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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
A 37-month-old male infant from Guangxi Province, China, with recurrent pneumonia since infancy exhibited recurrent pain in the right abdomen and fevers for 3 months. The abdominal pain was related to eating food, but not to physical activity and position. His maximum temperature was 40 °C. Physical examination revealed lymphadenopathy in the left neck and hepatomegaly. His abdomen was soft with normal bowel sounds; however, the liver and spleen were palpable 4 cm below his costal margins. The rest of the physical examination was unremarkable. Routine blood tests revealed 16.9 × 10 9 /L leucocytes, 9.5 × 10 9 /L neutrophils, 4.4 × 10 9 /L lymphocytes, 0.22 × 10 9 /L eosinophils, and 90 g/L hemoglobin. Blood was observed in his stool. The serum albumin and C-reactive protein levels were 29.0 g/L (40–60 g/L) and > 192 mg/L (< 10 mg/L), respectively. Erythrocyte sedimentation rate was 28 mm/h (≤15 mm/h). Serum aspergillus galactomannan antigen was 0.826 (normal<0.5). His CD4+ T-cell count was 1078 cells/μL , while the percentage of his natural killer cells was 18.10% (normal: 9–15%). Serum immunoglobulin (Ig) M was slightly elevated, while IgG and IgA were normal. Serum aspartate aminotransferase, alanine aminotransferase, and creatinine levels, as indicated by the blood test, were all normal. Anti-nuclear and anti-HIV antibodies and INF-γ autoantibody were all negative. Blood and stool cultures were negative. Chest computed tomography (CT) showed disseminated patchy exudates throughout the left upper and lower lobes of the right lung. Contrast-enhanced CT of the whole abdomen showed hepatomegaly, intestinal wall thickening in the ascending colon, and mesenteric lymphadenopathy in the cecum with . Colonoscopy showed a cobblestone pattern (non-ulcerated mucosa separated by ulcers) with erosion, ulcer, polypoid lesions, and lumen deformation from the colon to the cecum . Crohn ’ s disease and intestinal tuberculosis were also considered based on the presence of multiple ulcers on colonoscopy and on the clinical manifestations. Therefore, the patient was treated with mesalazine and thalidomide for 1 week but without clinical improvement. After 5 days, the colon biopsy revealed mucosal ulceration and ulcers in the colon and massive infiltration of the mucosa and submucosa by the engorged macrophages. A large number of fungal spores were observed in the interstitial space and the macrophages . Subsequently, the patient underwent ultrasound-guided liver biopsy. Histopathological examination of the liver tissue revealed granulomatous inflammation , while periodic acid-Schiff staining revealed aggregates of macrophages engorged with numerous yeast-like organisms 2–4 μm in diameter. These yeast-like organisms were spherical to oval and had a transverse septum . After 2 weeks, the bone marrow culture confirmed T. marneffei, and the diagnosis of disseminated Talaromycosis involving the liver, colon, lymph nodes, and bone marrow was made. Intravenous voriconazole (12 mg/kg every 12 h) was administered for 4 weeks. Subsequently, the liver size reduced and was palpable 1 cm below the costal margin. Voriconazole was then administered orally (7 mg/kg twice a day). Unfortunately, 1 month later, his abdominal pain and fever recurred, and he presented with reduced urine output. Abdominal radiograph showed bowel perforation, pneumoperitoneum, and intestinal obstruction . Hence, an emergency exploratory laparotomy with intestinal resection, anastomosis, and a colostomy was performed. During the surgery, we observed the pebble sign with erosion in the ileocecal intestinal cavity. The lesion segment was approximately 8 cm long. The ileocolic junction was narrow and obstructed, and the adjacent intestinal ducts were edematous and thickened. Postoperative pathology indicated the presence of T . marneffei. Whole-exome sequencing was performed using the patient’s and his parents’ peripheral blood. A heterozygous missense mutation in exon 17 of the STAT3 gene was found in the patient but not in his parents , indicating that the mutations were de novo. Fig. 1 Contrast-enhanced computed tomography of the whole abdomen. a Thickening of the intestinal wall in the ascending colon, and ( b ) mesenteric lymphadenopathy in the ileocecal region can be seen. The arrowhead indicates the mesenteric lymphadenopathy Fig. 2 a Colonoscopy showing a huge ulcer in the cecum and flushed and swollen surrounding mucosa, and b polypoid lesions. c Repeat colonoscopy after treatment shows good recovery of the stoma, located at the ileocecal region, within 35 cm from the anal verge Fig. 3 The yeast form of T. marneffei was confirmed by the histopathological analysis of the intestine using periodic acid-Schiff (PAS) staining. (magnification × 400) Fig. 4 a Granulomatous inflammation observed during histopathological examination of the liver. b PAS staining of liver tissue revealed numerous intracellular yeast-like or sausage-like cells 2–4 μm in diameter with a transverse septum (arrows) (magnification × 400) Fig. 5 Abdominal radiograph showing arc-shaped gas density shadows, intestinal inflatability, intestinal dilatation, and multiple gas-liquid planes under the diaphragm Fig. 6 The mutations found in patients with T. marneffei infections. Whole-exome sequencing indicate a STAT3 missense mutation of C to G
| 4.078125
| 0.977539
|
sec[1]/p[0]
|
en
| 0.999998
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32493232
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https://doi.org/10.1186/s12879-020-05113-4
|
[
"intestinal",
"liver",
"colon",
"blood",
"abdomen",
"abdominal",
"lymphadenopathy",
"serum",
"whole",
"colonoscopy"
] |
[
{
"code": "DA96.05",
"title": "Intestinal failure"
},
{
"code": "DB30.Y",
"title": "Other specified obstruction of large intestine"
},
{
"code": "DD3Z",
"title": "Ischaemic vascular disorders of intestine, unspecified"
},
{
"code": "DD30.Z",
"title": "Acute vascular disorders of intestine, unspecified"
},
{
"code": "DA93.0",
"title": "Paralytic ileus"
},
{
"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 ===
[DA96.05] Intestinal failure
Definition: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth.
Also known as: Intestinal failure
[DB30.Y] Other specified obstruction of large intestine
Also known as: Other specified obstruction of large intestine | Obstruction of large intestine due to compression or stenosis | Acute bowel obstruction, not elsewhere classified | Subacute bowel obstruction, not elsewhere classified | subacute intestinal obstruction NOS
[DD3Z] Ischaemic vascular disorders of intestine, unspecified
Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS
[DD30.Z] Acute vascular disorders of intestine, unspecified
Also known as: Acute vascular disorders of intestine, unspecified | Acute vascular disorders of intestine | acute intestinal ischemia NOS | acute intestinal ischemic syndrome | acute ischaemic bowel disease
[DA93.0] Paralytic ileus
Definition: A type of ileus, a functional not mechanical obstruction of the small intestines, and a state of pathophysiologic inhibition of motor activity due to non-mechanical causes. The paralysis does not need to be complete, but the intestinal muscles must be so inactive that it leads to a functional blockage of the intestine.
Also known as: Paralytic ileus | adynamic ileus | Paralytic ileus of bowel | ileus NOS | paralysis of bowel
Excludes: Obstructive ileus of small intestine due to impaction | Gallstone ileus of small intestine
[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 ---
[DA96.05] Intestinal failure
Def: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/o...
--PARENT--> [DA96.0] Intestinal malabsorption
Def: Intestinal malabsorption (syndrome) occurs due to pathological interference with the normal physiological sequence of digestion (intraluminal process), absorption (mucosal process), and transport (pos...
--CHILD--> [DA96.00] Bacterial overgrowth syndrome
Def: Bacterial overgrowth syndrome is a term that describes clinical manifestations that occur when poor movement of intestinal contents allows certain normal intestinal bacteria to grow excessively, causi...
--- Walk 2 ---
[DA96.05] Intestinal failure
Def: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/o...
--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--> [?] Amyloidosis of small intestine
Def: Amyloidosis of small intestine is a disease that results from the extracellular deposition of fibrillar amyloid proteins in the small intestine. Gastrointestinal tract amyloidosis occurs in 98% of pat...
--- Walk 3 ---
[DB30.Y] Other specified obstruction of large intestine
--PARENT--> [DB30] Obstruction of large intestine
Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...
--CHILD--> [DB30.1] Volvulus of large intestine
Def: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vess...
--- Walk 4 ---
[DB30.Y] Other specified obstruction of large intestine
--PARENT--> [DB30] Obstruction of large intestine
Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...
--PARENT--> [?] Diseases of large intestine
--- Walk 5 ---
[DD3Z] Ischaemic vascular disorders of intestine, unspecified
--PARENT--> [?] Ischaemic vascular disorders of intestine
Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand...
--CHILD--> [DD31] Chronic vascular disorders of intestine
--- Walk 6 ---
[DD3Z] Ischaemic vascular disorders of intestine, unspecified
--PARENT--> [?] Ischaemic vascular disorders of intestine
Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand...
--RELATED_TO--> [?] Angiodysplasia of colon
Def: Small dilated submucosal vessels of colonic mucosa with perforating vessels going through the muscularis mucosae....
|
[
"[DA96.05] Intestinal failure\n Def: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/o...\n --PARENT--> [DA96.0] Intestinal malabsorption\n Def: Intestinal malabsorption (syndrome) occurs due to pathological interference with the normal physiological sequence of digestion (intraluminal process), absorption (mucosal process), and transport (pos...\n --CHILD--> [DA96.00] Bacterial overgrowth syndrome\n Def: Bacterial overgrowth syndrome is a term that describes clinical manifestations that occur when poor movement of intestinal contents allows certain normal intestinal bacteria to grow excessively, causi...",
"[DA96.05] Intestinal failure\n Def: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/o...\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--> [?] Amyloidosis of small intestine\n Def: Amyloidosis of small intestine is a disease that results from the extracellular deposition of fibrillar amyloid proteins in the small intestine. Gastrointestinal tract amyloidosis occurs in 98% of pat...",
"[DB30.Y] Other specified obstruction of large intestine\n --PARENT--> [DB30] Obstruction of large intestine\n Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...\n --CHILD--> [DB30.1] Volvulus of large intestine\n Def: A volvulus is an abnormal twisting of the intestine around the axis of its own mesentery, resulting in obstruction of the more proximal bowel. Twisting of the mesentery may involve the mesenteric vess...",
"[DB30.Y] Other specified obstruction of large intestine\n --PARENT--> [DB30] Obstruction of large intestine\n Def: Hindrance of the passage of luminal contents in the large intestine. Obstruction of the large intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...\n --PARENT--> [?] Diseases of large intestine",
"[DD3Z] Ischaemic vascular disorders of intestine, unspecified\n --PARENT--> [?] Ischaemic vascular disorders of intestine\n Def: Intestinal ischemia characterised by blood supply to the gastrointestinal tract that is inadequate to meet its metabolic demand...\n --CHILD--> [DD31] Chronic vascular disorders of intestine",
"[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...."
] |
DA96.05
|
Intestinal failure
|
[
{
"from_icd11": "DD3Z",
"icd10_code": "K559",
"icd10_title": "Vascular disorder of intestine, unspecified"
},
{
"from_icd11": "DD3Z",
"icd10_code": "K558",
"icd10_title": "Other vascular disorders of intestine"
},
{
"from_icd11": "DD3Z",
"icd10_code": "K55-K64",
"icd10_title": ""
},
{
"from_icd11": "DD3Z",
"icd10_code": "K55",
"icd10_title": "Vascular disorders of intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55019",
"icd10_title": "Acute (reversible) ischemia of small intestine, extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55029",
"icd10_title": "Acute infarction of small intestine, extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55069",
"icd10_title": "Acute infarction of intestine, part and extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55021",
"icd10_title": "Focal (segmental) acute infarction of small intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55039",
"icd10_title": "Acute (reversible) ischemia of large intestine, extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55059",
"icd10_title": "Acute (reversible) ischemia of intestine, part and extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55042",
"icd10_title": "Diffuse acute infarction of large intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55041",
"icd10_title": "Focal (segmental) acute infarction of large intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55011",
"icd10_title": "Focal (segmental) acute (reversible) ischemia of small intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55012",
"icd10_title": "Diffuse acute (reversible) ischemia of small intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55049",
"icd10_title": "Acute infarction of large intestine, extent unspecified"
}
] |
K559
|
Vascular disorder of intestine, unspecified
|
A 55‐year‐old man developed pain, tingling, and numbness in both upper and lower parts of his legs with gradual exacerbation. He presented to an orthopedic clinic four months later, but was not diagnosed with any condition. Because of the progressive nature of his symptoms, he visited our hospital for further evaluation. He complained of worsening symptoms on both legs. He did not report recent weight loss, dysphasia, or diarrhea. His family history, past medical history, and drug history were unremarkable. He was a coal miner, and his other social history was unremarkable. His blood pressure was 150/92 mm Hg, his temperature was 36.6℃, his pulse was 71/min, and O 2 saturation was 98% at room air. Macroglossia was not seen. His neck was supple. The results of his cardiovascular examination were normal, the lungs were clear on bilateral auscultation, and the results of his abdominal examination were unremarkable with no hepatosplenomegaly. He showed muscle weakness in both upper and lower legs. Neurological tests showed no abnormalities. Manual muscle strength testing showed a grade 4/5 strength of both upper and lower legs based on the Medical Research Council scale. The complete blood counts were normal (hemoglobin: 14.6 g/L, mean cell volume: 94.3 fL, white blood cell count: 9.4 × 10 9 /L with 68.3% of neutrophils and 23.3% of lymphocytes, and platelets: 296 × 10 9 /L); inflammatory markers were also normal (C reactive protein: 0.04 mg/L; normal range: 0.0‐0.3 mg/dL, erythrocyte sedimentation rate: 10 mm/h; normal range: 0‐10 mm/h). Liver enzymes were slightly elevated; lactate dehydrogenase (349 U/L; normal range: 113‐270 U/L), alkaline phosphatase levels (45 U/L; normal range: 12‐34 U/L), and alanine transaminase levels (88 U/L; normal range: 9‐46 U/L). The total bilirubin level (0.5 μmol/L; normal range: 0.2‐1.2 mg/dL) as well as total protein level (8.0 g/dL; normal range: 6.7‐8.3 g/dL) were normal; however, the albumin level (3.1 g/L; normal range; 3.9‐4.9 g/L) was slightly reduced. The serum creatine kinase and aldolase levels (10.0 U/L; normal range: 1.0‐7.5 U/L) were over the normal upper limits. The brain natriuretic peptide level was within normal limit (11.7 pg/mL; normal level: ≤18.4 pg/mL). Antibodies against aminoacyl tRNA synthetase (ARS), Sjögren's (SSA/SSB), and histidyl tRNA synthetase (JO‐1) as well as neutrophil cytoplasm antibodies (pANCA/cANCA) were all negative. These results excluded collagenous disease and autoimmune disease. We performed an electrocardiogram and nerve conduction tests, the results of which were normal. Electromyography showed normal discharge at rest. Early motor unit potentials were within the normal range in all muscles including the bilateral biceps femoris muscles and the rectus femoris muscles. Although myopathies or neuropathies were unlikely according to the electromyography, his clinical symptoms and elevated CK/aldolase levels still suggested them. The patient was then referred for muscle biopsy. On muscle biopsy from the right rectus femoris, hematoxylin and eosin staining showed mild variation in muscle fiber size without any necrotic or regenerating fibers . No mononuclear cell infiltration was seen. On nicotinamide adenine dinucleotide tetrazolium reductase, intermyofibrillar network is nonspecifically disorganized in some fibers . On Congo red, amyloid was deposited in the area surrounding muscle fibers . The pathological findings led us to suggest amyloidosis. Quantitative serum immunoglobulins analyses demonstrated elevated IgG levels and decreased IgA (33 mg/dL, normal range: 110‐410 mg/dL), and IgM levels (18 mg/dL, normal range: 35‐220 mg/dL). Serum immunoelectrophoresis showed monoclonal gammopathy (IgG‐λ). The serum kappa/lambda ratio was 0.03 (normal range: 0.26‐1.65). The level of serum kappa and lambda free light‐chains were 7.9 mg/L (normal range: 3.3‐19.4 mg/L) and 266.0 mg/L (normal range: 5.7‐26.3 mg/L), respectively. Because amyloidosis or MM was suspected because of elevated IgG levels and the abnormal serum‐free light‐chain ratio, bone marrow aspiration, and biopsy were performed. Bone marrow aspirate smear showed 18% of plasma cells infiltration. Flow cytometry analysis showed an abnormal population of plasma cells that accounted for 18.5% of normal cells, most of which were positive for surface CD54, CD56, CD138, and cytoplasmic λ light‐chain. Fluorescence in situ hybridization test detected translocation of t(4;14) but not t(14;16) or del(17p). The bone marrow biopsy specimen was negative to Congo red staining. A whole‐body computed tomography (CT) revealed no evidence of lymph node swelling, bone lesions, or any other abnormalities. Furthermore, a CT scan of his legs revealed no dystrophy or myodemia . No abnormalities were observed on the T2‐weighed magnetic resonance imaging (MRI) . Echocardiogram demonstrated an ejection fraction of 75.4% without myocardial hypertrophy including interventricular septal thickness or any other abnormalities. Abdominal fat pad aspiration and biopsies from his gastric and rectal mucosa revealed no evidence of infiltration of amyloid deposits. These findings led to a diagnosis of AL amyloid myopathy isolated to skeletal muscles because the patient had abnormal plasma cell proliferation with a lack of MDEs or amyloid deposits in other areas.
| 4.039063
| 0.974609
|
sec[1]/p[0]
|
en
| 0.999997
|
33363840
|
https://doi.org/10.1002/ccr3.3310
|
[
"range",
"muscle",
"serum",
"legs",
"both",
"because",
"abnormalities",
"cell",
"muscles",
"biopsy"
] |
[
{
"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": "FB3Z",
"title": "Disorders of muscles, unspecified"
},
{
"code": "FB32.Y",
"title": "Other specified disorders of muscles"
},
{
"code": "8C70.Z",
"title": "Muscular dystrophy, unspecified"
},
{
"code": "FB32.2Z",
"title": "Ischaemic infarction of muscle, unspecified"
},
{
"code": "FB56.2",
"title": "Myalgia"
}
] |
=== 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
[FB3Z] Disorders of muscles, unspecified
Also known as: Disorders of muscles, unspecified | disorder of muscle, unspecified | muscle disease | muscular disease | muscular disorder
[FB32.Y] Other specified disorders of muscles
Also known as: Other specified disorders of muscles | Muscle wasting or atrophy, not elsewhere classified | muscle wasting | muscle wasting disorder | Sarcopenia
[8C70.Z] Muscular dystrophy, unspecified
Also known as: Muscular dystrophy, unspecified | Muscular dystrophy | Gower's muscular dystrophy | progressive musclular dystrophy | pseudohypertrophic atrophy
[FB32.2Z] Ischaemic infarction of muscle, unspecified
Also known as: Ischaemic infarction of muscle, unspecified | Ischaemic infarction of muscle | muscle infarction
[FB56.2] Myalgia
Definition: This is a disorder characterised by pain in a muscle or group of muscles.
Also known as: Myalgia | muscle ache | muscle soreness | muscular pain | myalgic
Excludes: Chronic primary musculoskeletal pain | Chronic secondary musculoskeletal pain
=== GRAPH WALKS ===
--- Walk 1 ---
[QA00.6Y] Other specified examination of eyes or vision
--PARENT--> [QA00.6] Examination of eyes or vision
--EXCLUDES--> [?] Examination for driving license
--- Walk 2 ---
[QA00.6Y] Other specified examination of eyes or vision
--PARENT--> [QA00.6] Examination of eyes or vision
--EXCLUDES--> [?] Examination for driving license
--- Walk 3 ---
[4B00.0Z] Neutropaenia, unspecified
--PARENT--> [4B00.0] Neutropenia
--CHILD--> [4B00.0Z] Neutropaenia, unspecified
--- Walk 4 ---
[4B00.0Z] Neutropaenia, unspecified
--PARENT--> [4B00.0] Neutropenia
--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 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 --EXCLUDES--> [?] Examination for driving license",
"[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license",
"[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --CHILD--> [4B00.0Z] Neutropaenia, unspecified",
"[4B00.0Z] Neutropaenia, unspecified\n --PARENT--> [4B00.0] Neutropenia\n --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...",
"[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": "FB3Z",
"icd10_code": "M60831",
"icd10_title": "Other myositis, right forearm"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60869",
"icd10_title": "Other myositis, unspecified lower leg"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60811",
"icd10_title": "Other myositis, right shoulder"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M6080",
"icd10_title": "Other myositis, unspecified site"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60851",
"icd10_title": "Other myositis, right thigh"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M6010",
"icd10_title": "Interstitial myositis of unspecified site"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M6018",
"icd10_title": "Interstitial myositis, other site"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M6088",
"icd10_title": "Other myositis, other site"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60862",
"icd10_title": "Other myositis, left lower leg"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60861",
"icd10_title": "Other myositis, right lower leg"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M6089",
"icd10_title": "Other myositis, multiple sites"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60852",
"icd10_title": "Other myositis, left thigh"
},
{
"from_icd11": "FB3Z",
"icd10_code": "M60821",
"icd10_title": "Other myositis, right upper arm"
}
] |
D473
|
Essential (hemorrhagic) thrombocythemia
|
A 26-year-old female patient was admitted to the First Affiliated Hospital of Zhejiang University School of Medicine (Hangzhou, China) in October 2019 due to persistent pain of the right side of the neck and left side of the axilla lymphadenopathy for more than 10 days. The lymph node on the right side of the neck was biopsied, and the pathology suggested nodular sclerosis classic Hodgkin lymphoma , a subtype of classic Hodgkin lymphoma. Immunohistochemistry (IHC) results of CD30 (+) , CD15 (+), PAX5 (+) , Bcl-2 (+), MUM-1 (+), Bcl-6 (partial +), CD21 (FDC+), Ki-67 (+, 60%), PD-1 (small lymphocytes +, 20%), CD3, CD5, CD7, CD20, CD45, anaplastic lymphoma kinase (ALK), and EMA were all negative. There was no obvious abnormal lymphocyte group in bone marrow smears or after bone marrow immunophenotyping. A bone marrow biopsy revealed that the proliferation of hematopoietic tissue was active. The chromosomal analysis showed 46, XX ( 20 ). In October 2019, primary positron emission tomography-computed tomography (PET/CT) showed that there were multiple enlarged lymph nodes in the bilateral neck, bilateral inguen, and left axilla, and that the size of the left axillary lymph node was 3.1 × 2.2 cm . The patient was diagnosed as having nodular sclerosis classic Hodgkin lymphoma IIIA, and she subsequently received ABVD chemotherapy (a combination of doxorubicin, bleomycin, vinblastine, and dacarbazine) for 2 cycles. In December 2019, the secondary PET/CT showed that the size of the left axillary lymph node was significantly smaller and that glucose metabolism of FDG was reduced . The patient subsequently received 3 cycles of ABVD chemotherapy. In May 2020, a tertiary PET/CT examination showed that the left axillary lymph node was larger and that metabolism was increased , following local recurrence after treatment. A biopsy of the left axillary lymph node was undertaken, and the pathology indicated classic Hodgkin lymphoma, nodular sclerosis type . The IHC results of testing of CD30 (+) , CD15 (+), PAX-5 (+ weak) , Bcl-2 (+), MUM1 (+), CD21 (FDc+), Ki-67 (+80%), Bcl-6, CD3, CD5, CD7, CD20, CD45, ALK, EMA, and EBER were all negative. Considering the disease progression of the patient, she received tislelizumab (200 mg Q3W) for 4 cycles. During that period, the left axillary lymph node of the patient was reduced in size. Next, the patient was scheduled to receive auto-SCT. She underwent the PET/CT in August, and we mobilized and collected autologous stem cells in September, without continuing tislelizumab treatment. In August 2020, the quaternary PET/CT revealed that multiple lymph nodes in the bilateral neck, the left clavicle and left axilla area were slightly enlarged and exhibited mildly increased metabolic activity suggesting that there was still residual tumor activity after targeted therapy. Thus, combined therapy of BV (100 mg) + tislelizumab (200 mg) was administered to the patient in October, 2020. Before the treatment, the lymph nodes of the patient were not significantly changed as revealed by US and CT scans. Overall, the patient did not exhibit disease progression from August to the time she received combination therapy in October. However, the patient had a slight fever, with the highest temperature being 37.6 °C after 2 days of this round of treatment, experienced pain in the axillary lymph nodes and had multiple skin rashes with pruritus all over the body after 1 week, accompanied by joint pain, fatigue and poor appetite for about 15 days. Before these reactions, the patient had no history of autoimmune or hyperimmune reactivity. Testing for the presence of inflammatory cytokines revealed that interleukin-4 (IL-4) concentrations decreased from 3.41 to 0.1 pg/ml, IL-2 and tumor necrosis factor-α (TNF-α) from 1.54 or 4.13 to 0.1 pg/ml, respectively. Interferon-γ (IFN-γ) concentrations increased from 2.95 to 15.43 pg/ml, IL-6 from 8.15 to 12.96 pg/ml, and IL-17A from 51.12 to 176.68 pg/ml ( Table 1 ). The US and CT scans showed that multiple lymph nodes were notably enlarged all over the body compared to before treatment . Next, the patient was given dexamethasone (5 mg i.v. QD) for 4 days combined with cetirizine (10 mg p.o. QD) for 3 days. The body rash of the patient subsided and pruritus was alleviated. During December, 2020, US scans revealed that the sizes of the bilateral cervical, axillary and inguen lymph nodes were reduced. A biopsy of the left axillary lymph node showed that lymphoid tissues exhibited a proliferative change . The results of IHC indicated that CD30 (−) , CD3 (+), CD20 (+), Ki-67 (around 5%+), CD5 (+), CD10 (germinal center +), Bcl-2 (+), Bcl-6 (germinal center +), MUM1 (scattered W+), PAX-5 (+) , CD21 (FDC+), VD23 (FDC+), cyclinD1c-Myc, ALK and EBER were all negative. During the wait for auto-SCT, the patient received a further 2 cycles of PD-1. In January 2021, the quinary PET/CT scans showed there was no obvious increase in glucose metabolism of FDG in the area of the lymph nodes, after the lesion had shrunk and tumor activity inhibited. Then the patient underwent auto-SCT. At present, she has been regularly followed-up and remains disease free for 10 months since transplant without the need for anti-tumor treatment. The patient never received radiation therapy. The clinical course of the patient is shown in Figure 4 .
| 4.050781
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC8795608
|
https://doi.org/10.3389/fimmu.2021.756583
|
[
"that",
"lymph",
"axillary",
"node",
"nodes",
"lymphoma",
"october",
"neck",
"classic",
"hodgkin"
] |
[
{
"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": "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 ===
[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
[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 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.2] Chronic migraine
Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...
