oesophageal ulcer due to endoscopic procedures"
},
{
"code": "DA42.8Z/PK80.32",
"title": "Gastritis due to endoscopic procedures"
},
{
"code": "DA51.5Y/PK80.32",
"title": "Duodenitis due to endoscopic procedures"
},
{
"code": "PL11.4",
"title": "Failure of sterile precautions, as mode of injury or harm"
},
{
"code": "PK80.92",
"title": "Vascular procedure associated with injury or harm, endoscopic approach"
}
] |
=== ICD-11 CODES FOUND ===
[LA89.Z] Functionally univentricular heart, unspecified
Also known as: Functionally univentricular heart, unspecified | Functionally univentricular heart | Univentricular cardiopathy | Single ventricle | univentricular heart
[BC45] Cardiomegaly
Also known as: Cardiomegaly | enlargement of heart | hypertrophic heart | heart hypertrophy | Cardiac hypertrophy
Includes: Left ventricular hyperplasia
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[PL11.4] Failure of sterile precautions, as mode of injury or harm
Definition: An infection occurred because standard procedures designed to minimize the risk of hospital acquired infection were not followed or were insufficient.
Also known as: Failure of sterile precautions, as mode of injury or harm | failure of sterile precautions during intervention | contamination as mode of injury or harm | failure to take proper precautions | Failure of sterile precautions during surgical and medical care
Excludes: Failure of sterile precautions without injury or harm
[PK80.92] Vascular procedure associated with injury or harm, endoscopic approach
Also known as: Vascular procedure associated with injury or harm, endoscopic approach
Excludes: Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm
=== GRAPH WALKS ===
--- Walk 1 ---
[LA89.Z] Functionally univentricular heart, unspecified
--PARENT--> [LA89] Functionally univentricular heart
Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...
--CHILD--> [LA89.1] Tricuspid atresia
Def: A congenital cardiovascular malformation with absence of the tricuspid valvar annulus (connection/junction) or an imperforate tricuspid valve....
--- Walk 2 ---
[LA89.Z] Functionally univentricular heart, unspecified
--PARENT--> [LA89] Functionally univentricular heart
Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...
--CHILD--> [LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--- Walk 3 ---
[BC45] Cardiomegaly
--PARENT--> [?] Diseases of the myocardium or cardiac chambers
Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--- Walk 4 ---
[BC45] Cardiomegaly
--PARENT--> [?] Diseases of the myocardium or cardiac chambers
Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...
--CHILD--> [BC42] Myocarditis
Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...
--- Walk 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...
--EXCLUDES--> [?] Dressler syndrome
Def: A condition of postmyocardial infarction (1 to 8 weeks), characterised by a set of associated symptom, including malaise, fever, pericardial discomfort, leukocytosis, an elevated sedimentation rate, a...
|
[
"[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.1] Tricuspid atresia\n Def: A congenital cardiovascular malformation with absence of the tricuspid valvar annulus (connection/junction) or an imperforate tricuspid valve....",
"[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....",
"[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...",
"[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC42] Myocarditis\n Def: Myocarditis (inflammatory cardiomyopathy) is inflammation of the heart muscle generally in the presence of a dilated cardiomyopathy that results from exposure to either discrete infectious external an...",
"[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 --EXCLUDES--> [?] Dressler syndrome\n Def: A condition of postmyocardial infarction (1 to 8 weeks), characterised by a set of associated symptom, including malaise, fever, pericardial discomfort, leukocytosis, an elevated sedimentation rate, a..."
] |
LA89.Z
|
Functionally univentricular heart, unspecified
|
[
{
"from_icd11": "LA89.Z",
"icd10_code": "Q209",
"icd10_title": "Congenital malformation of cardiac chambers and connections, unspecified"
},
{
"from_icd11": "BC45",
"icd10_code": "I517",
"icd10_title": "Cardiomegaly"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A1",
"icd10_title": "Myocardial infarction type 2"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21A9",
"icd10_title": "Other myocardial infarction type"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2109",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2119",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2111",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving right coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2102",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2129",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving other sites"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2121",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I2101",
"icd10_title": "ST elevation (STEMI) myocardial infarction involving left main coronary artery"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I214",
"icd10_title": "Non-ST elevation (NSTEMI) myocardial infarction"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I213",
"icd10_title": "ST elevation (STEMI) myocardial infarction of unspecified site"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I219",
"icd10_title": "Acute myocardial infarction, unspecified"
},
{
"from_icd11": "BA41.Z",
"icd10_code": "I21",
"icd10_title": "Acute myocardial infarction"
}
] |
Q209
|
Congenital malformation of cardiac chambers and connections, unspecified
|
Among the 6 children with CF, 5 cases presented with recurrent respiratory tract infection. Etiology suggested 3 cases of Pseudomonas aeruginosa and 2 cases of Staphylococcus aureus . 3 cases had pancreatic exocrine dysfunction, manifested as diarrhea and aliphatic diarrhea, of which, 1 case had high lipase in blood examination, and pancreatic ultrasound showed rough and enhanced pancreatic echo, considering pancreatic cystic fibrosis. 2 cases of CF combined with PBS; 1 case involved only the biliary tract and started with cholestasis without other systemic involvement. In 2 cases of sweat test, sweat chloride ions were all >60 mmol/L, as shown in Table 1 . Case 1: male, with a respiratory tract infection at the age of 2 months, manifested as cough and wheeze, viscous sputum with diarrhea and aliphatic diarrhea, excessive sweating, sweat crystals on his skin, and pulmonary function suggestive of moderate obstructive ventilatory dysfunction. Auxiliary examinations—blood routine tests: white blood cells (9.8–17.6) ∗ 10 9 /L, neutrophil percentage 29.6%–45.9%, hemoglobin 98–112 g/L, platelet (240–308) ∗ 10 9 /L, and C-reactive protein 5.78–14.36 mg/L; liver functions: alanine aminotransferase 80 U/L, aspartate aminotransferase 83 U/L; no abnormality was found in blood amylase; blood lipase 119.4 U/L, increased; a plurality of times of alveolar lavage fluid culture for Pseudomonas aeruginosa ; sweat test result: chloride 140 mmol/L. Case 2: male, with a respiratory tract infection at the age of 7 months, manifested as cough, expectoration, and wheezing without diarrhea was investigated for liver function abnormalities; pulmonary function tests showed moderate-to-severe obstructive ventilatory dysfunction. Auxiliary examinations—blood routine tests: white blood cells 11.1 ∗ 10 9 /L, neutrophil percentage 63.8%, hemoglobin 128 g/L, platelet 431 ∗ 10 9 /L, and C-reactive protein <0.5 mg/L; stool routine: liposome 27–33/HPF, amyloid granule 1–5/HPF; liver function: alanine aminotransferase 78 U/L, aspartate aminotransferase 57 U/L; electrolytes, calcium, and glucose, renal function, and myocardial enzymes were almost normal. The alveolar lavage fluid was cultured for Pseudomonas aeruginosa ; sweat test result: chloride 110 mmol/L. Case 3: female, onset of respiratory infection at 3 months of age, accompanied by diarrhea, steatorrhea, growth retardation, and abnormal liver function. Auxiliary examination: blood routine examination—white blood cells 11.2 ∗ 10 9 /L, neutrophil percentage 34.4%, hemoglobin 97 g/L, platelet 202 ∗ 10 9 /L, C-reactive protein 6.89 mg/L; stool routine: fat globule: 30–45/HPF; erythrocyte sedimentation rate: 46 mm/h; liver functions: 69 U/L alanine aminotransferase, 99 U/L aspartate aminotransferase, and 157 U/L gamma-glutamyl transpeptidase; blood amylase: 18 U/L. The bronchoalveolar lavage fluid was cultured for Staphylococcus aureus . Case 4: male, meconium excretion was delayed after birth; pneumonia and diarrhea occurred in the neonatal period. At the age of seven months, he was hospitalized because of poor spirit for more than one month, drowsiness for half a month, and cough for four days. During this period, diarrhea still occurred and the stool was yellow. The fat globules were routinely visible through stool examination, and the lung function indicated moderate obstructive ventilatory dysfunction. Auxiliary examination: blood routine examination—white blood cells 7.1 ∗ 10 9 /L, neutrophil percentage 48.9%, lymphocyte percentage 43.8%, hemoglobin 117 g/L, platelet 346 ∗ 10 9 /L, and C- reactive protein 1.99 mg/L; blood electrolytes: K + 2.04 mmol/L, Na + 124.7 mmol/L, Cl − 54.6 mmol/L; blood gas analysis: PH7.631, increased. Sputum culture showed Staphylococcus aureus . The child was suffering from hypokalemia, low sodium, low chlorine, and alkalosis; the initial diagnosis did not exclude Batter syndrome, and further examination of urinary potassium, urinary sodium, and urinary chlorine were normal. Case 5: female, with yellow sclera staining of her skin on the 3rd day after birth. The jaundice improved after symptomatic treatment and then became worse again. She was hospitalized for 54 days after birth; liver function tests: total bilirubin 188.9 μ m mol/L, direct bilirubin 154.4 μ m mol/L, total bile acid 127.1 μ m mol/L, gamma-glutamyl transpeptidase 55 U/L, alanine aminotransferase 110 U/L, and aspartate aminotransferase 135 U/L. Auxiliary examination: blood routine examination—white blood cells 7.61 ∗ 10 9 /L, neutrophil percentage 18.9%, lymphocyte percentage 69.7%, hemoglobin 104 g/L, platelet 373 ∗ 10 9 /L, and C-reactive protein 1.1 mg/L. Case 6: male, with a respiratory tract infection at the age of 1 years, manifested as nasal congestion, cough, fever, and runny nose, with pulmonary function suggestive of a mild obstructive ventilatory dysfunction prior to relaxation, and electrolyte metabolism disorders (low sodium, low potassium, and low chlorine) combined with metabolic alkalosis during the second hospitalization, considering a combination of PBS. Auxiliary examination: blood routine examination—white blood cells 6.1 ∗ 10 9 /L, neutrophil percentage 41.5%, lymphocyte percentage 44.0%, hemoglobin 131 g/L, platelet 234 ∗ 10 9 /L, and C-reactive protein 15.41 mg/L. Bacterial culture of bronchoalveolar lavage fluid was Pseudomonas aeruginosa .
| 4.175781
| 0.50293
|
sec[2]/sec[1]/p[0]
|
en
| 0.999997
|
34765005
|
https://doi.org/10.1155/2021/7254391
|
[
"blood",
"function",
"diarrhea",
"routine",
"aminotransferase",
"cases",
"mmol",
"auxiliary",
"white",
"cells"
] |
[
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
},
{
"code": "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 ===
[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
[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 ---
[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....
--EXCLUDES--> [?] Certain conditions originating in the perinatal period
Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.4Z] Haematuria, unspecified
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--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 --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 --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --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
|
CIDP is a type of motor sensory peripheral neuropathy mediated by immunity. Studies in the literature have estimated various prevalence rates, ranging from 1 to 9 per 1000,000 people. Diagnosis relies mainly on clinical symptoms, signs, and electrophysiological examinations. Owing to its rarity in clinical practice and the variability of its symptoms, it is highly susceptible to misdiagnosis and mistreatment in clinical practice. Patients with CIDP typically experience symptoms that progress for more than 8 weeks, with chronic progression or relief of recurrence, including varying degrees of limb weakness, mostly symmetrical, involving both proximal and distal ends, with reduced or absent limb key reflexes, accompanied by deep and superficial sensory abnormalities; albuminocytologic dissociation can be observed in cerebrospinal fluid examination; electrophysiological examination indicates a slowdown in peripheral nerve conduction velocity, conduction block, or abnormal waveform dispersion. The diagnostic process of this patient is complex, and currently, CIDP remains an exclusive diagnosis. Before diagnosing CIDP, other diseases should be excluded. In June 2023, we conducted a series of examinations and tests on the patient and inquired in detail about his onset process and family history. The patient denied having a history of genetic, infectious, or special diseases in his family, and there were no similar patients in his family. No obvious abnormalities were observed in routine blood tests, blood coagulation, erythrocyte sedimentation rate, hepatitis B, hepatitis C, syphilis, acquired immunodeficiency syndrome, rheumatoid factor, immunoglobulin M, immunoglobulin E, immunoglobulin A, immunoglobulin G, antinuclear antibody, blood complement C3, blood complement C4, and autoimmune antibodies. The patient had been taking atorvastatin for a long time to regulate blood lipids. Muscle damage related to atorvastatin is mainly characterized by myalgia and myasthenia, which are usually transient. The patient was mainly characterized by myasthenia, did not have myalgia, and the course of the disease was chronic progression; therefore, drug poisoning was ruled out. Ischemic cerebrovascular disease often presents as hemiplegia and hemiblindness, accompanied by dizziness or consciousness disorders, and imaging examination shows ischemic lesions. The patient had symmetrical limb weakness, which could be ruled out using cranial MRI. Multiple sclerosis presents as alternating episodes of limb weakness accompanied by sensory abnormalities and is usually accompanied by visual changes. Characteristic multiple lesions can be seen on cranial MRI. Our patient did not show any visual changes, and multiple sclerosis was ruled out based on the MRI results. Paraneoplastic peripheral neuropathy is mostly purely sensory or sensorimotor with obvious sensory symptoms and progressive progression. Peripheral nerve damage can occur before, simultaneously, or after the onset of cancer. The patient cranial MRI, cervical MRI, pelvic MRI, and chest CT did not show any evidence of tumor-related symptoms. The clinical manifestations of our patient were mainly motor symptoms, albuminocytologic dissociation was observed in the cerebrospinal fluid examination, and paraneoplastic peripheral neuropathy was ruled out. Polymyositis is characterized by progressive weakness of the symmetrical proximal muscles of the limbs, and electromyography indicates active myogenic damage. The patient muscle weakness symptoms were simultaneously affected at the proximal and distal ends, and electromyography showed extensive neurogenic abnormalities. The myositis antibody spectrum was negative and polymyositis was ruled out. After excluding these diseases, the patient was diagnosed with CIDP. The pathological process of primary demyelination leads to secondary axonal degeneration, which results in disability. Early diagnosis and treatment can minimize the severity of axonal degeneration. Our patient came to the hospital for treatment nearly 4 months after experiencing symptoms, which delayed the start of treatment. CIDP can be divided into 2 categories: typical and variant. A typical CIDP possesses all the above symptom characteristics, while variant CIDP includes pure motor type, pure sensory type,distal acquired demyelinating symmetric polyneuropathy, and multifocal acquired demyelinating sensory and motor neuropathy. The patient developed symptoms at 65 years of age and presented with chronic progression, meeting the typical diagnostic criteria for CIDP. GC, IVIg, or PE can be used as first-line treatment for CIDP. We considered several factors when choosing treatment options, such as safety, accessibility, and disease characteristics. At present, with faster onset and better compliance than GC,IVIg tends to be the preferred treatment for most patients, but the cost is high. PE is only used for IVIG- and GC-refractory patients because of the lack of long-term data and equipment requirements. Owing to economic reasons, our patient chose GC as the initial treatment. We observed that methylprednisolone therapy was effective and the patient symptoms improved; however, over time, the CIDP condition had progressed. Therefore, we added MMF, and the patient condition improved. Unfortunately, 2 months later, the patient developed nocardiosis.
| 4.339844
| 0.69043
|
sec[2]/p[0]
|
en
| 0.999998
|
PMC11175944
|
https://doi.org/10.1097/MD.0000000000038544
|
[
"cidp",
"sensory",
"weakness",
"blood",
"ruled",
"motor",
"neuropathy",
"mainly",
"patients",
"progression"
] |
[
{
"code": "MB27.Z",
"title": "Symptoms or signs of perceptual disturbance, unspecified"
},
{
"code": "6B60.3",
"title": "Dissociative neurological symptom disorder, with other sensory disturbance"
},
{
"code": "MB40.9",
"title": "Neurological neglect syndrome"
},
{
"code": "7B02.0",
"title": "Hypnagogic exploding head syndrome"
},
{
"code": "9B73.3",
"title": "Serous retinal detachment"
},
{
"code": "MG22",
"title": "Fatigue"
},
{
"code": "FB32.Y",
"title": "Other specified disorders of muscles"
},
{
"code": "MB5Z",
"title": "Paralytic symptoms, unspecified"
},
{
"code": "FA31.5",
"title": "Acquired pes planus"
},
{
"code": "MF50.2Y",
"title": "Other specified urinary incontinence"
}
] |
=== ICD-11 CODES FOUND ===
[MB27.Z] Symptoms or signs of perceptual disturbance, unspecified
Also known as: Symptoms or signs of perceptual disturbance, unspecified | Symptoms or signs involving perceptual disturbance | sensory loss
[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
[MB40.9] Neurological neglect syndrome
Also known as: Neurological neglect syndrome | hemiakinesia | hemi-inattention | left sided neglect | visuospatial neglect
[7B02.0] Hypnagogic exploding head syndrome
Definition: Hypnagogic exploding head syndrome is characterised by the perception of a sudden, loud noise or sense of a violent explosion in the head that typically occurs as the individual is falling asleep. On occasion, these episodes may occur with awakening during the night. They are associated with abrupt arousal following the event, often with a sense of fright.
Also known as: Hypnagogic exploding head syndrome | Hypnagogic sensory disturbance
Includes: Hypnagogic sensory disturbance
[9B73.3] Serous retinal detachment
Definition: This occurs due to inflammation, injury or vascular abnormalities that results in fluid accumulating underneath the retina without the presence of a hole, tear, or break.
Also known as: Serous retinal detachment | serous retinal detachment, unspecified eye | sensory retinal detachment | Retinal detachment without retinal break | Retinal detachment NOS
Excludes: Central serous chorioretinopathy
[MG22] Fatigue
Definition: 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 reduced efficiency in responding to stimuli. Fatigue is normal following a period of exertion, mental or physical, but sometimes may occur in the absence of such exertion as a symptom of health conditions.
Also known as: Fatigue | decreased energy | worn out | Lethargy | lethargic
Includes: General physical deterioration | Lethargy
Excludes: Combat fatigue | Exhaustion due to exposure | heat exhaustion
[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
[MB5Z] Paralytic symptoms, unspecified
Also known as: Paralytic symptoms, unspecified | paralysis syndrome | incomplete paralysis | complete paralysis | paresis
[FA31.5] Acquired pes planus
Also known as: Acquired pes planus | acquired flat foot | acquired talipes planus | fallen arch | flat foot
Excludes: Congenital pes planus
[MF50.2Y] Other specified urinary incontinence
Also known as: Other specified urinary incontinence | Overflow Incontinence | Extraurethral urinary incontinence | Dribbling of urine | Urethra sphincter incontinence
=== GRAPH WALKS ===
--- Walk 1 ---
[MB27.Z] Symptoms or signs of perceptual disturbance, unspecified
--PARENT--> [MB27] Symptoms or signs involving perceptual disturbance
Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....
--CHILD--> [MB27.0] Depersonalisation
Def: Experiencing the self as strange or unreal, or feeling detached from, or as though one were an outside observer of, one’s thoughts, feelings, sensations, body, or actions. Depersonalization may take t...
--- Walk 2 ---
[MB27.Z] Symptoms or signs of perceptual disturbance, unspecified
--PARENT--> [MB27] Symptoms or signs involving perceptual disturbance
Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....
--CHILD--> [MB27.2] Hallucinations
Def: Sensory perceptions of any modality occurring in the absence of the appropriate (external) stimulus. The person may or may not have insight into the unreal nature of the perception....
--- Walk 3 ---
[6B60.3] Dissociative neurological symptom disorder, with other sensory disturbance
Def: 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...
--PARENT--> [6B60] Dissociative neurological symptom disorder
Def: Dissociative neurological symptom disorder is characterised by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sen...
--CHILD--> [6B60.1] Dissociative neurological symptom disorder, with auditory disturbance
Def: Dissociative neurological symptom disorder, with auditory disturbance is characterised by auditory symptoms such as loss of hearing or auditory hallucinations that are not consistent with a recognised...
--- Walk 4 ---
[6B60.3] Dissociative neurological symptom disorder, with other sensory disturbance
Def: 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...
--PARENT--> [6B60] Dissociative neurological symptom disorder
Def: Dissociative neurological symptom disorder is characterised by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sen...
--CHILD--> [6B60.2] Dissociative neurological symptom disorder, with vertigo or dizziness
Def: Dissociative neurological symptom disorder, with vertigo or dizziness is characterised by a sensation of spinning while stationary (vertigo) or dizziness that is not consistent with a recognised disea...
--- Walk 5 ---
[MB40.9] Neurological neglect syndrome
--PARENT--> [MB40] Sensation disturbance
--CHILD--> [MB40.1] Allodynia
Def: Pain due to a normally non-painful stimulus...