--- Walk 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...
--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 3 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 4 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm
--CHILD--> [QA72] Incorrect substance without injury or harm
Def: Incorrect substance administration occurs when a substance is given which was not the intended or prescribed drug and does not result in injury or harm....
--- 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--> [PL13.1] Underdosing, as mode of injury or harm
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...",
"[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....",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [QA72] Incorrect substance without injury or harm\n Def: Incorrect substance administration occurs when a substance is given which was not the intended or prescribed drug and does not result in 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--> [PL13.1] 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--> [PL13.1] Underdosing, as mode of injury or harm"
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
An 8-year-old female who presented with left rib pain, hematuria and fever was admitted to our hospital. The maximum temperature reached 39.9 °C, with no chills or rash. She was administered cefepime and azithromycin for 1 day, cefotaxime for 5 days, and methylprednisolone for 1 day. On physical examination, her general condition was poor, with eyelid and lower limb edema; coarse respiratory sounds and auscultation of blisters of both lungs were noted, and no other abnormal findings were present at that time. Laboratory findings were as follows: white blood cell count 6.32*10 9 /L, neutrophil 0.48, lymphocyte 0.42, red blood cell count 3.40*10 12 /L, hemoglobin 93 g/L, and platelet count 48*10 12 /L. Her urine revealed 363.69 red blood cells/high-powered field (hpf), protein 3+, 5.1 white blood cells/hpf, erythrocyte sedimentation rate (ESR) 135 mm/h, C-reactive protein (CRP) 25.2 mg/L, albumin 17.6 g/L, total cholesterol 7.21 mmol/L, and urinary protein 3.2 g/24 h. Other laboratory findings included activated partial thromboplastin time (APTT) 138.7 s, direct antiglobulin test positive, ferritin 358.4 μg/L, D-dimer 4937.00 μg/L, and FDG 33.8 μg/ml. Serum showed C3 0.92 g/L (0.9–1.8), C4 0.17 g/L (0.1–0.4), ANA:anti-SSA-60 ±, anti-nRNP/Sm positivity, homogeneous 1:3200 positivity, dsDNA 1:10 positivity, antinucleoome antibody positivity, antimitochondrial M2 positivity, anticardiolipin IgM 12 U/ml (0–10), and anti-β2GPI 223 U/ml (0–20). Bone marrow biopsy revealed secondary anemia, and globular red blood cells accounted for 5.5%. However, respiratory pathogens, myocardial enzymes, mycoplasma pneumoniae/chlamydia antibodies, procalcitonin, folic aci, vitamin B12, reticulocytes, bacterial cultures of blood, stool, tuberculosis spots, Epstein-Barr virus, cytomegalovirus, ANCA were all negative. Hematuria location: urine abnormal red blood cell 60%, urine uniform red blood cell 40%. Bronchoscope results showed inflammation of the endobronchial membrane. Pulmonary CT revealed patchy high-density shadows in all lobes of the lungs, especially in the lower lobes of the lungs . Color Doppler ultrasonography of the lower limbs ruled out deep vein thrombosis. Abdominal color ultrasound revealed abdominal effusion. Echocardiography showed a kind of round moderate echo with a diameter of approximately 2.0 cm that could be seen at the bottom of the right atrium near the opening of the inferior vena cava. The patient was diagnosed with right atrial thrombus . Renal pathology using light microscopy revealed 52 glomeruli in the renal tissue; there were 52 glomeruli in the renal tissue, with slight proliferation of mesangial cells and mesangial matrix, swelling and slight proliferation of segmental foot nuclear endothelial cells, slight thickening of glomerular basement membrane and a large amount of phenophilin deposition in subepithelial cells. No microthrombi or crescents were observed, and a small amount of inflammatory cell infiltration dominated by neutrophils was found in some glomeruli. There was slight edema in the renal interstitium, and there was no renal tubular atrophy and obvious inflammatory cell infiltration and fibrosis. No obvious abnormalities were found in the arterioles. Immunofluorescence analysis was positive for IgA, IgM, IgG, C3, C4, and C1q deposited along the glomerular capillary wall and segmental mesangial area. The above features were consistent with membranous LN with mesangial proliferative LN (consistent with types V and II LN) . Nephrotic syndrome is a common disease in children that is characterized by edema, massive proteinuria (>50 mg/kg.24 h), hypoproteinemia (<25 g/l) and hypercholesterolemia (>5.7 mmol/l). Our patient’s disease characteristics were consistent with those of nephrotic syndrome . We continued to track the etiology of nephrotic syndrome, and the child had no family history of renal disease; therefore, we investigated secondary factors, including serology results that were positive for ANA and anti-dsDNA with low C3 levels. Although her platelets and hemoglobin levels were significantly lower than normal, she had no rash, arthralgia, photosensitivity, oral ulcer, or butterfly erythema, so a renal biopsy was performed, which suggested LN. The patient was finally diagnosed with SLE and LN. She was treated with pulse methylprednisolone for 3 days and IV diuretic with albumin, followed by oral steroids 1 mg/kg.d after 3 days, with rapid resolution of edema. Anticardiolipin IgM of 12 U/ml and anti-β2GPI of 223 U/ml were consistent with secondary APS. What was the cause of the space-occupying mass in the right atrium? At this point, as no clear etiological evidence was found, a repeated echocardiography indicated that the nature of the right atrial mass was a thrombus. The mass was reduced by anticoagulant therapy with heparin for 2 weeks. By 3 weeks, proteinuria decreased to 1.0 g/day, and by 16 weeks, she was in complete remission with < 0.5 g proteinuria. After 6 months of follow-up, the patient has remained in complete remission, but 2.5 mg of prednisolone is administered each day. Fig. 1 High-density shadows in all lobes of the lungs Fig. 2 Echocardiography:right atrial thrombus Fig. 3 Slight proliferation of mesangial cells and mesangial matrix Fig. 4 Large amount of furophilic protein deposition subepithelial cell
| 4.0625
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999996
|
33203428
|
https://doi.org/10.1186/s12969-020-00484-z
|
[
"blood",
"cell",
"cells",
"renal",
"mesangial",
"that",
"anti",
"positivity",
"edema",
"lungs"
] |
[
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
},
{
"code": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
[MA12.4] Finding of steroid agent in blood
Also known as: Finding of steroid agent in blood | steroid in blood
[MA12.2] Finding of hallucinogen in blood
Also known as: Finding of hallucinogen in blood | hallucinogen in blood
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--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...
--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--> [MF50.41] Microscopic haematuria
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] 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 --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--> [MF50.41] Microscopic haematuria",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
In 2017, he was first seen at our pituitary outpatient clinic for a second opinion. His therapy consisted of ketoconazole 1000 mg/day, together with thyroid and testosterone hormone replacement therapy. Hormonal workup revealed persistent Cushing’s disease (CD) with elevated 08:00 h ACTH (225 ng/L, 08:00 h normal range: 7.2–63 ng/L) and cortisol (378.5 µg/L, 08:00 h normal range: 62–180 µg/L) and high 24-h urinary free cortisol (UFC) despite the maximal dosage of ketoconazole. MRI of the brain showed no macroscopic disease. Pasireotide 0.6 mg twice daily was initiated, but had to be discontinued for severe iatrogenic diabetes mellitus. Cabergoline 0.25 mg twice weekly was started with unsatisfactory response. Bilateral adrenalectomy was performed in September 2017. Unfortunately, follow-up revealed small residual adrenal tissue on the left side. The patient refused a second surgery for complete removal of the adrenal remnant. Disease control was nonetheless achieved with stable 08:00 h ACTH (231 ng/L), cortisol (151.6 µg/L) and UFC (126.9 µg/24 h = 47.8 µg/L). In May 2018, the patient deteriorated with the development of diplopia due to left abducens nerve palsy. Plasma ACTH had increased (357.3 ng/L) and MRI revealed recurrence of the pituitary tumor with suprasellar and cavernous sinus invasion. Additionally, metastases were detected in the posterior fossa, left cerebellum and cervical drop metastases at the level of the dens and the third cervical vertebra . These findings confirmed the evolution toward corticotroph pituitary carcinoma, possibly in the context of Nelson's syndrome given the rapid progression after the bilateral adrenalectomy. Biopsy of the pituitary carcinoma for reanalysis of proliferative markers could not be performed at the time; the metastases were considered unsafe for biopsy. TMZ chemotherapy (150–200 mg/m 2 , 5 days in a 28-day cycle) was promptly initiated. First evaluation after three cycles of TMZ showed persistent CD with stable tumor burden. Ketoconazole (800 mg/day) was restarted and TMZ therapy was continued for a total of nine cycles , when clinical progressive disease was suspected with the development of right oculomotor and abducens nerve palsies and increasing 08:00 h ACTH (419.9 ng/L) and cortisol (208 µg/L). However, no radiological progression could be detected. The patient agreed to start with a combination ICI therapy of ipilimumab (3 mg/kg) and nivolumab (1 mg/kg) every 3 weeks, for 4 cycles in a compassionate use setting ( Table 1 ). Initial evaluation after the first four cycles demonstrated disease stabilization with declining ACTH and cortisol levels (ACTH: 338.9 ng/L; cortisol: 199 µg/L, 24-h urinary cortisol: 354.8 µg/24 h = 140.7 µg/L) without radiological change. Maintenance therapy with nivolumab (240 mg) was then continued every 2 weeks. Up to now, the patient has a non-progressive disease, one year after the initiation of ICI, with declining 08:00 h ACTH and UFC as shown in Fig. 2 . Radiological disease stabilization is observed when comparing MRI obtained after the last TMZ cycle with follow-up imaging one year after the initiation of ICI . However, there is no resolution of the diplopia. He did not experience any immune-related adverse events. His CD is still under control with 800 mg of ketoconazole daily. Figure 1 Gadolinium-enhanced T1-weighted magnetic resonance imaging of the pituitary carcinoma. Panel A shows invasion of the cavernous sinus (arrow) and the metastases of the posterior fossa, left cerebellum and cervical drop metastases at the level of the dens and the third cervical vertebra (asterix) . Panel B shows evaluation of the pituitary carcinoma after nine cycles of TMZ treatment . Panel C shows stable disease (irRECIST criteria) 1 year after initiation of ICI . IrRECIST, immune-related Response Evaluation Criteria in Solid Tumors; ICI, Immune Checkpoint Inhibitors. Figure 2 Timeline of 08:00 h ACTH and UFC during follow-up. ACTH, Adrenocorticotropic hormone (08:00 h normal range: 7.2–63 ng/L); ICI, Immune Checkpoint Inhibitors; UFC, Urinary Free Cortisol (normal range: 4.2–60 µg/24 h). A full color version of this figure is available at https://doi.org/10.1530/EJE-20-0151 . Table 1 Data of plasma 08:00 h ACTH, 08:00 h cortisol, and UFC during follow up with the corresponding treatment. Date 08:00 h Cortisol 1 (µg/L) 08:00 h ACTH 2 (ng/L) UFC 3 (µg/L) Treatment Jun/17 378.5 225 606.2 Ketoconazole 1000 mg + Pasireotide 0.6 mg twice daily started Sep/17 151.6 231 47.8 Bilateral adrenalectomy already performed + hydrocortisone and fludrocortisone suppletion started May/18 132 357.3 177 Hydrocortisone and fludrocortisone stopped + temozolomide 350 mg 5 days every 4 weeks + ketoconazole 800 mg restarted Aug/18 145 418 243.8 Temozolomide 350 mg 5 days every 4 weeks (nine cycles) + ketoconazole 800 mg Apr/19 208 419.9 284.7 Ipilimumab (3 mg/kg) and nivolumab (1 mg/kg) every 3 weeks + ketoconazole 800 mg Aug/19 199 338.9 140.7 Nivolumab 240 mg every 2 weeks + ketoconazole 800 mg Nov/19 196 346.9 136.6 Nivolumab 240 mg every 2 weeks + ketoconazole 800 mg Feb/20 74 293.7 74.1 Nivolumab 240 mg every 2 weeks + ketoconazole 800 mg 1 Cortisol, 08:00 h normal: 62–180 µg/L; 2 Adrenocorticotropic hormone, 08:00 h normal range: 7.2–63 ng/L; 3 Urinary free cortisol, normal range: 4.2–60 µg/24 h.
| 4.078125
| 0.966797
|
sec[1]/p[1]
|
en
| 0.999997
|
33112279
|
https://doi.org/10.1530/EJE-20-0151
|
[
"cortisol",
"ketoconazole",
"acth",
"every",
"pituitary",
"range",
"cycles",
"nivolumab",
"metastases",
"urinary"
] |
[
{
"code": "5A70.Y",
"title": "Other specified Cushing syndrome"
},
{
"code": "5A70.Z",
"title": "Cushing syndrome, unspecified"
},
{
"code": "5A76.Y",
"title": "Other specified disorders of adrenal gland"
},
{
"code": "5A74.0",
"title": "Acquired adrenocortical insufficiency"
},
{
"code": "5A74.Y",
"title": "Other specified adrenocortical insufficiency"
},
{
"code": "5A70.1",
"title": "Ectopic ACTH syndrome"
},
{
"code": "5A70.0",
"title": "Pituitary-dependent Cushing disease"
},
{
"code": "5A61",
"title": "Hypofunction or certain other specified disorders of pituitary gland"
},
{
"code": "5A61.0",
"title": "Hypopituitarism"
},
{
"code": "5A61.Y",
"title": "Other specified hypofunction or disorders of pituitary gland"
}
] |
=== ICD-11 CODES FOUND ===
[5A70.Y] Other specified Cushing syndrome
Also known as: Other specified Cushing syndrome | ACTH-dependent Cushing syndrome | ACTH-independent Cushing syndrome | ACTH-independent Cushing syndrome due to bilateral adrenocortical hyperplasia | ACTH-independent macronodular adrenal hyperplasia
[5A70.Z] Cushing syndrome, unspecified
Also known as: Cushing syndrome, unspecified | Cushing syndrome | Hyperadrenocorticism | Hypercortisolism | Cushing syndrome NOS
[5A76.Y] Other specified disorders of adrenal gland
Also known as: Other specified disorders of adrenal gland | Suprarenal gland abscess | Suprarenal abscess | Adrenal gland inflammation | adrenal glandular inflammation
[5A74.0] Acquired adrenocortical insufficiency
Definition: This is a acquired condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol; but may also include impaired production of aldosterone (a mineralocorticoid), which regulates sodium conservation, potassium secretion, and water retention.
Also known as: Acquired adrenocortical insufficiency | Addison disease | Chronic acquired adrenal insufficiency | Autoimmune Addison disease | Primary Addison disease
Excludes: Amyloidosis
[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
[5A70.1] Ectopic ACTH syndrome
Also known as: Ectopic ACTH syndrome | Cushing syndrome secondary to ectopic ACTH-secretion | Ectopic Cushing syndrome | hypercortisolism due to nonpituitary tumour | ectopic ACTH - [adrenocorticotropic hormone] secretion
[5A70.0] Pituitary-dependent Cushing disease
Definition: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hypercortisolism. The condition is associated with increased morbidity and mortality that can be mitigated by treatments that result in sustained endocrine remission. Transsphenoidal pituitary surgery (TSS) remains the mainstay of treatment for this disease but requires considerable neurosurgical exper
Also known as: Pituitary-dependent Cushing disease | Overproduction of pituitary ACTH | Pituitary-dependent hyperadrenocorticism | Corticotroph pituitary adenoma | ACTH- [adrenocorticotropic hormone] secreting pituitary adenoma
[5A61] Hypofunction or certain other specified disorders of pituitary gland
Definition: Clinical status with disordered function of the pituitary gland without excessive pituitary hormone production, which is caused by a variety of diseases
Also known as: Hypofunction or certain other specified disorders of pituitary gland | disorder of pituitary gland | pituitary disease | pituitary gland disease | pituitary glandular disease
Excludes: Postprocedural hypopituitarism | Craniopharyngioma
[5A61.0] Hypopituitarism
Definition: A disorder manifesting a deficiency or decrease of one or more pituitary hormones, which is caused by a variety of diseases such as tumour, trauma/surgery, irradiation, inflammation and haemorrhage/infarction.
Also known as: Hypopituitarism | subpituitarism | hypophyseal dystrophy | hypohypophysism | anterior pituitary insufficiency (in part)
Includes: pituitary cachexia | pituitary short stature
[5A61.Y] Other specified hypofunction or disorders of pituitary gland
Also known as: Other specified hypofunction or disorders of pituitary gland | Prolactin deficiency | Isolated prolactin deficiency | Hypothalamic dysfunction, not elsewhere classified | dyspituitarism
=== GRAPH WALKS ===
--- Walk 1 ---
[5A70.Y] Other specified Cushing syndrome
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--CHILD--> [5A70.1] Ectopic ACTH syndrome
--- Walk 2 ---
[5A70.Y] Other specified Cushing syndrome
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system
--- Walk 3 ---
[5A70.Z] Cushing syndrome, unspecified
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system
--- Walk 4 ---
[5A70.Z] Cushing syndrome, unspecified
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--CHILD--> [5A70.1] Ectopic ACTH syndrome
--- Walk 5 ---
[5A76.Y] Other specified disorders of adrenal gland
--PARENT--> [5A76] Certain specified disorders of adrenal gland
--PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system
--- Walk 6 ---
[5A76.Y] Other specified disorders of adrenal gland
--PARENT--> [5A76] Certain specified disorders of adrenal gland
--CHILD--> [5A76.Y] Other specified disorders of adrenal gland
|
[
"[5A70.Y] Other specified Cushing syndrome\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.1] Ectopic ACTH syndrome",
"[5A70.Y] Other specified Cushing syndrome\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system",
"[5A70.Z] Cushing syndrome, unspecified\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system",
"[5A70.Z] Cushing syndrome, unspecified\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.1] Ectopic ACTH syndrome",
"[5A76.Y] Other specified disorders of adrenal gland\n --PARENT--> [5A76] Certain specified disorders of adrenal gland\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system",
"[5A76.Y] Other specified disorders of adrenal gland\n --PARENT--> [5A76] Certain specified disorders of adrenal gland\n --CHILD--> [5A76.Y] Other specified disorders of adrenal gland"
] |
5A70.Y
|
Other specified Cushing syndrome
|
[
{
"from_icd11": "5A70.Z",
"icd10_code": "E242",
"icd10_title": "Drug-induced Cushing's syndrome"
},
{
"from_icd11": "5A70.Z",
"icd10_code": "E249",
"icd10_title": "Cushing's syndrome, unspecified"
},
{
"from_icd11": "5A70.Z",
"icd10_code": "E248",
"icd10_title": "Other Cushing's syndrome"
},
{
"from_icd11": "5A70.Z",
"icd10_code": "E24",
"icd10_title": "Cushing's syndrome"
},
{
"from_icd11": "5A74.0",
"icd10_code": "E273",
"icd10_title": "Drug-induced adrenocortical insufficiency"
},
{
"from_icd11": "5A74.0",
"icd10_code": "E271",
"icd10_title": "Primary adrenocortical insufficiency"
},
{
"from_icd11": "5A74.0",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5A70.1",
"icd10_code": "E243",
"icd10_title": "Ectopic ACTH syndrome"
},
{
"from_icd11": "5A70.0",
"icd10_code": "E240",
"icd10_title": "Pituitary-dependent Cushing's disease"
},
{
"from_icd11": "5A61",
"icd10_code": "E233",
"icd10_title": "Hypothalamic dysfunction, not elsewhere classified"
},
{
"from_icd11": "5A61",
"icd10_code": "E23",
"icd10_title": "Hypofunction and other disorders of the pituitary gland"
},
{
"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"
}
] |
E242
|
Drug-induced Cushing's syndrome
|
A 26‐year‐old caucasian female comes to the emergency room complaining about abdominal pain. After examination, it became evident that she was pregnant and labor had started. The pregnancy was not planned nor monitored. Regarding her medical background, she was diagnosed with schizophrenia at the age of 20, when she was hospitalized in the context of bizarre and paranoid delusional ideas, perplexity, disorganized speech, loosening of associations, inappropriate laughs, and total absence of insight. No other medical comorbidities were found. By that time, she was consuming cannabinoids daily, a habit she abandoned after her first psychotic episode. There is no record on the use of other drugs. Regarding family history, her mother had depressive disorder and a cousin had schizophrenia. During this hospitalization, she was firstly treated with olanzapine. However, since there was no improvement, a switch was made to clozapine, titrated until 600 mg, then reduced to 400 mg, due to transaminases elevation and fever. After 36 days of treatment she was discharged and, on her first outpatient consultation, clozapine was reduced to 200 mg, due to weight gain, somnolence, and amenorrhea. Subsequently, she began to miss follow‐up appointments, having reduced clozapine by herself. In the following consultation, a change to risperidone 6mg was made, as she maintained marked weight gain and amenorrhea, with high risk of therapeutic noncompliance. She abandoned psychiatric follow‐up and, approximately 10 months later, she was brought to the hospital due to dysphoric mood, evasive posture, and hostile contact, and it was found that she had abandoned antipsychotic therapy. At that stage treatment with risperidone was resumed and 100 mg of paliperidone palmitate monthly injection was added. The patient complied with this treatment for 3 months, when she abandoned monitoring and medication, and fled to another city. She was hospitalized three months later, presenting with aggressive contact, irritable mood, and disorganized behavior. She was discharged to compulsory outpatient treatment, on 6mg risperidone, which she abandoned, and monthly 75 mg paliperidone palmitate. As previously mentioned, during this process she suffered noticeable weight gain and amenorrhea, that lasted several months, attributable to the antipsychotic therapy. These side effects might have contributed to the underestimation of eventual signs of pregnancy. During one and a half year, she continued the injectable medication and risperidone was gradually stopped. After that time, the doctor considered to stop the injectable medication and started paliperidone 9 mg daily. However, one year later, psychotic symptoms arose and, according to her history of poor compliance with medication it was necessary to restart a long‐acting drug. Palmitate paliperidone monthly long‐acting injection 100 mg was prescribed, together with quetiapine 300 mg, for emotional instability, irritability, and insomnia. After one and a half year, quetiapine had been stopped and palmitate paliperidone monthly long‐acting injection was reduced to 75 mg. After a total of 17 monthly injections of palmitate paliperidone, either taken at the hospital or in the community to ensure compliance, a switch was made to palmitate paliperidone 3‐monthly long‐acting injection 263 mg, to facilitate treatment maintenance in a patient prone to avoid it and requiring a lot of family effort for compliance. The 3‐monthly injection was administered twice, the last one approximately 2 months before the infant's birth. She was on no other medication. When she arrived at the emergency service, she had no psychotic symptoms, was in a relationship and had a job, although it should be mentioned that the patient has mild cognitive deficit which led to school failure and difficulty in obtaining a job and a driver's license. In the emergency room, she complained of abdominal pain and reported she had noticed abdominal bloating, which she did not value. After medical examination, pregnancy was considered although she had amenorrhea that lasted more than 1 year. On gynecological examination, a vaginal discharge of white fluid was noted, which according to the patient had started earlier that day. The echography showed the presence of a fetus in cephalic position, with cardiac sounds present. Since the pregnancy was not monitored and the position of the fetus prevented the measurement of biometrics, it was not possible to calculate how many weeks it lasted. Fetal morphological ultrasound, cardiotocography, or laboratorial studies were not performed during the entire pregnancy. She was taken to the delivery room and gave birth to a healthy newborn male with 2420grams, with an APGAR score of 9‐10‐10, without complications. The patient and the family were pleased with the baby's arrival. Social care was involved in social risk evaluation, to guarantee the protection of the baby. He was closely monitored, and there were no signs or symptoms during the first 2 weeks after delivery. The mother decided not to breastfeed. To the date of this case report, approximately 1 year after birth, the child showed no health or developmental issues. With regard to the patient's follow‐up, she continues to receive palmitate paliperidone 3‐monthly injection and is asymptomatic.
| 3.773438
| 0.982422
|
sec[1]/p[0]
|
en
| 0.999996
|
33363785
|
https://doi.org/10.1002/ccr3.3213
|
[
"that",
"paliperidone",
"monthly",
"palmitate",
"injection",
"pregnancy",
"abandoned",
"medication",
"this",
"amenorrhea"
] |
[
{
"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": "PL11.2Z",
"title": "Embolisation, as mode of injury or harm, unspecified"
},
{
"code": "QA50",
"title": "Embolisation without injury or harm"
},
{
"code": "EL73.2",
"title": "Adverse reaction to injection of neurotoxin"
},
{
"code": "EL73.0",
"title": "Adverse reaction to dermal or deep fillers"
},
{
"code": "ED6Y",
"title": "Other specified disorders of skin pigmentation"
}
] |
=== 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
[PL11.2Z] Embolisation, as mode of injury or harm, unspecified
Also known as: Embolisation, as mode of injury or harm, unspecified | Embolisation, as mode of injury or harm | embolic phenomenon as mode of injury | embolism due to intervention | injection of air as mode of injury
[QA50] Embolisation without injury or harm
Definition: An embolisation without documented injury or harm occurs when a solid object within the venous or arterial circulation propagates to a distal location and becomes lodged there.
Also known as: Embolisation without injury or harm | Embolic phenomenon without documented injury or harm | Air embolism without documented injury or harm | Injection of air without injury or harm
Excludes: Embolisation, as mode of injury or harm
[EL73.2] Adverse reaction to injection of neurotoxin
Definition: Adverse event resulting from use of neurotoxins, especially botulinum toxin, into the skin. This is most commonly administered for aesthetic reasons. Recognised problems include ptosis, diplopia and hypersensitivity to the toxin. Details of the reaction should be coded separately.
Also known as: Adverse reaction to injection of neurotoxin | Adverse reaction to injection of botulinum toxin
[EL73.0] Adverse reaction to dermal or deep fillers
Definition: Any adverse event attributable to the use of injected fillers used for soft tissue augmentation.
Also known as: Adverse reaction to dermal or deep fillers | Cutaneous necrosis following injection of filler | Foreign body granulomatous reaction to injected filler | Nodule formation attributable to injected filler | Serious adverse reaction to injection of filler
Excludes: Pyogenic abscess of the skin
[ED6Y] Other specified disorders of skin pigmentation
Also known as: Other specified disorders of skin pigmentation | Non-melanin pigmentation due to ingested or injected substance | Carotenoderma | Argyria | Chrysiasis
=== GRAPH WALKS ===
--- Walk 1 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.0] Migraine without aura
Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...
--- Walk 2 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.1] Migraine with aura
Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso...
--- Walk 3 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm
--CHILD--> [QA70] Overdose of substance without injury or harm
Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration...
--- Walk 4 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 5 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.1] Underdosing, as mode of injury or harm
--- Walk 6 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.2] Drug-related injury or harm in the context of correct administration or dosage, as mode of injury or harm
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] Migraine without aura\n Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...",
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.1] Migraine with aura\n Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso...",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [QA70] Overdose of substance without injury or harm\n Def: Overdose of a substance occurs when a patient is given more of a prescribed drug or other substance than is intended. Can be the result of inaccurate measurement of drug, including oral administration...",
"[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
|
When referred to our institution, the patient described weakness while climbing and descending stairs without upper extremity complaints. During his physical examination, he was noted to have atrophy in the quadriceps muscles with moderate weakness. Electromyography (EMG) showed increased membrane instability and early recruitment with fractionation of the motor unit potentials, showing a brief, small, abundant, polyphasic motor unit potential pattern. His creatine kinase (CK) level was elevated at 647IU/L. A muscle biopsy showed myopathic features with rimmed vacuoles characteristic of s-IBM. The patient was informed of his correct diagnosis and counseled on his prognosis. Patient 1 is represented as patient 8 in Table 1 . Table 1 Retrospective chart review Patient Age (yr) Time to diagnosis (mo) Sex Symptoms Examination at initial presentation a Electrodiagnostic studies Muscle biopsy Diagnosis before referral 1 56 24 M Gait difficulty, then grip weakness WE 4− (L), FF 2, HF 5− (L), KE 3, DF 2 Myopathic End-stage muscle wasting Possible myopathy 2 70 60 M Asymmetric leg weakness, recurrent falls HF 4− (L), HE 4−; HF 3 (R), KE 4−, KF 5−, DF 4, Myopathic s-IBM strongly confirmed by p62-positive fibers Unknown 3 76 36 M Difficulty getting up from chair then difficulty opening jars; mild dysphagia SA 5−, EF 4−, EE 4−, FE 4; digits 4 and 5 FF 4 (L), HF 4−, KE 4 Mixed proximal myopathy End-stage muscle wasting, no inclusion bodies or lymphocytic infiltrates Probable myopathy 4 81 48 M Leg weakness, falls, difficulty getting up from chair Mild digit 5 flexion weakness, HF 4 Myopathic Fibers with adjacent lymphocytes, inclusions in fibers, interstitial fibrosis, COX-negative fibers Comorbid RA 5 85 72 M Difficulty climbing stairs, then asymmetric grip weakness Distal FF 2, KE 3, PF 4+ (L) Length dependent axonopathy, myopathy Atrophy with scattered morula, with mild chronic inflammation Peripheral neuropathy 6 67 60 M Grip weakness, then difficulty getting up from chair FF 3, HF 3, KE 2, PF 4 NA Intramyofiber inclusions Unknown 7 77 48 F Getting up from chair and gait difficulty, then difficulty opening jars SA 2, EF 2, EE 4, FF 2, FE 4+, HE 4, HA 4, KE 2, KF 4−, DF 4−, PF 4− Myopathic NA Unknown 8 55 48 M Proximal leg weakness, difficulty getting up from chair, climbing stairs FF 4, HF 5−, HE 5−, KF 4−, KE 4 Myopathic Chronic and active vacuolar myopathy, severe IBM ALS 9 54 145 M Grip weakness, then leg weakness, getting up from chair and ambulation difficulty FF 3 (R); 4 (L), KE 3 (L), KE 4− (R) Myopathic 2003: polymyositis Polymyositis 2013: chronic and active vacuolar myopathy 10 68 48 M Weakness with grip, opening jars, handling coins, then proximal leg weakness EF 5−, EE 4+, FF 3 (R) 2 (L), KE 4− (R); 2 (L), HF 4+ Myopathic Intramyofiber inclusions with fibrosis, absent oxidative positivity Neuropathy vs. myopathy 11 63 36 F Proximal leg weakness, then finger flexor weakness, some difficulty swallowing solids. Digits 4 and 5 FF 2 (R); digits 2–5 FF 2 (L), KE 4−, DF 4+ (R); 4− (L), PF 4+ Myopathic Prominent lymphocytic infiltration Unknown 12 73 120 M Proximal leg weakness HE 4, KE 3 Chronic denervation in the L4 muscles Biceps with minimal denervation changes, quadriceps too atrophic to biopsy Possible myopathy 13 43 60 M Finger flexor and proximal leg weakness HE 4−, KE 3+ (R); 4− (L) NA Lymphocytes, myopathy Inflammatory myopathy vs. IBM 14 67 24 M Proximal leg weakness, then finger flexors HF R 4, KE R 4 (R); 4+ (L), DF R 2 (R); 4+ (L) Myopathic Multifocal endomysial inflammation and fibrosis, intramyofiber inclusions Extrapyramidal disease vs. lumbosacral radiculopathy 15 75 6 M L leg weakness, L hand weakness, b/l arm weakness SA 4, FF 4−, HF 3, HA 4, KF 4+, DF 4+, KE 4− Myopathic Atrophic myofibers, minimal endomysial inflammation, rimmed vacuoles Unknown 16 71 120 F Leg weakness, then hand weakness, then difficulty swallowing B 4+ (R); 4 (L); WE 4 (R), FE 3, FF 3, KE 4− Myopathic Intramyofiber inclusions IBM 17 81 240 F Proximal leg weakness, then finger flexor weakness; some difficulty swallowing SA 3 (R); 4− (L), FE 4−, WE 4−, WF 4−, FF 4−, HF 2, HE 3, KE 3, DF3, PF 3 NA Severe inflammatory myopathy Polymyositis 18 82 24 M R hand weakness, then L hand weakness FF 3R (R); 2 (L) Myopathic Ragged red fibers, COX-negative fibers ALS 19 56 60 M Progressive weakness in hand grip WF 5−, FF 4 Myopathic NA Possible ALS 20 55 120 M Difficulty holding heavy objects, then difficulty getting up from chair EE 4, FF 4, HF 4−, KE 5− NA Endomysial mononuclear infiltration, internal nuclei in many fibers, ragged red fibers with rimmed vacuoles, COX-negative fibers IBM Abbreviations : ALS amyotrophic lateral sclerosis, B biceps, b/l bilateral, COX cytochrome oxidase, DF dorsiflexors, EE elbow extension, EF elbow flexion, FE finger extension, FF finger flexion, HA hip abduction, HE hip extension, HF hip flexion, IBM inclusion body myositis, KE knee extension, KF knee flexion, L left, LE lower extremity, NA not available, PF plantarflexors, pt patient, PT physical therapy, R right, RA rheumatoid arthritis, SA shoulder abduction, s - IBM sporadic inclusion body myositis, UE upper extremity, WE wrist extension, WF wrist flexion a Strength is given according to the Medical Research Council grading system. Muscle groups not listed are otherwise normal strength
| 4.199219
| 0.929688
|
sec[1]/sec[0]/p[1]
|
en
| 0.999996
|
26268316
|
https://doi.org/10.1186/s13256-015-0647-z
|
[
"weakness",
"difficulty",
"myopathic",
"myopathy",
"fibers",
"getting",
"chair",
"grip",
"flexion",
"finger"
] |
[
{
"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"
},
{
"code": "QE50.7",
"title": "Personality difficulty"
},
{
"code": "QF2Z",
"title": "Difficulty or need for assistance with unspecified activity"
},
{
"code": "MC1Y",
"title": "Other specified symptoms or signs involving the visual system"
},
{
"code": "QF22",
"title": "Difficulty or need for assistance with communication"
},
{
"code": "QF25",
"title": "Difficulty or need for assistance with relationships"
}
] |
=== ICD-11 CODES FOUND ===
[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
[QE50.7] Personality difficulty
Definition: Personality difficulty refers to pronounced personality characteristics that may affect treatment or health services but do not rise to the level of severity to merit a diagnosis of Personality disorder. Personality difficulty is characterised by long-standing difficulties (e.g., at least 2 years), in the individual’s way of experiencing and thinking about the self, others and the world. In contrast to Personality disorders, these difficulties are manifested in cognitive and emotional experience
Also known as: Personality difficulty
Excludes: Personality disorder
[QF2Z] Difficulty or need for assistance with unspecified activity
Also known as: Difficulty or need for assistance with unspecified activity | need for assistance with activities | dependence on care provider | difficulty with activities
[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
[QF22] Difficulty or need for assistance with communication
Also known as: Difficulty or need for assistance with communication | communication difficulty | need for assistance with communication
[QF25] Difficulty or need for assistance with relationships
Also known as: Difficulty or need for assistance with relationships | difficulty with relationships | need for assistance with relationships | Difficulty or need for assistance with family relationships | Difficulty or need for assistance with formal relationships
=== GRAPH WALKS ===
--- Walk 1 ---
[MG22] Fatigue
Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...
--EXCLUDES--> [?] Exhaustion due to exposure
--PARENT--> [?] Effects of other deprivation
--- Walk 2 ---
[MG22] Fatigue
Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...
--EXCLUDES--> [?] Exhaustion due to exposure
--PARENT--> [?] Effects of other deprivation
--- Walk 3 ---
[FB32.Y] Other specified disorders of muscles
--PARENT--> [FB32] Certain specified disorders of muscle
Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....
--CHILD--> [FB32.2] Ischaemic infarction of muscle
--- Walk 4 ---
[FB32.Y] Other specified disorders of muscles
--PARENT--> [FB32] Certain specified disorders of muscle
Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....
--EXCLUDES--> [?] Cramp or spasm
--- Walk 5 ---
[MB5Z] Paralytic symptoms, unspecified
--PARENT--> [?] Paralytic symptoms
--CHILD--> [MB50] Tetraplegia
--- Walk 6 ---
[MB5Z] Paralytic symptoms, unspecified
--PARENT--> [?] Paralytic symptoms
--CHILD--> [MB50] Tetraplegia
|
[
"[MG22] Fatigue\n Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...\n --EXCLUDES--> [?] Exhaustion due to exposure\n --PARENT--> [?] Effects of other deprivation",
"[MG22] Fatigue\n Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...\n --EXCLUDES--> [?] Exhaustion due to exposure\n --PARENT--> [?] Effects of other deprivation",
"[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --CHILD--> [FB32.2] Ischaemic infarction of muscle",
"[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --EXCLUDES--> [?] Cramp or spasm",
"[MB5Z] Paralytic symptoms, unspecified\n --PARENT--> [?] Paralytic symptoms\n --CHILD--> [MB50] Tetraplegia",
"[MB5Z] Paralytic symptoms, unspecified\n --PARENT--> [?] Paralytic symptoms\n --CHILD--> [MB50] Tetraplegia"
] |
MG22
|
Fatigue
|
[
{
"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"
},
{
"from_icd11": "MG22",
"icd10_code": "R53",
"icd10_title": "Malaise and fatigue"
},
{
"from_icd11": "FB32.Y",
"icd10_code": "M6281",
"icd10_title": "Muscle weakness (generalized)"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8384",
"icd10_title": "Todd's paralysis (postepileptic)"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8331",
"icd10_title": "Monoplegia, unspecified affecting right dominant side"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8389",
"icd10_title": "Other specified paralytic syndromes"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8383",
"icd10_title": "Posterior cord syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8381",
"icd10_title": "Brown-Sequard syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8382",
"icd10_title": "Anterior cord syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8332",
"icd10_title": "Monoplegia, unspecified affecting left dominant side"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8334",
"icd10_title": "Monoplegia, unspecified affecting left nondominant side"
}
] |
R5382
|
Chronic fatigue, unspecified
|
This case is a humbling reminder of the devastating consequences of uncontrolled hyperparathyroidism (HPT) and of the risks for modern-day scurvy in dialysis patients. Vitamin C (ascorbic acid) is a water-soluble vitamin removed through HD . This, combined with poor nutrition and the fact that most vitamin C containing foods also contain potassium, leaves dialysis patients at high risk for vitamin C deficiency . In patients with ESKD, vitamin C deficiency may also lead to refractory anemia or erythropoietin resistance, possibly through decreased iron absorption and inflammatory oxidative stress . Dialysis patients are frequently prescribed vitamin B and C complex supplements, and such supplementation has been associated with a 16% lower risk of mortality . Vitamin C deficiency may also have potentiating effects on mineral bone disease associated with ESKD through alteration of vitamin D metabolism. Animal studies have demonstrated that vitamin C deficiency leads to a decrease in 1-α-hydroxylase activity in the kidney, a decrease in vitamin D receptors in the intestine, a decreased ability for active vitamin D to bind to these receptors, and the development of hypocalcemia . It also leads to a decrease in bone mineralization and hydroxyproline content, a major component of bone collagen . Furthermore, these effects were shown to persist despite adequate supplementation with vitamin D. Vitamin C deficiency has also been associated with the development of HPT in dialysis patients . While this may be due to blunting of the effect of vitamin D on the intestine, it is proposed that vitamin C could also be involved in calcium-sensing receptor (CaSR) c-AMP-mediated signaling within the parathyroid gland. Deficiency may lead to a blunted response from the CaSR, inappropriately high PTH levels, and promote the development of renal osteodystrophy . Severe, prolonged secondary HPT leads to devastating musculoskeletal disease, including Brown tumors (localized osteolytic masses due to overactivation of osteoclasts). While the orofacial skeleton is not thought to be a site of predilection for renal osteodystrophy, these bones are not spared its ravages. Localized jaw pain and bone enlargement related to secondary HPT have been reported, with Brown tumors being the most common histopathological finding . However, the soft tissue changes of the face related to chronic uremia may take on a more expansive, diffuse facial enlargement leading to the morphological changes described as uremic leontiasis ossea due to the resemblance to a lion’s face. The Sagliker syndrome, which likely represents another way of naming the same entity, has also been described . We believe our case fits well the clinical, radiological, and pathological presentation of uremic leontiasis ossea as a consequence of years of severe, uncontrolled HPT. Leontiasis ossea is a clinical entity characterized by an enlargement of the mandibular and maxillary bones with flattening of the nasal ridge, giving a leonine facies. It may be present in the context of Paget’s disease, acromegaly, fibrous dysplasia or secondary HPT from ESKD (uremic leontiasis ossea). Uremic leontiasis ossea is a rarely reported manifestation of renal osteodystrophy . Histologically, it resembles fibrous dysplasia except for the presence of giant cells which suggest a reactive condition . Radiographically, there is diffuse hypertrophy of the jaw bones, with ground-glass appearance and without the localized lytic masses typical of Brown tumors . The bone enlargement can be severe enough to cause compressive neuropathies and even airway compromise . Treatment with parathyroidectomy only rarely leads to improvement in bone deformities . Most often it will at least offer stabilization of the condition . We hypothesize here that the concurrent presence of severe vitamin C deficiency in our patient was a potentiating factor for the development of such severe HPT and renal osteodystrophy. To our knowledge, such an association has never been reported. Given its proposed role in regulating vitamin D metabolism and PTH levels , it is conceivable that a lack of vitamin C could potentiate renal osteodystrophy. Unfortunately, there is a paucity of data looking at the use of vitamin C in dialysis patients with HPT. One prospective observational study showed a significant reduction in PTH with the administration of vitamin C during dialysis . A randomized, controlled trial of vitamin C given for 8 weeks vs. control in dialysis patients with HPT found no significant difference in PTH levels at 8 weeks . However, the study has significant limitations related to a lack of methodological reporting making its results difficult to interpret. The potential association between vitamin C deficiency, altered vitamin D metabolism, and renal osteodystrophy requires further study. Our case highlights the devastating consequences of non-adherence to medical therapy in ESKD, the challenges in managing these patients and the importance of evaluating non-adherent patients for vitamin C deficiency. We believe it also highlights the potential benefits from expanding the role of psychological support for dialysis patients to ensure they are able to openly discuss concerns regarding their therapy which may affect adherence to routine medical recommendations.
| 4.464844
| 0.842773
|
sec[1]/p[0]
|
en
| 0.999997
|
31508269
|
https://doi.org/10.5414/CNCS109788
|
[
"vitamin",
"patients",
"deficiency",
"dialysis",
"bone",
"renal",
"osteodystrophy",
"that",
"leontiasis",
"ossea"
] |
[
{
"code": "5B7Z",
"title": "Unspecified undernutrition"
},
{
"code": "5B90.Z",
"title": "Unspecified vitamin excesses"
},
{
"code": "5B55.Z",
"title": "Vitamin A deficiency, unspecified"
},
{
"code": "6C4H.1Z",
"title": "Harmful pattern of use of non-psychoactive substances, unspecified"
},
{
"code": "5B90.Y",
"title": "Other specified vitamin excess"
},
{
"code": "PL14.C",
"title": "Patient received diagnostic test or treatment intended for another patient"
},
{
"code": "QB14",
"title": "Unavailability or inaccessibility of health care facilities"
},
{
"code": "PL14.2",
"title": "Problem associated with physical transfer of patient"
},
{
"code": "QB12.0",
"title": "Organ transplant candidate"
},
{
"code": "QA15.1",
"title": "Counselling related to sexual behaviour and orientation or sexual relationships of the person"
}
] |
=== ICD-11 CODES FOUND ===
[5B7Z] Unspecified undernutrition
Also known as: Unspecified undernutrition | Malnutrition NOS | nutritional deficiency NOS | nutritional depletion NOS | severe malnutrition NOS
[5B90.Z] Unspecified vitamin excesses
Also known as: Unspecified vitamin excesses | Vitamin excesses
[5B55.Z] Vitamin A deficiency, unspecified
Also known as: Vitamin A deficiency, unspecified | Vitamin A deficiency | Hypovitaminosis A
[6C4H.1Z] Harmful pattern of use of non-psychoactive substances, unspecified
Also known as: Harmful pattern of use of non-psychoactive substances, unspecified | Harmful pattern of use of non-psychoactive substances | harmful use of nonprescribed drugs, non-dependence producing | Abuse of antacids | Abuse of herbal or folk remedies
[5B90.Y] Other specified vitamin excess
Also known as: Other specified vitamin excess
[PL14.C] Patient received diagnostic test or treatment intended for another patient
Also known as: Patient received diagnostic test or treatment intended for another patient | wrong patient | incorrect patient
Excludes: Procedure undertaken at wrong site or wrong side, as mode of injury or harm
[QB14] Unavailability or inaccessibility of health care facilities
Also known as: Unavailability or inaccessibility of health care facilities | unavailability of medical facilities | Unavailability of outpatient clinic | Unavailability or inaccessibility of residential aged care service
Excludes: bed unavailable
[PL14.2] Problem associated with physical transfer of patient
Also known as: Problem associated with physical transfer of patient
[QB12.0] Organ transplant candidate
Also known as: Organ transplant candidate | patient waiting for organ availability | health services provided because of need for organ transplant | organ transplant candidate awaiting organ availability | person on organ transplant waiting list
[QA15.1] Counselling related to sexual behaviour and orientation or sexual relationships of the person
Also known as: Counselling related to sexual behaviour and orientation or sexual relationships of the person | advice on sexual behaviour or orientation | counselling on sexual behaviour or orientation | promiscuity counselling | patient concerned regarding sexual orientation
=== GRAPH WALKS ===
--- Walk 1 ---
[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 2 ---
[5B7Z] Unspecified undernutrition
--PARENT--> [?] Undernutrition
Def: Undernutrition is a condition in which the body’s requirements are unmet due to underconsumption or to impaired absorption and use of nutrients. It can be produced by lack of access to food, or as a c...
--EXCLUDES--> [?] Effects of hunger
--- Walk 3 ---
[5B90.Z] Unspecified vitamin excesses
--PARENT--> [5B90] Vitamin excesses
--CHILD--> [5B90.2] Hypervitaminosis D
Def: Hypervitaminosis D is secondary to excessive intake of vitamin D. It can occur with long-term high intake or with a substantial, acute ingestion. Excess amounts result in abnormally high concentration...
--- Walk 4 ---
[5B90.Z] Unspecified vitamin excesses
--PARENT--> [5B90] Vitamin excesses
--PARENT--> [?] Certain specified nutrient excesses
Def: Any disease caused by an excess of specific nutrients. Confirmation is by blood test....
--- Walk 5 ---
[5B55.Z] Vitamin A deficiency, unspecified
--PARENT--> [5B55] Vitamin A deficiency
Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...
--CHILD--> [5B55.2] Vitamin A deficiency with conjunctival xerosis and Bitot's spots
Def: Generalised conjunctival xerosis suggests advanced vitamin A deficiency. The entire conjunctiva appears dry, roughened, and corrugated, sometimes skin-like. In some individuals keratin and saprophytic...
--- Walk 6 ---
[5B55.Z] Vitamin A deficiency, unspecified
--PARENT--> [5B55] Vitamin A deficiency
Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...
--CHILD--> [5B55.0] Vitamin A deficiency with night blindness
Def: Night blindness (poor adaptation to darkness) is generally the earliest manifestation of vitamin A deficiency. In mild cases, night blindness is apparent only after photic stress. Affected children no...
|
[
"[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...",
"[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--> [?] Effects of hunger",
"[5B90.Z] Unspecified vitamin excesses\n --PARENT--> [5B90] Vitamin excesses\n --CHILD--> [5B90.2] Hypervitaminosis D\n Def: Hypervitaminosis D is secondary to excessive intake of vitamin D. It can occur with long-term high intake or with a substantial, acute ingestion. Excess amounts result in abnormally high concentration...",
"[5B90.Z] Unspecified vitamin excesses\n --PARENT--> [5B90] Vitamin excesses\n --PARENT--> [?] Certain specified nutrient excesses\n Def: Any disease caused by an excess of specific nutrients. Confirmation is by blood test....",
"[5B55.Z] Vitamin A deficiency, unspecified\n --PARENT--> [5B55] Vitamin A deficiency\n Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...\n --CHILD--> [5B55.2] Vitamin A deficiency with conjunctival xerosis and Bitot's spots\n Def: Generalised conjunctival xerosis suggests advanced vitamin A deficiency. The entire conjunctiva appears dry, roughened, and corrugated, sometimes skin-like. In some individuals keratin and saprophytic...",
"[5B55.Z] Vitamin A deficiency, unspecified\n --PARENT--> [5B55] Vitamin A deficiency\n Def: Vitamin A deficiency (VAD) is defined as a state in which tissue concentrations of vitamin A are low enough to have adverse health consequences even if there is no evidence of clinical xerophthalmia. ...\n --CHILD--> [5B55.0] Vitamin A deficiency with night blindness\n Def: Night blindness (poor adaptation to darkness) is generally the earliest manifestation of vitamin A deficiency. In mild cases, night blindness is apparent only after photic stress. Affected children no..."