--- Walk 6 ---
[MB40.9] Neurological neglect syndrome
--PARENT--> [MB40] Sensation disturbance
--CHILD--> [MB40.1] Allodynia
Def: Pain due to a normally non-painful stimulus...
|
[
"[MB27.Z] Symptoms or signs of perceptual disturbance, unspecified\n --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance\n Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....\n --CHILD--> [MB27.0] Depersonalisation\n Def: Experiencing the self as strange or unreal, or feeling detached from, or as though one were an outside observer of, one’s thoughts, feelings, sensations, body, or actions. Depersonalization may take t...",
"[MB27.Z] Symptoms or signs of perceptual disturbance, unspecified\n --PARENT--> [MB27] Symptoms or signs involving perceptual disturbance\n Def: Symptoms and signs involving a disruption in sensory perception, including depersonalization, derealization, and hallucinations in any modality....\n --CHILD--> [MB27.2] Hallucinations\n Def: Sensory perceptions of any modality occurring in the absence of the appropriate (external) stimulus. The person may or may not have insight into the unreal nature of the perception....",
"[6B60.3] Dissociative neurological symptom disorder, with other sensory disturbance\n Def: 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...\n --PARENT--> [6B60] Dissociative neurological symptom disorder\n Def: Dissociative neurological symptom disorder is characterised by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sen...\n --CHILD--> [6B60.1] Dissociative neurological symptom disorder, with auditory disturbance\n Def: Dissociative neurological symptom disorder, with auditory disturbance is characterised by auditory symptoms such as loss of hearing or auditory hallucinations that are not consistent with a recognised...",
"[6B60.3] Dissociative neurological symptom disorder, with other sensory disturbance\n Def: 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...\n --PARENT--> [6B60] Dissociative neurological symptom disorder\n Def: Dissociative neurological symptom disorder is characterised by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sen...\n --CHILD--> [6B60.2] Dissociative neurological symptom disorder, with vertigo or dizziness\n Def: Dissociative neurological symptom disorder, with vertigo or dizziness is characterised by a sensation of spinning while stationary (vertigo) or dizziness that is not consistent with a recognised disea...",
"[MB40.9] Neurological neglect syndrome\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.1] Allodynia\n Def: Pain due to a normally non-painful stimulus...",
"[MB40.9] Neurological neglect syndrome\n --PARENT--> [MB40] Sensation disturbance\n --CHILD--> [MB40.1] Allodynia\n Def: Pain due to a normally non-painful stimulus..."
] |
MB27.Z
|
Symptoms or signs of perceptual disturbance, unspecified
|
[
{
"from_icd11": "MB27.Z",
"icd10_code": "R449",
"icd10_title": "Unspecified symptoms and signs involving general sensations and perceptions"
},
{
"from_icd11": "MB27.Z",
"icd10_code": "R448",
"icd10_title": "Other symptoms and signs involving general sensations and perceptions"
},
{
"from_icd11": "MB27.Z",
"icd10_code": "R44",
"icd10_title": "Other symptoms and signs involving general sensations and perceptions"
},
{
"from_icd11": "6B60.3",
"icd10_code": "F446",
"icd10_title": "Conversion disorder with sensory symptom or deficit"
},
{
"from_icd11": "7B02.0",
"icd10_code": "G478",
"icd10_title": "Other sleep disorders"
},
{
"from_icd11": "9B73.3",
"icd10_code": "H3323",
"icd10_title": "Serous retinal detachment, bilateral"
},
{
"from_icd11": "9B73.3",
"icd10_code": "H3320",
"icd10_title": "Serous retinal detachment, unspecified eye"
},
{
"from_icd11": "9B73.3",
"icd10_code": "H3322",
"icd10_title": "Serous retinal detachment, left eye"
},
{
"from_icd11": "9B73.3",
"icd10_code": "H3321",
"icd10_title": "Serous retinal detachment, right eye"
},
{
"from_icd11": "9B73.3",
"icd10_code": "H332",
"icd10_title": "Serous retinal detachment"
},
{
"from_icd11": "MG22",
"icd10_code": "R5382",
"icd10_title": "Chronic fatigue, unspecified"
},
{
"from_icd11": "MG22",
"icd10_code": "R530",
"icd10_title": "Neoplastic (malignant) related fatigue"
},
{
"from_icd11": "MG22",
"icd10_code": "R532",
"icd10_title": "Functional quadriplegia"
},
{
"from_icd11": "MG22",
"icd10_code": "R531",
"icd10_title": "Weakness"
},
{
"from_icd11": "MG22",
"icd10_code": "R5383",
"icd10_title": "Other fatigue"
}
] |
R449
|
Unspecified symptoms and signs involving general sensations and perceptions
|
To the best of our knowledge, this is the first report of NGS-based diagnosis of a patient having NCC symptoms. The patient visited our hospital because of a long history of headache episodes for over 20 years. Subsequently, extensive clinical, pathological, and radiological examinations were performed to address the cause of the headache. Most patients with NCC present headache syndromes as shown in Table 2 [ 10 – 12 ]. Although CSF cytological and biochemical examinations showed increased intracranial pressure, suggesting signs of inflammation, no abnormalities were revealed in her brain by cerebral MRI. Along with the aggravating headache symptoms, the patient developed paroxysmal amaurosis, likely due to the increased cranial pressure. Further cerebral MRV exhibited the right dominant type of venous drainage system. But the cerebral venous sinus thrombosis was not considered in this case because of the chronic nature of symptoms, and the left venous sinus dysplasia was likely to be congenital. Six lumbar punctures were then performed, and the test results revealed significantly increased intracranial hypertension and an inflammatory profile of CSF with elevated white cells and slightly low glucose level. In addition, the patient had subtle leptomeningeal enhancement on cerebral MRI but without intra-parenchymal or intra-ventricular lesions. Because the patient had severe symptoms of intracranial hypertension, we hypothesized that the parasite might be located in the fourth ventricle. However, in case of extra-parenchymal NCC, the parasite can lack the typical cystic structures, making it more challenging to identify on imaging examinations. Thus, no signs of parasitic infection were detected in multiple cerebral MRI examinations. Considering the fact that the patient lives in an endemic area, where people exhibits higher occurrences of fever and headache, unusual features of NCC , due to eating cysticercus contaminated pork, we sought to genetically screen the pathogenic microorganisms corresponding to Taenia solium , present in the non-template controls (NTCs) Interestingly, the investigation revealed highly abundant Taenia solium in our patient with NCC, exceeding other possible background or contaminating microorganisms . Furthermore, the diagnosis of NCC was confirmed by a clinical CSF cysticercus antibody (IgG) assay and serological examinations. After anti-helminthic therapy, the elevated levels of serum/CSF cysticercus antibody titers and the DNA load in CSF were started to decrease as the treatment progressed. The clinical symptoms of the patient were relieved as well. One possible explanation for this phenomenon could be the subsequent release of Taenia solium DNA into the CSF when the larvae were destroyed . It has been found that parasitic DNA load in CSF could either increase or decrease after treatment, suggesting that serial analysis of parasitic load in CSF may not be useful, and further studies are needed . Table 2 Clinical features of fourteen patients with neurocysticercosis Case No. Age range,y. Delay,mo. Seizure Headache Visual impairment Transient LOC Cognitive decline Neuroimaging features Treatment 1 45–50 60 + + + – + Head CT showed scattered parenchymal Calcified lesions. Cerebral MRI showed hydrocephalus, enhancement of the basal meninges, and multiple cystic lesions in prepontine cistern and suprasellar cistern. ABZ, DXM, ETV 2 55–60 8 – – + – – Head CT showed a calcified lesion in the left frontal lobe. Cerebral MRI was normal hydrocephalus. Spine MRI was not performed. ABZ, DXM 3 50–55 96 – + + + + Head CT revealed no calcified lesion. Cerebral MRI showed hydrocephalus and enhanced lesion posterior to the medulla. ABZ, DXM 4 30–35 1 – – + – – Cerebral MRI showed hydrocephalus and multiple cystic lesions in the suprasellar cistern. ABZ, DXM, ETV 5 43–44 12 – + – – – Cerebral MRI with contrast showed several small hyperintense lesions involving right cerebellar hemisphere and bilateral occipital, with ring enhancement of gadolinium. Praziquantel 6 61–66 N – + N – – Cerebral MRI showed an irregular cystic lesion at the left Sylvian. Praziquantel, ABZ 7 36 N – + N – – Cerebral MRI showed cystic lesions in the right lateral hippocampus and left lateral fissure. Praziquantel, ABZ 8 44–48 N + + N + + Cerebral MRI showed an expanded ventricular system and hydrocephalus Praziquantel, ABZ, Ommaya reservoir implantation 9 66–67 N – – N – + Cerebral MRI showed an expanded ventricular system and a right ventricular cyst. Praziquantel, ABZ 10 50–53 N – + N – – Cerebral MRI showed an expanded ventricular system and hydrocephalus. Praziquantel, ABZ 11 41–42 N – + N – – Cerebral MRI showed an expanded ventricular system and hydrocephalus. Praziquantel, ABZ 12 47 N – + N – – Cerebral MRI showed an expanded ventricular system and hydrocephalus. Praziquantel, ABZ Age means the age at disease onset. The Delay means diagnostic delay. No.5 patient complained paroxysmal numbness of her left face and arm. No.9 patient presented with intermittent left lower limb weakness for one year. None of the remaining patients had focal neurological deficits +, positive;-, negative, N Not mention, No. Number, y. Year, mo. Month, LOC Loss of consciousness, CT Computed tomography, MRI Magnetic resonance imaging, ALB Albendazole, DXM Dexamethasone, ETV Endoscopic third ventriculostomy
| 4.34375
| 0.583008
|
sec[2]/p[0]
|
en
| 0.999996
|
34167488
|
https://doi.org/10.1186/s12883-021-02277-7
|
[
"cerebral",
"hydrocephalus",
"praziquantel",
"ventricular",
"headache",
"system",
"lesions",
"examinations",
"cystic",
"expanded"
] |
[
{
"code": "1D00.Z",
"title": "Infectious encephalitis, unspecified"
},
{
"code": "8E7Y",
"title": "Other specified diseases of the nervous system"
},
{
"code": "8B20",
"title": "Stroke not known if ischaemic or haemorrhagic"
},
{
"code": "8B1Z",
"title": "Cerebral ischaemia, unspecified"
},
{
"code": "8B11.5Z",
"title": "Cerebral ischaemic stroke, unspecified"
},
{
"code": "8D64.Z",
"title": "Hydrocephalus, unspecified"
},
{
"code": "LA04.Z",
"title": "Congenital hydrocephalus, unspecified"
},
{
"code": "KB05.Z",
"title": "Neonatal hydrocephalus, unspecified"
},
{
"code": "8D64.1Z",
"title": "Non-communicating hydrocephalus, unspecified"
},
{
"code": "8D64.1Y",
"title": "Other specified non-communicating hydrocephalus"
}
] |
=== ICD-11 CODES FOUND ===
[1D00.Z] Infectious encephalitis, unspecified
Also known as: Infectious encephalitis, unspecified | Infectious encephalitis, not elsewhere classified | encephalitis NOS | acute encephalitis NOS | acute brain inflammation
[8E7Y] Other specified diseases of the nervous system
Also known as: Other specified diseases of the nervous system | Circumscribed brain atrophy | circumscribed cerebral atrophy | atrophic lobar sclerosis | atrophic lobar brain sclerosis
[8B20] Stroke not known if ischaemic or haemorrhagic
Definition: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been determined by neuroimaging or other techniques.
Also known as: Stroke not known if ischaemic or haemorrhagic | apoplexy | brain vascular accident | cerebral accident | cerebral apoplexy
Excludes: sequelae of stroke
[8B1Z] Cerebral ischaemia, unspecified
Also known as: Cerebral ischaemia, unspecified | brain ischaemia | cerebrovascular ischaemic disease | cerebrovascular ischaemia | cerebral anaemia
[8B11.5Z] Cerebral ischaemic stroke, unspecified
Also known as: Cerebral ischaemic stroke, unspecified | Cerebral ischaemic stroke of unknown cause | cryptogenic stroke | occlusion and stenosis of cerebral and precerebral arteries, resulting in cerebral infarction | cerebral infarct
[8D64.Z] Hydrocephalus, unspecified
Also known as: Hydrocephalus, unspecified | Hydrocephalus | hydrocephaly NOS | Low pressure hydrocephaly | low pressure hydrocephalus
[LA04.Z] Congenital hydrocephalus, unspecified
Also known as: Congenital hydrocephalus, unspecified | Congenital hydrocephalus | Hydrocephalus in newborn | Congenital hydrocephaly
[KB05.Z] Neonatal hydrocephalus, unspecified
Also known as: Neonatal hydrocephalus, unspecified | Neonatal hydrocephalus | acquired hydrocephalus NOS | External hydrocephalus | macrohydrocephalus
[8D64.1Z] Non-communicating hydrocephalus, unspecified
Also known as: Non-communicating hydrocephalus, unspecified | Non-communicating hydrocephalus | obstructive hydrocephalus
[8D64.1Y] Other specified non-communicating hydrocephalus
Also known as: Other specified non-communicating hydrocephalus | Hydrocephalus due to fourth ventricle outflow obstruction | Hydrocephalus due to tumour
=== GRAPH WALKS ===
--- Walk 1 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.1] Fungal encephalitis
--- Walk 2 ---
[1D00.Z] Infectious encephalitis, unspecified
--PARENT--> [1D00] Infectious encephalitis, not elsewhere classified
Def: A disease of the brain, caused by an infection....
--CHILD--> [1D00.1] Fungal encephalitis
--- Walk 3 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--EXCLUDES--> [?] Pregnancy, childbirth or the puerperium
Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...
--- Walk 4 ---
[8E7Y] Other specified diseases of the nervous system
--PARENT--> [08] Diseases of the nervous system
Def: This is a group of conditions characterised as being in or associated with the nervous system....
--RELATED_TO--> [?] Syndromes with central nervous system anomalies as a major feature
--- Walk 5 ---
[8B20] Stroke not known if ischaemic or haemorrhagic
Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...
--EXCLUDES--> [?] Late effects of stroke not known if ischaemic or haemorrhagic
Def: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes....
--PARENT--> [?] Late effects of cerebrovascular disease
Def: Effects of cerebrovascular disease 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episo...
--- Walk 6 ---
[8B20] Stroke not known if ischaemic or haemorrhagic
Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...
--PARENT--> [?] Cerebrovascular diseases
Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi...
--CHILD--> [?] Cerebral ischaemia
|
[
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis",
"[1D00.Z] Infectious encephalitis, unspecified\n --PARENT--> [1D00] Infectious encephalitis, not elsewhere classified\n Def: A disease of the brain, caused by an infection....\n --CHILD--> [1D00.1] Fungal encephalitis",
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...",
"[8E7Y] Other specified diseases of the nervous system\n --PARENT--> [08] Diseases of the nervous system\n Def: This is a group of conditions characterised as being in or associated with the nervous system....\n --RELATED_TO--> [?] Syndromes with central nervous system anomalies as a major feature",
"[8B20] Stroke not known if ischaemic or haemorrhagic\n Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...\n --EXCLUDES--> [?] Late effects of stroke not known if ischaemic or haemorrhagic\n Def: Late effects occurring 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episodes....\n --PARENT--> [?] Late effects of cerebrovascular disease\n Def: Effects of cerebrovascular disease 1 month or later after the onset of the disease. Codes for acute stroke should be exclusively used for the acute stroke and immediately related hospitalisation episo...",
"[8B20] Stroke not known if ischaemic or haemorrhagic\n Def: Fulfills criteria for stroke in acute symptoms of focal brain injury that have lasted 24 hours or more (or led to death before 24 hours), but subtype of stroke (ischemic or haemorrhagic) has not been ...\n --PARENT--> [?] Cerebrovascular diseases\n Def: This is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. This includes “stroke”, which includes the following entities: Intracerebral haemorrhage; Subarachnoi...\n --CHILD--> [?] Cerebral ischaemia"
] |
1D00.Z
|
Infectious encephalitis, unspecified
|
[
{
"from_icd11": "1D00.Z",
"icd10_code": "G0490",
"icd10_title": "Encephalitis and encephalomyelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0491",
"icd10_title": "Myelitis, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0430",
"icd10_title": "Acute necrotizing hemorrhagic encephalopathy, unspecified"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0431",
"icd10_title": "Postinfectious acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0439",
"icd10_title": "Other acute necrotizing hemorrhagic encephalopathy"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0481",
"icd10_title": "Other encephalitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G0489",
"icd10_title": "Other myelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G04",
"icd10_title": "Encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "1D00.Z",
"icd10_code": "G048",
"icd10_title": "Other encephalitis, myelitis and encephalomyelitis"
},
{
"from_icd11": "8B20",
"icd10_code": "I64",
"icd10_title": ""
},
{
"from_icd11": "8B1Z",
"icd10_code": "I67848",
"icd10_title": "Other cerebrovascular vasospasm and vasoconstriction"
},
{
"from_icd11": "8B1Z",
"icd10_code": "I6789",
"icd10_title": "Other cerebrovascular disease"
},
{
"from_icd11": "8B1Z",
"icd10_code": "I6782",
"icd10_title": "Cerebral ischemia"
},
{
"from_icd11": "8B1Z",
"icd10_code": "I6781",
"icd10_title": "Acute cerebrovascular insufficiency"
},
{
"from_icd11": "8B1Z",
"icd10_code": "I67841",
"icd10_title": "Reversible cerebrovascular vasoconstriction syndrome"
}
] |
G0490
|
Encephalitis and encephalomyelitis, unspecified
|
This was a case of a 48-year-old community inspector with a history of possible hemorrhoids (hematochezia) for 2 months, gastric ulcer, cervical spondylosis, and penicillin allergy, who presented in January 2021 with fever, diarrhea, chest pain, fatigue, and syncope. The patient, who lived in a central urban area of Wuhan, China, had dizziness for 3 days and fell three times before being admitted to the hospital. Fever, diarrhea, and chest pain appeared 1 day before with chest pain subsided 5 min later. Physical examination: Temperature was 39.6°C, heart rate was 126 beats/min, breath rate was 20 breaths/min, blood pressure was 148/77 mm Hg, oxygen saturation (SpO 2 ) was 98%, and lung auscultation was clear. Other physical examinations were negative. CT scan of the chest showed left upper zone consolidation . Blood tests indicated a white blood cell count 2,910/mm 3 , neutrophil count 2,630/mm 3 , lymphocyte count 100/mm 3 , hemoglobin 82 g/l, platelet count 7,300/mm 3 , C-reactive protein 193.9 mg/l (normal value <10 mg/l), serum amyloid A (SAA) protein > 300 mg/l (normal value <10 mg/l), and procalcitonin (PCT) 6.51 ng/ml. Galactomannan enzyme immunoassay (GM-EIA) shows 0.12 (normal value 0–0.49) and fungus (1 → 3)-β-D-glucan test shows <37.50 pg/ml (normal value <70 pg/ml). Blood and sputum culture were performed. The patient was diagnosed with community-acquired pneumonia and empirical intravenous antibiotic therapy was started with ceftazidime. 1 day later, he fainted suddenly with SpO 2 80–90%, partial pressure of oxygen (pO 2 ) 71 mm Hg, and then transferred to the ICU due to deterioration of respiratory status, severe desaturation, and delirium. At the same time, wet and dry rales could be heard in both the lungs, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA) scores were 18 and 8, respectively ( Table 1 ). Tracheal intubation and mechanical ventilation were performed with positive end-expiratory pressure (PEEP) 10 mm Hg and a fraction of inspired oxygen (FiO 2 ) 100%. Flexible bronchoscopy was performed and showed pulmonary edema without the other abnormalities. To get more information on etiology, bronchoalveolar lavage fluid (BALF) samples were obtained for nanopore targeted sequencing (NTS) and sputum culture. The results of echocardiography showed the size of the ventricles and atria were normal, the thickness and amplitude of movement of the ventricular septum and the free wall of the left ventricle, the morphology and activity of the valves, and the opening and closing of the valves were normal. Simultaneously, antibiotic therapy was changed to meropenem and ganciclovir. In the following days, he presented with progressive worsening of the bilateral pulmonary infiltrates, high ventilatory parameters, and increasing serum PCT and creatinine levels with the signs of septic shock. Ultrafiltration was required for oligoanuria and severe fluid was overload. On the fourth day after intubation, pO 2 /FiO 2 was reduced to 59 and bronchoscopy showed severe airway mucosal edema. Then, ECMO was commenced on day 5 in the ICU. VV-ECMO was planned originally; VA-ECMO with the initial flow set at 4 L/min was finally performed as the heart rate of the patient sharply dropped before the inserting tubes. Then, the patient experienced intermittent episodes of significant hypoxemia with SpO 2 ranging from 41 to 81% corresponding to right radial artery partial pressure of arterial oxygen (PaO 2 ) ranging from 49 to 58 mm Hg. To find out the reason for hypoxemia, we raised the flow rate of ECMO from 4.0 to 4.5 L/min. This adjustment could not eliminate hypoxemia. The PaO 2 of the right radial artery was 60 mm Hg, while the PaO 2 of the right dorsal foot artery was 400 mm Hg. A severe North-South syndrome was presented as differential cyanosis. This cannot be eliminated by venoarterial venous (VAV)-ECMO with the presence of an internal jugular venous shunt of 18 Fr arterial cannulas. After the confirmation of ultrasound, the function of the heart was normal and at last, we converted to VV-ECMO. On day 2 (day 6) of ECMO, nucleic acid screening of the pharyngeal swab showed chlamydia. Antibiotic therapy with azithromycin was administered. Methylprednisolone pulses and respiratory physiotherapy were implemented. Improvement of pulmonary infiltrates was observed in the following days. After 7 days, ECMO support was discontinued (day 12) and ventilation was converted to high flow humidification oxygen therapy on the next day (day 13). On the 13th day after admission, the NTS results from the third sample of BALF showed the presence of C. psittaci and the readings of the sequences were 96. Therefore, the antibiotics were changed to meropenem and doxycycline accordingly. Signs of infection were improved after combined dialysis, nutrition, and other treatments. X-ray and CT scan of the chest demonstrated improved diffuse ground-glass infiltrates. Multiple cultures of blood and BALF were negative. The patient was weaned off the ventilator on the 17th day after the admission. Throughout the course of treatment, the indicators of infection and renal function tended to improve ( Table 2 ). He regained some kind of consciousness, but could not give the exact answer and the vasoactive drugs were significantly downregulated.
| 3.978516
| 0.977051
|
sec[1]/p[0]
|
en
| 0.999996
|
34722571
|
https://doi.org/10.3389/fmed.2021.731047
|
[
"ecmo",
"chest",
"blood",
"oxygen",
"pressure",
"count",
"this",
"pain",
"heart",
"antibiotic"
] |
[
{
"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": "CB7Z",
"title": "Diseases of the respiratory system, unspecified"
},
{
"code": "CB27",
"title": "Pleural effusion"
},
{
"code": "CA44",
"title": "Pyothorax"
},
{
"code": "MD30.Z",
"title": "Chest pain, unspecified"
},
{
"code": "NA80.Y&XJ1C6",
"title": "Thoracic haematoma"
},
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
}
] |
=== ICD-11 CODES FOUND ===
[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
[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
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
=== GRAPH WALKS ===
--- Walk 1 ---
[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
--PARENT--> [?] Surgical or other medical procedures associated with injury or harm in diagnostic or therapeutic use
--- Walk 2 ---
[PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure
--- Walk 3 ---
[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 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 ---
[CB7Z] Diseases of the respiratory system, unspecified
--PARENT--> [12] Diseases of the respiratory system
--RELATED_TO--> [?] Sleep-related breathing disorders
Def: Sleep related breathing disorders are characterised by abnormalities of respiration during sleep. In some of these disorders, respiration is also abnormal during wakefulness. The disorders are grouped...
--- Walk 6 ---
[CB7Z] Diseases of the respiratory system, unspecified
--PARENT--> [12] Diseases of the respiratory system
--RELATED_TO--> [?] Symptoms, signs or clinical findings of the respiratory system
|
[
"[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 --PARENT--> [?] Surgical or other medical procedures associated with injury or harm in diagnostic or therapeutic use",
"[PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure",
"[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--> [QC48.0] Personal history of long-term use of anticoagulants",
"[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --RELATED_TO--> [?] Sleep-related breathing disorders\n Def: Sleep related breathing disorders are characterised by abnormalities of respiration during sleep. In some of these disorders, respiration is also abnormal during wakefulness. The disorders are grouped...",
"[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the respiratory system"
] |
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": "CB7Z",
"icd10_code": "J989",
"icd10_title": "Respiratory disorder, unspecified"
},
{
"from_icd11": "CB7Z",
"icd10_code": "X",
"icd10_title": ""
},
{
"from_icd11": "CB7Z",
"icd10_code": "J09-J18",
"icd10_title": ""
},
{
"from_icd11": "CB27",
"icd10_code": "J910",
"icd10_title": "Malignant pleural effusion"
},
{
"from_icd11": "CB27",
"icd10_code": "J918",
"icd10_title": "Pleural effusion in other conditions classified elsewhere"
},
{
"from_icd11": "CB27",
"icd10_code": "J90",
"icd10_title": "Pleural effusion, not elsewhere classified"
},
{
"from_icd11": "CB27",
"icd10_code": "J90-J94",
"icd10_title": ""
},
{
"from_icd11": "CB27",
"icd10_code": "J91",
"icd10_title": "Pleural effusion in conditions classified elsewhere"
},
{
"from_icd11": "CA44",
"icd10_code": "J869",
"icd10_title": "Pyothorax without fistula"
},
{
"from_icd11": "CA44",
"icd10_code": "J860",
"icd10_title": "Pyothorax with fistula"
}
] |
Z794
|
Long term (current) use of insulin
|
A 38-year-old, 16-weeks pregnant American woman, while on babymoon in Malta with her husband, began bleeding. A gynaecological examination showed severe placental abruption and preterm rupture of the amniochorionic membranes (pPROM), which are indications of incipient miscarriage; the physicians informed the couple that the pregnancy would not continue for long, and that the fetus would not survive. Medical management of pPROM must be the result of balancing the potential benefits to the new-born from continuing the pregnancy against the risk of infection and serious health consequences for the mother, who is at high risk of infection. Indeed, in such circumstances, the foetal mortality rate is very high. This risk, in the specific case, was even higher since the fetus was only 16 weeks old and far from acquiring even a potential capacity for survival outside the maternal uterus . Conversely, the infectious (hence also life-threatening) risk to the mother was particularly high, necessitating an immediate emptying of the uterus to avoid serious short- and/or long-term complications. However, the Maltese law prevents doctors from intervening and/or participating in the voluntary termination of pregnancy, even in cases of serious danger to the health of the mother, as in this case. Therefore, since the foetal heartbeat was still detectable, the doctors did not carry out the abortion, even though this was the only and most effective therapeutic tool to avoid serious repercussions concerning the health of the woman, who was at high risk of death from sepsis. Fortunately, after more than a week, the couple obtained the consent of the local authorities to leave the country due to a situation defined by the Maltese authorities as ‘life-threatening’. The transfer to Spain—only partially reimbursed by the couple’s health insurance—was hindered by the difficulty of finding an airline that would take on the criminal consequences of the case . To date, the woman’s life is not in danger, but this does not exclude the possibility that the delayed medical intervention may have produced irreversible results on her psycho-physical health. The Maltese episode brings to light the tragic case, in 2012, of an Irish woman of Indian origin, pregnant at 17 weeks, who died of septicaemia after the Irish doctors refused to terminate a miscarriage due to persistent foetal heartbeat, as required by law in Ireland . These tragic cases confirm that abortion is often necessary to preserve a woman’s life and psycho-physical health. In the event that the continuation of pregnancy constitutes a serious risk to the health of the mother, health care providers are obliged to interrupt it with respect for her right to health, while making every effort to try to keep the fetus alive. This is all the more so the case where, as in the cases described, the mother’s psycho-physical health is at risk, and the fetus would have no independent life outside the womb. In such circumstances, there is no scientific reason not to resort to therapeutic abortion since there is no autonomous life to be preserved except that of the mother. It should also be specified that abortion is to be considered licit even when there is no immediate risk to the mother’s life, but the continuation of the pregnancy constitutes a serious danger to her state of health (physical or psychological): even in such circumstances, it cannot be forgotten that the mother is the only human being legally alive and, as such, the sole depositary of an inalienable right—that of health—which must be guaranteed . This is also considering that pregnancy-related diseases often have an unpredictable course, and their outcome is greatly influenced by the timeliness of therapeutic intervention. The non-accessibility or delayed accessibility to therapeutic abortion—if not scientifically justified—can produce irreversible medical-legal consequences with respect to the psycho-physical health of the woman. In the case of the recent Maltese episode, the lack of timely therapeutic intervention may have resulted in gynaecological damage that would hinder a possible future pregnancy, which is already undermined by the woman’s advanced age and previous miscarriage . Maltese legislative and bureaucratic limitations prevented the woman from having a safe therapeutic abortion, imposing the use of an untimely surgical intervention, which was associated with a greater risk of complications and lower chances of survival because it was implemented in conditions of greater clinical instability. Moreover, the woman was forced to undergo prolonged hospitalization and treatments, which would have otherwise not been required if the therapeutic procedure had been performed as scientifically indicated. Moreover, one cannot overlook the psychological outcomes that this tragic event will produce not only on the mother but also on her partner. Socio-religious and scientifically unfounded interferences forced the couple to live, for days, with the hope that their son’s heart would stop, this being the only condition of survival for the woman. This stressful circumstance—preventable and avoidable—was, in addition to that linked to the premature termination of pregnancy, already in itself associated with serious risk of repercussions– not always preventable—on the parents’ psychological health .
| 4.113281
| 0.955078
|
sec[1]/p[2]
|
en
| 0.999998
|
PMC9957392
|
https://doi.org/10.3390/healthcare11040520
|
[
"that",
"risk",
"mother",
"this",
"pregnancy",
"serious",
"life",
"therapeutic",
"even",
"abortion"
] |
[
{
"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": "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 ===
[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
[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 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--EXCLUDES--> [?] Headache, not elsewhere classified
Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....
--- Walk 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....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 5 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.1] Underdosing, as mode of injury or harm
--- Walk 6 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.2] Drug-related injury or harm in the context of correct administration or dosage, as mode of injury or harm
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --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....",
"[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 --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.2] Drug-related injury or harm in the context of correct administration or dosage, as mode of injury or harm"
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
A 4-year-old boy (height, 100 cm; weight, 16 kg) was hit in the chest by a car. He was conscious and complained of chest tightness. Upon arrival to the local hospital at 18 min after the injury, he was semiconscious and cyanotic. Breath sounds were not heard in the right hemithorax, and his vital signs were unstable: heart rate( HR) of 162 beats per minute (bpm), blood pressure (Bp) of 102/56 mmHg, respiratory rate (RR) of 32 times per minute, and oxygen saturation (S P O 2 ) of 70%. For sedation, 30 mg of propofol was administered intravenously, and emergency endotracheal tube above the carina was performed. Chest computed tomography (CT) showed right pneumothorax with lung compression of 90%, and the left clavicle was fractured . A chest tube was positioned in the right thoracic cavity, and a breathing balloon was used for ventilation. His vital signs were as follows: HR of 155 bpm, Bp of 97/50 mmHg, RR of 22 times per minute, and S P O 2 of 98%. Twenty-four minutes later, he was admitted to the Emergency Department of our hospital for further treatment. The results of blood gas analysis were as follows: pH, 7.12; carbon dioxide partial pressure (P a CO 2 ), 76 mmHg; oxygen partial pressure (P a O 2 ), 68 mmHg. Bronchoscopy indicated that the right middle lobe bronchus was ruptured. Transthoracic echocardiography ruled out associated blunt cardiac injury. Emergency exploratory thoracotomy and right middle or right middle and lower lobectomy were planned. The patient went into sudden cardiac arrest after being sent to the operating room (S P O 2, 76%; end-tidal carbon dioxide partial pressure (P et CO 2 ), 46 mmHg). Return of spontaneous circulation after twelve minutes of external chest compression. He did not regain consciousness. Mainstem intubation of the left bronchus was performed under direct fibreoptic guidance to ventilate the left lung. With pressure control ventilation, the fraction of inspiration O 2 was 100%, peak pressure was 32 cmH 2 O, and tidal volume was 45 mL; HR was 145 bpm, Bp was 92/48 mmHg (0.05 µg/kg/min norepinephrine), RR was 20 times per minute, and S P O 2 was 70%. Blood gas analysis results at this time were as follows: pH, 6.87; PaCO 2 , 114 mmHg; PaO 2 , 46 mmHg; plasma lactic acid (Lac), 6.7 mmol/L; K + , 3.2 mmol/L; haemoglobin 7.3 g/dl; and Ca + + 1.21 mmol/L. As sudden cardiac arrest occurred due to severe respiratory acidosis, we decided to initiate V-V ECMO. Our hospital has an adult ECMO centre, and it is 300 km away from our nearest paediatric ECMO centre, approximately a 3.5-h drive. To prevent death, we decided to use small adult ECMO tubes. ECMO was initiated percutaneously in the left femoral vein, and an incision was made in the right internal jugular vein . The blood flow was 1.7 L/min, sweep gas was 1.5 L/min, and FiO 2 was 100%. Cardiac arrest occurred again after ECMO, and we immediately administered cardiopulmonary resuscitation. Blood gas analysis results at this time were as follows: pH, 6.84; P a CO 2 , 72 mmHg; P a O 2 , 61 mmHg; Lac, 9.7 mmol/L; K + , 9.8 mmol/L; haemoglobin 7.3 g/dl; and Ca + + 1.21 mmol/L. Insulin (2 U) were added to the glucose injection (10%, 100 ml), and sodium bicarbonate (5%, 32 ml) and calcium chloride injection (3%, 0.1 g) were administered immediately. Spontaneous sinus rhythm was restored after 18 min. An exploratory thoracotomy was performed successfully; the root of the right middle lobe bronchus was found to be ruptured , as was a branch of the right middle lobe artery. Right middle lobectomy and right middle bronchoplasty were performed. The patient was admitted to the intensive care unit (ICU) after the operation. Mechanical ventilation and ECMO were continued, and we adjusted the ventilator parameters as follows: FiO 2 at 30%; positive end expiratory pressure (PEEP) at 10 cmH 2 O; respiratory rate at 12 times/minute, and tidal volume at 6 mL/kg. Oxygen saturation was between 98 and 100%. Along with mild hypothermia for brain protection (34-36 °C for 30 h), piperacillin sodium and tazobactam injection for the prevention of infection, methylprednisolone injection (16 mg q12 h) to reduce pulmonary exudation, and norepinephrine 0.15 µg/kg/min to maintain blood pressure were applied. On postoperative day 2, he became conscious and was responsive. Due to the traumatic wet lung on the left and secondary pulmonary infection, ECMO was withdrawn on the 6th day after the operation, with a total ECMO time of 137 h. Mechanical ventilation was withdrawn on postoperative day 11. On postoperative day 12, chest CT showed a mass of a high-density shadow in the upper lobe of the left lung with cavitation, which was considered a large traumatic pseudocyst . The patient left the ICU on postoperative day 16 and was discharged from the hospital on postoperative day 31 without neurological deficit. He is able to communicate and play normally. The timeline of the treatment process is shown in Fig. 4 . Fig. 1 Chest CT (6.12) showed right pneumothorax and right lung compression 90% (blue arrow) and left traumatic wet lung (white arrow) Fig. 2 Intraoperative findings. The root of the right middle lobe bronchus was disconnected (black arrow) Fig. 3 Chest CT (6.24) showed a mass of high-density shadow in the upper lobe of the left lung with cavitation (green arrow) Fig. 4 The timeline of the entire treatment process
| 3.867188
| 0.977539
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC9169275
|
https://doi.org/10.1186/s13019-022-01856-0
|
[
"mmhg",
"ecmo",
"chest",
"pressure",
"middle",
"lung",
"blood",
"lobe",
"mmol",
"minute"
] |
[
{
"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": "CB7Z",
"title": "Diseases of the respiratory system, unspecified"
},
{
"code": "CB27",
"title": "Pleural effusion"
},
{
"code": "CA44",
"title": "Pyothorax"
},
{
"code": "MD30.Z",
"title": "Chest pain, unspecified"
},
{
"code": "NA80.Y&XJ1C6",
"title": "Thoracic haematoma"
},
{
"code": "EH90.Z",
"title": "Pressure ulcer of unspecified grade"
},
{
"code": "MB23.L",
"title": "Pressured speech"
},
{
"code": "CB22.Y",
"title": "Other specified diseases of mediastinum, not elsewhere classified"
}
] |
=== 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
[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
[EH90.Z] Pressure ulcer of unspecified grade
Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer
[MB23.L] Pressured speech
Definition: Speech in which the person feels undue pressure to get the words out. The person’s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening.
Also known as: Pressured speech
Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders
[CB22.Y] Other specified diseases of mediastinum, not elsewhere classified
Also known as: Other specified diseases of mediastinum, not elsewhere classified | Hernia of mediastinum | mediastinal hernia | mediastinal herniation | Infectious mediastinitis
=== GRAPH WALKS ===
--- Walk 1 ---
[PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical procedure influencing the episode of care, without injury or harm
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure
--- Walk 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
--RELATED_TO--> [?] Skin complications of BCG immunisation
Def: Complications secondary to immunization with attenuated Mycobacterium bovis (Bacillus Calmette-Guérin or BCG)....
--- Walk 3 ---
[QC48.Y] Other specified personal history of medical treatment
--PARENT--> [QC48] Personal history of medical treatment
--CHILD--> [QC48.Y] Other specified personal history of medical treatment
--- 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 ---
[CB7Z] Diseases of the respiratory system, unspecified
--PARENT--> [12] Diseases of the respiratory system
--EXCLUDES--> [?] Developmental anomalies
Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....
--- Walk 6 ---
[CB7Z] Diseases of the respiratory system, unspecified
--PARENT--> [12] Diseases of the respiratory system
--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 --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical procedure",
"[PK81.1] Extracorporeal life support procedure associated with injury or harm in therapeutic use\n --PARENT--> [PK81] Certain medical procedures associated with injury or harm in therapeutic use\n --RELATED_TO--> [?] Skin complications of BCG immunisation\n Def: Complications secondary to immunization with attenuated Mycobacterium bovis (Bacillus Calmette-Guérin or BCG)....",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.Y] Other specified personal history of medical treatment",
"[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",
"[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --EXCLUDES--> [?] Developmental anomalies\n Def: This chapter includes conditions caused by failure of a particular body site or body system to develop correctly during the antenatal period....",
"[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --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": "CB7Z",
"icd10_code": "J989",
"icd10_title": "Respiratory disorder, unspecified"
},
{
"from_icd11": "CB7Z",
"icd10_code": "X",
"icd10_title": ""
},
{
"from_icd11": "CB7Z",
"icd10_code": "J09-J18",
"icd10_title": ""
},
{
"from_icd11": "CB27",
"icd10_code": "J910",
"icd10_title": "Malignant pleural effusion"
},
{
"from_icd11": "CB27",
"icd10_code": "J918",
"icd10_title": "Pleural effusion in other conditions classified elsewhere"
},
{
"from_icd11": "CB27",
"icd10_code": "J90",
"icd10_title": "Pleural effusion, not elsewhere classified"
},
{
"from_icd11": "CB27",
"icd10_code": "J90-J94",
"icd10_title": ""
},
{
"from_icd11": "CB27",
"icd10_code": "J91",
"icd10_title": "Pleural effusion in conditions classified elsewhere"
},
{
"from_icd11": "CA44",
"icd10_code": "J869",
"icd10_title": "Pyothorax without fistula"
},
{
"from_icd11": "CA44",
"icd10_code": "J860",
"icd10_title": "Pyothorax with fistula"
}
] |
Z794
|
Long term (current) use of insulin
|
A 65-year-old female was admitted to the Second Affiliated Hospital of Zhejiang Chinese Medical University in April 2019, and she reported a vaginal bleeding after sexual intercourse in December 2018. Pelvic ultrasound demonstrated a pelvic hematoma, and pharmaceutical conservative treatment was administrated. However, she had intermittent vaginal bleeding in the following three months. 1 Considering that the patient previously underwent total hysterectomy for uterine prolapse, the uterine pathologic specimen was reviewed. The patient had neither cervical and endometrial dysplasia or carcinoma in situ (CIS) nor a history of exposure to diethylstilbestrol (DES), and she was negative for human papilloma virus (HPV). Physical examination revealed a palpable mass (6.0 × 6.0 cm) in the pelvic cavity, which was hard in texture and poor in mobility, without significant tenderness. A small amount of dark-red secretions were visible within the vagina, and the anterior vaginal wall was hard and presented with irregular nodules. Vaginal neoplastic lesion was considered, and tumor index test and pelvic enhanced MRI were performed. Laboratory examination revealed elevation of CA125 (63.4 U ml −1 ) and cytokeratin 19 fragment (3.17 U ml −1 ), and other normal tumor indices. On pelvic MRI, a mass with a predominant cyst component (around 5.9 × 4.5 × 8.9 cm in size), which enveloped the left lower ureter and closely adhered to the posterior bladder wall and the rectum, was found within the vagina. The mass was hypointense signal on T 1 weighted imaging ( T 1 WI) , heterogeneously hyperintense signal on T 2 weighted imaging fat suppression ( T 2 WI-FS) , and slightly hyperintense signal on diffusion-weighted imaging (DWI) with increased apparent diffusion coefficient (ADC) . On enhanced MRI, the arterial phase showed mild enhancement of the margin and the mild grid-like enhancement of the interior of the mass with no enhancement in the cystic cavity ; while the delayed phase showed further enhancement of the margin and the interior of the mass . A vaginal malignancy was suggested, and whether it was a metastasis needed to be validated. To confirm the pathology of the vaginal tumor, biopsy of the vaginal mass was suggested and approved by the patient. Pathologic findings showed that the mass was nodular segmented by fibrous tissues and rich in mucin within the stroma. The cells were in medium-size, and the majority of them showed clear cytoplasm rich in mucin and partial acidophilic cytoplasm. In addition, the nuclei were hyperchromatic and had a signet ring appearance after squeezing to one side with visible mitosis . Immunohistochemistry showed CDX-2 (+) , Villin (+) , CK7 (+), GATA-3 (+), MUC-1 (weakly +), P53 (+), KI67 10%+ (CA125-, ER-, PR-). Combining the pathology and immunohistochemistry, vaginal signet ring cell carcinoma was diagnosed, while gastrointestinal tumor metastasis could not be excluded. Since primary vaginal tumor is rare, systemic examination is required to exclude metastasis. Vaginal signet ring cell carcinoma usually originates from gastrointestinal signet ring cell carcinoma and sometimes from breast and bladder signet ring cell carcinomas. Therefore, the patient was scheduled for gastroscopy, breast ultrasound, and abdominal-enhanced CT. No significant abnormalities were found on both the gastroscopy and breast ultrasound. The uterus and bilateral adnexa were absent on abdominal CT. Besides, an irregular mass skewed to the left and sized around 5.9 × 4.5 × 8.9 cm was found within the vagina, presenting with heterogeneously slightly low density and spotty calcification of the margin. The left lower ureter was enveloped by the mass, and part of the mass was closely adhered to the posterior bladder wall and the rectum . On enhanced CT scan, mild-to-moderate enhancement of the margin and mild grid-like enhancement in the interior of the mass were demonstrated . There was no significant abnormality in the gastrointestinal tract or other abdominal organs. Vaginal malignancy was reported, and metastasis could not be excluded. Considering all the aforementioned evidence collectively, primary signet ring cell carcinoma was highly suspected. Positron emission tomography-computed tomography (PET-CT) was given to confirm whether the tumor was primary or metastatic, and a local malignant tumor within the vagina with no any other neoplastic lesion in other body sites was reported . Combining the pathology, immunohistochemistry, and imaging results, primary vaginal signet ring cell carcinoma was diagnosed. The patient then underwent laparoscopic exploration under general anesthesia, showing absence of tumor in the abdominal organs ( e.g. liver, gallbladder, pancreas, diaphragm, stomach, and intestine) or the upper abdominal peritoneum. Besides, adhesions were found between intestinal wall/peritoneum and vaginal stump/bladder wall. After the adhesions were separated, an extraperitoneal mass, which was approximately 9.0 × 5.0 × 5.5 cm in size with a hard texture, was found as protruding from the vaginal stump to the left posterior bladder. The left ureter was enveloped by the mass, and the posterior margin of the mass was tightly adhered to some rectum. Neither the uterus nor bilateral adnexa were observed. The surgery scope required to be expanded, but the patient family refused.
| 4.085938
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|
sec[0]/p[0]
|
en
| 0.999995
|
PMC9976718
|
https://doi.org/10.1259/bjrcr.20220050
|
[
"vaginal",
"tumor",
"signet",
"ring",
"carcinoma",
"enhancement",
"cell",
"pelvic",
"within",
"wall"
] |
[
{
"code": "GA02.Z",
"title": "Vaginitis, unspecified"
},
{
"code": "GB07.1&XA1FS5",
"title": "Inflammation of tunica vaginalis"
},
{
"code": "GA1Z&XA1LK7",
"title": "Noninflammatory disorders of vagina"
},
{
"code": "GA02.0",
"title": "Acute vaginitis"
},
{
"code": "GA02.2&XT8W",
"title": "Chronic vaginitis"
},
{
"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 ===
[GA02.Z] Vaginitis, unspecified
Also known as: Vaginitis, unspecified | Vaginitis | inflammation of vagina | colpitis | vaginal inflammation
[GA02.0] Acute vaginitis
Also known as: Acute vaginitis | Acute vulvovaginitis | Vulvovaginitis NOS | Colpocystitis | Infective vaginitis
[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 ---
[GA02.Z] Vaginitis, unspecified
--PARENT--> [GA02] Vaginitis
--CHILD--> [GA02.1] Inflammatory vaginitis
Def: Clinical syndrome characterised by diffuse exudative vaginitis, epithelial cell exfoliation and a profuse purulent vaginal discharge, associated with vulvovaginal burning or irritation and dyspareunia...