] |
5B7Z
|
Unspecified undernutrition
|
[
{
"from_icd11": "5B7Z",
"icd10_code": "E43",
"icd10_title": "Unspecified severe protein-calorie malnutrition"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E538",
"icd10_title": "Deficiency of other specified B group vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E569",
"icd10_title": "Vitamin deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E638",
"icd10_title": "Other specified nutritional deficiencies"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E639",
"icd10_title": "Nutritional deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E41",
"icd10_title": "Nutritional marasmus"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E539",
"icd10_title": "Vitamin B deficiency, unspecified"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E568",
"icd10_title": "Deficiency of other vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E649",
"icd10_title": "Sequelae of unspecified nutritional deficiency"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E618",
"icd10_title": "Deficiency of other specified nutrient elements"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E40-E46",
"icd10_title": ""
},
{
"from_icd11": "5B7Z",
"icd10_code": "E50-E64",
"icd10_title": ""
},
{
"from_icd11": "5B7Z",
"icd10_code": "E53",
"icd10_title": "Deficiency of other B group vitamins"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E56",
"icd10_title": "Other vitamin deficiencies"
},
{
"from_icd11": "5B7Z",
"icd10_code": "E61",
"icd10_title": "Deficiency of other nutrient elements"
}
] |
E43
|
Unspecified severe protein-calorie malnutrition
|
A 69-year-old man with a feeling of epigastric compression was referred to our hospital for examination of an abdominal mass. His past medical history included hyperlipidemia, pulmonary emphysema, and bronchial asthma. He had no history of liver disease, blood transfusion, tattooing, or alcohol abuse. He had smoked 30 cigarettes per day for 35 years. The patient’s laboratory findings on admission were as follows: white blood cell count, 7500/μl; hemoglobin, 13.7 g/dl; platelet count, 21.1 × 10 4 /μl; C-reactive protein, 0.5 mg/dl; total protein, 6.7 g/dl; serum albumin, 4.0 g/dl; UN, 11.1 mg/dl; serum creatinine, 0.7 mg/dl; glucose, 86 g/dl; and HbA1c, 5.4%. Liver function tests revealed total bilirubin, 0.5 mg/dl; serum aspartate aminotransferase, 21 IU/l; serum alanine aminotransferase, 14 IU/l; serum glutamyltransferase, 83 IU/l; prothrombin time, 80.8%; and indocyanine green retention rate at 15 min, 8.6%, and indicated Child-Pugh class A. Antibody tests were negative for both hepatitis B surface antigen and hepatitis C virus. The following tumor markers were all within normal ranges: α-fetoprotein was 5.7 ng/ml (normal range < 10 ng/ml), PIVKA-II was 18 mAU/ml (normal range < 40mAU/ml), carcinoembryonic antigen was 1.5 ng/ml (normal range < 5.0 ng/ml), carbohydrate antigen 19-9 was 4.1 ng/ml (normal range < 37.0 ng/ml), and sIL-2R was 362 U/ml (normal range 121–613 U/ml). Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a relatively well-contrasted 12 × 11 × 8 cm tumor with a well-defined boundary replacing the lateral segment of the liver alongside multiple intrahepatic metastases. In addition, several nodules up to 12 mm were found in both lungs, suggesting metastasis. Contrast-enhanced CT revealed a hypodense tumor on plain scans, with heterogeneous and peripheral enhancement on early phase and delayed washout on late phase. MRI revealed a homogenous hypointense tumor on Tl-weighted images and a hyperintense one in T2-weighted images without encapsulation. On Gd-EOB-DTPA-enhanced MRI, the tumor was heterogeneously enhanced during the early phase and weakly enhanced during the late phase. SUVmax of the liver mass and the lung tumor in positron emission tomography (PET) were 10.4 and 1.5, respectively . No abnormal accumulation was observed in the lymph nodes, bones, peritoneum, or any other sites. Upper and lower gastrointestinal endoscopic examination detected no abnormal findings. Hepatocellular carcinoma was primarily suspected; however, intrahepatic cholangiocarcinoma or mixed hepatocellular and cholangiocarcinoma were other possible diagnoses. Lateral segmentectomy of the liver was performed to confirm diagnosis and prevent tumor rupture. Operation time was 104 min, with a bleeding volume of 240 ml. Macroscopically, the lateral segment of the liver was replaced by a lobular or multinodular tumor with a maximum diameter of 15 cm . In pathological findings, the tumor consisted of bundle-like proliferation of complicated banding spindle-like cells with clear cytoplasm, accompanied by storiform pattern and compressed blood vessels . Hydropic change and hyalinization were observed. Various degrees of nuclear atypia were observed, and nuclear fission images were demonstrated in 8/10 high-power field. Partial necrosis was present, with associated venous invasion and intrahepatic metastasis. Immunohistochemical staining for tumor cells revealed desmin, α-smooth muscle actin (αSMA), and h-caldesmon to be diffusely positive, while c-kit, S100, CD34, CAM5.2, EMA, CD163, and DOG1 were negative . Ki-67 labeling index of the main tumor was 70%. These findings suggested differentiation into the smooth muscle, informing a final diagnosis of leiomyosarcoma of the liver. No other neoplastic lesion was detected on image examinations such as gastrointestinal endoscopy, CT, MRI, and PET, so the tumor was considered to be primary, not metastatic liver tumor. Postoperative course was uneventful, and he was discharged on the 12th postoperative day. Four weeks after surgery, systemic chemotherapy with doxorubicin (75 mg/m 2 ) was commenced for metastatic tumors of the liver and lung. Fig. 1 CT demonstrated a a relatively well-contrasted 12 × 11 × 8 cm tumor with well-defined boundary replacing the lateral segment of the liver. Contrast-enhanced CT revealed a heterogeneous and peripheral enhancement on early phase. b Several nodules up to 12 mm were observed in both lungs, suggestive of metastasis Fig. 2 MRI demonstrated a large tumor and multiple intrahepatic metastases (arrow) Fig. 3 SUVmax of the liver mass in PET was 10.4. No abnormal accumulation was observed in the lymph nodes, bones, or peritoneum Fig. 4 Macroscopically, the lateral segment of the liver had been replaced by a lobular or multinodular tumor with a maximum diameter of 15 cm Fig. 5 In pathological findings, a the tumor consisted of bundle-like proliferation of complicated banding spindle-like cells with clear cytoplasm, accompanied by storiform pattern and compressed blood vessels. b Various degrees of nuclear atypia were observed, and nuclear fission images were demonstrated in 8/10 HPF Fig. 6 On immunohistochemical staining, a desmin and αSMA and b h-caldesmon were diffusely positive, while c-kit, S100, CD34, CAM5.2, EMA, CD163, and DOG1 were negative
| 4.101563
| 0.964844
|
sec[1]/p[0]
|
en
| 0.999997
|
32648231
|
https://doi.org/10.1186/s40792-020-00934-6
|
[
"tumor",
"liver",
"serum",
"range",
"enhanced",
"phase",
"blood",
"well",
"segment",
"intrahepatic"
] |
[
{
"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": "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 ===
[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
[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 ---
[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--> [?] 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--> [?] 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--> [2E61] Carcinoma in situ of other or unspecified digestive organs
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--PARENT--> [02] Neoplasms
Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair....
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --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--> [?] 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--> [?] 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--> [2E61] Carcinoma in situ of other or unspecified digestive organs",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --PARENT--> [02] Neoplasms\n Def: An abnormal or uncontrolled cellular proliferation which is not coordinated with an organism's requirements for normal tissue growth, replacement or repair...."
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 65-year-old Japanese female with a history of hyperlipidemia experienced palpitations and uncertain chest discomfort while eating, before developing left upper and lower limb paralysis. During emergency transport, her blood pressure dropped to 62 mmHg, and right joint paralysis developed. She was transported to our hospital 35 minutes after onset with an additional presentation of right back pain. Neurological severity was rated as National Institutes of Health Stroke Scale (NIHSS) 2 (left upper limb paralysis and right conjugate deviation). There was no heart murmur. Left–right difference in blood pressure at the emergency department was less than 20 mmHg (right upper limb 77/54 mmHg, left upper limb 87/45 mmHg, right lower limb 102/92 mmHg, left lower limb 94/51 mmHg). No elevation in white blood cells or C-reactive protein was noted, and there were no findings suggestive of acidosis. d -dimer was mildly elevated at 6.3 μg/mL. Serum creatinine and estimated glomerular filtration rate (eGFR) were 1.11 mg/dL and 38.6 mL/minute/1.73 m 2 , respectively, and renal function was not impaired to the extent that contrast media could not be used. An echocardiogram was not performed. Rehydration was started, and there was no hemodynamic deterioration. A chest radiograph taken 110 minutes after onset showed no enlargement of the aorta or mediastinum . A plain head CT scan did not suggest acute infarction or bleeding . However, on CT perfusion (CTP), the right middle cerebral artery region showed an elongation of delay (DLY) and increases in time to peak (TTP) and mean transit time (MTT). Cerebral blood flow (CBF) was decreased, but cerebral blood volume (CBV) was preserved . Due to the absence of early CT signs in the plain head CT, we determined that the patient had ischemic penumbra. On the CT angiography (CTA) reconstructed from the arterial phase of the CTP scan, the right middle cerebral artery was poorly depicted . However, the four-dimensional maximum-intensity projection (4D MIP) image reconstructed from CTP showed a delayed enhancement of both the right internal carotid artery and the right middle cerebral artery. In the late phase, the distal portion of the right middle cerebral artery was well depicted, and no stenosis or obstruction was observed at the intracranial artery, suggesting a proximal vascular lesion . A contrasted helical CT scan from the neck to abdomen was performed using contrast medium residue soon after CTP imaging. This revealed an acute aortic dissection of Stanford type A with false lumen patency, from the base of the aorta to the level of the renal artery bifurcation. The dissection extended to the proximal right common carotid artery, and the true lumen of the right internal carotid artery was narrowed. The left renal artery was supplied by the false lumen . The brain tissue status on CTP was reversible ischemia, not irreversible infarction, and the patient was deemed to be eligible for emergency surgery, which included total arch replacement and open stent graft insertion approximately 3.5 hours after the onset of illness. The left upper limb paralysis had recovered to a manual muscle test (MMT) grade of about 4–5 after the surgery. The patient was ambulatory upon discharge from the hospital 23 days after the onset. Fig. 1 The patient’s chest radiograph shows no enlargement of the mediastinum. There is no calcification of the aortic wall or pleural effusion Fig. 2 A plain head computed tomography scan does not reveal any sign of acute infarction or bleeding Fig. 3 On computed tomography perfusion scan, delay (DLY), time to peak (TTP), and mean transit time (MTT) are elongated. Cerebral blood flow is decreased, but cerebral blood volume (CBV) is preserved in the region of the right middle cerebral artery. The lesions with elongated DLY, TTP, and MTT may indicate major vessel occlusion. An area with decreased CBV is diagnosed as an infarction, which is irreversible ischemic tissue damage. Because CBV remained almost normal, we determined that the patient had a large ischemic penumbra and no infarction yet in this case Fig. 4 Computed tomography angiography reconstructed from computed tomography perfusion scan shows the right middle cerebral artery poorly depicted. The right internal carotid artery appears to be intact Fig. 5 Four-dimensional maximum-intensity projection image reconstructed from computed tomography perfusion scan. a , b The right internal carotid artery and the right middle cerebral artery indicate delayed enhancement compared to the contralateral side. c In the late phase, the distal middle cerebral artery also exhibits delayed enhancement, and no stenosis or obstruction is observed, suggesting a proximal vascular lesion. d No venous abnormality was seen in venous phase Fig. 6 Contrast computed tomography from the neck to abdomen was taken using a contrast medium. a A cross section at the level of the thoracic aorta revealed an acute aortic dissection of Stanford type A with false lumen patency. b A cross section of the aorta to the level of the renal artery bifurcation. The left renal artery is perfused by the false lumen. c Coronal reconstruction section of the neck. The dissection extends to the proximal right common carotid artery, with narrowing of the lumen of the right internal carotid artery
| 4.125
| 0.969727
|
sec[1]/p[0]
|
en
| 0.999998
|
34034814
|
https://doi.org/10.1186/s13256-021-02850-1
|
[
"artery",
"cerebral",
"middle",
"limb",
"blood",
"scan",
"carotid",
"mmhg",
"lumen",
"computed"
] |
[
{
"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": "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"
}
] |
=== 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
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--CHILD--> [?] Chronic arterial occlusive disease
--- Walk 2 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--CHILD--> [BD30] Acute arterial occlusion
--- Walk 3 ---
[BD52] Certain specified disorders of arteries or arterioles
--CHILD--> [BD52.2] Stricture of artery
--PARENT--> [BD52] Certain specified disorders of arteries or arterioles
--- Walk 4 ---
[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...
--CHILD--> [?] Cutaneous leukocytoclastic vasculitis
Def: Skin-limited small vessel leucocytoclastic vasculitis of unspecified or unknown aetiology...
--- 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...
--PARENT--> [?] ICD Category
--- Walk 6 ---
[BD52.3] Rupture of artery
--PARENT--> [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...
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [?] Chronic arterial occlusive disease",
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD30] Acute arterial occlusion",
"[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.2] Stricture of artery\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles",
"[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...\n --CHILD--> [?] Cutaneous leukocytoclastic vasculitis\n Def: Skin-limited small vessel leucocytoclastic vasculitis of unspecified or unknown aetiology...",
"[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",
"[BD52.3] Rupture of artery\n --PARENT--> [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..."
] |
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 19-year-old female with a past medical history of asthma presented to urgent care with complaints of a severe sore throat, neck swelling, and fatigue for two days. The initial work-up showed a positive heterophile/EBV reflex test, a negative group A strep test, and a negative influenza A and B test. She was discharged with supportive care for infectious mononucleosis. Over the next week, her symptoms continued to worsen. She was taken to the emergency department for an episode of hemoptysis, fever, eye pain, and copious purulent drainage from her nose. Upon presentation, she was in distress due to a severe headache, photophobia, and blurred vision. She also endorsed having diplopia, bloody purulent nasal discharge, neck swelling, nausea, vomiting, and anorexia. She denied any recent travel, trauma, or history of neurosurgery. The patient was hypotensive (96/60 mm Hg), febrile (103 °F), and tachycardic (120 beats/minute) upon presentation. Her examination revealed sinus tenderness, nuchal rigidity, and right-sided cervical lymphadenopathy. The eye examination showed right eye proptosis, chemosis, pain with extraocular eye movements (particularly with upward gaze), and a bilateral abducens nerve palsy . The rest of her exam was unremarkable. Her labs upon admission showed a leukocytosis of 18 K/µL (4.0-10.5 K/µL), thrombocytopenia of 36 K/µL (140-450 K/µL), transaminitis with an aspartate aminotransferase (AST) of 56 U/L (0-32 U/L) and alanine aminotransferase (ALT) of 49 U/L (0-33 U/L), alkaline phosphatase of 164 U/L (30-115 U/L), total bilirubin of 4.07 mg/dL (0.0-120 mg/dL), C-reactive protein (CRP) of 192.10 (<10 mg/L), international normalized ratio (INR) of 1.3, D-dimer of 4.41 ug/mL (0.0-0.50 ug/mL), and procalcitonin of 90.71 ng/mL (0.0-0.25 ng/mL). A CT scan of the head, a chest X-ray, and blood cultures were ordered. Due to suspicion for meningitis, a lumbar puncture was performed in the emergency department. The lumbar puncture showed cloudy yellow fluid, white blood cells 2,069 cells/µL (0-4 cells/µL), 66% neutrophils, glucose of 56 mg/dL (40-75 mg/dL), and protein of 190 mg/dL (15.0-45.0 mg/dL). This was suggestive of bacterial meningitis. Aerobic and anaerobic cultures of her cerebrospinal fluid (CSF) were negative. A CT of the head showed bilateral cavernous sinus thrombosis, right superior ophthalmic vein thrombosis, and opacification of the right frontal, maxillary, and sphenoid sinuses . The chest X-ray and chest CT were unremarkable . The patient was admitted to the intensive care unit for the management of sepsis. An extensive initial work-up, including HIV, rapid plasma regain (RPR), and viral hepatitis serologies, was negative, but the preliminary blood cultures would eventually grow gram-negative rods. Based on the examination, abnormal laboratory findings, and abnormal imaging findings, numerous departments were consulted, including infectious disease, otolaryngology, neurosurgery, and ophthalmology. She was then started on broad-spectrum IV antimicrobials including linezolid, meropenem, acyclovir, and doxycycline along with heparin for anticoagulation. An MRI of the brain supported her CT scan findings of a cavernous sinus thrombosis, thrombosis of the right superior ophthalmic vein with concomitant right orbital proptosis, retro-orbital congestion, and enhancement with enlargement of the right lateral rectus . When her blood cultures came back positive for F. necrophorum , the antibiotic regimen was narrowed to ceftriaxone and metronidazole. Of note, the CT scan and ultrasound of the neck were negative for jugular venous thrombophlebitis. An ultrasound of the liver and spleen was performed to rule out septic emboli. It was negative for any abscesses but did show splenomegaly (14 cm). The patient required multiple right sinus surgeries including maxillary antrostomy, ethmoidectomy, sphenoidectomy, and septoplasty during her stay. The culture from the tissues obtained from her nasal sinuses after the procedure also grew Fusobacterium . The ophthalmology service performed daily vision checks and treated her right eye prophylactically with erythromycin due to lagophthalmos. For her cavernous sinus and superior ophthalmic vein thrombosis, she was continued on heparin that was later transitioned to warfarin. On day 6 of admission, the patient showed significant clinical improvement with decreased headache, reduced eye pain, improved visual acuity, decreased proptosis, and increased extraocular motility. However, she continued to have medial deviation of her left eye. She was discharged home on day 12 with IV ceftriaxone and oral metronidazole for a two-week course with three months of warfarin and follow-up appointments scheduled one week after discharge. After completing her IV antibiotic course, the patient was transitioned to amoxicillin/clavulanate for an additional two weeks. At her ENT follow-up, a nasal endoscopy was performed that showed well healing surgical sites. At her oculoplastic follow-up, she continued to show left eye medial deviation that was unchanged from when she was discharged. Furthermore, she continued to endorse blurry vision and diplopia that was improving but denied eye pain or pressure. At this point, she was referred to neuro-ophthalmology for further evaluation of her abducens nerve palsy.
| 3.916016
| 0.980469
|
sec[1]/p[0]
|
en
| 0.999996
|
32879837
|
https://doi.org/10.7759/cureus.10131
|
[
"sinus",
"thrombosis",
"pain",
"blood",
"cultures",
"including",
"that",
"neck",
"discharged",
"upon"
] |
[
{
"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"
},
{
"code": "DD30.Z",
"title": "Acute vascular disorders of intestine, unspecified"
},
{
"code": "JA61.Y",
"title": "Other specified venous complications in pregnancy"
},
{
"code": "JB41.Y",
"title": "Other specified venous complications in the puerperium"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "DB61",
"title": "Perianal venous thrombosis"
}
] |
=== ICD-11 CODES FOUND ===
[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
[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
[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
[JB41.Y] Other specified venous complications in the puerperium
Also known as: Other specified venous complications in the puerperium | Genital varices in the puerperium | varix of vulva in puerperium | Postpartum varicose veins of legs | varicose veins of legs in the puerperium
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[DB61] Perianal venous thrombosis
Definition: Extremely painful cherry like lesions under the perianal skin containing clotted blood have been attributed to rupture of a blood vessel with haematoma. However, histology confirmed that these lesions are thrombi lying within the thin-walled vessels of the external anal plexus.
Also known as: Perianal venous thrombosis | thrombosed external pile | anal thrombosis | Perianal haematoma (nontraumatic) | perianal thrombosis
Includes: perianal thrombosis | Perianal haematoma (nontraumatic)
=== GRAPH WALKS ===
--- Walk 1 ---
[CA0A.Z] Chronic rhinosinusitis, unspecified
--PARENT--> [CA0A] Chronic rhinosinusitis
Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...
--CHILD--> [CA0A.Y] Other specified chronic rhinosinusitis
--- Walk 2 ---
[CA0A.Z] Chronic rhinosinusitis, unspecified
--PARENT--> [CA0A] Chronic rhinosinusitis
Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...
--EXCLUDES--> [?] Acute sinusitis
Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries o...
--- Walk 3 ---
[CA0J.Y] Other specified nasal polyp
--PARENT--> [CA0J] Nasal polyp
Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...
--EXCLUDES--> [?] Benign neoplasm of middle ear, nasal cavity or accessory sinuses
--- Walk 4 ---
[CA0J.Y] Other specified nasal polyp
--PARENT--> [CA0J] Nasal polyp
Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...
--CHILD--> [CA0J.0] Polypoid sinus degeneration
Def: Also referred to as Woakes' syndrome or ethmoiditis. Woakes' syndrome is characterised by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of th...
--- Walk 5 ---
[LB03.Y] Other specified structural developmental anomalies of umbilical cord
--PARENT--> [LB03] Structural developmental anomalies of umbilical cord
Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....
--RELATED_TO--> [?] Fetus or newborn affected by short umbilical cord
Def: An umbilical cord < 2 SD in length below mean for the gestational age. At term, this is < 35 cm. Often associated with fetal hypokinesia...
--- Walk 6 ---
[LB03.Y] Other specified structural developmental anomalies of umbilical cord
--PARENT--> [LB03] Structural developmental anomalies of umbilical cord
Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....
--RELATED_TO--> [?] Umbilical cord haemangioma
Def: Tumour composed of thin walled blood vessels lined by endothelium present within the cord....
|
[
"[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --CHILD--> [CA0A.Y] Other specified chronic rhinosinusitis",
"[CA0A.Z] Chronic rhinosinusitis, unspecified\n --PARENT--> [CA0A] Chronic rhinosinusitis\n Def: Sinusitis is an inflammation of the mucosal lining of the paranasal sinuses secondary to both infectious and allergic mechanisms. The retention of sinus secretions is the most important event in the d...\n --EXCLUDES--> [?] Acute sinusitis\n Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries o...",
"[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --EXCLUDES--> [?] Benign neoplasm of middle ear, nasal cavity or accessory sinuses",
"[CA0J.Y] Other specified nasal polyp\n --PARENT--> [CA0J] Nasal polyp\n Def: Nasal polyp is an inflammatory and proliferating mass arising from the epithelial linings of nasal cavity and paranasal sinuses. In general, nasal polyp appears to be greyish white, smoothly surfaced,...\n --CHILD--> [CA0J.0] Polypoid sinus degeneration\n Def: Also referred to as Woakes' syndrome or ethmoiditis. Woakes' syndrome is characterised by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of th...",
"[LB03.Y] Other specified structural developmental anomalies of umbilical cord\n --PARENT--> [LB03] Structural developmental anomalies of umbilical cord\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Fetus or newborn affected by short umbilical cord\n Def: An umbilical cord < 2 SD in length below mean for the gestational age. At term, this is < 35 cm. Often associated with fetal hypokinesia...",
"[LB03.Y] Other specified structural developmental anomalies of umbilical cord\n --PARENT--> [LB03] Structural developmental anomalies of umbilical cord\n Def: Any condition caused by failure of the umbilical cord to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Umbilical cord haemangioma\n Def: Tumour composed of thin walled blood vessels lined by endothelium present within the cord...."