--- Walk 2 ---
[GA02.Z] Vaginitis, unspecified
--PARENT--> [GA02] Vaginitis
--PARENT--> [?] Inflammatory disorders of the female genital tract
--- Walk 3 ---
[GA02.0] Acute vaginitis
--PARENT--> [GA02] Vaginitis
--CHILD--> [GA02.0] Acute vaginitis
--- Walk 4 ---
[GA02.0] Acute vaginitis
--PARENT--> [GA02] Vaginitis
--RELATED_TO--> [?] Vulvovaginal ulceration or inflammation
|
[
"[GA02.Z] Vaginitis, unspecified\n --PARENT--> [GA02] Vaginitis\n --CHILD--> [GA02.1] Inflammatory vaginitis\n Def: Clinical syndrome characterised by diffuse exudative vaginitis, epithelial cell exfoliation and a profuse purulent vaginal discharge, associated with vulvovaginal burning or irritation and dyspareunia...",
"[GA02.Z] Vaginitis, unspecified\n --PARENT--> [GA02] Vaginitis\n --PARENT--> [?] Inflammatory disorders of the female genital tract",
"[GA02.0] Acute vaginitis\n --PARENT--> [GA02] Vaginitis\n --CHILD--> [GA02.0] Acute vaginitis",
"[GA02.0] Acute vaginitis\n --PARENT--> [GA02] Vaginitis\n --RELATED_TO--> [?] Vulvovaginal ulceration or inflammation"
] |
GA02.Z
|
Vaginitis, unspecified
|
[
{
"from_icd11": "GA02.0",
"icd10_code": "N760",
"icd10_title": "Acute vaginitis"
},
{
"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"
}
] |
N760
|
Acute vaginitis
|
A 62-year-old female patient was referred to the nephrology unit for asymptomatic urinary abnormalities including microscopic hematuria and proteinuria, which had persisted for a year. The patient also complained of general weakness and mild dyspnea during exercise. Two years earlier, the patient had undergone mitral valve repair surgery for mitral regurgitation (MR) and paroxysmal atrial fibrillation with artificial chordae and an annuloplasty rings . During the current visit, the patient showed a blood pressure of 120/80 mmHg, pulse rate 65/min, respiration rate 22/min, and body temperature 36.5°C. Other than hyperthyroidism, she had no significant medical history such as diabetes mellitus, hypertension, or kidney disease; she also had no episodes of gross hematuria. Physical examination revealed conjunctival pallor but no evidence of jaundice in the sclerae. Moreover, there was no evidence of intra-abdominal organomegaly or edema of the lower limbs. Chest auscultation indicated regular heart sounds, with a holosystolic murmur (Grade IV/VI) in the apex region. A peripheral blood test at admission revealed the following: white blood cell (WBC) count, 4300/μL (neutrophils 59%); hemoglobin (Hb), 8.9 g/dL; and platelet count, 227,000/μL. Serum biochemical examination revealed the following: blood urea nitrogen (BUN), 24.1 mg/dL; creatinine (Cr), 0.8 mg/dL (estimated glomerular filtration rate, eGFR; 79 mL/min/1.73m 2 ); aspartate aminotransferase, 55 IU/L; alanine aminotransferase, 16 IU/L; total protein, 6.8 g/dL; serum albumin, 4.3 g/dL; and C-reactive protein, 0.6 mg/L. Anemia-related hematological test results are described in Table 1 . Urinalysis results were as follows: pH 5.5, occult blood 2+, and albumin 2+. Microscopic urinary sediment evaluation revealed 1–3 WBCs per high-power field (HPF) and 10–30 red blood cells (RBCs) per HPF (dysmorphic 80%). Twenty-four-hour urine examination revealed a urine protein level of 375 mg/day and a Cr clearance of 76.7 mL/min/1.73 m 2 . Serum immunoglobulin (Ig) levels, including IgG, IgA, and IgM, were normal, whereas the serum complement 3 (C3) level was reduced (67.2 mg/dL; normal range, 90–180 mg/dL); the levels of C4 and 50% hemolyzing dose of complement were normal. Moreover, serological test results for rheumatoid factor, viral markers (hepatitis B surface antigen, hepatitis C antibody, anti-human immunodeficiency virus antibody), lupus studies (antinuclear antibody, anti-double stranded DNA antibody), anti-neutrophil cytoplasmic antibody, and cryoglobulin were negative. On the chest radiograph, there were no abnormal findings, except for a slight cardiomegaly. The size and shape of both kidneys were normal on renal ultrasonography, whereas peripheral blood smear showed normocytic normochromic anemia with polychromasia, poikilocytosis, schistocytes, and spherocytes, suggesting hemolytic anemia . PNH was excluded based on negative results of the flow cytometry tests for percentages of CD59+ cells and CD55+ cells among RBCs and granulocytes. Consequently, we suspected an asymptomatic urinary abnormality and performed a percutaneous renal biopsy on the third day after admission, to rule out glomerulopathy associated with a systemic disease. The renal biopsy showed 2 global glomerulosclerosis in all 23 glomeruli. The other glomeruli did not show significant pathologic abnormalities such as endocapillary proliferation, crescents or intravascular fibrin thrombi. However, interstitium showed extensive deposition of coarsely granular pigments mostly in tubular epithelial cells and within the tubular lumen on hematoxylin and eosin stains . Prussian blue iron stain demonstrated marked renal hemosiderosis with extensive iron depositions in the tubules . Immunofluorescence studies did not show any immune deposits in glomeruli. Electron microscopy showed unremarkable glomerular structure with no electron-dense deposits in the mesangium and along the capillary walls . However, irregularly shaped electron-dense particles were found within the lysosomes in tubules, particular in proximal tubular epithelial cells . Transthoracic echocardiography performed on the seventh day after admission showed moderate MR, which was due to tethering of the posterior leaflet. However, unlike in an MR due to typical posterior leaflet tethering, the direction of regurgitant blood flow was anterior, due to the blood striking the annuloplasty ring . On the basis of the laboratory and renal biopsy findings, the patient was diagnosed with chronic intravascular hemolysis and renal hemosiderosis following mitral valve repair. Subsequently, we recommended a mitral valve repeat surgery, but the patient refused surgery. We initiated a treatment regimen that included daily oral administration of ferrous sulfate 160 mg/day, N- acetylcysteine 200 mg/day, and bisoprolol 2.5 mg/day. Concentrated RBC transfusion was not performed. At 24 months after the kidney biopsy, renal function remained stable with biochemical test results showing BUN level of 19.4 mg/dL and Cr level of 0.9 mg/dL (eGFR; 76 mL/min/1.73m 2 ); however, clinical signs of hemolytic anemia persisted (Table 1 ). Urinalysis results showed albumin 1+, RBC 5–10/HPF, and random urine protein-Cr ratio of 215 mg/g, which represented no significant differences compared to the results seen during the renal biopsy.
| 4.097656
| 0.97168
|
sec[1]/p[0]
|
en
| 0.999997
|
32011483
|
https://doi.org/10.1097/MD.0000000000018798
|
[
"blood",
"renal",
"cells",
"antibody",
"biopsy",
"mitral",
"serum",
"protein",
"anemia",
"however"
] |
[
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
},
{
"code": "GC2Z&XA6KU8",
"title": "Disease of kidney, not elsewhere classified"
},
{
"code": "GB6Z",
"title": "Kidney failure, unspecified"
},
{
"code": "LB30.1",
"title": "Renal dysplasia"
},
{
"code": "NB92.0Y",
"title": "Other specified injury of kidney"
},
{
"code": "LB30.7",
"title": "Ectopic or pelvic kidney"
}
] |
=== ICD-11 CODES FOUND ===
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
[MA12.4] Finding of steroid agent in blood
Also known as: Finding of steroid agent in blood | steroid in blood
[MA12.2] Finding of hallucinogen in blood
Also known as: Finding of hallucinogen in blood | hallucinogen in blood
[GB6Z] Kidney failure, unspecified
Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS
[LB30.1] Renal dysplasia
Definition: A condition characterised by abnormal development of one or both kidneys.
Also known as: Renal dysplasia | congenital renal dysplasia | dysplasia of kidney | dysplastic kidney | Primary renal dysplasia
Excludes: Autosomal dominant polycystic kidney disease
[NB92.0Y] Other specified injury of kidney
Also known as: Other specified injury of kidney | Injury of kidney without open wound into cavity | Injury of kidney with open wound into cavity | Haematoma of kidney | traumatic perirenal haematoma
[LB30.7] Ectopic or pelvic kidney
Definition: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones
Also known as: Ectopic or pelvic kidney | Congenital displaced kidney | congenital misplaced kidney | congenital malposition of kidney | congenital prolapsed kidney
Includes: Congenital displaced kidney | Malrotation of kidney
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Diseases of the immune system
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--PARENT--> [MF50] Abnormal micturition
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.4Z] 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--> [MA12.2] Finding of hallucinogen in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of blood, blood-forming organs, or the immune system",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --PARENT--> [MF50] Abnormal micturition",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] 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--> [MA12.2] Finding of hallucinogen in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
The patient is a 30-year-old woman who presented with a chief complaint of irregular menses and hirsutism. Since adolescence, she menstruated every 2 to 3 months, accompanied by mild cramping. Her menstrual flow typically lasted for 6 to 7 days, and she occasionally had spotting between periods. Her facial hair was bothersome enough to require regular shaving. She never had acne, breast tenderness, or breast discharge. She experienced headaches once or twice a month but denied experiencing blurry vision and diplopia. She had never had children or tried to become pregnant but wanted to start a family with her husband in the coming years. She denied experiencing changes in thirst or urination, muscle aches, skin changes, bruising, rashes, frequent infections, anxiety, or depression. She denied the use of tobacco, alcohol, or recreational substances. She had a family history of irregular menses (her mother and sister) and type 1 diabetes (her mother and grandmother). Physical examination revealed no visual field defects, facial plethora, or telangiectasia. There was hirsutism at the chin. There was no goiter. Her skin was warm and dry, with no obvious rashes or bruises, and her abdomen was soft, with normal hair distribution and typical external genitalia for her age. Her body mass index was 23, her heart rate was 86 beats per minute, and her blood pressure was 124/80. Her previous medical history included a prolactin level of 34.7 ng/mL (reference range, 2.0-23.0 ng/mL) and an am total serum testosterone level of 77 ng/dL (reference range, 25-125 ng/dL, not sex-specific). She also had a 2-mm × 3-mm posterior pituitary lesion on magnetic resonance imaging. A pelvic ultrasound 3 years before presentation was reported to be normal. Other laboratory parameters before the initial evaluation can be found in Table 1 . As part of this medical team’s initial evaluation, laboratory findings revealed the following: the am 17-hydroxyprogesterone level was 554 ng/dL (female reference range, 10-300 ng/dL), the total testosterone measured by Liquid Chromatography-Tandem Mass Spectrometry level was 83 ng/dL (reference range for females and children, 9-55 ng/dL), and the prolactin level was 29.6 ng/mL (reference range, 2.0-23.0 ng/mL). The findings of the further laboratory testing performed at that time can be found in Table 2 . The patient was started on cabergoline (0.25 mg) biweekly, which decreased her prolactin level to 4.4 ng/dL in 4 weeks. At the lowered prolactin level, the patient continued to report menstrual irregularities and hirsutism. A 250-mcg cosyntropin test was performed. The am 17-hydroxyprogesterone level increased from 44 ng/dL at time 0 to 837 ng/dL at 60 minutes ( Table 3 ). The adrenocorticotrophic hormone level was 178 pg/mL (reference range, 7.2-63 pg/mL) and the baseline am cortisol level was 24.1 mcg/dL (reference range, 8-25 mcg/dL). After a 1-mg dexamethasone suppression test, her serum am dexamethasone level was 197 ng/dL (140-295 ng/dL for 1-mg dexamethasone ingested the previous evening) and her am serum cortisol level was 0.5 mcg/dL (8-24 mcg/dL) ( Table 3 ). Table 1 Initial Laboratory Work-up Test Result Reference range Na (mmol/L) 138 135-145 K (mmol/L) 4.4 3.5-5.0 Cl (mmol/L) 107 98-108 HCO 3 (mmol/L) 21 22-29 BUN (mg/dL) 10 5-20 Creatinine (md/dL) 0.74 0.60-1.20 Glucose (mg/dL) 102 70-99 Ca (mg/dL) 9 8.5-10.5 Alkaline phosphatase (units/L) 51 25-125 AST (units/L) 31 13-39 ALT (units/L) 10 7-52 Total bilirubin (mg/dL) 0.5 0.0-1.0 Total protein (g/dL) 6.8 6.4-8.0 Albumin (g/dL) 4.2 2.5-5.0 TSH (mcU/nL) 2.086 0.400-4.200 Prolactin (ng/mL) 34.7 2.0-23.0 Total testosterone serum (ng/dL) 77 25-125 Abbreviations: Na = sodium; K= potassium; Cl = chloride; HCO 3 = Bicarbonate; BUN = Blood Urea Nitrogen; Ca = Calcium; AST = Aspartate Transaminase; ALT = Alanine Transaminase; TSH = Thyroid Stimulating Hormone Abnormal baseline Prolactin level bolded. Total testosterone level bolded in this female patient. Table 2 Endocrine Work-up for Hyperandrogenism Test Result Reference range 17-OH progesterone (ng/dL) 554 10-300 ng/dL Total testosterone F/C LC-MS/MS (ng/dL) 83 9-55 Serum prolactin (ng/mL) 29.6 2.0-23.0 DHEA sulfate (mcg/dL) 223 35-430 Estradiol (pg/mL) 261 N/A IGF-1 (ng/mL) 202 87-368 Serum sex hormone–binding globulin (nmol/L) 106.61 30-135 Free testosterone F/C LC-MS/MS (pg/mL) 6.6 0.8-7.4 FSH (mU/mL) 11.5 N/A LH (mU/mL) 35.5 N/A Abbreviations: OH = hydroxy; F/C = Females and Children; LC-MS/MS = Liquid Chromatography-Tandem Mass Spectrometry; DHEA = Dehydroepiandrosterone; IGF-1 = Insulin-like Growth Factor 1; FSH = Follicular Stimulating Hormone; LH = Leutinizing Hormone; N/A = Not Available (due to known phase of ovulation) Abnormal labs bolded. Table 3 Adrenocorticotropic Hormone Stiumation Test, Dexamethasone Suppression Test, and Repeat FSH & LH Levels Test Result Reference range ACTH (pg/mL) 178.0 7.2-63.0 Baseline 17-OH progesterone (ng/dL) 444 10-300 60-min 17-OH progesterone (ng/dL) 837 <1000 Baseline cortisol (mcg/dL) 24.1 8-25 Cortisol after 1mg dexamethasone suppression test (mcg/dL) 0.5 8-24 FSH (mU/mL) 4.1 N/A LH (mU/mL) 10.0 N/A Abbreviations: OH = hydroxy; ACTH = adrenocorticotropic hormone; FSH = Follicular Stimulating Hormone; LH = Leutinizing Hormone; N/A = Not Available (due to unknown phase of ovulation) ACTH stimulation labs bolded.
| 4.023438
| 0.978027
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC9701904
|
https://doi.org/10.1016/j.aace.2022.10.003
|
[
"reference",
"range",
"hormone",
"prolactin",
"total",
"serum",
"testosterone",
"dexamethasone",
"laboratory",
"baseline"
] |
[
{
"code": "6B22.Z",
"title": "Olfactory reference disorder, unspecified"
},
{
"code": "MB26.03",
"title": "Delusion of reference"
},
{
"code": "6B22.1",
"title": "Olfactory reference disorder with poor to absent insight"
},
{
"code": "4B00.0Z",
"title": "Neutropaenia, unspecified"
},
{
"code": "3B63.1Z",
"title": "Acquired thrombocytosis, unspecified"
},
{
"code": "QA00.6Y",
"title": "Other specified examination of eyes or vision"
},
{
"code": "MA14.1C",
"title": "Raised antibody titre"
},
{
"code": "BD11.1",
"title": "Left ventricular failure with mid range ejection fraction"
},
{
"code": "5B3Z",
"title": "Endocrine diseases, unspecified"
},
{
"code": "6C4H.1Z",
"title": "Harmful pattern of use of non-psychoactive substances, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[6B22.Z] Olfactory reference disorder, unspecified
Also known as: Olfactory reference disorder, unspecified | Olfactory reference disorder | Delusions of malodour
[MB26.03] Delusion of reference
Definition: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature.
Also known as: Delusion of reference
[6B22.1] Olfactory reference disorder with poor to absent insight
Definition: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level.
Also known as: Olfactory reference disorder with poor to absent insight
[4B00.0Z] Neutropaenia, unspecified
Also known as: Neutropaenia, unspecified | Neutropenia | Disorders with decreased neutrophil counts | neutropaenic disorder | neutrophil count below reference range
[3B63.1Z] Acquired thrombocytosis, unspecified
Also known as: Acquired thrombocytosis, unspecified | Acquired thrombocytosis | Idiopathic haemorrhagic thrombocythaemia | Essential thrombocythaemia | primary haemorrhagic thrombocythaemia
[QA00.6Y] Other specified examination of eyes or vision
Also known as: Other specified examination of eyes or vision | No Impairment of Contrast vision | Normal colour vision | No Impairment of Dark adaptation | No diplopia
[MA14.1C] Raised antibody titre
Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre
Excludes: isoimmunization, in pregnancy affecting fetus or newborn
[BD11.1] Left ventricular failure with mid range ejection fraction
Also known as: Left ventricular failure with mid range ejection fraction | HFmEF - [heart failure with mid range ejection fraction] | Left ventricular failure with mid range ejection fraction due to cardiomyopathy | Left ventricular failure with mid range ejection fraction due to coronary artery disease | Left ventricular failure with mid range ejection fraction due to myocarditis
[5B3Z] Endocrine diseases, unspecified
Also known as: Endocrine diseases, unspecified | endocrine disorder NOS | disorder of endocrine gland | disease of endocrine gland | disorder of endocrine system
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies
=== GRAPH WALKS ===
--- Walk 1 ---
[6B22.Z] Olfactory reference disorder, unspecified
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.1] 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 2 ---
[6B22.Z] Olfactory reference disorder, unspecified
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.0] Olfactory reference disorder with fair to good insight
Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...
--- Walk 3 ---
[MB26.03] Delusion of reference
Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....
--PARENT--> [MB26.0] Delusion
Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...
--CHILD--> [MB26.02] Delusion of guilt
Def: A delusion involving exaggerated or inappropriate responsibility, need for punishment or retribution, or disproportionate consequences of one’s actions, such as that a minor error in the past will lea...
--- 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--> [MB26.02] Delusion of guilt
Def: A delusion involving exaggerated or inappropriate responsibility, need for punishment or retribution, or disproportionate consequences of one’s actions, such as that a minor error in the past will lea...
--- 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--> [6B22.0] Olfactory reference disorder with fair to good insight
Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...
--- Walk 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--> [6B22.0] Olfactory reference disorder with fair to good insight
Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...
|
[
"[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...",
"[6B22.Z] Olfactory reference disorder, unspecified\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.0] Olfactory reference disorder with fair to good insight\n Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...",
"[MB26.03] Delusion of reference\n Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....\n --PARENT--> [MB26.0] Delusion\n Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...\n --CHILD--> [MB26.02] Delusion of guilt\n Def: A delusion involving exaggerated or inappropriate responsibility, need for punishment or retribution, or disproportionate consequences of one’s actions, such as that a minor error in the past will lea...",
"[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--> [MB26.02] Delusion of guilt\n Def: A delusion involving exaggerated or inappropriate responsibility, need for punishment or retribution, or disproportionate consequences of one’s actions, such as that a minor error in the past will lea...",
"[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--> [6B22.0] Olfactory reference disorder with fair to good insight\n Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...",
"[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--> [6B22.0] Olfactory reference disorder with fair to good insight\n Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a..."
] |
6B22.Z
|
Olfactory reference disorder, unspecified
|
[
{
"from_icd11": "6B22.Z",
"icd10_code": "F428",
"icd10_title": "Other obsessive-compulsive disorder"
},
{
"from_icd11": "3B63.1Z",
"icd10_code": "D473",
"icd10_title": "Essential (hemorrhagic) thrombocythemia"
},
{
"from_icd11": "MA14.1C",
"icd10_code": "R760",
"icd10_title": "Raised antibody titer"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E342",
"icd10_title": "Ectopic hormone secretion, not elsewhere classified"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E348",
"icd10_title": "Other specified endocrine disorders"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E349",
"icd10_title": "Endocrine disorder, unspecified"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E20-E35",
"icd10_title": ""
},
{
"from_icd11": "5B3Z",
"icd10_code": "E34",
"icd10_title": "Other endocrine disorders"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5B3Z",
"icd10_code": "E351",
"icd10_title": ""
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F558",
"icd10_title": "Abuse of other non-psychoactive substances"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F552",
"icd10_title": "Abuse of laxatives"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F553",
"icd10_title": "Abuse of steroids or hormones"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F551",
"icd10_title": "Abuse of herbal or folk remedies"
},
{
"from_icd11": "6C4H.1Z",
"icd10_code": "F55",
"icd10_title": "Abuse of non-psychoactive substances"
}
] |
F428
|
Other obsessive-compulsive disorder
|
The total co lonoscopy (TCS) performed six days after his first visit revealed a tumor with a circumferential ulcer covered with a thick slough in the splenic flexure of the transverse colon. Moreover, the marked thickening and inflammatory changes of the surrounding mucosa made it difficult for the endoscope to pass through, although the lesion had not yet developed into an intestinal obstruction . Histopathological analysis of several specimens of the tumor was performed, but the findings at that time were only erosion of the mucosa with moderate inflammatory cell infiltration and regenerative changes in the mucosal epithelium. Although a definitive diagnosis was not yet made at that time, we recommended an exploratory laparotomy because of intestinal stenosis. However, he requested a second opinion. While undergoing tests to obtain a second opinion from another hospital, he became aware that the palpable mass decreased in size. Furthermore, a follow-up CT performed after he obtained a second opinion (36 days after the first CT) showed that the tumor had regressed spontaneously and the swelling of small lymph nodes around the tumor had disappeared . Therefore, TCS was reperformed 41 days after his first visit to our hospital. The tumor had decreased in size and the inflammatory changes in the surrounding mucosa tended to improve; however, tightening of the surrounding mucosa due to scarring and the continuous narrowing of the intestine over a length of approximately 30 mm were observed . Histopathological analysis of a biopsy specimen of the periphery of the tumor showed widespread erosion of the mucosa and the formation of granulation tissue with marked infiltration of inflammatory cells consisting of small lymphocytes, plasma cells, histiocytes, and medium-size atypical nucleated cells in the mucosal tissue. Some of the B-lymphocyte antigen CD20-positive B cells (CD20-positive B cells) identified by immunohistochemical analysis were also found to be positive for Epstein–Barr virus (EBV)-encoded small RNA (EBER)-1 by in situ hybridization (ISH), suggesting the high possibility of EBV − positive mucocutaneous ulcer (EBV-MCU) . Forty-eight days after his first visit, while he was being prepared exploratory laparotomy, he started to suffer from constipation and intermittent abdominal pain. Because plain abdominal CT revealed intestinal distention on the oral side of the narrowed area in the transverse colon, the patient was diagnosed as having intestinal obstruction and underwent decompression by transanal ileus tube insertion . Therefore, although the definitive diagnosis was not yet confirmed histopathologically, transverse colon segmental resection was performed with the patient’s fully informed consent. The resected specimen showed an ulcer of 35 mm × 25 mm in size with narrowing of the intestine . The histopathological analysis of the specimen revealed marked inflammatory cell infiltration and fibrosis in all layers of the colon wall. Most of the infiltrating cells were lymphocytes and plasma cells. Also, Hodgkin and Reed–Sternberg (HRS)-like multinucleated large B cells were found scattered . A large proportion of CD20-positive B cells identified by immunohistochemical analysis were also found to be positive for EBER-1 by ISH, similarly to the postoperative immunohistochemistry test. No apparent clonal growth of lymphocytes was shown by the flow cytometry of the resected specimen. No dividing cells were identified by G-banding differential staining. Taking these findings together, he was finally diagnosed as having EBV-MCU. No recurrence was observed 20 months after the surgery. Fig. 2 First total colonoscopy. Total colonoscopy (TCS) revealed a circumferential ulcer of the tumor covered with a thick slough in the splenic flexure of the transverse colon. The surrounding mucosa showed marked inflammatory changes and thickening (2 a and 2 b ) Fig. 3 Second total colonoscopy. In the second TCS, the circumferential ulcer of the tumor had decreased in size and the inflammatory changes in the surrounding mucosa trended to improve; however, tightening of the surrounding mucosa due to scarring was observed. There was a continuous narrowing of the lumen over a length of approximately 30 mm (3 a and 3 b ) Fig. 4 Histopathological analysis. Histopathological analysis revealed widespread erosion of the mucosa and the formation of granulation tissue with marked infiltration of inflammatory cells consisting of small lymphocytes, plasma cells, histiocytes, and medium-size atypical nucleated cells in the mucosal tissue of the large intestine (hematoxylin–eosin stain, original magnification × 40) ( a ). Some of the CD20-positive B cells identified by immunohistochemical analysis (original magnification × 40) ( b ) were also found to be positive for EBER-1 by ISH (original magnification × 40) ( c ). The resected specimen showed an ulcerative lesion with narrowing of the lumen ( d ). The histopathological analysis of the resected specimen revealed marked infiltration of inflammatory cells, consisting mainly of small lymphocytes and plasma cells, as well as fibrosis in all layers of the colon wall (hematoxylin–eosin stain, original magnification × 2) ( e ). HRS-like multinucleated large B cells were also occasionally present (hematoxylin–eosin stain, original magnification × 40) ( f )
| 4.089844
| 0.972168
|
sec[1]/p[3]
|
en
| 0.999998
|
31931725
|
https://doi.org/10.1186/s12876-020-1162-2
|
[
"cells",
"inflammatory",
"mucosa",
"tumor",
"colon",
"surrounding",
"histopathological",
"specimen",
"ulcer",
"changes"
] |
[
{
"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": "FA2Z",
"title": "Inflammatory arthropathies, unspecified"
},
{
"code": "FB84.Z",
"title": "Osteomyelitis or osteitis, unspecified"
},
{
"code": "8C1Z",
"title": "Mononeuropathy of unspecified site"
},
{
"code": "BD90.Z",
"title": "Lymphadenitis, unspecified"
},
{
"code": "FB55.Z",
"title": "Enthesopathies, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[FA2Z] Inflammatory arthropathies, unspecified
Also known as: Inflammatory arthropathies, unspecified | polyarthritis NOS | inflammatory joint disease NOS | nonpyogenic arthritis NOS | arthritic nodosa
[FB84.Z] Osteomyelitis or osteitis, unspecified
Also known as: Osteomyelitis or osteitis, unspecified | Osteomyelitis or osteitis | bone inflammation | bone ulcer | bone inflammatory disease
[8C1Z] Mononeuropathy of unspecified site
Also known as: Mononeuropathy of unspecified site | inflammation of nerve NOS | nerve condition NOS | neuritis NOS | nerve disease NOS
[BD90.Z] Lymphadenitis, unspecified
Also known as: Lymphadenitis, unspecified | Lymphadenitis | adenitis NOS | inflammation of gland | lymphatic gland inflammation
[FB55.Z] Enthesopathies, unspecified
Also known as: Enthesopathies, unspecified | Certain specified enthesopathies | Enthesopathy of elbow | enthesopathy of elbow region | Adhesive capsulitis not elsewhere classified
=== GRAPH WALKS ===
--- Walk 1 ---
[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--> [?] Lysosomal acid lipase deficiency
Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...
--- Walk 4 ---
[5C56.20] Mucolipidosis
--PARENT--> [5C56.2] Glycoproteinosis
Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....
--CHILD--> [5C56.21] Oligosaccharidosis
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --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--> [?] Lysosomal acid lipase deficiency\n Def: Lysosomal Acid Lipase (LAL) Deficiency happens when the body does not produce enough active lysosomal acid lipase (LAL or LIPA) enzyme. This enzyme plays an important role in breaking down fatty mater...",
"[5C56.20] Mucolipidosis\n --PARENT--> [5C56.2] Glycoproteinosis\n Def: These are lysosomal storage diseases affecting glycoproteins, resulting from defects in lysosomal function. The term is sometimes reserved for conditions involving degradation of glycoproteins....\n --CHILD--> [5C56.21] Oligosaccharidosis",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy"
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M1389",
"icd10_title": "Other specified arthritis, multiple sites"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M1380",
"icd10_title": "Other specified arthritis, unspecified site"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13862",
"icd10_title": "Other specified arthritis, left knee"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13872",
"icd10_title": "Other specified arthritis, left ankle and foot"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13871",
"icd10_title": "Other specified arthritis, right ankle and foot"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13861",
"icd10_title": "Other specified arthritis, right knee"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13879",
"icd10_title": "Other specified arthritis, unspecified ankle and foot"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13842",
"icd10_title": "Other specified arthritis, left hand"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13841",
"icd10_title": "Other specified arthritis, right hand"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13811",
"icd10_title": "Other specified arthritis, right shoulder"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13162",
"icd10_title": "Monoarthritis, not elsewhere classified, left knee"
}
] |
D571
|
Sickle-cell disease without crisis
|
On physical examination at referral, all vital signs were within normal limits. The cat's body weight was 3.45 kg and the body condition score was 3/9, indicating the cat was underweight. Mild, multifocal erythema and crusting were present on the dorsal nose, concave pinnae and the dorsal, interdigital, haired skin and claw folds of all four paws. Some of the digits were swollen and the cat resented palpation of the digits . Two sharply demarcated, 2 cm large areas of complete focal alopecia with central raised adherent crusts were on the shoulder and mid‐dorsum, in areas of previous antiviral subcutaneous injections. Pruritus was moderate to severe and mainly focused on the affected areas including the aforementioned alopecic locations. Cytological preparations of crusts from the pinnae and affected digits revealed non‐degenerate neutrophils, nuclear streaming and several clusters of acantholytic keratinocytes with an absence of bacterial and fungal organisms. Other dermatological investigations such as skin scraping, trichogram and Wood's lamp examination, from various affected skin areas, were unremarkable. Major differential diagnoses considered were infectious causes (bacterial or fungal organisms, esp. Trichophyton spp .), autoimmune causes (PF), cutaneous adverse drug reactions and FIP‐associated dermatitis. Full‐thickness skin biopsies were recommended, but the owner declined because of concerns about sedation and anaesthesia. Instead, multiple crusts from the pinnae and paws were sampled and submitted for histopathology. In addition, dermatophyte culture of hair and crusts as well as an aerobic bacterial culture of surface swabs from the lesions on the paws were performed. A blood test for feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) antigen (IDEXX SNAP Combo) was negative. Amoxicillin/clavulanic acid (14.6 mg/kg q12 h PO; Clavulox ® ; Zoetis, Rhodes, Australia) was continued pending the results of the bacterial culture and all topical therapy was discontinued. The antiviral injections were continued by the owner. Three weeks after referral, skin lesions had not improved and new crusting lesions were identified on the dorsum and around the nipples. Cytology from the crusts at the new lesion sites revealed neutrophilic inflammation, clusters of acantholytic keratinocytes and no microorganisms. Cytology of the two focal areas of alopecia was unremarkable. Results from the previous tests included a negative dermatophyte culture and light growth of Staphylococcus aureus susceptible to amoxicillin/clavulanic acid. Histopathology revealed multiple large intracorneal crusts composed of abundant intact neutrophils, rounded/angular acantholytic keratinocytes and focal colonies of bacterial cocci at areas of erosions . A Periodic Acid‐Schiff (PAS) stain did not reveal any fungal organisms. A diagnosis of PF was made based on the appearance and distribution of the lesions, supportive histopathology, a negative fungal culture and the lack of response to an antimicrobial to which the cultured S. aureus was susceptible. Due to the presumptive FIP diagnosis, immunosuppressive doses of systemic glucocorticoids were avoided and therapy was initiated using topical hydrocortisone aceponate twice daily (one pump per application, applied indirectly via product‐moistened cotton swab) on affected areas (Cortavance ® ; Virbac Limited, Sufflox, United Kingdom), pentoxifylline (26.5 mg/kg q12 h PO; Pentoxifylline 400mg ® ; Oceanside Pharmaceuticals, New Jersey, USA) and omega‐3/6‐fatty acids (767 mg q24 h PO; VetriScience ® ; VetriScience Laboratories; Vermont, USA). At re‐examination 2 weeks later, the skin lesions improved significantly. The cat no longer resented its paws being touched and only a few crusts remained on the front paws and the trunk. The cat was more active and no signs of iatrogenic Cushing's occurred. The owner reported that if the hydrocortisone aceponate application was missed, the crusts immediately relapsed. Cytology of the residual crusts revealed neutrophilic inflammation, no microorganisms and no acantholytic keratinocytes. Pruritus was still present and cetirizine (0.7 mg/kg q12 h PO; Zyrtec ® ; GlaxoSmithKline, Hong Kong, China) was added . Two months later, clinical examination revealed a healthy cat, free of systemic signs with complete resolution of crusted skin lesions and pruritus. The 12‐week injection course of the antiviral drug had been completed by the owner during this time. The two well‐demarcated areas of alopecia remained. The topical glucocorticoid was tapered and completely withdrawn after approximately 6 months. The pentoxifylline was subsequently reduced to once daily and withdrawn 4 months later. At the time of writing, 20 months have passed since the initial presentation and 10 months since all medications were discontinued and the cat is clinically normal except for mild gingivostomatitis, with no systemic signs and no relapse of the crusting skin lesions . On repeating serum biochemistry, the only residual abnormality was a mild persistent hyperglobulinaemia (5.6 g/dl, normal range: 2.8–5.1 g/dl). The total serum protein (8.7 g/dl, normal range: 5.7–8.9 g/dl), albumin (3.1 g/dl, normal range: 2.2–4.0 g/dl) and the albumin/globulin ratio had resolved (0.5, normal range: 0.5–1.2). The two alopecic areas persisted.
| 4.140625
| 0.960449
|
sec[1]/p[2]
|
en
| 0.999997
|
35212177
|
https://doi.org/10.1002/vms3.768
|
[
"areas",
"crusts",
"skin",
"lesions",
"paws",
"bacterial",
"culture",
"affected",
"acantholytic",
"keratinocytes"
] |
[
{
"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"
},
{
"code": "ME66.1",
"title": "Changes in skin texture"
},
{
"code": "1G04.1",
"title": "Crusted scabies"
},
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "ME66.Y",
"title": "Other specified skin changes"
},
{
"code": "EM0Y",
"title": "Other specified diseases of the skin"
}
] |
=== ICD-11 CODES FOUND ===
[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
[ME66.1] Changes in skin texture
Definition: Alterations in skin texture of unspecified cause.
Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis
[1G04.1] Crusted scabies
Definition: Crusted scabies results from unchecked proliferation of the human scabies mite in individuals who are unable to mount an adequate immune response to infestation. Extensive thick crusts containing vast numbers of mites form over the skin, particularly of the extremities. Because itching is usually absent, the diagnosis is frequently overlooked. Patients with crusted scabies may serve as the source for widespread outbreaks of scabies in institutions such as hospitals and care homes.
Also known as: Crusted scabies | Norwegian scabies
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[ME66.Y] Other specified skin changes
Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta
[EM0Y] Other specified diseases of the skin
Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures
=== GRAPH WALKS ===
--- Walk 1 ---
[QF29] Difficulty or need for assistance with major areas of life
--PARENT--> [?] Difficulty or need for assistance with activities
Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....
--CHILD--> [QF20] Difficulty or need for assistance with learning
--- Walk 2 ---
[QF29] Difficulty or need for assistance with major areas of life
--PARENT--> [?] Difficulty or need for assistance with activities
Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....
--EXCLUDES--> [?] Dependence on enabling machines or devices
--- Walk 3 ---
[EH40.1Y] Other specified infantile napkin dermatoses
--PARENT--> [EH40.1] Infantile napkin dermatoses
--RELATED_TO--> [?] Acrodermatitis enteropathica
Def: Acrodermatitis enteropathica is an uncommon autosomal recessive disorder of intestinal zinc absorption. Signs usually appear within the first months of life with an exudative and crusted erythema loca...
--- Walk 4 ---
[EH40.1Y] Other specified infantile napkin dermatoses
--PARENT--> [EH40.1] Infantile napkin dermatoses
--RELATED_TO--> [?] Neonatal nutritional zinc deficiency
Def: An eruption clinically indistinguishable from acrodermatitis enteropathica but due to nutritional deficiency rather than a genetically-determined zinc malabsorption as in the former condition. It occu...
--- Walk 5 ---
[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 6 ---
[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....
|
[
"[QF29] Difficulty or need for assistance with major areas of life\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF20] Difficulty or need for assistance with learning",
"[QF29] Difficulty or need for assistance with major areas of life\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --EXCLUDES--> [?] Dependence on enabling machines or devices",
"[EH40.1Y] Other specified infantile napkin dermatoses\n --PARENT--> [EH40.1] Infantile napkin dermatoses\n --RELATED_TO--> [?] Acrodermatitis enteropathica\n Def: Acrodermatitis enteropathica is an uncommon autosomal recessive disorder of intestinal zinc absorption. Signs usually appear within the first months of life with an exudative and crusted erythema loca...",
"[EH40.1Y] Other specified infantile napkin dermatoses\n --PARENT--> [EH40.1] Infantile napkin dermatoses\n --RELATED_TO--> [?] Neonatal nutritional zinc deficiency\n Def: An eruption clinically indistinguishable from acrodermatitis enteropathica but due to nutritional deficiency rather than a genetically-determined zinc malabsorption as in the former condition. It occu...",
"[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...."