] |
CA0A.Z
|
Chronic rhinosinusitis, unspecified
|
[
{
"from_icd11": "CA0A.Z",
"icd10_code": "J329",
"icd10_title": "Chronic sinusitis, unspecified"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J324",
"icd10_title": "Chronic pansinusitis"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J320",
"icd10_title": "Chronic maxillary sinusitis"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J322",
"icd10_title": "Chronic ethmoidal sinusitis"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J323",
"icd10_title": "Chronic sphenoidal sinusitis"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J328",
"icd10_title": "Other chronic sinusitis"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J321",
"icd10_title": "Chronic frontal sinusitis"
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J30-J39",
"icd10_title": ""
},
{
"from_icd11": "CA0A.Z",
"icd10_code": "J32",
"icd10_title": "Chronic sinusitis"
},
{
"from_icd11": "DA09.61",
"icd10_code": "K046",
"icd10_title": "Periapical abscess with sinus"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55019",
"icd10_title": "Acute (reversible) ischemia of small intestine, extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55029",
"icd10_title": "Acute infarction of small intestine, extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55069",
"icd10_title": "Acute infarction of intestine, part and extent unspecified"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55021",
"icd10_title": "Focal (segmental) acute infarction of small intestine"
},
{
"from_icd11": "DD30.Z",
"icd10_code": "K55039",
"icd10_title": "Acute (reversible) ischemia of large intestine, extent unspecified"
}
] |
J329
|
Chronic sinusitis, unspecified
|
Here we report the case of a 9yo Chinese boy who presented with a history of livedo reticularis and recurrent fevers that began around 1 month of age. He had an ischemic stroke at 2yo and another at 8yo followed by a hemorrhagic stroke that same year. At the time of each of his strokes, he was treated with high-dose intravenous methylprednisolone, oral prednisone, and high-dose intravenous immunoglobulin (IVIG). However, he was still left gait instability, dysarthria, poor fine motor, and minor cognitive impairment. Laboratory work up showed elevated white blood cell counts and mild anemia as well as slightly elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Serum cytokines levels (including interleukin (IL)-2, IL-4, IL-6, IL-10, TNF-α, and interferon (IFN)-γ) were assessed using cytometric bead array techniques and IL-6 and IL-10 were found to be elevated (Table 1 ). T/B/NK cell counts by flow cytometry indicated that while the proportion of CD3 − CD16 + CD56 + NK cells was relatively low, the proportion of CD3 + CD4 + T cells was relatively high and the ratio of CD3 + CD4 + T cells and CD3 + CD8 + T cells was also elevated. Serum immunoglobulin (Ig) and complement (C) testing revealed that IgM was notably low, while C4 was elevated (Table 1 ). Fig. 1 Clinical features of patients with DADA2 and identification of mutations in ADA2 . a–b Livedo reticularis on the trunk and limbs of the proband. c Livedo reticularis on a leg of the sister. d Axial T2WI showed a high signal nodule in the right thalamus with clear edges, which was a fresh infarction area (red arrow). e ADC graph indicated a low signal patch area in the right part of the brainstem, which was a new infarct lesion (white arrow), and high signal patch shadow in the left part of the brainstem, which was an old infarction (red arrow). f 2d-MRV demonstrated bilateral transverse sinus narrowing, and local signal interruption, which suggested bilateral transverse sinus thrombosis (red arrow). g Calcification in the left globus pallidus (red arrow) and hemorrhagic stroke in the left temporal lobe (white arrow) were seen on CT image. h Axial T2WI showed Maxillary sinusitis (red arrow). i T2 dark-fluid indicated a new small lesion in the right lenticula (red arrow). j Pedigree of the family with compound heterozygous mutations in ADA2. k Schematic representation of the exome data-filtering approach assuming recessive inheritance in this family. l Confirmation of ADA2 mutations by Sanger sequencing. m In silico modeling of mutation at Arg169 based on crystal structure of human ADA2. n ADA2 enzyme activity of patients compared to carriers and healthy controls. o–p Relative ADA2 enzyme activity of wild type and mutant ADA2 in cell culture supernatant and whole cell lysates. q Western blot of wild type and indicated mutant ADA2 expression in supernatant and cell lysates. r RNA-sequencing analysis of genes involved in inflammatory pathway in patient PBMCs compared with age-matched healthy control (control-LPS, sister-LPS and proband-LPS: healthy control, sister and proband gene expression level with LPS stimulation(1 μg/ml); control-basal, sister-basal, proband-basal: healthy control, sister and proband gene expression at basal level) Table 1 Laboratory features of patients with DADA2 Laboratory features Normal range Brother Sister Before Anti-TNF treatment After Anti-TNF treatment 1M 2Y1M 7Y11M 8Y4M 8Y7M 10Y 4Y5M CBC WBC (× 10 9 /L) 4.0–12.0 15.84↑ 11.90 9.35 9.63 7.44 6.40 7.95 Hb (g/L) 110–155 91↓ 105↓ 109↓ 92↓ 96↓ 126 103 PLT (× 10 9 /L) 100–400 535↑ 453↑ 327 328 239 209 334↓ CRP (mg/L) 0–8 23↑ 12↑ 3.52 8.85↑ 32.45↑ 0.53 14.08↑ ESR (mm/h) 0–20 47↑ 13 40↑ 18 8 49↑ Cytokines IL-2 (pg/mL) 1.1–9.8 2.1 1.3 2.1 1.1 1.0 3.5 IL-4 (pg/mL) 0.1–3.0 1.5 1.0 1.9 1.8 4.0 1.9 IL-6 (pg/mL) 1.7–16.6 35.2↑ 22.0↑ 1389↑ 32.8↑ 4.6 26.3↑ IL-10 (pg/mL) 2.6–4.9 7.0↑ 3.7 6.4↑ 8.0↑ 6.1 5.9↑ TNF-α (pg/mL) 0.1–5.2 2.0 1.0 1.0 2.1 83.8 1.3 IFN-γ (pg/mL) 1.6–17.3 14.7 17.5↑ 16.9 80.9↑ 16.4 23.6↑ Ig * IgG (g/L) 5.44 (3.22–7.18) 12.16 (3.82–10.58) 15.9 (6.36–13.24) 9.2 (6.36–13.24) 9.50 (6.36–13.24) 18.2↑ (5.00–10.60) IgA (g/L) 0.18 (0.13–0.35) 0.52 (0.14–1.14) 1.97 (0.63–1.79) 1.5 (0.63–1.79) 0.96 (0.63–1.79) 2.36 (0.34–1.38) IgM (g/L) 0.06↓ (0.23–0.91) 0.29↓ (0.40–1.28) 0.27↓ (0.29–1.21) 0.15↓ (0.29–1.21) 0.30 (0.29–1.21) 0.6 (0.44–1.44) IgE (IU/L) 1–100 13.5 99.9 56 18.9 42.1 54.4 C C3 (g/L) 0.9–1.8 1.43 1.35 1.41 1.40 1.10 1.66 C4 (g/L) 0.1–0.4 0.47↑ 0.51↑ 0.57↑ 0.57↑ 0.47 0.56↑ T/B/NK cells * CD19 + B cell (%) 27.15 (15.0–20.0) 13.50 (15.0–20.0) 18.00 (15.0–20.0) 24.10 (19.0–29.0) CD3+ T cell (%) 68.72 (53.0–74.0) 67.5 (65.0–72.0) 76.8 (65.0–72.0) 65.00 (65.0–72.0) 63.00 (62.0–70.0) CD3 + CD4+ T cell (%) 46.15 (36.0–38.0) 37.65↑ (27.0–34.0) 42.00↑ (27.0–34.0) 31.70 (27.0–34.0) 39.90 (30.0–40.0) CD3 + CD8 + T cell (%) 18.00 (13.5–19.5) 24.80 (23.0–30.0) 29.10 (23.0–30.0) 24.10 (23.0–30.0) 19.40 (20.0–27.0) CD4 + /CD8 + 2.56↑ (1.9–2.5) 1.52↑ (1.0–1.4) 1.44↑ (1.0–1.4) 1.32 (1.0–1.4) 2.06 (1.2–2.0) CD3 − CD16 + CD56 + NK cell (%) 3.15↓ (11.0–24.0) 10.2↓ (11.0–24.0) 7.20↓ (11.0–24.0) 8.10 (7.0–16.0) * Because T/B/NK cell counts and serum IgG, IgA and IgM levels have different reference ranges at different ages, the corresponding reference ranges are indicated in parentheses following the data
| 4.191406
| 0.934082
|
sec[0]/p[0]
|
en
| 0.999997
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33517505
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https://doi.org/10.1007/s10875-021-00981-0
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[
{
"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": "6C01.Z",
"title": "Encopresis, unspecified"
},
{
"code": "6C00.Z",
"title": "Enuresis, unspecified"
},
{
"code": "MF50.2Z",
"title": "Urinary incontinence, unspecified"
},
{
"code": "5A14",
"title": "Diabetes mellitus, type unspecified"
},
{
"code": "6C0Z",
"title": "Elimination disorders, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[6C01.Z] Encopresis, unspecified
Also known as: Encopresis, unspecified | Encopresis | Problems of bowel control | encopresis of nonorganic origin | faecal incontinence of nonorganic origin
[6C00.Z] Enuresis, unspecified
Also known as: Enuresis, unspecified | Enuresis | Functional enuresis | Problems of bladder control | enuresis NOS
[MF50.2Z] Urinary incontinence, unspecified
Also known as: Urinary incontinence, unspecified | Urinary incontinence | urinary incontinence, NOS | bladder incontinence NOS | absence of bladder continence
[5A14] Diabetes mellitus, type unspecified
Also known as: Diabetes mellitus, type unspecified | diabetes NOS | DM - [diabetes mellitus] NOS | severe diabetes mellitus | sudden-onset diabetes mellitus
Excludes: Idiopathic Type 1 diabetes mellitus | Type 2 diabetes mellitus | Diabetes mellitus, other specified type
[6C0Z] Elimination disorders, unspecified
Also known as: Elimination disorders, unspecified | Problems of bowel or bladder control
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of carbohydrate metabolism
--- 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--> [5C56.21] 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 ...
--CHILD--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
--- Walk 6 ---
[3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--PARENT--> [?] Anaemias or other erythrocyte disorders
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of carbohydrate metabolism",
"[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--> [5C56.21] 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 --CHILD--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --PARENT--> [?] Anaemias or other erythrocyte disorders"
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "6C01.Z",
"icd10_code": "F981",
"icd10_title": "Encopresis not due to a substance or known physiological condition"
},
{
"from_icd11": "6C00.Z",
"icd10_code": "F980",
"icd10_title": "Enuresis not due to a substance or known physiological condition"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N39498",
"icd10_title": "Other specified urinary incontinence"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N3941",
"icd10_title": "Urge incontinence"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N3946",
"icd10_title": "Mixed incontinence"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N3945",
"icd10_title": "Continuous leakage"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N3944",
"icd10_title": "Nocturnal enuresis"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N39490",
"icd10_title": "Overflow incontinence"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N3943",
"icd10_title": "Post-void dribbling"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "N3942",
"icd10_title": "Incontinence without sensory awareness"
},
{
"from_icd11": "MF50.2Z",
"icd10_code": "R32",
"icd10_title": "Unspecified urinary incontinence"
}
] |
D571
|
Sickle-cell disease without crisis
|
In collaboration, we proposed phage therapy combined with a surgical staged strategy (approved by the ethic committee of our hospital and by the French national health care authority; performed after the patient gave informed consent). Indeed, a step-by-step approach, or staged surgical strategy, is usually performed in this type of infection, with two steps pursuing different aims. In complex infections requiring implementation of definitive implants, a first stage consisting of debridement, abscess evacuation and antibiotics is required to treat the infection. Then a second stage is needed, usually after at least 2 weeks of antibiotic window, to permanently stabilize the spine with definite osteosynthesis. During the second stage, new bacterial samples are usually harvested to check for microbiological success, and to rule out superinfection. More specifically, in the case presented here, we performed a first stage consisting of open surgery, L2-L3 and L3-L4 disc debridements (discectomy), local administration of the three-phage cocktail, and a partial stabilization, bridging the infected area with osteosynthesis from T11-T12-L1 to L5-sacrum (to avoid neurological complications), and systemic cefiderocol antibiotherapy for 6 weeks. This was followed by a second stage consisting of definite reconstruction with removal of the partial stabilization osteosynthesis, inter body fusion cages in L2-L3 and L3-L4, and spinal osteosynthesis outside the septic location, from T12-L1 to L5-S1, to finalize consolidation. For the first stage, magistral preparation of the phage cocktail was done in real time by our hospital pharmacist. During the first stage, the phage cocktail (dilution in 7 mL; final phage titer of 10 6 pfu/mL) was administered locally at L2-L3 and L3-L4 after abscess evacuation, debridement, and lavage with bicarbonate solution. Additive quality controls (QCs) were performed by the French hospital pharmacy that included sterility test for bacterial and fungal contamination and endotoxin concentration. Of note, six out of the seven microbiological samples performed during surgery were positive to P. aeruginosa (same antibiogram). Cefiderocol was started intravenously after the surgery, 2 g during 3 h every 8 h (6 g/day) for a duration of 6 weeks. Quickly, the pain was significantly reduced. During the treatment, the patient experienced Clostridioides difficile diarrhea, but no other serious adverse event was reported. Two weeks after the end of the first stage (two months after the initial surgical debridement), and then 2 weeks after the withdrawal of cefiderocol, the second stage was performed. The patient had neither systemic (no fever, CRP 10 mg/L) nor clinical signs of persistent infection. The same phage cocktail was locally administered (same volume and phage concentration) before insertion of the intersomatic cages at L2-L3 and L3-L4 level. Cefiderocol was started again intravenously pending the culture results. However, P. aeruginosa still grew in culture from bone biopsy (only two out of the six samples that were collected) with a small colony variant phenotype, but remained susceptible to the phage cocktail and cefiderocol . Whole genome sequencing of this strain identified numerous acquired genes accounting for this high level of resistance to antibiotics (Table 3 ). Although the strain had become resistant to this antibiotic, colistin (colistimethate sodium) was added intravenously at a dose of 2 MUI/8 h (6 MUI/day) to potentially synergize with cefiderocol 5 . As the cultures revealed persistence of the P. aeruginosa , phages were also added intravenously over 3-h infusions (30 mL, phage titers 10 6 pfu/mL) every day for 21 days . Under this treatment, the patient experienced abdominal pain related to gall stone migration and relapsing C. difficile infection. No adverse event potentially related to phage therapy was noticed. Antibiotics (cefiderocol and colistin) were stopped at 3 months. The outcome was favorable during the follow-up (21 months), without implant loosening nor clinical signs of infection , and the patient was walking without pain (Supplementary Movie 1 ). Unfortunately, he died from severe COVID-19 pneumonia responsible for refractory hypoxia in December 2020. Table 3 List of chromosomal mutations identified in the genome of the SCV morphotype (n°2) when compared to the genome of morphotype n°1. Gene Protein Mutation Effect on the protein Impact on the protein function Hypothetical protein Unknown 99T > C synonymous variant Unlikely sdh A Succinate dehydrogenase flavoprotein subunit 1673A > G missense variant: His558Arg Unlikely: same family of aminoacids ser A Phosphoglycerate deshydrogenase 40T > C missense variant: Phe14Leu Possible: different families of aminoacids Hypothetical protein Unknown 739A > C missense variant: Thr247Pro Unknown pbu E Purine efflux pump PbuE 605G > AT missence variant: insertion of Arg in 202 Unlikely (end of protein) nod D2 Nodulation protein 303G > T synonymous variant Unlikely lgr D non-ribosomal peptide synthetase 2668A > T stop gained Lys890* Possible: truncated protein of 890 amino acids versus 991 Variant calling was performed using the Snippy software ( https://github.com/tseemann/snippy ) after annotation of the reference genome of morphotype n°1 (Prokka software).
| 4.125
| 0.841797
|
sec[1]/p[1]
|
en
| 0.999999
|
PMC9306240
|
https://doi.org/10.1038/s41467-022-31837-9
|
[
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"cocktail",
"osteosynthesis",
"intravenously"
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[
{
"code": "FA24.4",
"title": "Juvenile systemic arthritis"
},
{
"code": "9B71.3&XS5S",
"title": "Retinopathy of prematurity, Stage 2"
},
{
"code": "GB61.Z",
"title": "Chronic kidney disease, stage unspecified"
},
{
"code": "GB61.0",
"title": "Chronic kidney disease, stage 1"
},
{
"code": "GB60.0",
"title": "Acute kidney failure, stage 1"
},
{
"code": "GB61.1",
"title": "Chronic kidney disease, stage 2"
},
{
"code": "4A00.0Y",
"title": "Other specified functional neutrophil defects"
},
{
"code": "8A40.Y",
"title": "Other specified multiple sclerosis"
},
{
"code": "8E4A.0",
"title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord"
},
{
"code": "8E01.2",
"title": "Variant Creutzfeldt-Jakob Disease"
}
] |
=== ICD-11 CODES FOUND ===
[FA24.4] Juvenile systemic arthritis
Definition: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eruptions) and by an equal sex ratio. Fever peaks are associated with transient cutaneous eruptions and diffuse erythematosis or urticarial-like lesions. The presence of arthritis is essential for diagnosis but may appear later in the disease course. The number of sites affected is variable (mono-, oli
Also known as: Juvenile systemic arthritis | Still disease | Juvenile systemic onset arthritis complicated by macrophage activation syndrome | Juvenile systemic arthritis, multiple sites | juvenile arthritis with systemic onset, multiple sites
[GB61.Z] Chronic kidney disease, stage unspecified
Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease
[GB61.0] Chronic kidney disease, stage 1
Definition: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)
Also known as: Chronic kidney disease, stage 1 | chronic renal failure, stage 1 | CKD - [chronic kidney disease] stage 1 | normal or increased eGFR (>90 ml/min/1.73m²)
Includes: chronic renal failure, stage 1
[GB60.0] Acute kidney failure, stage 1
Definition: Rate of change of serum creatinine: Increase 1.5-1.9 times baseline within 7 days OR increase by 0.3 mg/dl increase within 48 h OR Magnitude of urine output: <0.5 ml/kg/h for 6-12 hours
Also known as: Acute kidney failure, stage 1 | Acute nontraumatic kidney injury, mild | Acute nontraumatic kidney injury, stage 1 | AKI - [acute kidney injury] stage 1 | AKI - [acute kidney injury] mild
Includes: Acute nontraumatic kidney injury, mild
[GB61.1] Chronic kidney disease, stage 2
Definition: Kidney damage and GFR 60-89 ml/min/1.73m²
Also known as: Chronic kidney disease, stage 2 | kidney damage and mild decrease in GFR | chronic renal failure, stage 2 | CKD - [chronic kidney disease] stage 2 | kidney damage and mild decrease in eGFR - [estimated glomerular filtration rate]
Includes: chronic renal failure, stage 2
[4A00.0Y] Other specified functional neutrophil defects
Also known as: Other specified functional neutrophil defects | Chronic granulomatous disease | Chronic septic granulomatosis | CGD - [chronic granulomatous disease] | chronic granulomatous disorder
[8A40.Y] Other specified multiple sclerosis
Also known as: Other specified multiple sclerosis | Certain specified rare variants of multiple sclerosis | Multiple sclerosis, Marburg variant | Myelinoclastic diffuse sclerosis | Schilder disease
[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord
Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem
Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis
[8E01.2] Variant Creutzfeldt-Jakob Disease
Definition: A disease of the brain, that is suspected to be caused by a prion associated with Bovine Spongiform Encephalopathy. This disease is characterised by a long incubation period, psychiatric symptoms followed by neurological deficits, and is fatal. Transmission may be by ingestion of food (with a bovine origin) contaminated with infected brain or spinal cord from an infected cow, or blood transfusion. Confirmation is by pathological examination of the brain.
Also known as: Variant Creutzfeldt-Jakob Disease | vCJD - [Variant Creutzfeldt-Jakob Disease]
=== GRAPH WALKS ===
--- Walk 1 ---
[FA24.4] Juvenile systemic arthritis
Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru...
--PARENT--> [FA24] Juvenile idiopathic arthritis
Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ...
--EXCLUDES--> [?] Rheumatoid arthritis with splenomegaly and leukopenia
Def: The triad of rheumatoid arthritis (RA), splenomegaly, and neutropaenia is called Felty's syndrome. Persistent neutropaenia (<2000/mm3) must be present, but the complete triad is not required for a dia...
--- Walk 2 ---
[FA24.4] Juvenile systemic arthritis
Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru...
--PARENT--> [FA24] Juvenile idiopathic arthritis
Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ...
--PARENT--> [?] Inflammatory arthropathies
--- Walk 3 ---
[GB61.Z] Chronic kidney disease, stage unspecified
--PARENT--> [GB61] Chronic kidney disease
Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...
--EXCLUDES--> [?] Hypertensive renal disease
Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....
--- Walk 4 ---
[GB61.Z] Chronic kidney disease, stage unspecified
--PARENT--> [GB61] Chronic kidney disease
Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...
--EXCLUDES--> [?] Hypertensive renal disease
Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....
--- Walk 5 ---
[GB61.0] Chronic kidney disease, stage 1
Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...
--PARENT--> [GB61] Chronic kidney disease
Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...
--CHILD--> [GB61.2] Chronic kidney disease, stage 3a
Def: GFR 45-59 ml/min/1.63m²...
--- Walk 6 ---
[GB61.0] Chronic kidney disease, stage 1
Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...
--PARENT--> [GB61] Chronic kidney disease
Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...
--CHILD--> [GB61.0] Chronic kidney disease, stage 1
Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...
|
[
"[FA24.4] Juvenile systemic arthritis\n Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru...\n --PARENT--> [FA24] Juvenile idiopathic arthritis\n Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ...\n --EXCLUDES--> [?] Rheumatoid arthritis with splenomegaly and leukopenia\n Def: The triad of rheumatoid arthritis (RA), splenomegaly, and neutropaenia is called Felty's syndrome. Persistent neutropaenia (<2000/mm3) must be present, but the complete triad is not required for a dia...",
"[FA24.4] Juvenile systemic arthritis\n Def: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eru...\n --PARENT--> [FA24] Juvenile idiopathic arthritis\n Def: Juvenile idiopathic arthritis (JIA) is the term used to describe a group of inflammatory articular disorders of unknown cause that begin before the age of 16 and last over 6 weeks. Six disorders have ...\n --PARENT--> [?] Inflammatory arthropathies",
"[GB61.Z] Chronic kidney disease, stage unspecified\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --EXCLUDES--> [?] Hypertensive renal disease\n Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....",
"[GB61.Z] Chronic kidney disease, stage unspecified\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --EXCLUDES--> [?] Hypertensive renal disease\n Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....",
"[GB61.0] Chronic kidney disease, stage 1\n Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --CHILD--> [GB61.2] Chronic kidney disease, stage 3a\n Def: GFR 45-59 ml/min/1.63m²...",
"[GB61.0] Chronic kidney disease, stage 1\n Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)...\n --PARENT--> [GB61] Chronic kidney disease\n Def: Glomerular Filtration Rate (GFR) < 60 ml/min/1.73m² or presence of kidney damage that is present for more than 3 months. Evidence of kidney damage can include structural abnormalities (imaging or hist...\n --CHILD--> [GB61.0] Chronic kidney disease, stage 1\n Def: Kidney damage with normal or increased GFR (>90 ml/min/1.73m²)..."
] |
FA24.4
|
Juvenile systemic arthritis
|
[
{
"from_icd11": "FA24.4",
"icd10_code": "M0820",
"icd10_title": "Juvenile rheumatoid arthritis with systemic onset, unspecified site"
},
{
"from_icd11": "FA24.4",
"icd10_code": "M082",
"icd10_title": "Juvenile rheumatoid arthritis with systemic onset"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N183",
"icd10_title": "Chronic kidney disease, stage 3 (moderate)"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N189",
"icd10_title": "Chronic kidney disease, unspecified"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N250",
"icd10_title": "Renal osteodystrophy"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N18",
"icd10_title": "Chronic kidney disease (CKD)"
},
{
"from_icd11": "GB61.0",
"icd10_code": "N181",
"icd10_title": "Chronic kidney disease, stage 1"
},
{
"from_icd11": "GB61.1",
"icd10_code": "N182",
"icd10_title": "Chronic kidney disease, stage 2 (mild)"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3183",
"icd10_title": "Dementia with Lewy bodies"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G2581",
"icd10_title": "Restless legs syndrome"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3184",
"icd10_title": "Mild cognitive impairment, so stated"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G9349",
"icd10_title": "Other encephalopathy"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G0481",
"icd10_title": "Other encephalitis and encephalomyelitis"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G9589",
"icd10_title": "Other specified diseases of spinal cord"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G2589",
"icd10_title": "Other specified extrapyramidal and movement disorders"
}
] |
M0820
|
Juvenile rheumatoid arthritis with systemic onset, unspecified site
|
Because of the worsening of symptoms, fingolimod at a dose of 0.5 mg once daily was initiated in December 2011. The first MRI after the initiation of fingolimod was done in January 2012 and showed two new lesions, but no contrast enhancement was seen. An MRI in July 2012 showed no new lesions. In March 2013, the sense of vibration had normalized, but reflexes were still exaggerated in both legs. In July 2013, MRI displayed no new lesions. On September 6 2013, she experienced symptoms of a urinary tract infection, and because of that she contacted her general practitioner. She was then treated with Selexid ® (Pivmecillinam) for 3 days and symptoms ameliorated. A family member had communicated with her on September 15 and reported that everything had been completely normal. On September 17, she again came in contact with her general practitioner. She had been found disoriented outside her home. She was at that time fully awake, but she had some mild speech difficulties and apraxia. She was immediately sent in to the nearest hospital, and not to our hospital. At that hospital, some kind of CNS infection was suspected. However, blood samples did not show any abnormalities and she had no fever or any other signs of an ongoing infection. Also, rheumatological markers for inflammation/vasculitis were negative. A first lumbar puncture was not done until September 21, and a second on October 3. No abnormalities were seen in any of the CSF (cerebrospinal fluid) analysis. No pleocytosis, no rise in lactic acid or albumine levels could be seen. Glucose levels were also normal. Interleukin 6 and 10, beta-Amyloid, and Tau levels were also normal. PCR was negative for Mycobacterium , Herpes simplex 1 and 2, Varicella zoster, enteroviruses, and JC-virus. No Borrelia or syphilis antibodies were present. Fungus screening in the CSF was also negative. In addition, anti-neuronal antibodies were negative in both CSF and blood samples. MRI was, by unknown reasons, not done until September 21 and was at that time described as not changed from an earlier MRI done 2 months before . Her condition had, however, deteriorated. She experienced a headache with mild light sensitivity. She was somnolent and when she was awake she had clear speech difficulties and was disoriented. EEG was abnormal with generalized rhythmic slow activity of delta frequency within the fronto-temporal regions, but no epileptic discharges were seen. However, on September 25, she had a generalized epileptic seizure. Her symptoms then continued to worsen. She suffered from lethargy and had visual hallucinations. Delusions were present and she was still disoriented. At this time and also earlier, no hypertension was at hand, blood pressure had always been around 120/80. Fingolimod had by unknown reasons not been discontinued. A new EEG on September 26 showed generalized slow activity over the whole left hemisphere, and in the frontal region also episodic rhytmic delta activity with triphasic like appearance was seen. Still, no epileptic discharges were present. In spite of the lack of epileptic activity on the EEG, the cause of all symptoms was thought to be primarily epileptic. Anti-epileptic medication was initiated (Keppra ® , Levetiracetam). On October 2, our hospital was contacted for the first time and fingolimod was then without any delay discontinued since a rare side effect was suspected. At that time, also a CT brain angiography was done and, as expected, no signs of vasculitis were seen. Already a week after discontinuation of fingolimod, the patient had slightly improved. She was more awake and responded to questions, but she had still speech difficulties and was confused. On October 11, a new MRI scan showed widespread cortical and subcortical changes with some mass-effect in the temporo-occipital-parietal lobes in the left hemisphere . Contrast enhancement was also seen in the leptomeninges. There were no areas with restricted diffusion and no signs of hemorrhage. Retrospectively, subtle cortical edema could now be seen in the same areas in the MRI scan from September. In addition, hyperperfusion could also be seen in the same areas. A new EEG was done in October 18, but no changes were seen compared with the registration on October 2. On October 23, the patient was moved to another hospital for rehabilitation. At that time, she had still right homonymous hemianopia. She had also still some speech difficulties and cognitive deficits, but now she was fully oriented and had no visual hallucinations. In November, acute intermittent porphyria was also ruled out as a possible cause of her present condition. She continued to improve and on January 27 2014, she could speak without problems and the visual fields were nearly normal, only a right inferior quadrantanopia remained. A visual examination on April 15 showed only two small, non-corresponding, right inferior scotomas, which do not obstruct her ability to drive a car. She started to work halftime in May, and fulltime in June. An MRI on May 15 showed unchanged neuroinflammatory lesion load and superficial residual cortical lesions in parts of the occipital lobe. When the clinical course and the imaging findings were analyzed at our hospital, we found them highly consistent with posterior reversible encephalopathy syndrome (PRES).
| 3.9375
| 0.979492
|
sec[1]/p[0]
|
en
| 0.999997
|
25788891
|
https://doi.org/10.3389/fneur.2015.00039
|
[
"september",
"that",
"still",
"time",
"october",
"epileptic",
"fingolimod",
"lesions",
"speech",
"difficulties"
] |
[
{
"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": "FA24.4",
"title": "Juvenile systemic arthritis"
},
{
"code": "KD3B.Z",
"title": "Unspecified time of fetal death, cause not specified"
},
{
"code": "QA46.1",
"title": "Single stillbirth"
},
{
"code": "FA23",
"title": "Adult-onset Still disease"
},
{
"code": "KD3B.0",
"title": "Antepartum fetal death"
}
] |
=== 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
[FA24.4] Juvenile systemic arthritis
Definition: Systemic-onset juvenile idiopathic arthritis represents 10-11% of cases of juvenile idiopathic arthritis (JIA) and is marked by the severity of the extra-articular manifestations (fever, cutaneous eruptions) and by an equal sex ratio. Fever peaks are associated with transient cutaneous eruptions and diffuse erythematosis or urticarial-like lesions. The presence of arthritis is essential for diagnosis but may appear later in the disease course. The number of sites affected is variable (mono-, oli
Also known as: Juvenile systemic arthritis | Still disease | Juvenile systemic onset arthritis complicated by macrophage activation syndrome | Juvenile systemic arthritis, multiple sites | juvenile arthritis with systemic onset, multiple sites
[KD3B.Z] Unspecified time of fetal death, cause not specified
Also known as: Unspecified time of fetal death, cause not specified | Fetal death, cause not specified | stillbirth NOS | stillborn NOS | intrauterine fetal demise
[QA46.1] Single stillbirth
Definition: Stillbirth is the complete expulsion or extraction from a woman of a fetus, following its death prior to the complete expulsion or extraction, at 22 or more completed weeks of gestation.
Stillbirths are distinct from cases of induced abortion.
When information on gestational age is unavailable use birthweight 500 grams and more as the criteria.
Also known as: Single stillbirth | outcome of delivery of single stillborn
[FA23] Adult-onset Still disease
Definition: Adult onset Still's disease is a rare rheumatic condition characterised by a combination of symptoms, such as fever higher than 39 degrees C, cutaneous rash during fever peaks, joint or muscle pain, lymph node hypertrophy, increase of white blood cells (especially polymorphonuclear neutrophils) and abnormalities of liver metabolism.
Also known as: Adult-onset Still disease | Adult-onset Still disease, multiple sites | Adult-onset Still disease, shoulder region | Adult-onset Still disease, acromioclavicular joint | Adult-onset Still disease, glenohumeral joint
Excludes: Still disease NOS
[KD3B.0] Antepartum fetal death
Definition: Antepartum fetal death is a fetal death before the onset of labour. If vital status of the fetus at the onset of labour is unknown, consider it was antepartum if there is presence of signs of maceration at the time of delivery.
Macerated stillbirth - is the complete expulsion or extraction from a woman of a fetus following a fetal death at 22 or more completed weeks of gestation; or if gestational age is not available with a birthweight of 500g or more with skin showing signs of maceration.
An
Also known as: Antepartum fetal death | macerated stillbirth | antepartum stillbirth
Includes: macerated stillbirth | antepartum stillbirth
=== GRAPH WALKS ===
--- Walk 1 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.2] Chronic migraine
Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...
--- Walk 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...
--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 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
--PARENT--> [?] Causes of healthcare related harm or injury
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...",
"[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....",
"[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 --PARENT--> [?] Causes of healthcare related harm or injury"
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
A 22–year old man was referred to our center because of a large mediastinal mass along with skeletal and lymph node metastases. The clinical picture was dominated by shortness of breath due to severe superior vena cava syndrome with pleural–pericardial effusion . Laboratory tests showed elevated alpha–fetoprotein (765 ng/mL; normal value <10.9 ng/mL) and lactate dehydrogenase (LDH) = 14,468 U/L (normal range 240–480 U/L). Taken altogether these findings strongly suggested a mediastinal non–seminoma germ cell tumor (GCT) but, unexpectedly, a biopsy of a supraclavicular enlarged lymph node revealed a poorly differentiated and diffusely necrotic carcinoma . Immunohistochemistry was weakly positive for AE1–AE3 cytokeratin pool, TTF–1, p63, synaptophysin, chromogranin A, CD34 and, focally, EMA and cytokeratin 7, but negative for PLAP, alpha–fetoprotein, beta–HCG, CD30, CD3, CD20, CD117, Melan–A, S100 protein, ALK, PAX8, and desmin, thereby ruling out GCT (Table. 1 describes detailed immunohistochemistry profile and clues to diagnosis suggested by each immunohistochemical marker) . Due to such peculiar presentation and the high levels of alpha–fetoprotein, a second pathology opinion was requested. GCT was again excluded and a diagnosis of poorly differentiated large cell carcinoma with neuroendocrine differentiation was rendered. However, taking advantage of the clinical presentation and the patient’s young age, in a third consultation, a monoclonal antibody against NUT protein was used along with fluorescence in situ hybridization (FISH) analysis for NUT–BRD4 translocation . Tumor cells revealed diffuse decoration for NUT protein and FISH analysis confirmed the occurrence of t(15;19) BRD4–NUT translocation , thereby establishing the diagnosis of NUT midline carcinoma . Fig. 1 Disease status at diagnosis. Panel a , c : CT scan showing bulky mediastinal mass with involvemente of right lung ilum, compression of the right superior bronchus, and dislocation of the trachea and right intermediate bronchus with pleural and pericardial effusion (panel a axial, panel c sagittal). Panel b : PET scan showing supraclavicular involvement of the disease and absence of liver metastases. CT, computed tomography; PET positron emission tomography Fig. 2 Pathology images. Panel a , b : Hematoxilin and eosin stain (panel a 20X magnification, panel b 40X magnification). NUT carcinoma typically shows sheets of monomorphic round to ovoid cells with scant pale eosinophilic to basophilic cytoplasm; nuclei with irregular outlines and slightly coarse chromatin with small nucleoli. Necrosis, mitotic figures and crush artefact are common. Panel c : diffuse nuclear immunohistochemical staining with nuclear protein in testis (NUT) antibody (40X magnification). NUT (C52B1, CELL Signaling, Technology) Rabbit mAb detects endogenous levels of total NUT protein. The antibody also detects levels of BRD4-Nut fusion protein. Panel d : FISH showing positivity for NUT-BRD4 fusion gene. FISH was performed using dual color single fusion probes: BAC clone (RP11-122P18) spanning NUT gene is labeled in spectrum orange, BAC clone RP11-637P24 covering BRD4 gene is labeled in spectrum green. The presence of the translocation t (15;19)(q14;p13) BRD4/NUT is showed by overlapping of one green and one orange probe signal (white arrows). FISH, fluorescence in situ hybridization; NUT, nuclear protein in testis; BRD4, bromodomain–containing protein–4; BAC, bacterial artificial chromosome Table 1 Immunohistochemistry profile at the time of first evaluation Weakly positive Clues to diagnosis (if positive) Negative Clues to diagnosis (if positive) AE1-AE3 cytokeratin pool Carcinomas, GCT (rare), thymoma, mesenchymal tumors PLAP Seminoma TTF-1 Lung, thyroid cancer AFP Non-seminoma GCT, HCC, pancreas carcinoma p63 Basal/squamous carcinoma, mesenchymal tumors, lymphomas, adenoid cystic carcinoma, salivary gland tumors, thymoma, thymic carcinoma, breast, urothelial carcinoma Beta-HCG Non-seminoma GCT Synaptophysin Neuroendocrine neoplasms, adrenal gland carcinoma, mesenchymal tumors CD30 Lymphomas (HL and NHL), non-seminoma GCT, Chromogranin A Neuroendocrine tumors CD3 T-cell lymphomas CD34 Hematologic malignances, mesenchymal tumors, papillary thyroid carcinoma, thymoma CD20 B-cell lymphomas Focally positive CD117 Mesenchymal tumors, GCT, SCLC, leukemias, lymphomas, melanoma EMA adenocarcinoma, renal cell carcinoma, choriocarcinoma, mesenchymal tumors, mesothelioma, lymphoma, thymic carcinoma Melan-A Melanoma, mesenchymal tumors, adrenal cortical tumors, sex-cord stromal tumors Cytokeratin 7 Lung cancer and other carcinomas, GCT (rare), mesenchymal tumors S-100 Melanoma, mesenchymal tumors, adenoid cystic carcinoma, sex-cord stromal tumors ALK Lymphomas, NSCLC, mesenchymal tumors, RCC (rare) PAX8 Thymic carcinoma, thymomas, thyroid anaplastic carcinoma, RCC, neuroendocrine neoplasms, seminoma Desmin Mesenchymal tumors TTF-1 thyroid transcription factor-1, EMA epithelial membrane antigen, PLAP placental alkaline phosphatase, AFP alpha-fetoprotein, beta-HCG human chorionic gonadotropin, ALK anaplastic lymphoma kinase, GCT germ cell tumor, HCC hepatocellular carcinoma, HL Hodgkin’s lymphoma, NHL Non-Hodgkin lymphoma, RCC renal cell carcinoma, SCLC small cell lung cancer, NSCLC non-small cell lung cancer
| 4.195313
| 0.918457
|
sec[1]/p[0]
|
en
| 0.999997
|
28407756
|
https://doi.org/10.1186/s12885-017-3262-0
|
[
"carcinoma",
"tumors",
"mesenchymal",
"cell",
"panel",
"protein",
"seminoma",
"lymphomas",
"fish",
"lung"
] |
[
{
"code": "2D41",
"title": "Unspecified carcinoma of unspecified site"
},
{
"code": "2C3Y",
"title": "Other specified malignant neoplasms of skin"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2C25.5",
"title": "Unspecified malignant epithelial neoplasm of bronchus or lung"
},
{
"code": "2C90.Y",
"title": "Other specified malignant neoplasms of kidney, except renal pelvis"
},
{
"code": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
},
{
"code": "2F9C",
"title": "Neoplasms of unknown behaviour of connective or other soft tissue"
}
] |
=== ICD-11 CODES FOUND ===
[2D41] Unspecified carcinoma of unspecified site
Also known as: Unspecified carcinoma of unspecified site | carcinoma of unspecified primary site | carcinoma NOS | Carcinoma in polyp of unspecified site | Carcinoma with apocrine metaplasia of unspecified site
[2C3Y] Other specified malignant neoplasms of skin
Also known as: Other specified malignant neoplasms of skin | Malignant neoplasm of eyelid NOS | Malignant pilonidal cyst | Radiotherapy-induced skin malignancy | Cutaneous carcinoma
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2C25.5] Unspecified malignant epithelial neoplasm of bronchus or lung
Also known as: Unspecified malignant epithelial neoplasm of bronchus or lung | unspecified carcinoma of bronchus or lung | Metastatic lung carcinoma [primary lung carcinoma spreading elsewhere] | Metastatic carcinoma of lung [primary carcinoma of lung spreading elsewhere] | Lung carcinoma
[2C90.Y] Other specified malignant neoplasms of kidney, except renal pelvis
Also known as: Other specified malignant neoplasms of kidney, except renal pelvis | Congenital mesoblastic nephroma | Nephroblastoma | Wilms tumour of kidney | Wilms tumour of unspecified site
Includes: Nephroblastoma
[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
[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
[2F9C] Neoplasms of unknown behaviour of connective or other soft tissue
Also known as: Neoplasms of unknown behaviour of connective or other soft tissue | connective or other soft tissue tumour NOS | Abdominal desmoid of unknown behaviour of unspecified site | Mixed mesenchymal tumour of unspecified site | Muscular neoplasm of unknown behaviour
Includes: Muscular neoplasm of unknown behaviour
=== GRAPH WALKS ===
--- Walk 1 ---
[2D41] Unspecified carcinoma of unspecified site
--PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites
--EXCLUDES--> [?] Malignant mesenchymal neoplasms
Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...
--- Walk 2 ---
[2D41] Unspecified carcinoma of unspecified site
--PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites
--CHILD--> [2D40] Adenocarcinoma of unspecified site
Def: A common cancer characterised by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to ...
--- Walk 3 ---
[2C3Y] Other specified malignant neoplasms of skin
--PARENT--> [?] 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...
--EXCLUDES--> [?] Carcinoma in situ of skin
Def: Stage 0 includes: Tis, N0, M0. Tis: Carcinoma in situ. N0: No regional lymph node metastasis. M0: No clinical or radiographic evidence of distant metastasis....
--- Walk 4 ---
[2C3Y] Other specified malignant neoplasms of skin
--PARENT--> [?] 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...
--CHILD--> [2C31] Squamous cell carcinoma of skin
Def: A carcinoma arising from the squamous cells of the epidermis. Skin squamous cell carcinoma is most commonly found on sun-exposed areas. The majority of the tumours are well-differentiated....
--- 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
|
[
"[2D41] Unspecified carcinoma of unspecified site\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --EXCLUDES--> [?] Malignant mesenchymal neoplasms\n Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...",
"[2D41] Unspecified carcinoma of unspecified site\n --PARENT--> [?] Malignant neoplasms of ill-defined or unspecified primary sites\n --CHILD--> [2D40] Adenocarcinoma of unspecified site\n Def: A common cancer characterised by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to ...",
"[2C3Y] Other specified malignant neoplasms of skin\n --PARENT--> [?] 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...\n --EXCLUDES--> [?] Carcinoma in situ of skin\n Def: Stage 0 includes: Tis, N0, M0. Tis: Carcinoma in situ. N0: No regional lymph node metastasis. M0: No clinical or radiographic evidence of distant metastasis....",
"[2C3Y] Other specified malignant neoplasms of skin\n --PARENT--> [?] 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...\n --CHILD--> [2C31] Squamous cell carcinoma of skin\n Def: A carcinoma arising from the squamous cells of the epidermis. Skin squamous cell carcinoma is most commonly found on sun-exposed areas. The majority of the tumours are well-differentiated....",
"[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"
] |
2D41
|
Unspecified carcinoma of unspecified site
|
[
{
"from_icd11": "2E6Z",
"icd10_code": "D098",
"icd10_title": "Carcinoma in situ of other specified sites"
},
{
"from_icd11": "2E6Z",
"icd10_code": "D099",
"icd10_title": "Carcinoma in situ, unspecified"
},
{
"from_icd11": "2E6Z",
"icd10_code": "D00-D09",
"icd10_title": ""
},
{
"from_icd11": "2E6Z",
"icd10_code": "D09",
"icd10_title": "Carcinoma in situ of other and unspecified sites"
},
{
"from_icd11": "2E6Z",
"icd10_code": "D097",
"icd10_title": ""
},
{
"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"
}
] |
D098
|
Carcinoma in situ of other specified sites
|
Written informed consent was obtained from the patient for publication of this case report. A 64-year-old woman (body weight, 72 kg; height, 155 cm) with a history of epilepsy with complex partial seizures developed right knee osteoarthritis and was scheduled for total knee arthroplasty. One year previously, she underwent the same operation on the contralateral side and developed tonic-clonic convulsions after emergence of general anesthesia in the operating room and the ward. She was then treated with repeated diazepam administration; however, her postoperative management became difficult due to repeated respiratory arrests. Her epilepsy control improved subsequently although seizure attacks occurred approximately once a week, according to her medical record. She was under medication of valproate sodium, carbamazepine, and levetiracetam, each of which blood concentrations was in a therapeutic range. Preoperative examinations revealed no other abnormal findings except for an increase in γ-glutamyltransferase (61 U/L) probably due to medication. On the morning of surgery, she took usual anticonvulsants and received no anesthetic premedication. Patient monitoring included continuous electrocardiography, pulse oximetry (SpO 2 ), capnometry, and non-invasive blood pressure. Patient state index was also monitored using Root® with SedLine® . After femoral nerve block with 20 mL of 0.375% ropivacaine, general anesthesia with tracheal intubation was induced with propofol 80 mg, remifentanil 0.19 μg/kg/min, and rocuronium 50 mg, and maintained with sevoflurane 1.3% and remifentanil 0.14–0.23 μg/kg/min. During the anesthesia, SpO 2 was maintained at 97% or more and end-tidal CO 2 was kept between 36 and 41 mmHg (more than 39 mmHg at most time points during the last hour). Patient state index were between 22 and 27. For postoperative analgesia, acetaminophen 1 g and flurbiprofen axetil 50 mg were intravenously administered. The surgery was completed without incident, and after the recovery of consciousness and spontaneous respiration, patient’s trachea was extubated. Tonic muscular contraction was observed in the upper limbs, body trunk, neck, and face along with respiratory depression. SpO 2 decreased from 100 to 88%. Although these symptoms were temporarily relieved by midazolam 3 mg iv, they recurred in a few minutes. Additional midazolam 6 mg and phenytoin 125 mg were administered in the recovery room, but the symptoms did not improve, and the patient was transferred to the intensive care unit (ICU). Levetiracetam 500 mg was administered by intravenous drip. In addition, a total of 15 mg diazepam was administered intermittently during the first hour and the patient often required respiratory assistance with jaw thrust. However, convulsions persisted. CDSA showed a spread of warmer colors (i.e., higher power) in a wide frequency band of the EEG during the convulsions with PSI > 80. She could not rest in bed and complained of knee pain once with dizziness. Dexmedetomidine (0.37 μg/kg loading in 10 min followed by 0.6 μg/kg/h) was administered, and she was sedated in 20 min. During the improvement from the convulsion, CSDA showed a decrease in warmer colors in a wide frequency band and raw EEG showed decreased amplitude . After termination of convulsions, in the CDSA, blue tones, which indicate a drop in EEG power, became predominant . Dexmedetomidine administration was continued until the next morning while gradually decreasing the dose to 0.2 μg/kg/h . No cardiopulmonary suppression or recurrence of convulsions that required intervention was observed. Blood test revealed no electrolyte disturbance. She was unconscious after induction of general anesthesia until the next morning. She had convulsions once on the eighth day after surgery without major problems and was discharged on the 20th day. Fig. 1 Screen captures of color density spectral array (CDSA) in the intensive care unit. The upper and lower portions of left panels represent EEG power spectrum obtained from the left and right forehead, respectively. X -axis represents time. Y -axes represent frequency (Hz). The farther from the center horizontal line the higher the frequency. The right vertical line represents power of EEG (dB) where warmer colors represent higher power. White curves represent spectral edge frequency 95%, which is the frequency below which 95% of the spectral power of an EEG resides. Vertical white bars represent missing data on CDSA due to artifacts. Right panels represent 10-s EEG in the left front polar (fp1) region, corresponding to selected time points (black triangle) in left panels. a CDSA immediately after the patient entered the ICU. A black arrow represents the time of administration of diazepam 5 mg iv. Black horizontal bars represent convulsions. b A black arrow represents the start of dexmedetomidine administration. c Approximately 2 h after the start of dexmedetomidine infusion. Patient state index was about 23. d CDSA next morning. A black arrow represents the spontaneous awakening. PSI increased from 40 to 83 in a minute. Corresponding EEG of d could not be downloaded due to a technical failure. Although d shows an asymmetric CDSA, the cause is unknown. Raw EEG waves were illustrated by EDFbrowser 1.64 using “.edf” files downloaded from Root® system
| 3.902344
| 0.977051
|
sec[1]/p[0]
|
en
| 0.999997
|
32026959
|
https://doi.org/10.1186/s40981-019-0234-1
|
[
"convulsions",
"cdsa",
"represent",
"power",
"frequency",
"represents",
"black",
"anesthesia",
"administration",
"which"
] |
[
{
"code": "8A68.Z",
"title": "Type of seizure, unspecified"
},
{
"code": "MB46.Y",
"title": "Other specified abnormal involuntary movements"
},
{
"code": "KB06",
"title": "Neonatal seizures"
},
{
"code": "8A63.0Z",
"title": "Febrile seizures, unspecified"
},
{
"code": "8A66.0",
"title": "Convulsive status epilepticus"
},
{
"code": "PB6Y",
"title": "Other unintentional cause of morbidity or mortality"
},
{
"code": "PA83.2&XE02T",
"title": "Accidental contact with powered knife"
},
{
"code": "MA80.1",
"title": "Dysphasia"
},
{
"code": "PA83.2",
"title": "Unintentionally cut or pierced by other or unspecified sharp object"
},
{
"code": "PA83.2&XE8MJ",
"title": "Accidental contact with powered chain-saw"
}
] |
=== ICD-11 CODES FOUND ===
[8A68.Z] Type of seizure, unspecified
Also known as: Type of seizure, unspecified | Types of seizures | uncontrolled seizures | Seizure NOS | fits NOS
[MB46.Y] Other specified abnormal involuntary movements
Also known as: Other specified abnormal involuntary movements | Reflex convulsions | Dystonic movements
[KB06] Neonatal seizures
Definition: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn.
Also known as: Neonatal seizures | convulsions in newborn | fits in newborn | neonatal convulsions | seizures in newborn
Excludes: Benign familial neonatal epilepsy | Epilepsy due to prenatal or perinatal vascular insults
[8A63.0Z] Febrile seizures, unspecified
Also known as: Febrile seizures, unspecified | Febrile seizures | febrile convulsion NOS | febrile fit | pyrexial convulsion
[8A66.0] Convulsive status epilepticus
Definition: Convulsive status epilepticus is defined as 5 min or more of (i) continuous clinical convulsive seizure activity or (ii) recurrent seizure activity without recovery (returning to baseline) between seizures.
Also known as: Convulsive status epilepticus | Tonic-clonic status epilepticus | grand mal status | grand mal status epilepticus | Grand mal status, epileptic
[PB6Y] Other unintentional cause of morbidity or mortality
Also known as: Other unintentional cause of morbidity or mortality | Exposure to other and unspecified man-made environmental factors | Exposure to other specified factors | Contact with agricultural machinery | contact with animal-powered farm machine
[MA80.1] Dysphasia
Definition: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition.
Also known as: Dysphasia | loss of power of expression or comprehension | Alalia | Aphemia | Semantic dysphasia
Excludes: progressive isolated aphasia | Developmental speech or language disorders
[PA83.2] Unintentionally cut or pierced by other or unspecified sharp object
Also known as: Unintentionally cut or pierced by other or unspecified sharp object | Unintentionally cut or pierced by archery objects | Contact with nonpowered hand tool | Accidental contact with axe | Accidental contact with can-opener
=== GRAPH WALKS ===
--- Walk 1 ---
[8A68.Z] Type of seizure, unspecified
--PARENT--> [8A68] Types of seizures
--CHILD--> [8A68.1] Absence seizures, atypical
Def: Absence seizures with changes in tone more pronounced than in typical absences or with non-abrupt onset and/or cessation, often associated with slow, irregular, generalised spike-wave activity....
--- Walk 2 ---
[8A68.Z] Type of seizure, unspecified
--PARENT--> [8A68] Types of seizures
--CHILD--> [8A68.2] Absence seizures, typical
Def: Seizures characterised by sudden onset, interruption of ongoing activities, blank stare, possibly brief upward gaze deviation, unresponsiveness, duration from few seconds to half a minute, and rapid r...
--- Walk 3 ---
[MB46.Y] Other specified abnormal involuntary movements
--PARENT--> [MB46] Abnormal involuntary movements
Def: Abnormal involuntary movements include abnormal head movements, tremor, cramp, spasm, fasciculation, and other abnormal involuntary movements...