] |
QF29
|
Difficulty or need for assistance with major areas of life
|
[
{
"from_icd11": "QF29",
"icd10_code": "Z742",
"icd10_title": "Need for assistance at home and no other household member able to render care"
},
{
"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": "2B66.Z",
"icd10_code": "C0689",
"icd10_title": "Malignant neoplasm of overlapping sites of other parts of mouth"
},
{
"from_icd11": "2B66.Z",
"icd10_code": "C062",
"icd10_title": "Malignant neoplasm of retromolar area"
},
{
"from_icd11": "2B66.Z",
"icd10_code": "C060",
"icd10_title": "Malignant neoplasm of cheek mucosa"
},
{
"from_icd11": "2B66.Z",
"icd10_code": "C069",
"icd10_title": "Malignant neoplasm of mouth, unspecified"
},
{
"from_icd11": "2B66.Z",
"icd10_code": "C061",
"icd10_title": "Malignant neoplasm of vestibule of mouth"
},
{
"from_icd11": "2B66.Z",
"icd10_code": "C06",
"icd10_title": "Malignant neoplasm of other and unspecified parts of mouth"
},
{
"from_icd11": "2B66.Z",
"icd10_code": "C068",
"icd10_title": "Malignant neoplasm of overlapping sites of other and unspecified parts of mouth"
},
{
"from_icd11": "ME66.1",
"icd10_code": "R234",
"icd10_title": "Changes in skin texture"
},
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
}
] |
Z742
|
Need for assistance at home and no other household member able to render care
|
The patient had the abovementioned treatment history and the episodes of variceal bleeding. In addition, the computed tomography (CT) findings at that time showed the marked splenomegaly . Moreover, the microscopic findings of the nontumoral background liver, which was sampled at the ALPPS, indicated the SOS (data not shown). Based on these findings, we considered that the patient’s symptoms might have arisen from the portal-hypertension. Therefore, we initiated the use of tolvaptan (7.5 mg a day) immediately after the transfer. After that, the water-retention symptoms were rapidly relieved. Moreover, the patient’s general condition dramatically recovered with the Eastern Cooperative Oncology Group performance status of 0. CT taken 4 weeks after initiating tolvaptan demonstrated the remarkable mitigation of pleural effusion, ascites, and lower body edema . The patient was discharged from hospital 5 weeks after the transfer. Since then, however, the patient often suffered the esophageal variceal bleeding and frequently underwent the EVL , which was necessitated 4 times during the 2 months after the discharge. Namely, the EVL could not properly control the variceal bleeding, which disallowed the patient to recommence the antineoplastic treatment. Because hyperammonemia was not observed despite the portal-hypertension, we decided to perform the portosystemic shunt. His recurrent CRLM remained solitary at that time and thus the patient had a possibility of receiving repeat hepatectomy after effective chemotherapy in future. Thus, TIPS was considered a relative contraindication. Hence, we performed surgery consisting of splenectomy and surgical portosystemic shunting 3.5 months after the transfer. Because the patient had a left-sided inferior vena cava (IVC) , the confluence of the right and left testicular veins existed in the vicinity of the inferior mesenteric vein . Therefore, the portosystemic shunt was achieved through the side-to-end-anastomosis of the inferior-mesenteric-vein-to-testicular-vein-trunk following the splenectomy. Portal venous pressure was altered during the surgery as the following: 25 mmHg before splenectomy, 17 mmHg immediately after splenectomy, and 12 mmHg after the portosystemic shunting. The patient was uneventfully discharged from hospital 7 days after the surgery. Fig. 2 Findings of upper gastrointestinal endoscopy before the shunt surgery. The patient often developed hematemesis and/or melena originating from the esophageal varices and frequently necessitated the endoscopic variceal ligation (EVL). Endoscopic findings that needed the EVL ([red wale markings, white arrows, a ], [cherry red spot, white arrowheads, b ]) were frequently observed and the EVL was also performed frequently. Snake-skin-like mosaic pattern of the mucosa and numerous red-brown spots (black arrows) were observed in the lower body ( c ), upper body ( d ), and fundus of the stomach. These findings corresponded to the diagnosis of portal hypertensive gastropathy. Findings of the numerous red-brown spots suggested the severe portal hypertension Fig. 3 The left-sided inferior vena cava of the present case. The inferior vena cava (IVC) (white arrows) started to shift to the left side at the level of the divergence of the superior mesenteric artery from the abdominal aorta ( a ). As descending to the caudal direction, the IVC passed in front of the aorta ( b ). Below the level of the confluence of the left renal vein and the IVC, the IVC locates in the left side of the abdominal aorta. As shifting to the left side, the IVC (white arrows) gets closer to the inferior mesenteric vein (IMV) (white arrowheads) ( c , d ). As further descending to the caudal side, the confluence of the testicular vein trunk and the IVC was observed ( c , black arrow). At the level of the confluence of the right and left testicular veins (black arrows) ( d ), the IMV (white arrowheads) locates very adjacent to the testicular veins (black arrows) Fig. 4 Intraoperative findings of the shunt surgery, abdominal computed tomography findings 2 weeks after the shunt surgery, and upper gastrointestinal endoscopic findings at 2 weeks after the shun surgery. The portosystemic shunt was achieved through the side-to-end-anastomosis of the inferior-mesenteric-vein-to-the-testicular-vein-trunk ( a ). Namely, the cut end of the testicular vein trunk (yellow arrows) was anastomosed to the right lateral wall of the inferior mesenteric vein (IMV) (white arrowheads) ( a ). Portal vein phase of the dynamic contrast-enhancement computed tomography (CECT) ( b ) showed that the IMV (white arrowhead) was connected to the inferior vena cava (IVC) (black arrow) by the testicular vein trunk (yellow arrow). Venous phase of the dynamic CECT ( c ) also demonstrated that the vascular flow from the IMV (white arrowhead) to the IVC (black arrow) was well maintained through the testicular vein (yellow arrow) ( c ). Findings of the upper gastrointestinal endoscopy at 2 weeks after the shunt surgery revealed that findings such as red wale marking, cherry red spot, or hematocystic spot, that need the endoscopic variceal ligation were not observed at all ( d ). Findings of the portal hypertensive gastropathy were nearly eradicated ( e , f , g ) and the gastric mucosa showed the nearly complete recovery to the normal mucosa ( e , f , g )
| 4.019531
| 0.97168
|
sec[1]/p[2]
|
en
| 0.999998
|
32592150
|
https://doi.org/10.1007/s12328-020-01157-w
|
[
"vein",
"that",
"testicular",
"white",
"portal",
"shunt",
"arrows",
"mesenteric",
"side",
"black"
] |
[
{
"code": "BD7Z",
"title": "Diseases of veins, unspecified"
},
{
"code": "MC88",
"title": "Prominent veins"
},
{
"code": "BD7Y",
"title": "Other specified diseases of veins"
},
{
"code": "BD75.Y",
"title": "Venous varicosities of other specified sites"
},
{
"code": "BD73.2Z",
"title": "Systemic vein obstruction, unspecified"
},
{
"code": "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 ===
[BD7Z] Diseases of veins, unspecified
Also known as: Diseases of veins, unspecified
[MC88] Prominent veins
Also known as: Prominent veins
[BD7Y] Other specified diseases of veins
Also known as: Other specified diseases of veins
[BD75.Y] Venous varicosities of other specified sites
Also known as: Venous varicosities of other specified sites | Caput medusae | Jugular venous aneurysm | jugular vein aneurysm | Orbital varices
[BD73.2Z] Systemic vein obstruction, unspecified
Also known as: Systemic vein obstruction, unspecified | Systemic vein obstruction
[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 ---
[BD7Z] Diseases of veins, unspecified
--PARENT--> [?] Diseases of veins
--RELATED_TO--> [?] Other venous complications following abortion, ectopic or molar pregnancy
--- Walk 2 ---
[BD7Z] Diseases of veins, unspecified
--PARENT--> [?] Diseases of veins
--CHILD--> [BD72] Venous thromboembolism
--- Walk 3 ---
[MC88] Prominent veins
--PARENT--> [?] Symptoms or signs involving the circulatory system
--RELATED_TO--> [?] Fear of cardiovascular disease
--- Walk 4 ---
[MC88] Prominent veins
--PARENT--> [?] Symptoms or signs involving the circulatory system
--CHILD--> [MC80] Abnormal blood-pressure reading, without diagnosis
Def: Abnormal blood-pressure reading, without diagnosis is a reading of blood pressure which is higher than normal blood pressure or lower than normal blood pressure, without diagnosis....
--- Walk 5 ---
[BD7Y] Other specified diseases of veins
--PARENT--> [?] Diseases of veins
--CHILD--> [BD72] Venous thromboembolism
--- Walk 6 ---
[BD7Y] Other specified diseases of veins
--PARENT--> [?] Diseases of veins
--RELATED_TO--> [?] Other venous complications following abortion, ectopic or molar pregnancy
|
[
"[BD7Z] Diseases of veins, unspecified\n --PARENT--> [?] Diseases of veins\n --RELATED_TO--> [?] Other venous complications following abortion, ectopic or molar pregnancy",
"[BD7Z] Diseases of veins, unspecified\n --PARENT--> [?] Diseases of veins\n --CHILD--> [BD72] Venous thromboembolism",
"[MC88] Prominent veins\n --PARENT--> [?] Symptoms or signs involving the circulatory system\n --RELATED_TO--> [?] Fear of cardiovascular disease",
"[MC88] Prominent veins\n --PARENT--> [?] Symptoms or signs involving the circulatory system\n --CHILD--> [MC80] Abnormal blood-pressure reading, without diagnosis\n Def: Abnormal blood-pressure reading, without diagnosis is a reading of blood pressure which is higher than normal blood pressure or lower than normal blood pressure, without diagnosis....",
"[BD7Y] Other specified diseases of veins\n --PARENT--> [?] Diseases of veins\n --CHILD--> [BD72] Venous thromboembolism",
"[BD7Y] Other specified diseases of veins\n --PARENT--> [?] Diseases of veins\n --RELATED_TO--> [?] Other venous complications following abortion, ectopic or molar pregnancy"
] |
BD7Z
|
Diseases of veins, unspecified
|
[
{
"from_icd11": "BD7Z",
"icd10_code": "I82412",
"icd10_title": "Acute embolism and thrombosis of left femoral vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82621",
"icd10_title": "Acute embolism and thrombosis of deep veins of right upper extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82432",
"icd10_title": "Acute embolism and thrombosis of left popliteal vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82C11",
"icd10_title": "Acute embolism and thrombosis of right internal jugular vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82441",
"icd10_title": "Acute embolism and thrombosis of right tibial vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82422",
"icd10_title": "Acute embolism and thrombosis of left iliac vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82622",
"icd10_title": "Acute embolism and thrombosis of deep veins of left upper extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I824Z1",
"icd10_title": "Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82401",
"icd10_title": "Acute embolism and thrombosis of unspecified deep veins of right lower extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I824Z2",
"icd10_title": "Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82612",
"icd10_title": "Acute embolism and thrombosis of superficial veins of left upper extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82721",
"icd10_title": "Chronic embolism and thrombosis of deep veins of right upper extremity"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82C12",
"icd10_title": "Acute embolism and thrombosis of left internal jugular vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82B12",
"icd10_title": "Acute embolism and thrombosis of left subclavian vein"
},
{
"from_icd11": "BD7Z",
"icd10_code": "I82421",
"icd10_title": "Acute embolism and thrombosis of right iliac vein"
}
] |
I82412
|
Acute embolism and thrombosis of left femoral vein
|
A 64-year-old female patient was referred to our outpatient department for surgical evaluation due to paroxysmal epigastric abdominal pain, with mild deterioration after movement and exercise. The patient's medical history referred that she underwent total thyroidectomy, with central and left lateral compartment dissection due to thyroid papillary cancer with nodal metastasis (pT3b(m)N1Mx based on The American Joint Committee on Cancer staging) one year before her admission to our clinic. Moreover, she had already visited a Gastroenterologist, who suggested her undergoing endoscopy of the upper gastrointestinal (GI) system and a Computerized Tomography (CT) scan. The report of the upper GI endoscopy referred that mild esophagitis and gastritis were present while the CT scan revealed a 51 mm-diameter solid mass at the site of hepatogastric ligament applying pressure on the abdominal aorta. Our findings during the initial physical examination and laboratory test were normal ( Table 1 ). Next, to identify the nature of this mass, we suggested that she should undergo an endoscopic ultrasound during which biopsies from the bulging mass would be received and sent for pathology and immunohistochemical analysis. The differential diagnosis of pathology report suggested a ganglioneuroma or a neuroendocrine neoplasm and the further immunohistochemical analysis reported that the mass included neoplasmatic cells being positive to S100 protein and also cells with positive immunostaining for neurofibers (NF), two findings which both were indicative of ganglioneuroma. Under the probable diagnosis of a ganglioneuroma, we decided to evaluate its activity regarding the secretion of catecholamines or other neurotransmitters. As a result, an analysis for creatinine, total catecholamines, metanephrines, and vanillylmandelic acid of a 24-h urine collection was performed, without revealing any abnormality ( Table 1 ). In addition, the patient underwent screening for mutations in the ret proto-oncogene from the patient's genomic deoxyribonucleic acid (DNA) for any genetic disorders to be found, which did not detect any mutation in exons 5, 8, 10, 11, 13, 14, 15, and 16. Moreover, it was of great importance, a more comprehensive radiological assessment to be held, due to mass' special location. Thus, the patient underwent chest CT scan and abdominal CT Angiography scan with 3D reconstruction of the celiac trunk which reported again the known tumor of about 51 mm diameter, located between the aorta and the inferior vena cava in the hepatogastric space. Based on all the before mentioned data, we decided, after consensus, to suggest the patient undergoing surgical excision of the tumor due to its potential for malignancy. The patient's decision was congruent with our suggestion and she underwent a laparotomy and surgical excision of the mass. Intraoperatively, the tumor was found at the cephalad aspect of the common hepatic artery, over the portal vein, and the inferior vena cava. A negative-margin resection was achieved and the tumor was sent for pathology analysis. In addition, all the nodal tissue around the celiac trunk was excised after skeletonizing the vessels . The postoperative period was uncomplicated and the patient was discharged the 2nd postoperative day. The final pathology report revealed that the tumor included two masses, a sub round one enveloped by capsule and sized 6.0 × 4.2 × 3.7 cm, and a second smaller one attached to the first's outer surface. It was presented with neoplastic features and consisted of large, irregularly shaped cells. The number of nuclei was >5/10 per visual field, while in some areas they formed “zellballen balls,” and the cytoviscosity was considered as moderate to maximum. In addition, in some areas the ganglion cell population did not mix with the upper cellular findings, but appeared to be of neurogenic origin, as evidenced by immunohistochemical staining for protein S100 and CD56. Furthermore, in some areas a capsule was identified, and it was disrupted by the neoplastic cells. In these areas, neoplasmatic embolisms were identified inside the thin-walled vessels. However, the wall of the vessels was not found to be positive for immunohistochemical staining regarding CD34 and D2-40. Moreover, the neoplasmatic cells were positive for CD56, synaptophysin, and chromogranin and their nuclei presented also positive for ATRX staining, while p53 protein was identified only in <5% of them. However, the cells were negative for neurofibrins, inhibin, Melan A and HMB-45. In conclusion, the superior morphological and immunohistochemical findings were consistent with a composite paraganglioma and to a small limited extent, a ganglioneuroma. In addition, the particular histological features of the paraganglioma (diffuse growth, capsular and vascular infiltration, Ki67 cell proliferation index >2%, tumor size >5 cm) classify the neoplasm as a high metastatic potential one, according to the GAPP classification system. Two months after the procedure, the subsequent imaging evaluation of the patient, with chest and abdominal CT scan and ultrasound of the upper abdomen, did not reveal any pathological findings, except for a new-described small cyst at the head of the pancreas possibly due to chronic pancreatic inflammation. The laboratory tests were normal as well.
| 4.039063
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC8901723
|
https://doi.org/10.3389/fsurg.2022.824076
|
[
"cells",
"tumor",
"that",
"scan",
"immunohistochemical",
"abdominal",
"which",
"pathology",
"ganglioneuroma",
"addition"
] |
[
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
},
{
"code": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
}
] |
=== ICD-11 CODES FOUND ===
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
[2F9Z] Neoplasms of unknown behaviour of unspecified site
Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature
Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules
Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung
Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site
[2F92] Neoplasms of unknown behaviour of skin
Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Clinical findings on antenatal screening of mother
Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....
--- Walk 3 ---
[5C56.20] Mucolipidosis
--EXCLUDES--> [?] Sialidosis
--CHILD--> [?] Sialidosis type 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
--EXCLUDES--> [?] Sialidosis
--PARENT--> [?] Oligosaccharidosis
--- Walk 5 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--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--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....",
"[5C56.20] Mucolipidosis\n --EXCLUDES--> [?] Sialidosis\n --CHILD--> [?] Sialidosis type 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 --EXCLUDES--> [?] Sialidosis\n --PARENT--> [?] Oligosaccharidosis",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --RELATED_TO--> [?] Osteonecrosis due to haemoglobinopathy",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --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": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
}
] |
D571
|
Sickle-cell disease without crisis
|
A 17-month-old boy was hospitalized on April 27, 2021, due to swelling in the right scrotum for seven days. He was previously healthy and has a healthy, 11-year-old brother. There was no family history of immunodeficiency or recurrent infections. Routine immunization with Bacillus Calmette- Guerin(BCG) was administered without any untoward consequences. Physical examination showed painless bilateral cervical lymphadenopathy (about 1.0cm in diameter), a normal BCG scar, no cardiopulmonary abnormalities, a soft palpable abdomen without tenderness with a circumference of 54cm, no skin rash, and an enlarged right scrotum. Routine blood tests showed moderate anemia(hemoglobin 82g/L, MCV63.2fL, MCH 19.0pg, MCHC 301g/L), leukocytosis (23.56×10 9 /L), neutrophils 57%, lymphocytes 33%, monocytes 10%, and thrombocytosis (523×10 9 /L). Other tests showed increased erythrocyte sedimentation rate (ESR 53 mm/h, normal value<20 mm/h), C-reactive protein (CRP 16.36 mg/dL,normal value<0.8mg/dL), procalcitonin (PCT1.72ng/mL, normal value<0.05ng/mL), and D-Dimer . Albumin, ferritin, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides and fibrinogen were within the normal range, which did not meet HLH diagnostic criteria. Serum IgG and IgA levels were slightly increased to 1082 mg/dL (reference 453-916mg/dL) and 115 mg/dL (reference 21-100mg/dL) respectively,while IgM and IgE levels were normal. A flow cytometric analysis of lymphocyte subsets showed CD3 + cells of 45.55% (reference value 53.88-72.87%), CD3 + CD8 + cells of 14.91% (reference value 19-32.51%), CD3 + CD4 + cells of 26.01% (reference value 24.08-42.52%), CDl9 + cells of 44.77% (reference value 13.23-26.39%), CDl6 + CD56 + cells of 8.95% (reference value7.21-20.9%), and CD4/CD8 1.74 (reference value 0.90-2.13). Epstein-Barr virus and cytomegalovirus DNA detection and antibodies (IgG and IgM) in serum were negative. Further, tuberculin skin test and interferon-gamma release assay (IGRA) were negative. In addition, blood, urine, and stool culture were all negative. Abdomen ultrasound scan (US) and abdominal computerized tomography (CT) scan showed localized intestinal wall thickening in the right upper abdominal cavity (about 8mm), thickening of the right upper abdominal omentum, extensive lymphadenopathy, multiple abscesses of the liver and spleen, ascites, and right hydrocele. Chest CT showed bilateral upper lobe pneumonia and pleuritis. The patient presented with fever after hospitalization and was administered with intravenous Latamoxef Sodium (70mg/kg/day, every 12h) and subsequently cefoperazone-sulbactam sodium (240mg/kg/day, every 6h) plus linezolid (30mg/kg/day, every 8h) due to suspected bacterial infection. The patient was also treated with IVIG (2g/kg) but the symptoms did not improve. Abdominocentesis was performed which revealed unclear yellowish-green ascetic fluid containing 23453 cells/mm3 with neutrophilic predominance and protein and glucose concentrations of 46.5 and 58.1 mg/dl respectively. Gram-staining and acid-fast staining tests were all negative. The ascites culture identified B. Contaminans. Therefore, the treatments were switched to meropenem (60mg/kg/day, every 6h) plus linezolid. Following this treatment, he was afebrile and showed improvement in his ascites. Due to concerns of possible underlying primary immunodeficiency, NADPH activity was tested. DHR(dyhydrorhodamine)-1,2,3, can be oxidised to rhodamine-1,2,3, which emits a fluorescent signal detected by the enzyme labelling. The tests showed profound decrease in NADPH activity and relative activity (3%, reference value 31-216%). The patient subsequently developed progressive bilateral cervical lymphadenopathy with low-grade fever. Empirical anti-tuberculosis therapy with rifampicin (10mg/kg/day, in a single dose) was administered which effectively improved the symptoms. Prednisone (1 mg/kg/day, in 2 doses) was administered orally due to persistent intestinal wall thickening, elevated CRP (29-41mg/L), and platelet count (maximum 615×10 9 /L), which decreased the intestinal wall thickening and the platelet count to 368×10 9 /L, while the CRP level to 8mg/L. After 40 days of hospitalization, the patient was discharged on cefdinir (15mg/kg/day, in 3 doses), and was subsequently started on trimethoprim-sulfamethoxazole (sulfamethoxazole 20mg/kg/day in a single dose) and voriconazole (5mg/kg/day in a single dose) prophylaxis along with continuation of linezolid and rifampicin. After discharge, targeted next-generation sequencing analysis identified a nonsense variant in CYBB gene . At a follow-up visit performed after 1 month, prednisone was stopped but the anti-infection therapies were continued. Up to now, his clinical presentation is normal and there is no signs of the disease. Hematopoietic stem cell transplantation (HSCT) was recommended. Fig. 1 Abdominal CT scan showed localized intestinal wall thickening in the right upper abdominal cavity, thickening of the right upper abdominal omentum, extensive lymphadenopathy and ascites Fig. 2 Electropherogram showing the position of the variant in CYBB gene in the patient in a healthy control and the family members Fig. 3 Electropherogram of the patient’s mother showing normal Fig. 4 Electropherogram of the patient’s father showing normal
| 4.214844
| 0.934082
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC8974071
|
https://doi.org/10.1186/s13052-022-01246-1
|
[
"reference",
"cells",
"abdominal",
"thickening",
"which",
"lymphadenopathy",
"intestinal",
"wall",
"ascites",
"every"
] |
[
{
"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": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
=== GRAPH WALKS ===
--- Walk 1 ---
[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 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.Z] Olfactory reference disorder, unspecified
--- 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...
--PARENT--> [MB26] Symptoms or signs involving content of thought
Def: Symptoms and signs involving content of thought include delusions, experiences of influence, passivity, and control, grandiosity, homicidal ideation, identity disturbance, obsessions, overvalued ideas...