--EXCLUDES--> [?] Tic disorders
Def: Disorders characterized by brief, sudden, repetitive movements (motor tics) or utterances (phonic or vocal tics) that are temporarily suppressible and are usually preceded by a strong urge to perform ...
--- Walk 4 ---
[MB46.Y] Other specified abnormal involuntary movements
--PARENT--> [MB46] Abnormal involuntary movements
Def: Abnormal involuntary movements include abnormal head movements, tremor, cramp, spasm, fasciculation, and other abnormal involuntary movements...
--PARENT--> [?] Symptoms or signs involving the nervous system
--- Walk 5 ---
[KB06] Neonatal seizures
Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....
--EXCLUDES--> [?] Epilepsy due to prenatal or perinatal vascular insults
Def: Epilepsy occurring in relation to an ischemic stroke or haemorrhagic stroke, with the stroke occurring or presumed to occur before birth [prenatal] or between 22 weeks of gestation and 7 days after bi...
--CHILD--> [?] Epilepsy due to prenatal or perinatal ischemic stroke
Def: Epilepsy occurring in relation to an ischemic stroke, with the stroke occurring or presumed to occur before birth [prenatal] or between 22 weeks of gestation and 7 days after birth [perinatal]. No oth...
--- Walk 6 ---
[KB06] Neonatal seizures
Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....
--EXCLUDES--> [?] Benign familial neonatal epilepsy
Def: Epilepsy of the newborn characterised by frequent brief seizures within the first few days of life. Onset may be as late as 3 months of age. Seizures typically remit spontaneously within 6 weeks. The ...
--PARENT--> [?] Genetic epileptic syndromes with neonatal onset
Def: Epilepsy with onset in the first 30 days of life resulting from one or more known or presumed genetic defects in which seizures are the core symptom of the disorder....
|
[
"[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.1] Absence seizures, atypical\n Def: Absence seizures with changes in tone more pronounced than in typical absences or with non-abrupt onset and/or cessation, often associated with slow, irregular, generalised spike-wave activity....",
"[8A68.Z] Type of seizure, unspecified\n --PARENT--> [8A68] Types of seizures\n --CHILD--> [8A68.2] Absence seizures, typical\n Def: Seizures characterised by sudden onset, interruption of ongoing activities, blank stare, possibly brief upward gaze deviation, unresponsiveness, duration from few seconds to half a minute, and rapid r...",
"[MB46.Y] Other specified abnormal involuntary movements\n --PARENT--> [MB46] Abnormal involuntary movements\n Def: Abnormal involuntary movements include abnormal head movements, tremor, cramp, spasm, fasciculation, and other abnormal involuntary movements...\n --EXCLUDES--> [?] Tic disorders\n Def: Disorders characterized by brief, sudden, repetitive movements (motor tics) or utterances (phonic or vocal tics) that are temporarily suppressible and are usually preceded by a strong urge to perform ...",
"[MB46.Y] Other specified abnormal involuntary movements\n --PARENT--> [MB46] Abnormal involuntary movements\n Def: Abnormal involuntary movements include abnormal head movements, tremor, cramp, spasm, fasciculation, and other abnormal involuntary movements...\n --PARENT--> [?] Symptoms or signs involving the nervous system",
"[KB06] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....\n --EXCLUDES--> [?] Epilepsy due to prenatal or perinatal vascular insults\n Def: Epilepsy occurring in relation to an ischemic stroke or haemorrhagic stroke, with the stroke occurring or presumed to occur before birth [prenatal] or between 22 weeks of gestation and 7 days after bi...\n --CHILD--> [?] Epilepsy due to prenatal or perinatal ischemic stroke\n Def: Epilepsy occurring in relation to an ischemic stroke, with the stroke occurring or presumed to occur before birth [prenatal] or between 22 weeks of gestation and 7 days after birth [perinatal]. No oth...",
"[KB06] Neonatal seizures\n Def: A paediatric condition characterised by rapid and repeated muscle contraction and relaxation, resulting in an uncontrolled shaking of the body of a newborn....\n --EXCLUDES--> [?] Benign familial neonatal epilepsy\n Def: Epilepsy of the newborn characterised by frequent brief seizures within the first few days of life. Onset may be as late as 3 months of age. Seizures typically remit spontaneously within 6 weeks. The ...\n --PARENT--> [?] Genetic epileptic syndromes with neonatal onset\n Def: Epilepsy with onset in the first 30 days of life resulting from one or more known or presumed genetic defects in which seizures are the core symptom of the disorder...."
] |
8A68.Z
|
Type of seizure, unspecified
|
[
{
"from_icd11": "8A68.Z",
"icd10_code": "R561",
"icd10_title": "Post traumatic seizures"
},
{
"from_icd11": "8A68.Z",
"icd10_code": "R569",
"icd10_title": "Unspecified convulsions"
},
{
"from_icd11": "8A68.Z",
"icd10_code": "R56",
"icd10_title": "Convulsions, not elsewhere classified"
},
{
"from_icd11": "8A68.Z",
"icd10_code": "R568",
"icd10_title": ""
},
{
"from_icd11": "KB06",
"icd10_code": "P90",
"icd10_title": "Convulsions of newborn"
},
{
"from_icd11": "8A66.0",
"icd10_code": "G410",
"icd10_title": ""
},
{
"from_icd11": "PB6Y",
"icd10_code": "X58XXXD",
"icd10_title": "Exposure to other specified factors, subsequent encounter"
},
{
"from_icd11": "MA80.1",
"icd10_code": "R4702",
"icd10_title": "Dysphasia"
},
{
"from_icd11": "MA80.1",
"icd10_code": "R470",
"icd10_title": "Dysphasia and aphasia"
},
{
"from_icd11": "PA83.2",
"icd10_code": "W28XXXA",
"icd10_title": "Contact with powered lawn mower, initial encounter"
},
{
"from_icd11": "PA83.2",
"icd10_code": "W269XXA",
"icd10_title": "Contact with unspecified sharp object(s), initial encounter"
},
{
"from_icd11": "PA83.2",
"icd10_code": "W268XXA",
"icd10_title": "Contact with other sharp object(s), not elsewhere classified, initial encounter"
},
{
"from_icd11": "PA83.2",
"icd10_code": "W26",
"icd10_title": "Contact with other sharp objects"
},
{
"from_icd11": "PA83.2",
"icd10_code": "W268",
"icd10_title": "Contact with other sharp object(s), not elsewhere classified"
},
{
"from_icd11": "PA83.2",
"icd10_code": "W269",
"icd10_title": "Contact with unspecified sharp object(s)"
}
] |
R561
|
Post traumatic seizures
|
The case was an 82-year-old man who had a 50 mm infrarenal AAA . The patient presented with a history of above the knee amputation of the right leg due to gangrene from Buerger’s Disease. CTA demonstrated extensive occlusion of the right EIA, CFA and SFA. As the collateral circulation originating from the right hypogastric artery fed the amputated right leg, no ischemic symptoms were observed in the leg. Since the patient was octogenarian, he requested an endovascular treatment. If a revascularization was to be performed, a concurrent FP bypass surgery would be required due to the occluded proximal SFA and profunda femoris artery (PFA). However, because of the absence of ischemic symptoms in his right leg, it was decided that EVAR be performed using the occluded vessel as a pathway to deliver the endograft, without revascularizing the vessel . The occluded right CFA was punctured under ultrasound guidance using 21G needle (Medikit Co, Tokyo, Japan). A 0.014 in. guidewire (Command, Abbott, IL, USA) was inserted into the needle, and was then advanced to the level of the inguinal ligament. To improve the backup force, the needle was replaced with a microcatheter (Prominent Neo 2, Tokai Medical Products, Aichi, Japan). Under the support of the microcatheter, the guidewire was successfully advanced to the proximal ostium of the right EIA. Due to the impossibility of penetrating the hard proximal cap of the occluded EIA, a bidirectional approach was employed instead. A 6F guiding sheath (45 cm Destination, Terumo Corporation, Tokyo, Japan) was advanced from the left CFA to the right CIA. An antegrade penetration of the right EIA cap was also difficult, with the wire (0.014 in. Astato XS 9–40, Asahi Intec, Nagoya, Japan) going outside of the vessel easily. Intravascular ultrasound (Eagle Eye Platinum ST, Philips Healthcare, Eindhoven, Netherlands) located at the left CIA confirmed that the guidewire advanced from the occluded right CFA had entered the subintimal space of the right CIA. For re-entry of the guidewire into the true lumen, an OUTBACK ELITE Re-Entry catheter (Cordis, CA, USA) was employed. A semi-compliant angioplasty balloon (Sterling, 8–40 mm, Boston Scientific, MA, USA) was located at the right CIA, which was targeted by the re-entry catheter. A puncture of the inflated balloon was successfully performed using the re-entry device, followed by insertion of a guidewire into the punctured balloon. Retracting the punctured balloon into the sheath advanced from the left CFA while inserting the guidewire from the right CFA successfully established a through and through wire between the left and right CFAs. A 12Fr sheath (DrySeal Flex Introducer Sheath, WL Gore, Flagstaff, AZ, USA) was inserted from the right CFA. A 16 Fr Dryseal sheath for a main body graft was inserted from the left CFA. A conventional EVAR procedure was subsequently performed using an EXCLUDER AAA Endoprosthesis (WL Gore, Flagstaff, AZ, USA). A final angiogram showed the excluded aneurysm without any endoleak. Since there was an antegrade arterial flow into the right EIA which was used for the delivery of the 12F sheath, embolization was performed in order to occlude the channel. During the retraction of the 12F sheath, a leakage of contrast media was identified at a disrupted portion of the EIA. Detachable coils and plugs were used to embolize the channel [Interlock coils: 6 mm, 4 mm (Boston Scientific, MA, USA); AVP-2: 8 mm, 10 mm (Abbott, IL, USA)]. A post-operative CT confirmed that the aneurysm had been successfully excluded, while preserving the collateral vessels from the right hypogastric artery. Fig. 1 CT before endovascular aneurysm repair. a VR image of CT angiography shows the occlusion of the right EIA to the SFA with collateral network from the right hypogastric artery (arrow heads), b Axial plane of CT shows AAA (arrow head), c Contrast enhanced CT shows occlusion of the right CFA (arrow head), d The occluded EIA (arrow head) was atrophied. Arrow shows EIV. CFA: common femoral artery, EIA: external iliac artery, EIV: external iliac vein, SFA: superficial femoral artery, VR: volume rendering Fig. 2 Procedure detail. a The occluded right CFA was punctured under ultrasound guidance (arrowhead: tip of the needle), b A guidewire (arrow heads) was advanced via the occluded right CFA, c A guidewire was advanced to the subintimal space of the right CIA, d The OUTBACK reentry device in the subintimal space (arrow head) was directed to an angioplasty balloon located at the lumen of the right CIA (arrows), e Insertion of the wire (arrowhead) into the punctured balloon, f Retracting the punctured balloon with the wire established a through and through wire, g Main body graft (arrowheads) which was delivered via left iliac artery was deployed and then the contralateral limb (arrows) was delivered via right iliac artery, h Completion angiogram shows a successful exclusion of the AAA, i Embolization of the tract was performed using coils and a plug (arrowheads) where a 12F sheath was advanced. A leakage of contrast media (arrows) indicates vessel disruption, j Post-operative CT shows implanted endograft (arrowheads), coils and plugs (arrows), and preserved collateral channels. AAA: abdominal aortic aneurysm, CFA: common femoral artery, CIA: common iliac artery
| 3.974609
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999997
|
34245375
|
https://doi.org/10.1186/s42155-021-00247-1
|
[
"artery",
"occluded",
"guidewire",
"advanced",
"sheath",
"balloon",
"arrow",
"punctured",
"using",
"wire"
] |
[
{
"code": "BD5Z",
"title": "Diseases of arteries or arterioles, unspecified"
},
{
"code": "BD52",
"title": "Certain specified disorders of arteries or arterioles"
},
{
"code": "BD52.3",
"title": "Rupture of artery"
},
{
"code": "BD52.2",
"title": "Stricture of artery"
},
{
"code": "BD40.Z",
"title": "Atherosclerotic chronic arterial occlusive disease, unspecified"
},
{
"code": "BE2Y",
"title": "Other specified diseases of the circulatory system"
},
{
"code": "DB30.Y",
"title": "Other specified obstruction of large intestine"
},
{
"code": "DA0C.Y",
"title": "Other specified periodontal disease"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "GA16.Y",
"title": "Other specified acquired abnormalities of uterus, except cervix"
}
] |
=== ICD-11 CODES FOUND ===
[BD5Z] Diseases of arteries or arterioles, unspecified
Also known as: Diseases of arteries or arterioles, unspecified | artery disease NOS | arterial disease NOS | arteriolar disease NOS | disorder of artery NOS
[BD52] Certain specified disorders of arteries or arterioles
Also known as: Certain specified disorders of arteries or arterioles | Aortic dilatation - joint hypermobility - arterial tortuosity | Generalised arterial calcification of infancy | Median arcuate ligament syndrome | Aortic root abscess
Excludes: collagen (vascular) diseases | Hypersensitivity angiitis | Acute arterial occlusion
[BD52.3] Rupture of artery
Also known as: Rupture of artery | ruptured artery | artery fistula | Aortic duodenal fistula | Aortic colon fistula
Excludes: traumatic rupture of artery - see injury of blood vessel by body region
[BD52.2] Stricture of artery
Also known as: Stricture of artery | arterial stenosis | arterial stricture | artery stricture | stenosis of artery
[BD40.Z] Atherosclerotic chronic arterial occlusive disease, unspecified
Also known as: Atherosclerotic chronic arterial occlusive disease, unspecified | Atherosclerotic chronic arterial occlusive disease | arteriosclerosis, NOS | generalised atherosclerosis | atherosclerosis NOS
[BE2Y] Other specified diseases of the circulatory system
Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart
[DB30.Y] Other specified obstruction of large intestine
Also known as: Other specified obstruction of large intestine | Obstruction of large intestine due to compression or stenosis | Acute bowel obstruction, not elsewhere classified | Subacute bowel obstruction, not elsewhere classified | subacute intestinal obstruction NOS
[DA0C.Y] Other specified periodontal disease
Also known as: Other specified periodontal disease | Chronic periodontitis | Adult periodontitis | adult-onset periodontitis | chronic pericementitis
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[GA16.Y] Other specified acquired abnormalities of uterus, except cervix
Also known as: Other specified acquired abnormalities of uterus, except cervix | Polyp of corpus uteri | intrauterine polyp | polyp of body of uterus | polyp of uterus
=== GRAPH WALKS ===
--- Walk 1 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--CHILD--> [BD50] Aortic aneurysm or dissection
Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...
--- Walk 2 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--EXCLUDES--> [?] Diseases of coronary artery
Def: Conditions affecting the blood perfusion of the heart....
--- Walk 3 ---
[BD52] Certain specified disorders of arteries or arterioles
--CHILD--> [BD52.1] Arteriovenous fistula, acquired
--PARENT--> [BD52] Certain specified disorders of arteries or arterioles
--- Walk 4 ---
[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...
--CHILD--> [?] Cutaneous leukocytoclastic vasculitis
Def: Skin-limited small vessel leucocytoclastic vasculitis of unspecified or unknown aetiology...
--- Walk 5 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--EXCLUDES--> [?] Pathological fracture
--- Walk 6 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--EXCLUDES--> [?] Pathological fracture
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD50] Aortic aneurysm or dissection\n Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...",
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --EXCLUDES--> [?] Diseases of coronary artery\n Def: Conditions affecting the blood perfusion of the heart....",
"[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.1] Arteriovenous fistula, acquired\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles",
"[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...\n --CHILD--> [?] Cutaneous leukocytoclastic vasculitis\n Def: Skin-limited small vessel leucocytoclastic vasculitis of unspecified or unknown aetiology...",
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Pathological fracture",
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --EXCLUDES--> [?] Pathological fracture"
] |
BD5Z
|
Diseases of arteries or arterioles, unspecified
|
[
{
"from_icd11": "BD5Z",
"icd10_code": "I7389",
"icd10_title": "Other specified peripheral vascular diseases"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7419",
"icd10_title": "Embolism and thrombosis of other parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7411",
"icd10_title": "Embolism and thrombosis of thoracic aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7410",
"icd10_title": "Embolism and thrombosis of unspecified parts of aorta"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I7381",
"icd10_title": "Erythromelalgia"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I745",
"icd10_title": "Embolism and thrombosis of iliac artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I789",
"icd10_title": "Disease of capillaries, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I748",
"icd10_title": "Embolism and thrombosis of other arteries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I749",
"icd10_title": "Embolism and thrombosis of unspecified artery"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I781",
"icd10_title": "Nevus, non-neoplastic"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I788",
"icd10_title": "Other diseases of capillaries"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I744",
"icd10_title": "Embolism and thrombosis of arteries of extremities, unspecified"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I70-I79",
"icd10_title": ""
},
{
"from_icd11": "BD5Z",
"icd10_code": "I74",
"icd10_title": "Arterial embolism and thrombosis"
},
{
"from_icd11": "BD5Z",
"icd10_code": "I73",
"icd10_title": "Other peripheral vascular diseases"
}
] |
I7389
|
Other specified peripheral vascular diseases
|
A 28-year-old primigravid was referred for detailed fetal ultrasound at 36 weeks of gestation due to suspicion of fetal ventriculomegaly. Her obstetric and medical history as well as familial history were unremarkable. She had not been exposed to any known teratogens and had no clinical sign of TORCH infection. Her marriage was not consanguineous. The current pregnancy course was uneventful. Mid-pregnancy anomaly ultrasound screening was unremarkable. Ultrasound at the referring hospital at 34 weeks of gestation showed a male fetus with dilated bilateral lateral ventricles (18 mm, and 10 mm width), third ventricle and fourth ventricle, and a round shape, anechoic cyst (13 × 10 mm), at the left parieto-occipital lobe adjacent to the left lateral ventricle . However, the color Doppler ultrasound was not applied. All structures were otherwise normal. Fetal biometry revealed appropriate for gestational age. Serologic tests for TORCH infection were negative. On follow-up ultrasound at 36 +5 weeks at our hospital, the size of lateral ventricles, third ventricle and fourth ventricle were relatively the same. The round -shape anechoic cyst at the left parieto-occipital lobe was increased in size, 32 × 27 × 25 mm, with expanding hyperechoic area surrounding the cyst, representing pericystic hemorrhage. The left lateral ventricle was filled with hyperechoic irregular mass (hemorrhage) in most part. Color and spectral Doppler ultrasound showed turbulent flow in the cyst. The originating point of arterial jet arose from the left posterior cerebral arteries at left lateral border of temporal-parietal area of the hemisphere . With color Doppler flow, the course of the left posterior cerebral artery could be traced from the circle of Willis to the aneurysm. Three-dimension color flow ultrasound was helpful in confirming the diagnosis . The main prenatal diagnosis was aneurysm the left posterior cerebral artery with leakage leading to periventricular and intraventricular hemorrhage and pressure effect on the hemisphere. Fetal cardiomegaly and hepatomegaly (cardiac diameter as well as circumference and liver length were of greater than 95 th percentile of reference ranges) were also documented. Peak systolic velocity of the middle cerebral artery was 103.5 cm/s (greater than 1.5 MoM). After multidisciplinary consensus (neonatologists, pediatric neurosurgeons, and maternal–fetal medicine team) and patient counseling about poor prognosis in case of no intervention, planned delivery for postnatal management was performed by induction of labor at 37 weeks of gestation. However, cesarean section was performed due to failure of induction, giving birth to a male newborns, weighing 2,600 gm with Apgar scores of 9, 10 and 10 at 1, 5 and 10 min, respectively. Grossly, the newborn was not obviously abnormal except for pale skin. The occipitofrontal circumference was 37 cm. The fetal movement was normal. Neonatal CT brain scans on day 1 and CTA of the neonatal brain on day 5 after birth showed as follows: The arteriovenous malformation in left parietal lobe, fed by left middle and left posterior cerebral arteries, drained into cortical vein and left transverse sigmoid sinuses, with intervening arteriovenous malformation nidus, 12 × 13 × 12 cm in size. Intranidal saccular aneurysm sized 48 × 55 × 50 mm. A heterogeneous hyperdense lesion of intra-perenchymal hematoma at left perieto-tempero-occipital lobes. Encephalomalacia at left fronto-parieto-temperal lobes. Diffuse brain atrophy. Moderate amount of intraventricular hemorrhage in left lateral ventricle and third ventricle. Severe hydrocephalus with rightward bowing of the midline structures with no brain herniation was noted. The complete blood count showed fetal anemia; hematocrit and hemoglobin level of 32.5% and 10.3 g/dl respectively, and normal platelet concentration. The neonatal chest film x-ray, including abdomen, showed mild cardiomegaly and hepatomegaly. Though the baby survived and well received breast feeding, the prognosis was relatively poor. The couple opted to have palliative and supportive care at home, without neurosurgical correction. The baby developed severe hydrocephalus with gradually worsening and died on 46 th days of life. Fig. 1 Oblique coronal scan of the posterior fetal head at 34 weeks of gestation shows well-circumscribed anechoic cyst 1 cm diameter, protruding from the left lateral wall of the lateral ventricle Fig. 2 Color flow mapping at transventricular view at 36 weeks of gestation shows cystic mass with progressive enlargement and active flow jet originating from lateral wall of the lateral ventricle (arrow) with pericystic and intraventricular hyperechoic area representing hemorrhage. (A: aneurysm; IVH: intraventricular hemorrhage) Fig. 3 Rendered 3D-color flow ultrasound of the fetal brain at 36 weeks of gestation shows course of posterior cerebral artery (PCA) feeding the aneurysm from lateral wall of parieto-temporal hemisphere (arrow: indicating originating point of flow jet feeding the aneurysm). (ACA: anterior cerebral artery; MCA: middle cerebral artery) Fig. 4 Neonatal CT brain with contrast on day 1 after birth shows marked ventriculomegaly (V) and bright hyperechoic area representing active flow in the aneurysm (A), surrounded by hyperechoic area of hemorrhage
| 4.058594
| 0.975098
|
sec[1]/p[0]
|
en
| 0.999995
|
37848838
|
https://doi.org/10.1186/s12884-023-06056-9
|
[
"ventricle",
"fetal",
"ultrasound",
"flow",
"cerebral",
"hemorrhage",
"aneurysm",
"gestation",
"color",
"artery"
] |
[
{
"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": "LD9Z",
"title": "Developmental anomalies, unspecified"
},
{
"code": "KB20.Z",
"title": "Intrauterine hypoxia, unspecified"
},
{
"code": "3A50.4",
"title": "Hereditary persistence of fetal haemoglobin"
},
{
"code": "KB42",
"title": "Persistent pulmonary hypertension of the newborn"
},
{
"code": "LD2Z",
"title": "Multiple developmental anomalies or syndromes, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[LD9Z] Developmental anomalies, unspecified
Also known as: Developmental anomalies, unspecified | congenital malformations, deformations and chromosomal abnormalities | congenital malformation NOS | developmental abnormality NOS | fetal abnormality NOS
[KB20.Z] Intrauterine hypoxia, unspecified
Also known as: Intrauterine hypoxia, unspecified | Intrauterine hypoxia | fetal distress | fetal distress syndrome | intrauterine distress
[3A50.4] Hereditary persistence of fetal haemoglobin
Definition: Hereditary persistence of fetal haemoglobin (HPFH) associated with beta-thalassaemia is a haemoglobinopathy characterised by high haemoglobin (Hb)F levels and an increased number of fetal-Hb-containing cells. The association of HPFH with beta-thalassaemia mitigates the clinical manifestations which vary from a normal state to beta-thalassaemia intermedia.
Also known as: Hereditary persistence of fetal haemoglobin | HPFH - [Hereditary persistence of fetal haemoglobin] | fetal haemoglobin | persistence of fetal haemoglobin | persistent haemoglobin F
[KB42] Persistent pulmonary hypertension of the newborn
Definition: Persistent pulmonary hypertension of the newborn is a cardiopulmonary disorder characterised by systemic arterial hypoxemia secondary to pulmonary hypertension and extrapulmonary right-to-left shunting across the foramen ovale and ductus arteriosus.
Also known as: Persistent pulmonary hypertension of the newborn | persistent fetal circulation syndrome | fetal circulation | PFC - [persistent fetal circulation] syndrome | PPHN - [Persistent pulmonary hypertension of the newborn]
[LD2Z] Multiple developmental anomalies or syndromes, unspecified
Also known as: Multiple developmental anomalies or syndromes, unspecified | multiple congenital birth defects NOS | multiple congenital birth deformities NOS | multiple fetal abnormalities NOS | severe birth deformities NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[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--> [LA89.0] Double inlet atrioventricular connection
Def: A congenital cardiovascular malformation with a univentricular atrioventricular connection wherein both atria connect to one ventricle either via two separate atrioventricular valves or a common atrio...
--- 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--> [BC41] Acquired ventricular abnormality
Def: A postnatal pathological change in form or function of a ventricle....
--- 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...
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--- Walk 5 ---
[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...
--EXCLUDES--> [?] Subsequent myocardial infarction
Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction...
|
[
"[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--> [LA89.0] Double inlet atrioventricular connection\n Def: A congenital cardiovascular malformation with a univentricular atrioventricular connection wherein both atria connect to one ventricle either via two separate atrioventricular valves or a common atrio...",
"[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--> [BC41] Acquired ventricular abnormality\n Def: A postnatal pathological change in form or function of a ventricle....",
"[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...",
"[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 --EXCLUDES--> [?] Subsequent myocardial infarction\n Def: Infarction of any myocardial site, occurring within 4 weeks (28 days) from onset of a previous infarction..."