--- Walk 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--> [MB26.02] Delusion of guilt
Def: A delusion involving exaggerated or inappropriate responsibility, need for punishment or retribution, or disproportionate consequences of one’s actions, such as that a minor error in the past will lea...
--- 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--> [6B22.0] Olfactory reference disorder with fair to good insight
Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...
--- Walk 6 ---
[6B22.1] Olfactory reference disorder with poor to absent insight
Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.Z] Olfactory reference disorder, unspecified
|
[
"[6B22.Z] Olfactory reference disorder, unspecified\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.1] 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.Z] Olfactory reference disorder, unspecified\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.Z] Olfactory reference disorder, unspecified",
"[MB26.03] Delusion of reference\n Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....\n --PARENT--> [MB26.0] Delusion\n Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...\n --PARENT--> [MB26] Symptoms or signs involving content of thought\n Def: Symptoms and signs involving content of thought include delusions, experiences of influence, passivity, and control, grandiosity, homicidal ideation, identity disturbance, obsessions, overvalued ideas...",
"[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--> [MB26.02] Delusion of guilt\n Def: A delusion involving exaggerated or inappropriate responsibility, need for punishment or retribution, or disproportionate consequences of one’s actions, such as that a minor error in the past will lea...",
"[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--> [6B22.0] Olfactory reference disorder with fair to good insight\n Def: All definitional requirements of olfactory reference disorder are met. Much of the time, the individual is able to entertain the possibility that his or her disorder-specific beliefs may not be true a...",
"[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": "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]"
}
] |
F428
|
Other obsessive-compulsive disorder
|
A 48-year-old male patient came to our hospital and sought diagnosis and treatment on September 7, 2023, mainly due to “headache, bilateral blurry vision and narrowed visual field for more than 6 months”. The patient began to have headaches and blurry vision in both eyes in March 2023 without obvious cause, and his situation did not improve after treatment in the ophthalmology department of other hospitals. Later on, the patient manifested a gradual aggravation of bilateral blurry vision and began to have narrowed visual field little by little, and his condition did not improve after searching for a cure in the ophthalmology departments of other hospitals many times. Then, the patient received a head MRI examination at another hospital on September 1, 2023; an occupying lesion was found in the sellar area and suprasellar cisterna, and the diagnosis was considered to be a pituitary tumor, craniopharyngioma, epidermoid cyst, or other neoplastic lesions. In order to seek further diagnosis and treatment, the patient came to our hospital and was admitted to our neurosurgery department on September 7, 2023. The patient was in good health previously and had no family history of tumors or other hereditary diseases. Physical examination revealed that the patient had binocular vision and temporal hemianopsia. The MRI examination of the head on September 8, 2023, indicated there was an occupying lesion in the sellar area and suprasellar cisterna, the size was 4.4 × 3.9 × 2.6 cm, and the diagnosis was considered to be a pituitary tumor, craniopharyngioma, epidermoid cyst, or other neoplastic lesions . As the lesion invaded bilateral cavernous sinuses and crossed the internal carotid artery, the grade of this PA was Knosp3. Laboratory test results showed that the serum levels of prolactin (PRL), adrenocorticotropic hormone (ACTH), growth hormone (GH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), IGF-1, and thyroid-stimulating hormone (TSH) were all normal. Considering the medical history, clinical symptoms, physical signs, and examination results of the patient, we made a possible diagnosis of a pituitary tumor, craniopharyngioma, or other tumor lesions. After communicating with the patient and his family members about the condition and treatment plan, they asked for a “craniotomy to remove intracranial tumor” and signed the informed consent. Then, a craniotomy sellar tumor resection was successfully performed on September 12. 2023. The postoperative pathological diagnosis was a non-functional PA; the immune markers were as follows: ACTH(−), CD56(+), CK(+), CK20(−), CK8/18(+), CgA(−), FSH(−), glial fibrillary acidic protein (GFAP) (−), GH(−), Ki-67(+,3-5%), LH(−), neuron specific endase (NSE) (+), P53(+), P63(−), PIT-1(−), progesterone receptor (PR) (−), PRL(−), S-100(+), SF-1(−), Syn(−), TSH(−), TTF-1(−), Tg(−), Villin(−), Vim(+), and WT-1(+) . The patient’s headache symptoms were relieved, bilateral vision and visual field improved gradually after the operation, and he was discharged on September 23, 2023. On November 18, 2023, the patient was readmitted to our hospital due to “headache combined with blurred vision and vomiting for 2 weeks”. Physical examination revealed that the patient had blurred vision. A head MRI examination on November 21, 2023, indicated there was no tumor recurrence in the sellar area, but the third ventricle and bilateral lateral ventricles were dilated . Cerebrospinal fluid examination showed that the pressure was 350 mmH 2 O, and the biochemical/routine index was normal. The diagnosis was considered to be hydrocephalus, and a ventriculoperitoneal shunt surgery was performed on December 7, 2023. The patient’s headache symptoms were relieved, and bilateral vision improved gradually after the operation. A head MRI examination on December 9, 2023, indicated that the volume of the third ventricle and bilateral lateral ventricles was smaller than before . On December 12, 2023, the patient began to manifest severe pain in the left hip and left lower limb. An MRI examination of the lumbar spine on December 15, 2023, indicated that there was an occupying lesion in the L4–S1 intraspinal area, the size was 1.5 × 1.4 × 9.2 cm, and the diagnosis was considered to be a metastatic tumor . Considering the medical history, clinical symptoms, physical signs, and examination results of the patient, we made a diagnosis of PC with spinal cord metastasis. After communicating with the patient and his family members about the therapeutic strategy for PC with spinal cord metastasis, they refused to accept further treatments including surgery, radiotherapy, and chemotherapy, and he was discharged on January 11, 2024. In the follow-up survey, we learned that the patient underwent intraspinal metastatic resection at another hospital on January 29, 2024, and the postoperative pathological diagnosis was considered to be a tumor metastasized from the PA; his immune markers were as follows: GFAP(partial+), Oligo-(2−), EMA(dot +), P53(in +), Syn(+), CgA(−), SOX-2(+) and SOX-2(−), ATRX IDH-1(+), H3 K27M(−), INI1 (without missing), and Ki-67 (MIB) (+5% to 10%). Then, the patient received temozolomide (TMZ) therapy for 3 months, but his result was not satisfactory; his eyesight was becoming worse, and the muscle strength of both lower limbs gradually decreased.
| 3.859375
| 0.983887
|
sec[2]/p[0]
|
en
| 0.999996
|
39544231
|
https://doi.org/10.3389/fendo.2024.1440247
|
[
"tumor",
"vision",
"that",
"september",
"considered",
"hormone",
"headache",
"head",
"lesion",
"sellar"
] |
[
{
"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": "9E1Z",
"title": "Diseases of the visual system, unspecified"
},
{
"code": "MC1Y",
"title": "Other specified symptoms or signs involving the visual system"
},
{
"code": "9D9Z",
"title": "Vision impairment, unspecified"
},
{
"code": "9D90.2",
"title": "Moderate vision impairment"
},
{
"code": "QA00.6Z",
"title": "Examination of eyes or vision, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[9E1Z] Diseases of the visual system, unspecified
Also known as: Diseases of the visual system, unspecified | eye diseases NOS | disorder of vision | visual disorder
[MC1Y] Other specified symptoms or signs involving the visual system
Also known as: Other specified symptoms or signs involving the visual system | Erythema of eyelid | Visual disturbances | disturbances of vision | difficulty seeing
[9D9Z] Vision impairment, unspecified
Also known as: Vision impairment, unspecified | sight impaired | blindness and low vision | impaired vision
[9D90.2] Moderate vision impairment
Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision]
Includes: visual impairment category 2, in both eyes
[QA00.6Z] Examination of eyes or vision, unspecified
Also known as: Examination of eyes or vision, unspecified | Examination of eyes or vision | general eye examination | routine eye examination | vision examination
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F92] Neoplasms of unknown behaviour of skin
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] 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--> [2E62] Carcinoma in situ of middle ear or respiratory system
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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--> [2E62] Carcinoma in situ of middle ear or respiratory system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach"
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
An 86-year-old Japanese male patient diagnosed with a submucosal tumor, approximately 15 mm in diameter, located in the lower esophagus 5 years ago, but had not received any treatment because of the small size of the tumor and his age of 81 years. In addition, he has a medical history of chronic obstructive pulmonary disease and was on regular health check-ups with his family doctor. The patient was referred to our hospital with dysphagia for 3 months. Physical examination and laboratory findings were normal for his age. Chest X-ray revealed a suspected mediastinal tumor. Contrast-enhanced computed tomography (CT) scan of the chest revealed a huge solid tumor, 95 × 90 × 65 mm in diameter, protruding into the left thoracic cavity . Esophagogastroduodenoscopy revealed a submucosal tumor with a narrowed lumen and dell in the lower esophagus , and upper gastrointestinal series revealed a smooth and round defect in the left wall of the lower-third of the esophagus . Endoscopic ultrasound showed a well-defined hypoechoic lesion on the left side of the esophagus. After a fine-needle aspiration biopsy under endoscopic ultrasonography, the tumor was diagnosed as GIST with positive immunostaining for CD34 and c-kit and negative for alpha-SMA and S100. We assessed the tumor as resectable based on these image findings, but there was a risk of tumor rupture during the surgical procedure due to the size and location of the lesion. Therefore, the patient received neoadjuvant imatinib (400 mg/day) treatment to reduce the tumor size. After 28 days of oral administration of imatinib, the size of the tumor decreased (80 × 65 × 60 mm) on chest CT scan, but a pleural effusion on the left lung field was observed . 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) CT scan revealed increased accumulation in the tumor with a maximum standardized uptake value (SUV max) of 2.6 . There were no apparent distant metastases. The patient refused to continue the imatinib treatment because of side effects such as loss of appetite and dysphagia. Therefore, mediastino-laparoscopic transhiatal esophagectomy was performed under general anesthesia with endotracheal intubation by two-lung ventilation. An EZ access with three 5-mm ports was placed in the left cervical incision to start the pneumo-mediastinum (CO 2 insufflation, 8 mmHg). In brief, the tissue surrounding the cervical and middle esophagus was dissected under the mediastinoscopy . Laparoscopically, traction was applied to the abdominal esophagus with cotton tape to dissect the tissue surrounding the tumor . After left thoracotomy under laparoscopy, the tumor was completely resected along with part of the lower lobe of the left lung using linear stapler . The left gastric artery, left gastroepiploic artery, and short gastric artery were ligated and dissected under laparoscopy, and a gastric tube was created. Esophageal reconstruction was performed using a gastric tube in the posterior sternal route. The surgical time was 415 min and the amount of blood loss was minimal. The resected tumor measured 75 × 70 × 55 mm in diameter and contained necrosis and mucosal ulceration . The microscopic findings of hematoxylin–eosin staining showed that monotonous spindle cells were densely proliferate continuing in muscularis propria of esophagus . Immunohistochemical analysis revealed that CD34, c-kit and discovered on GIST (DOG)-1 were diffusely positive in tumor cells and alfa-SMA, desmin and S-100 were negative . According to these results, the diagnosis of GIST was made. In addition, the tumor cells were showed as low mitotic activity (2/50 high power fields) and classified as high-risk group according to modified Fletcher classification. The postoperative course was uneventful, and the patient was discharged in good condition on postoperative day 14. The patient refused the treatment due to the side-effect of neoadjuvant imatinib despite the high risk of recurrence. There was no recurrence in the 8 months after the surgery without adjuvant imatinib administration. Fig. 1 CT imaging before neoadjuvant therapy with imatinib shows that the tumor size is about 100 mm in diameter ( a , b ). Esophagogastroduodenoscopy reveals a submucosal tumor with a narrowed lumen and ulceration in the lower esophagus ( c ). Upper gastrointestinal series reveals compression towards the left side of the esophagus without mucosal changes ( d ) Fig. 2 CT after neoadjuvant therapy with imatinib shows that the tumor is approximately 70 mm in diameter with pleural effusion ( a ) and PET–CT shows that SUV max was 2.6 with no apparant distant metastasis ( b ) Fig. 3 Using a mediastinoscope, the upper and middle thoracic esophagus is dissected from the surrounding tissue without lymph node dissection ( a ). A laparoscopic incision of the left diaphragm provides a clear image of the left thoracic cavity ( b , c ). The tumor is completely resected along with part of the lower lobe of the left lung using linear stapler ( d ) Fig. 4 Macroscopic observation of the resected specimen shows the tumor size to be 75 × 70 × 55 mm in diameter ( a ). Histopathological findings of the tumor cells show that spindle cells densely proliferate ( b ). Immunostaining of c-kit ( c ) and DOG-1 ( d ) shows diffuse dark-brownish deposition at the cytoplasm of the spindle tumor cells
| 4.015625
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999998
|
35666331
|
https://doi.org/10.1186/s40792-022-01464-z
|
[
"tumor",
"esophagus",
"imatinib",
"diameter",
"that",
"cells",
"side",
"neoadjuvant",
"lung",
"resected"
] |
[
{
"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": "DA2Z",
"title": "Diseases of oesophagus, unspecified"
},
{
"code": "DA24.Z",
"title": "Oesophagitis, unspecified"
},
{
"code": "DA20.0",
"title": "Oesophageal obstruction"
},
{
"code": "DA25.Z",
"title": "Oesophageal ulcer, unspecified"
},
{
"code": "LB12.Y",
"title": "Other specified structural developmental anomalies of oesophagus"
}
] |
=== 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
[DA2Z] Diseases of oesophagus, unspecified
Also known as: Diseases of oesophagus, unspecified | disease of oesophagus | disorder of oesophagus | oesophageal disease | oesophageal disorder
[DA24.Z] Oesophagitis, unspecified
Also known as: Oesophagitis, unspecified | Oesophagitis | inflammation of oesophagus | oesophagitis NOS | oesophageal inflammation
[DA20.0] Oesophageal obstruction
Definition: Hindrance of the passage of luminal contents in the oesophagus. Obstruction of oesophagus can be partial or complete, and caused by intrinsic or extrinsic factors.
Also known as: Oesophageal obstruction | obstruction of oesophagus | oesophageal narrowing | obstructed oesophagus | Stricture of oesophagus
Excludes: Congenital stenosis or stricture of oesophagus | Anatomical alteration due to gastro-oesophageal reflux disease | Neoplasms of the oesophagus
[DA25.Z] Oesophageal ulcer, unspecified
Also known as: Oesophageal ulcer, unspecified | Oesophageal ulcer | Ulcer of oesophagus | ulcer of oesophagus NOS | OU - [oesophageal ulcer]
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature
Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature....
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Localised adiposity
Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....
--PARENT--> [?] Overweight or localised adiposity
Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME62] Acute skin eruption of uncertain or unspecified nature\n Def: A provisional diagnosis for an acute skin eruption of less than six weeks' duration of unknown, uncertain or unspecified nature....",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --PARENT--> [?] Overweight or localised adiposity\n Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...."
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
Pregnancy-related heart disease can be caused by a preexisting maternal condition that is either first diagnosed or has worsened during pregnancy or by a condition newly acquired during pregnancy such as PPCM (Case 5 ) or peripartum SCAD (Case 6 ). Case 5 Non-sustained ventricular tachyarrhythmia and dyspnea in a 31-year-old woman. A 31-year-old primiparous woman with a history of polycystic ovary syndrome and obesity (body mass index 33 kg/m 2 ) and no family history of CVD was referred to hospital for a planned caesarian section. Her pregnancy has been complicated by hypertension and gestational diabetes. The aftermath of delivery was marked by episodes of non-sustained ventricular tachyarrhythmia and dyspnea. Troponin and NT-proBNP were within normal range. An echocardiography revealed a mildly reduced LVEF (40%) without regional wall motion abnormalities and relevant valvular abnormality, as well as normal right-sided cardiac cavities. CMR was performed confirming a mildly reduced LVEF of 42% (panels A and B ) with no regional component, particularly no pattern suggestive of TTC. LV and RV were non-dilated (respectively, LV end-diastolic volume 85 mL/m 2 , N: 66–101 mL/m 2 ; and RV-end-diastolic volume 80 mL/m 2 , N: 65–111 mL/m 2 ), hence excluding preexisting cardiomyopathies and DCM. No myocardial LGE was detected ( C ), excluding necrosis, and pharmacological stress revealed no ischemia ( D ). T1 ( E ) and T2 ( F ) mapping of the LV myocardium were normal, 1247 ms and 39 ms (N: 38 ± 2.3 ms), respectively, thus excluding scar and edema/myocarditis. Based on the timing of the disease (early postpartum) and other cardiomyopathies being excluded, the diagnosis of PPCM was made. Dyspnea during or in the direct aftermath of pregnancy is a common situation, which can result either from hemodynamic adaptations to pregnancy or from complications. The differential diagnosis in this setting includes pulmonary embolism and PPCM. Key to the diagnosis of PPCM is the timing of the disease and the absence of previous cardiomyopathies. Advanced noninvasive imaging is helpful in this setting, to establish LV systolic dysfunction and to rule out concurrent cardiomyopathies. Abbreviations : CVD : cardiovascular disease; CMR : cardiac magnetic resonance; DCM : dilated cardiomyopathy; LGE : late gadolinium enhancement; LV : left ventricle; LVEF : left ventricular ejection fraction; N : normal; NT-proBNP : N-terminal brain natriuretic peptide; PPCM : peripartum cardiomyopathy; RV : right ventricle; TTC : Takotsubo cardiomyopathy Case 6 Intermittent retrosternal pain in a 30-year-old woman, 6 weeks postpartum. A 30-year-old female patient, 6 weeks postpartum after an uncomplicated pregnancy with no prior medical history or CVRFs, presented to the emergency department for intermittent retrosternal pain which had evolved over 2 weeks. Admission workup revealed a mildly elevated troponin (0.64 µg/L, N < 0.10 µg/L) while the ECG showed no abnormality suggestive of myocardial ischemia. The patient, being at low clinical likelihood of CAD, was referred for CCTA using a triple rule-out setting. The diagnoses of pulmonary embolism and aortic dissection were excluded. Coronary analysis showed no evidence of calcification or stenosis but revealed a complete occlusion of the distal segment of the left anterior descending artery ( A , yellow arrowhead, volume rendering reconstruction of the heart and the coronary tree), compatible with either a SCAD or a thrombotic occlusion. The patient was referred for urgent ICA which confirmed the diagnosis of SCAD ( B - D , red arrowheads), without signs of regional or diffuse hypokinesia in the ventriculography. A conservative strategy was initiated, combining anticoagulation with dual antiplatelet therapy. After the acute episode, a whole-body angio-magnetic resonance imaging was performed that found no evidence of fibromuscular dysplasia. Genetic analysis ruled out genetic disorders. ICA was repeated after 6 weeks, confirming spontaneous partial revascularization of the dissected artery with persistence of a 50% residual stenosis with TIMI III post-stenotic flow ( E , blue arrowhead), treated conservatively by continuation of dual antiplatelet therapy. 13 N-NH 3 -PET-MPI was also realized, showing no signs of scar or ischemia ( F , horizontal and vertical long axes, at rest and stress). Although rare, SCAD is a classical cause of ACS in the late stages of pregnancy and in the early postpartum period. Therefore, SCAD should be suspected in young women without cardiovascular risk factors presenting with ACS or cardiac arrest. While CCTA is preferred in hemodynamically stable patients, ICA is often required to establish the diagnosis. Noninvasive imaging can also be useful to screen for predisposing vascular diseases and to exclude differential diagnosis of chest pain in young women, such as pulmonary embolism. Abbreviations : 13 N-NH 3 : asnitrogen-13-radiolabeled ammonia; ACS : acute coronary syndrome; CAD : coronary artery disease; CCTA : coronary computed tomography angiography; CVRF : cardiovascular risk factor; ECG : electrocardiogram; ICA : invasive coronary angiography; MPI : myocardial perfusion imaging; PET; positron emission tomography; SCAD : spontaneous coronary artery dissection; TIMI : thrombolysis in myocardial infarction score
| 4.246094
| 0.851563
|
sec[2]/sec[5]/p[1]
|
en
| 0.999995
|
35974185
|
https://doi.org/10.1007/s00259-022-05914-6
|
[
"pregnancy",
"coronary",
"scad",
"ppcm",
"cardiomyopathies",
"myocardial",
"postpartum",
"imaging",
"artery",
"either"
] |
[
{
"code": "JA80.Z",
"title": "Maternal care related to unspecified multiple gestation"
},
{
"code": "JA01.1",
"title": "Tubal pregnancy"
},
{
"code": "QA40",
"title": "Pregnancy examination or test"
},
{
"code": "JA61.Y",
"title": "Other specified venous complications in pregnancy"
},
{
"code": "JA01.Y",
"title": "Other specified ectopic pregnancy"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[JA80.Z] Maternal care related to unspecified multiple gestation
Also known as: Maternal care related to unspecified multiple gestation | Maternal care related to multiple gestation | multiple gestation, unspecified, unspecified trimester | multiple pregnancy | Multiple pregnancy NOS
[JA01.1] Tubal pregnancy
Definition: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy.
Also known as: Tubal pregnancy | Fallopian pregnancy | fallopian tube pregnancy | Tubal abortion | Rupture of fallopian tube due to pregnancy
Includes: Fallopian pregnancy | Tubal abortion
[QA40] Pregnancy examination or test
Also known as: Pregnancy examination or test | pregnancy examination | pregnancy test | Pregnancy examination or test, pregnancy not confirmed | pregnancy not yet confirmed
[JA61.Y] Other specified venous complications in pregnancy
Also known as: Other specified venous complications in pregnancy | Venous thrombosis in pregnancy | antepartum thrombosis NOS | Gestational thrombosis NOS | thrombosis in pregnancy NOS
[JA01.Y] Other specified ectopic pregnancy
Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[JA80.Z] Maternal care related to unspecified multiple gestation
--PARENT--> [JA80] Maternal care related to multiple gestation
--PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems
Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...
--- Walk 2 ---
[JA80.Z] Maternal care related to unspecified multiple gestation
--PARENT--> [JA80] Maternal care related to multiple gestation
--CHILD--> [JA80.0] Twin pregnancy
--- Walk 3 ---
[JA01.1] Tubal pregnancy
Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....
--PARENT--> [JA01] Ectopic pregnancy
Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....
--PARENT--> [?] Abortive outcome of pregnancy
Def: A group of conditions characterised by pregnancy which does not result in live offspring. These conditions include e.g. abortion, ectopic pregnancy or molar pregnancy....
--- Walk 4 ---
[JA01.1] Tubal pregnancy
Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....
--PARENT--> [JA01] Ectopic pregnancy
Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....
--CHILD--> [JA01.1] Tubal pregnancy
Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....
--- Walk 5 ---
[QA40] Pregnancy examination or test
--PARENT--> [?] Contact with health services for reasons associated with reproduction
--CHILD--> [?] Contact with health services for procreative management
--- Walk 6 ---
[QA40] Pregnancy examination or test
--PARENT--> [?] Contact with health services for reasons associated with reproduction
--RELATED_TO--> [?] Contact with health services for preimplantation genetic diagnosis
Def: A reason for encounter to genetically profile oocytes, zygotes, or embryos through in vitro fertilization prior to implantation for diagnosis of genetic, structural, or chromosomal alterations....
|
[
"[JA80.Z] Maternal care related to unspecified multiple gestation\n --PARENT--> [JA80] Maternal care related to multiple gestation\n --PARENT--> [?] Maternal care related to the fetus, amniotic cavity or possible delivery problems\n Def: A group of conditions characterised by the provision of health interventions to the mother due to conditions associated with the fetus, the amniotic cavity, or to issues associated with labour and del...",
"[JA80.Z] Maternal care related to unspecified multiple gestation\n --PARENT--> [JA80] Maternal care related to multiple gestation\n --CHILD--> [JA80.0] Twin pregnancy",
"[JA01.1] Tubal pregnancy\n Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --PARENT--> [?] Abortive outcome of pregnancy\n Def: A group of conditions characterised by pregnancy which does not result in live offspring. These conditions include e.g. abortion, ectopic pregnancy or molar pregnancy....",
"[JA01.1] Tubal pregnancy\n Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....\n --PARENT--> [JA01] Ectopic pregnancy\n Def: Any condition characterised by implantation of the embryo outside the endometrium and endometrial cavity during pregnancy....\n --CHILD--> [JA01.1] Tubal pregnancy\n Def: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy....",
"[QA40] Pregnancy examination or test\n --PARENT--> [?] Contact with health services for reasons associated with reproduction\n --CHILD--> [?] Contact with health services for procreative management",
"[QA40] Pregnancy examination or test\n --PARENT--> [?] Contact with health services for reasons associated with reproduction\n --RELATED_TO--> [?] Contact with health services for preimplantation genetic diagnosis\n Def: A reason for encounter to genetically profile oocytes, zygotes, or embryos through in vitro fertilization prior to implantation for diagnosis of genetic, structural, or chromosomal alterations...."
] |
JA80.Z
|
Maternal care related to unspecified multiple gestation
|
[
{
"from_icd11": "JA80.Z",
"icd10_code": "O30",
"icd10_title": "Multiple gestation"
},
{
"from_icd11": "JA80.Z",
"icd10_code": "O308",
"icd10_title": "Other specified multiple gestation"
},
{
"from_icd11": "JA80.Z",
"icd10_code": "O309",
"icd10_title": "Multiple gestation, unspecified"
},
{
"from_icd11": "JA01.1",
"icd10_code": "O00102",
"icd10_title": "Left tubal pregnancy without intrauterine pregnancy"
},
{
"from_icd11": "JA01.1",
"icd10_code": "O0010",
"icd10_title": "Tubal pregnancy without intrauterine pregnancy"
},
{
"from_icd11": "JA01.1",
"icd10_code": "O00101",
"icd10_title": "Right tubal pregnancy without intrauterine pregnancy"
},
{
"from_icd11": "JA01.1",
"icd10_code": "O00111",
"icd10_title": "Right tubal pregnancy with intrauterine pregnancy"
},
{
"from_icd11": "JA01.1",
"icd10_code": "O001",
"icd10_title": "Tubal pregnancy"
},
{
"from_icd11": "QA40",
"icd10_code": "Z3201",
"icd10_title": "Encounter for pregnancy test, result positive"
},
{
"from_icd11": "QA40",
"icd10_code": "Z3200",
"icd10_title": "Encounter for pregnancy test, result unknown"
},
{
"from_icd11": "QA40",
"icd10_code": "Z3202",
"icd10_title": "Encounter for pregnancy test, result negative"
},
{
"from_icd11": "QA40",
"icd10_code": "Z32",
"icd10_title": "Encounter for pregnancy test and childbirth and childcare instruction"
},
{
"from_icd11": "QA40",
"icd10_code": "Z320",
"icd10_title": "Encounter for pregnancy test"
},
{
"from_icd11": "QA40",
"icd10_code": "Z321",
"icd10_title": ""
},
{
"from_icd11": "BA4Z",
"icd10_code": "I248",
"icd10_title": "Other forms of acute ischemic heart disease"
}
] |
O30
|
Multiple gestation
|
A 23-year-old female with a history of AML who was diagnosed at age 12 with high-risk group (HRG) FLT3 ITD positive AML-M4. The presence of a central nervous system (CNS) disease/leukemia was not observed. The patient has been in remission after allogeneic stem cell transplantation from an unrelated donor since 2013. Patient with chronic renal failure, probably due to the toxic effects of CSA or cidofovir, after radical treatment for bladder cancer. She was under the constant care of the Department of Nephrology due to dialysis. In 2022, she was admitted to the hematology department because of an elevated platelet count. To assess posttransplant chimerism, karyotype analysis and fluorescence in situ hybridyzation (FISH) were performed. Karyotype analysis was performed on a bone marrow (BM) sample and revealed 46, XY (20). FISH of the sex chromosomes was carried out with probe sets for the X centromere (CEPX) and Y centromere (CEPY), which also showed 100% donor cells . Chimerism test was also performed by QF STR-PCR method using the NGM SElect Human Identification Kit (ThermoFisher Scientific, MA, USA). The study confirmed 100% donor identity. However, to additionally confirm that it was not a relapse of the disease, a PCR fragment analysis test was performed to exclude whether the patient had the FLT3 variant, as in the original diagnosis. No mutation was detected in the FLT3 gene. BM examination revealed follicular marrow of medium density with the presence of cellular shadows. The red blood cell system was normal. The granulocytic system was in the upper reference range with a whole series of maturations, and the presence of morphological disorders was mainly in the cytoplasm. The platelet-forming system was characterized by an increased number of megakaryocytes at various stages of development, some with an abnormal nuclear shape. Platelets presented features of anisocytosis and granulation abnormalities. The lymphatic system and the monocyte-macrophage system did not significantly change. Notably, there was an increased percentage of blasts (5.2%) and basophils (3.3%). Additionally, flow cytometric analysis was performed on the diagnostic bone marrow aspirate and showed 5% myeloid blasts. Also, the Ogata score was calculated via four parameters: the granulocyte:lymphocyte SSC ratio, the lymphocyte:myeloblast CD45 mean fluorescence intensity ratio, the percentage of CD34+ B-cell progenitors among the total CD34+ cells and the percentage of CD34-positive myeloblasts among the total nucleated cells. The Ogata score was 4, which indicated dysplasia. Due to the increasing platelet count, molecular tests were performed for suspected myeloproliferative neoplasms. Molecular tests did not detect the presence of mutations in the genes characteristic of myeloproliferative neoplasms such as JAK2V617F, CALR and MPL . Due to the diagnosis of triple-negative essential thrombocythemia, molecular diagnostics was expanded to include next-generation sequencing to search for a clonal marker of the disease. An AmpliSeq Myeloid Panel was used (MiniSeq, Illumina). The panel detects mutations in 40 genes (23 full genes and 17 hotspot genes), among which mutations occur most often in hematological cancers. Variants were detected via bioinformatic analysis using the BaseSpace Illumina and Variant Interpreter applications in relation to the human hg19 genome. Data analysis identified pathogenic variants in the ASXL1 and SETBP1 genes and one pathogenic variant in the EZH2 gene in the splicing region ( Table 1 ). “Clonal drivers” genes such as ASXL1 or EZH2 are one of the most frequently mutated genes in MPNs. These gene mutations occur in all myeloid malignancies and are not specific to MPN. Mutations in the ASXL1 gene, whose protein product is involved in the regulation of gene expression, have negative prognostic and predictive significance . Missense mutation was identified in the SETBP1 gene. Mutations in the SETBP1 gene are associated with an unfavorable prognosis in patients with hematologic malignancies . To exclude an NGS method error caused by technical limitations, the internal tandem duplication mutation in the FLT3 gene was additionally determined by fragment analysis. The result was negative, which confirmed that it was new leukemia clone. The patient was in good condition and was treated with interferon. She was referred to the hematology clinic, where she was monitored. After less than 2 years, she was readmitted to the hematology department with suspicion of disease progression. A bone marrow biopsy revealed 14% blasts. Molecular tests were performed for the presence of mutations in the FLT3 ITD, FLT3 TKD and NPM1 genes and the presence of the following fusion genes: BCR::ABL1, CBFB::MYH11, RUNX1::RUNX1T1 and PML::RARA . The tests performed did not confirm any of the above mentioned genetic changes. The patient was classified as MDS/AML and was treated with venetoclax and azacitidine (VenAZA) at reduced doses due to neutropenia. The patient could not be qualified for a second bone marrow transplant because of kidney failure. Unfortunately, the patient’s condition deteriorated. She required more and more frequent dialysis. Additionally, shortness of breath and oedema occurred. Infections and persistent inflammation (C-reactive protein >300) led to patient death.
| 4.28125
| 0.861816
|
sec[1]/p[0]
|
en
| 0.999997
|
39907609
|
https://doi.org/10.18632/oncotarget.28686
|
[
"genes",
"gene",
"mutations",
"presence",
"system",
"marrow",
"bone",
"which",
"additionally",
"molecular"
] |
[
{
"code": "9A70.Y",
"title": "Other specified hereditary corneal dystrophies"
},
{
"code": "GB81",
"title": "Autosomal dominant polycystic kidney disease"
},
{
"code": "8A02.12",
"title": "Dystonia associated with heredodegenerative disorders"
},
{
"code": "5C50.E0",
"title": "Classical organic aciduria"
},
{
"code": "8E02.0",
"title": "Genetic Creutzfeldt-Jakob disease"
},
{
"code": "GB90.4A",
"title": "Nephrogenic diabetes insipidus"
},
{
"code": "4A01.21",
"title": "Immune dysregulation syndromes presenting primarily with autoimmunity"
},
{
"code": "8C73.Z",
"title": "Mitochondrial myopathies, unspecified"
},
{
"code": "QB61.4",
"title": "Presence of colostomy"
},
{
"code": "QB61.0",
"title": "Presence of tracheostomy"
}
] |
=== ICD-11 CODES FOUND ===
[9A70.Y] Other specified hereditary corneal dystrophies
Also known as: Other specified hereditary corneal dystrophies | Epithelial juvenile corneal dystrophy | TGFBI - [transforming growth factor beta-induced] gene | Granular corneal dystrophy | granular-lattice corneal dystrophy
Includes: Granular corneal dystrophy
[GB81] Autosomal dominant polycystic kidney disease
Definition: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and due to mutations on chromosomes 16 and 4. Non-renal manifestations can include cysts in the liver and less commonly pancreas. Cerebral arterial aneurysms with subarachnoid haemorrhage, and other non-renal vascular abnormalities can also occur.
Also known as: Autosomal dominant polycystic kidney disease | adult polycystic kidney disease | Polycystic kidney, adult type | APCKD - [autosomal polycystic kidney disease] | Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis
[8A02.12] Dystonia associated with heredodegenerative disorders
Definition: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen.
Also known as: Dystonia associated with heredodegenerative disorders | Dystonia due to autosomal dominant disorders | Rapid-onset dystonia-parkinsonism | Dystonia due to dentatorubropallidoluysian atrophy | Dystonia due to Huntington disease
[5C50.E0] Classical organic aciduria
Definition: This a term used to classify a group of metabolic disorders which disrupt normal amino acid metabolism, particularly branched-chain amino acids, causing a buildup of acids which are usually not present.
Also known as: Classical organic aciduria | Methylmalonic aciduria - homocystinuria | Methylmalonic acidaemia - homocystinuria | Methylmalonic aciduria - homocystinuria type cbl C | Methylmalonic acidaemia - homocystinuria type cbl C
[8E02.0] Genetic Creutzfeldt-Jakob disease
Definition: A disease of the brain, that is associated with a prion. This disease is characterised by neurological deficits, and is fatal. Confirmation is by pathological examination of the brain.
Also known as: Genetic Creutzfeldt-Jakob disease | CJD - [Creutzfeldt-Jakob disease] | Creutzfeldt-Jakob | Creutzfeldt-Jakob disease | JCD - [Jakob-Creutzfeldt disease]
[GB90.4A] Nephrogenic diabetes insipidus
Definition: Nephrogenic diabetes insipidus is a condition in which the kidney tubules respond poorly to pituitary secreted anti-diuretic hormone, resulting in a failure to concentrate the urine, and water loss. Polyuria with dilute urine and polydypsia (excessive thirst) are present. It can be congenital or acquired with many causes. The congenital forms may be attributed to vasopressin receptor or aquaporin-2 defects. They are characterised by polyuria with polydipsia, recurrent bouts of fever, constipatio
Also known as: Nephrogenic diabetes insipidus | renal diabetes insipidus | familial nephrogenic diabetes | antidiuretic-hormone-resistant diabetes insipidus | adiuretin-resistant diabetes insipidus
Excludes: Central diabetes insipidus
[4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity
Also known as: Immune dysregulation syndromes presenting primarily with autoimmunity | Syndrome with autoimmunity | Immunodeficiency syndromes presenting primarily with autoimmunity | FADD-related immunodeficiency | X-linked immune dysregulation – polyendocrinopathy – enteropathy
[8C73.Z] Mitochondrial myopathies, unspecified
Also known as: Mitochondrial myopathies, unspecified | Mitochondrial myopathies | Myopathies in mitochondrial disorders
[QB61.4] Presence of colostomy
Also known as: Presence of colostomy | colon stoma status | colostomy status
[QB61.0] Presence of tracheostomy
Also known as: Presence of tracheostomy | trachea stoma status | tracheostomy status
=== GRAPH WALKS ===
--- Walk 1 ---
[9A70.Y] Other specified hereditary corneal dystrophies
--PARENT--> [9A70] Hereditary corneal dystrophies
Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...
--CHILD--> [9A70.0] Endothelial corneal dystrophy
--- Walk 2 ---
[9A70.Y] Other specified hereditary corneal dystrophies
--PARENT--> [9A70] Hereditary corneal dystrophies
Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...
--RELATED_TO--> [?] X-linked ichthyosis
Def: X-linked ichthyosis is an X-linked recessive genodermatosis associated with steroid sulfatase deficiency and elevated plasma cholesterol sulfate. Generalised scaling is present at or shortly after bir...
--- Walk 3 ---
[GB81] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--PARENT--> [?] Cystic or dysplastic kidney disease
Def: Any disease of the kidney, caused by determinants arising during the antenatal period or after birth. These diseases are characterised by pathological changes to one or both kidneys, and may manifest ...
--RELATED_TO--> [?] Tuberous sclerosis
Def: A disease caused by a dominant mutation of 9q34 (TSC1) or 16p13 (TSC2). This disease may present with facial angiofibromas, Koenen tumours, fibrous plaques on the forehead and scalp, renal angiomyolip...
--- Walk 4 ---
[GB81] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--PARENT--> [?] Cystic or dysplastic kidney disease
Def: Any disease of the kidney, caused by determinants arising during the antenatal period or after birth. These diseases are characterised by pathological changes to one or both kidneys, and may manifest ...
--CHILD--> [GB81] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--- Walk 5 ---
[8A02.12] Dystonia associated with heredodegenerative disorders
Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....
--PARENT--> [8A02.1] Secondary dystonia
Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....
--CHILD--> [8A02.10] Drug-induced dystonia
Def: This is dystonia due to medications either as an idiosyncratic side effect or due to overdose of medications....
--- Walk 6 ---
[8A02.12] Dystonia associated with heredodegenerative disorders
Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....
--PARENT--> [8A02.1] Secondary dystonia
Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....
--CHILD--> [8A02.12] Dystonia associated with heredodegenerative disorders
Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....
|
[
"[9A70.Y] Other specified hereditary corneal dystrophies\n --PARENT--> [9A70] Hereditary corneal dystrophies\n Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...\n --CHILD--> [9A70.0] Endothelial corneal dystrophy",
"[9A70.Y] Other specified hereditary corneal dystrophies\n --PARENT--> [9A70] Hereditary corneal dystrophies\n Def: The term corneal dystrophy embraces a heterogeneous group of bilateral genetically determined non-inflammatory corneal diseases that are usually restricted to the cornea. The designation is imprecise ...\n --RELATED_TO--> [?] X-linked ichthyosis\n Def: X-linked ichthyosis is an X-linked recessive genodermatosis associated with steroid sulfatase deficiency and elevated plasma cholesterol sulfate. Generalised scaling is present at or shortly after bir...",
"[GB81] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --PARENT--> [?] Cystic or dysplastic kidney disease\n Def: Any disease of the kidney, caused by determinants arising during the antenatal period or after birth. These diseases are characterised by pathological changes to one or both kidneys, and may manifest ...\n --RELATED_TO--> [?] Tuberous sclerosis\n Def: A disease caused by a dominant mutation of 9q34 (TSC1) or 16p13 (TSC2). This disease may present with facial angiofibromas, Koenen tumours, fibrous plaques on the forehead and scalp, renal angiomyolip...",
"[GB81] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --PARENT--> [?] Cystic or dysplastic kidney disease\n Def: Any disease of the kidney, caused by determinants arising during the antenatal period or after birth. These diseases are characterised by pathological changes to one or both kidneys, and may manifest ...\n --CHILD--> [GB81] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...",
"[8A02.12] Dystonia associated with heredodegenerative disorders\n Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....\n --PARENT--> [8A02.1] Secondary dystonia\n Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....\n --CHILD--> [8A02.10] Drug-induced dystonia\n Def: This is dystonia due to medications either as an idiosyncratic side effect or due to overdose of medications....",
"[8A02.12] Dystonia associated with heredodegenerative disorders\n Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen....\n --PARENT--> [8A02.1] Secondary dystonia\n Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....\n --CHILD--> [8A02.12] Dystonia associated with heredodegenerative disorders\n Def: Dystonia occurring as a part of a more complex heredodegenerative disorder. It is not a pure dystonia and other neurological findings such as ataxia, pyramidal signs and cognitive issues may be seen...."
] |
9A70.Y
|
Other specified hereditary corneal dystrophies
|
[
{
"from_icd11": "GB81",
"icd10_code": "Q612",
"icd10_title": "Polycystic kidney, adult type"
},
{
"from_icd11": "8E02.0",
"icd10_code": "A8100",
"icd10_title": "Creutzfeldt-Jakob disease, unspecified"
},
{
"from_icd11": "8E02.0",
"icd10_code": "A8109",
"icd10_title": "Other Creutzfeldt-Jakob disease"
},
{
"from_icd11": "8E02.0",
"icd10_code": "A810",
"icd10_title": "Creutzfeldt-Jakob disease"
},
{
"from_icd11": "GB90.4A",
"icd10_code": "N251",
"icd10_title": "Nephrogenic diabetes insipidus"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D8982",
"icd10_title": "Autoimmune lymphoproliferative syndrome [ALPS]"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D89813",
"icd10_title": "Graft-versus-host disease, unspecified"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D89810",
"icd10_title": "Acute graft-versus-host disease"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D89811",
"icd10_title": "Chronic graft-versus-host disease"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D8989",
"icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D89812",
"icd10_title": "Acute on chronic graft-versus-host disease"
},
{
"from_icd11": "4A01.21",
"icd10_code": "D898",
"icd10_title": "Other specified disorders involving the immune mechanism, not elsewhere classified"
},
{
"from_icd11": "8C73.Z",
"icd10_code": "G713",
"icd10_title": "Mitochondrial myopathy, not elsewhere classified"
},
{
"from_icd11": "QB61.4",
"icd10_code": "Z933",
"icd10_title": "Colostomy status"
},
{
"from_icd11": "QB61.0",
"icd10_code": "Z930",
"icd10_title": "Tracheostomy status"
}
] |
Q612
|
Polycystic kidney, adult type
|
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