] |
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 58-year-old healthy Tamil farmer was admitted to the emergency unit of a district general hospital in Northern Sri Lanka with history of nausea, vomiting, and altered level of consciousness 1 hour after acetamiprid poisoning. He had ingested 150 g of acetamiprid dissolved in water. On examination, he was conscious with Glasgow Coma Scale score of 14/15 (GCS 14/15), and both pupils were equally reactive to light and 3 mm in size. His blood pressure was 112/65 mmHg, pulse 86 beats per minute, respiratory rate 12 breaths per minute, and core body temperature 36.8°C. The rest of the systemic examinations were unremarkable. Gastric lavage was performed, and a single dose of activated charcoal was administrated. One hour later, he developed reduced level of consciousness with GCS of 8/15. His oxygen saturation dropped to 75%, and blood pressure was 60/40 mmHg. His arterial blood gas was tested , showing severe lactic acidosis (pH 7.18, PaCO 2 29 mmHg, PaO 2 102.3 mmHg, HCO 3 − 11.2 mEq/L, blood lactate 11.9 mmol/L). To correct acidosis, 100 ml of 8.4% intravenous sodium bicarbonate was given. He was electively intubated. Subsequently, he was given fluid boluses of 30 ml/kg, such as 0.9% saline 2 L, 2% albumin saline 500 ml, and 5% human albumin 250 ml, which was guided according to dynamic parameters of fluid responsiveness such as inferior vena cava distensibility and right ventricular collapse in imaging studies. However, his blood pressure was suboptimal. Therefore, noradrenaline infusion at rate of 0.1 μg/kg/minute was initiated. His 12-lead electrocardiography (ECG) showed ST depression in leads I, II, aVF, and V 3 –V 6 . His high-sensitivity troponin I was 571 ng/L. Two-dimensional echocardiography (2D Echo) was done, and it showed mild left ventricular dysfunction with ejection fraction of 45%. Blood results are presented in Table 1 . He had persistent hypotension of 70/40 mmHg and severe lactic acidosis despite therapy . Subsequently, ultrasound-guided central venous line and intraarterial line were inserted. He was given dobutamine at rate of 10 μg/kg/minute followed by adrenaline infusion of 0.1 μg/kg/minute and vasopressin 1 U/kg/minute. Despite four inotropes, his blood pressure was suboptimal, and the infusion of noradrenaline, dobutamine, adrenaline, and vasopressin was increased to maximum doses of 0.7 μg/kg/minute, 20 μg/kg/minute, 1 μg/kg/minute, and 3 U/kg/minute, respectively. His blood pressure was maintained with infusion of four inotropes for 24 hours. Furthermore, 100 ml, 100 ml, and 50 ml of 8.4% intravenous sodium bicarbonate was repeated to correct acidosis according to calculated deficit and 100 ml/kg of 0.9% normal saline as maintenance therapy for the next 36 hours. He had persistent hypokalemia that required intravenous KCl of 60 mmol over 4 hours, 60 mmol for 3 hours, and 20 mmol for 1 hour. At end of 36 hours, his blood pressure and lactate level were brought to normal level. He was ventilated for 72 hours in the intensive care unit with further supportive therapy. He gradually improved and was extubated on day 3 of his illness. His repeat ECG and 2D Echo showed no abnormalities . His coronary angiography showed normal coronary epicardial arteries . He was discharged from hospital on day 6 of hospital admission. Fig. 1 Serial arterial blood gas reports of patient with acetamiprid poisoning Fig. 2 The 12 lead electrocardiography (ECG) showed ST depression in I, II, V 3 –V 6 on admission and resolution of ECG changes on discharge in a patient with acetamiprid poisoning. Table 1 Biochemical profile of patient with clinical progression of disease Biochemical investigation Date Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Full blood count White cell count 9540 10,400 10,600 11,320 10,324 10,321 Neutrophils (50–70%) 67 80 87 76 69 75 Lymphocytes (20–40%) 32 14 7 23 21 23 Hemoglobin (12–16 g/dL) 10.5 10.4 10.6 10.5 11.0 10.7 Red cell count (400,000–550,000 mm 3 ) 376,000 352,000 394,000 375,000 321,000 311,000 Platelets (150,000–450,000 mm 3 ) 303,000 246,000 342,000 327,000 298,000 276,000 Inflammatory markers ESR (first hour) – – 45 – . 35 CRP (0–1.0 mg/dL) – 3.1 2.1 1.7 1.1 1.1 Renal function tests Blood urea (18–55 mg/dL) 30 23 35 23 35 40 Serum creatinine (0.7–1.5 mg/dL) 1.17 1.51 1.83 1.64 1.1 1.1 Serum electrolytes Serum sodium (135–145 mmol/L) 145.2 138.1 139.1 134.9 135.6 134.8 Serum potassium (3.5–5.0 mmol/L) 2.39 2.4 3.1 4.2 5.2 4.5 Serum calcium (8.6–10.2 mg/dL) – 8.2 8.2 8.7 8.5 8.4 Serum phosphorus (2.6–4.5 mg/dL) – 3.5 3.1 2.7 2.8 2.3 Liver profile Serum aspartate aminotransferase (AST) (0–45 U/L) 19 61 188 123 72 47 Serum alanine aminotransferase (ALT) (0–35 U/L) 15 62 68 34 45 39 Serum bilirubin (0–2.0 mg/dL) 5.6 6.14. 6.13 4.1 3.1 2.1 Serum protein (6.4–8.3 g/dL) 5.59 5.12 5.0 5.8 5.9 5.8 Clotting profile Prothrombin time/international normalized ratio (PT/INR) (< 1.4) – 1.4 – 1.1 – 1.0 Activated partial thromboplastin time (APTT) (< 35 s) – 33 – 34 – 35 High-sensitivity troponin I (< 19 ng/L) 571 – 240.8 133.6 – 18 AST: Asparate transaminase, ALT: Alanine transaminase, PT/INR: Prothrombin time/International Normalized Ratio, APTT: Activated partial thromboplastin time Fig. 3 A , B Coronary angiography showing normal right ( A ) and left coronary arteries ( B ) in a patient with acetamiprid poisoning
| 3.916016
| 0.978516
|
sec[1]/p[0]
|
en
| 0.999997
|
34325742
|
https://doi.org/10.1186/s13256-021-02919-x
|
[
"blood",
"minute",
"serum",
"pressure",
"mmol",
"hours",
"acetamiprid",
"mmhg",
"hour",
"poisoning"
] |
[
{
"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": "ED5Y",
"title": "Other specified disorders of epidermal keratinisation"
},
{
"code": "KD30.0",
"title": "Birth depression with 5 minute Apgar score 0-3"
},
{
"code": "KD30.1",
"title": "Birth depression with 5 minute Apgar score 4-6"
},
{
"code": "KB21.0",
"title": "Severe birth asphyxia"
},
{
"code": "KB21.1",
"title": "Mild and moderate birth asphyxia"
}
] |
=== 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
[ED5Y] Other specified disorders of epidermal keratinisation
Also known as: Other specified disorders of epidermal keratinisation | Follicular digitate keratoses | Lichen spinulosus | Keratosis spinulosa | Keratosis circumscripta
[KD30.0] Birth depression with 5 minute Apgar score 0-3
Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 0 to 3 at 5 minutes following birth.
Also known as: Birth depression with 5 minute Apgar score 0-3
[KD30.1] Birth depression with 5 minute Apgar score 4-6
Definition: A condition characterised by cardiorespiratory and neurological depression, defined as an Apgar score between 4 and 6 at 5 minutes following birth.
Also known as: Birth depression with 5 minute Apgar score 4-6
[KB21.0] Severe birth asphyxia
Definition: Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent.
Also known as: Severe birth asphyxia | severe perinatal hypoxia | asphyxia pallida of newborn | Asphyxia with 5-minute Apgar score 0-3 | newborn severe asphyxia
[KB21.1] Mild and moderate birth asphyxia
Definition: Normal respiration not established within one minute, but heart rate 100 or above, some muscle tone present, some response to stimulation.
Also known as: Mild and moderate birth asphyxia | asphyxia livida of newborn | Asphyxia with 5-minute Apgar score 4-7 | Blue asphyxia
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues
Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--CHILD--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions
Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--CHILD--> [MF50.41] Microscopic haematuria
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.1] Finding of cocaine in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --CHILD--> [?] Coagulation defects, purpura or other haemorrhagic or related conditions\n Def: A condition caused by determinants arising during the antenatal period, after birth or by genetically inherited factors, leading to coagulation defects. This condition is characterised by increased br...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.41] Microscopic haematuria",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] 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 26-year-old female patient without a history of neurological symptoms presented to our hospital with bilateral optic neuritis which had gradually developed within 5 days prior to admission. Other than hypothyreosis, her past medical history was unremarkable. The patient complained of mainly left-sided bilateral blurred vision, reduced color discrimination, and pain with eye movement. Visual acuity was impaired on both eyes (left: 20/80; right: 20/40). Ophthalmological examination yielded no retinal abnormalities, but optic coherence tomography (OCT) was not possible as the patient was unable to focus appropriately. She was unable to read letters bilaterally during low-contrast visual acuity (LCVA) testing using 2.5% low-contrast Snellen charts. Visual evoked potentials (VEPs) yielded no response for the left eye, while P100 latencies for the right eye were pathologically increased to 139.5 ms. At admission, neurological examination revealed no further abnormalities. Cerebrospinal fluid (CSF) analysis 9 days after the first occurrence of symptoms revealed a lymphomonocytic pleocytosis of 72/μl with positive oligoclonal bands (OCBs) and intrathecal IgM synthesis. The MRZ reaction (MRZR), anti-AQP4, and anti-MOG antibodies as well as vasculitis screening and virological/microbiological analyses were all negative (see Table 1 ). 1 day later, intravenous corticosteroids (1,000 mg/day for five consecutive days) were initiated, and on the following day, numerous supra- and infratentorial gadolinium (Gad)-enhancing and non-enhancing T2w as well as two Gad-enhancing spinal lesions consistent with the diagnosis of multiple sclerosis (MS) were seen on MRI . In detail, there was Gad enhancement in both optic nerves, more than 35 dot-shaped Gad-enhancing juxtacortical/periventricular lesions with typical Dawson's finger configuration, and more than 12 active infratentorial lesions. Due to the typical presentation and the above-described paraclinical findings, we dispensed with further imaging such as magnetic resonance spectroscopy or positron emission tomography–computed tomography. As intravenous steroids resulted in no clinical improvement, five cycles of plasmapheresis and two additional cycles of immunoadsorption were performed. Following this treatment, her sight ameliorated subjectively as she regained the ability to recognize outlines, but overall improvement was poor. While LCVA yielded a score of 0 bilaterally, OCT was now possible, showing a normal peripapillary retinal nerve fiber layer thickness in both eyes (right: 102 μm; left: 103 μm). The patient was scheduled for ocrelizumab therapy within the following 2 weeks and discharged. Regarding other therapeutic options, we decided against alemtuzumab due to her known diagnosis of hypothyroidism. Moreover, the patient was opposed to natalizumab treatment due to concerns regarding progressive multifocal leukoencephalopathy even though she had a negative anti-John–Cunningham virus antibody titer. 1 day after discharge, the patient received the 13-valent pneumococcal conjugate vaccine in preparation for the planned ocrelizumab treatment. Within the next 5 days (i.e., ca. 1 month after the initial symptoms), she experienced a second relapse and was re-admitted to our hospital with a newly developed left spastic hemiplegia and progressive loss of vigilance. MRI revealed a fulminant progression of the lesion load and Gad enhancement with now more than 100 Gad-enhancing lesions . CSF analysis prior to the following therapy showed a shift to a lymphogranulocytic pleocytosis. Serum NfL was 340 pg/ml as measured by ELISA . After exclusion of an infectious etiology, a course of intravenous high-dosage corticosteroid (2,000 mg/day for 3 consecutive days) was administered. On the second day of corticosteroid therapy, the patient was started on an additional high-dose cyclophosphamide (HiCy) therapy for 4 consecutive days with 50 mg/kg/day, reaching a cumulative absolute dose of 14 g. Shortly after this combined therapy, serum NfL peaked at 833 pg/ml. 3 days after HiCy therapy, stem cells were mobilized with 6 mg granulocyte-colony stimulating factor. As expected, blood analysis revealed leukopenia and lymphopenia immediately after HiCy treatment. A recovery of the leukocytic population was observed at 10 days later. Circa 3 days after the last dose of cyclophosphamide, we observed both clinical and radiological improvement. While the total lesion load was stable, only 16 lesions were still active . Peripheral CD34-positive hematopoietic stem cells (HSC) were harvested by leukapheresis 3 weeks later and cryopreserved for future transplantation, if needed. The patient was discharged with mild residual neurological deficits and was closely monitored both clinically and radiologically . Serum NfL levels slowly decreased over the course of 10 weeks to 566 pg/ml. 9 weeks after the HiCy treatment, maintenance therapy with ocrelizumab was initiated following standard dosing (i.e., loading with 300 mg i.v. twice within 2 weeks and 600 mg i.v. as maintenance). 6 months later, the patient was still clinically stable without any relapses. The only residual symptom was a slightly impaired visual acuity (left: 20/30; right: 20/30). The VEP P100 latencies had returned to normal (right, 110 ms; left, 109 ms).
| 4.121094
| 0.973633
|
sec[1]/p[0]
|
en
| 0.999996
|
34248832
|
https://doi.org/10.3389/fneur.2021.696807
|
[
"both",
"enhancing",
"lesions",
"within",
"visual",
"hicy",
"neurological",
"optic",
"acuity",
"yielded"
] |
[
{
"code": "LB99.6",
"title": "Acheiria"
},
{
"code": "MB51.Z",
"title": "Diplegia of upper extremities, unspecified"
},
{
"code": "LB9A.4",
"title": "Apodia"
},
{
"code": "LB51",
"title": "Anorchia or microorchidia"
},
{
"code": "9D90.2",
"title": "Moderate vision impairment"
},
{
"code": "8A04.0",
"title": "Enhanced physiological tremor"
},
{
"code": "8E4A.0",
"title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord"
},
{
"code": "FA5Z",
"title": "Arthropathies, unspecified"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
}
] |
=== ICD-11 CODES FOUND ===
[LB99.6] Acheiria
Definition: A condition caused by failure of one or both hands to develop during the antenatal period.
Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist
[MB51.Z] Diplegia of upper extremities, unspecified
Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs
[LB9A.4] Apodia
Definition: A condition caused by failure of the foot to develop during the antenatal period.
Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side
[LB51] Anorchia or microorchidia
Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging.
Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis
[9D90.2] Moderate vision impairment
Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision]
Includes: visual impairment category 2, in both eyes
[8A04.0] Enhanced physiological tremor
Definition: This is a high frequency, low amplitude tremor present with posture or action. It represents an exacerbation of a physiologic tremor which may have been worsened by drugs, stress, anxiety, etc.
Also known as: Enhanced physiological tremor
[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord
Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem
Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis
[FA5Z] Arthropathies, unspecified
Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS
[ME60.Z] Skin lesion of unspecified nature
Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature
=== GRAPH WALKS ===
--- Walk 1 ---
[LB99.6] Acheiria
Def: A condition caused by failure of one or both hands to develop during the antenatal period....
--PARENT--> [LB99] Reduction defects of upper limb
Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB99.0] Amelia of upper limb
Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....
--- Walk 2 ---
[LB99.6] Acheiria
Def: A condition caused by failure of one or both hands to develop during the antenatal period....
--PARENT--> [LB99] Reduction defects of upper limb
Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB99.2] Radial hemimelia
Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....
--- Walk 3 ---
[MB51.Z] Diplegia of upper extremities, unspecified
--PARENT--> [MB51] Diplegia of upper extremities
Def: This is a loss of motor control in both arms....
--PARENT--> [?] Paralytic symptoms
--- Walk 4 ---
[MB51.Z] Diplegia of upper extremities, unspecified
--PARENT--> [MB51] Diplegia of upper extremities
Def: This is a loss of motor control in both arms....
--PARENT--> [?] Paralytic symptoms
--- Walk 5 ---
[LB9A.4] Apodia
Def: A condition caused by failure of the foot to develop during the antenatal period....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.1] Tibial hemimelia
Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....
--- Walk 6 ---
[LB9A.4] Apodia
Def: A condition caused by failure of the foot to develop during the antenatal period....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.1] Tibial hemimelia
Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....
|
[
"[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.0] Amelia of upper limb\n Def: A condition caused by the failure of an upper limb to develop during the antenatal period. This condition is characterised by absence of the upper limb....",
"[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.2] Radial hemimelia\n Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....",
"[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --PARENT--> [?] Paralytic symptoms",
"[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --PARENT--> [?] Paralytic symptoms",
"[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....",
"[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula...."
] |
LB99.6
|
Acheiria
|
[
{
"from_icd11": "LB99.6",
"icd10_code": "Q7131",
"icd10_title": "Congenital absence of right hand and finger"
},
{
"from_icd11": "LB99.6",
"icd10_code": "Q7133",
"icd10_title": "Congenital absence of hand and finger, bilateral"
},
{
"from_icd11": "LB99.6",
"icd10_code": "Q7130",
"icd10_title": "Congenital absence of unspecified hand and finger"
},
{
"from_icd11": "LB99.6",
"icd10_code": "Q713",
"icd10_title": "Congenital absence of hand and finger"
},
{
"from_icd11": "MB51.Z",
"icd10_code": "G830",
"icd10_title": "Diplegia of upper limbs"
},
{
"from_icd11": "LB9A.4",
"icd10_code": "Q7231",
"icd10_title": "Congenital absence of right foot and toe(s)"
},
{
"from_icd11": "LB9A.4",
"icd10_code": "Q7230",
"icd10_title": "Congenital absence of unspecified foot and toe(s)"
},
{
"from_icd11": "LB9A.4",
"icd10_code": "Q723",
"icd10_title": "Congenital absence of foot and toe(s)"
},
{
"from_icd11": "LB51",
"icd10_code": "Q550",
"icd10_title": "Absence and aplasia of testis"
},
{
"from_icd11": "LB51",
"icd10_code": "Q55",
"icd10_title": "Other congenital malformations of male genital organs"
},
{
"from_icd11": "9D90.2",
"icd10_code": "H542",
"icd10_title": "Low vision, both eyes"
},
{
"from_icd11": "8A04.0",
"icd10_code": "G252",
"icd10_title": "Other specified forms of tremor"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3183",
"icd10_title": "Dementia with Lewy bodies"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G2581",
"icd10_title": "Restless legs syndrome"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3184",
"icd10_title": "Mild cognitive impairment, so stated"
}
] |
Q7131
|
Congenital absence of right hand and finger
|
Varus Deformity : SMOT was done through a medial approach to the distal tibia. All patients received treatment with a medial opening wedge osteotomy. When performing a medially-based open wedge osteotomy, if the CORA level was at the level of the tibial joint surface or within 1.5 cm proximal to it, the designed osteotomy made 15 mm above the joint space to allow for minimal osteosynthesis, improve union, and avoid bayonet deformities. The goal of the osteotomy is to obtain overcorrection about 4 degrees of valgus of the LDTA to compensate for the cartilage degeneration in the medial tibiotalar joint. The preexisting varus deformation forces that affect the soft tissue are also offset by this overcorrection . If site of the CORA was higher than the 2.5 cm proximal to tibial plafond, the designed osteotomy was done through it running obliquely from distal medial to proximal lateral applying osteotomy rule one for deformity correction . Fig. 1 A Male patient 22 years old presented after one year from trauma by post-traumatic right ankle OA with varus deformity and nonunion of distal third fibular fracture and medial malleolus. Medial wedge opening supramalleolar osteotomy with bone graft, fibular plating, and screw fixation of the medial malleolus were done. a – d Preoperative X-rays show degrees of anterior distal tibial angle (ADTA), lateral distal tibial angle (LDTA), talar tilt (TT), and talocrural angle (TCA). e – h X-rays show degrees of ADTA, LDTA, TT, and TCA after 8 weeks with the union of supramalleolar osteotomy, fibular fracture and medial malleolus. Fig. 2 A Male patient 28 years old presented after 2 years from trauma by post-traumatic right ankle OA with varus deformity. Medial wedge opening supramalleolar osteotomy with bone graft, and fibular osteotomy were done. a – d Preoperative X-rays show degrees of anterior distal tibial angle (ADTA), lateral distal tibial angle (LDTA), talar tilt (TT), and talocrural angle (TCA). e – h X-rays show degrees of ADTA, LDTA, TT, and TCA after 9 weeks with union of supramalleolar, and fibular osteotomies Valgus Deformity : A medial-based wedge closing osteotomy was done through medial approach to the distal tibia. Overcorrection of the LDTA by 2–4° in varus direction was aimed by such osteotomy. In accordance with the preoperative plan, a low cut was made for resection of the tibial bone, which was parallel to and within 15 mm proximal to the joint space giving adequate distance for the distal fixation of the used plate. The upper cut was done obliquely in such way to remove the preplanned length of the base of the wedge from the medial tibial cortex. Placement of two guide wires in the site and the direction of the planned osteotomy was done under image intensifier guidance to ensure accurate bone resection. The osteotomy was then made with a wide saw blade and forced to be shut manually. To achieve a stable fixation, a rigid locked plate fixation is used. Additional Procedures : (1) Fibular Osteotomy (FO): Oblique or Z-form fibular osteotomy (FO) was frequently necessary. The FO is carried out using a separate lateral approach. It was indicated if the talus was not properly repositioned to the medial malleolus after the SMOT had been performed in patients with a congruent or incongruent deformity. This osteotomy was stabilized with one plate or two screws according to lateral soft tissue condition . (2) Medial or lateral sliding calcaneus osteotomy aiming for realigning the hindfoot with painless mobile subtalar joint. (3) Subtalar joint fusion was used for correction of hindfoot residual varus or valgus deformity associated with painful degenerative changes of the subtalar joint. (4) Proximal dorsal wedge closing osteotomy of first metatarsal to correct the forefoot pronation. (5) Reconstruction of the lateral collateral ligament (LCL) of the ankle was done by Broström-Gauld operation. Arthroscopic assessment of the ankle joint was done in one case for assessment the extent of cartilage damage and severity of the LCL injury. This was necessary to stabilize the talus in a corrected position within the ankle mortise after bony correction. (6) Tendons transfer around the ankle was needed to restore the muscular balance. Total split tibialis posterior tendon transfer to the peroneus brevis and the tibialis anterior tendons in the dorsum of the foot was used in the cases of weakness of ankle pronation and dorsiflexion. Post-operative Protocol: Patient follow-up at the time of suture removal after 2 weeks. Radiographic examinations were done after 1.5 months, 3 months, and 1 year for assessment of union and angles mentioned before. The patients were immobilized in a plaster cast for 6 weeks with adequate thromboembolic prophylaxis. Protected full weight-bearing in walking boots for further 6 weeks is advised. Full weight-bearing was allowed after healing of osteotomies. Rehabilitation exercises like passive and active mobilization, coordination and proprioception of muscular activity, muscle strengthening, and gait training were started after the 6th week post-operative. The rehabilitation program was tailored for each patient according to the bony and soft tissue procedure done. Assessment of AOFAS ankle–hindfoot score for pain, function, and alignment was done in the final visit.
| 4.171875
| 0.725586
|
sec[1]/sec[0]/p[0]
|
en
| 0.999997
|
37943337
|
https://doi.org/10.1007/s00590-023-03773-x
|
[
"osteotomy",
"tibial",
"joint",
"ankle",
"deformity",
"wedge",
"fibular",
"varus",
"ldta",
"angle"
] |
[
{
"code": "LB9A.1",
"title": "Tibial hemimelia"
},
{
"code": "FA31.Y",
"title": "Other specified acquired deformities of limbs"
},
{
"code": "FB54.Y",
"title": "Other specified enthesopathies of lower limb"
},
{
"code": "8C75",
"title": "Distal myopathies"
},
{
"code": "8C11.4",
"title": "Lesion of tibial nerve"
},
{
"code": "FA5Z",
"title": "Arthropathies, unspecified"
},
{
"code": "FA2Z",
"title": "Inflammatory arthropathies, unspecified"
},
{
"code": "FA36.Z",
"title": "Effusion of joint, unspecified"
},
{
"code": "FA37.Y",
"title": "Other specified certain joint disorders, not elsewhere classified"
},
{
"code": "FA34.3",
"title": "Contracture of joint"
}
] |
=== ICD-11 CODES FOUND ===
[LB9A.1] Tibial hemimelia
Definition: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula.
Also known as: Tibial hemimelia | Longitudinal reduction defect of tibia | agenesis of tibia | congenital absence of tibia | congenital absence of tibia with or without absence of some distal elements
[FA31.Y] Other specified acquired deformities of limbs
Also known as: Other specified acquired deformities of limbs | Acquired deformity of forearm | Deflection of radius | Bowing of the radius | Bowing of forearm
[FB54.Y] Other specified enthesopathies of lower limb
Also known as: Other specified enthesopathies of lower limb | Anterior tibial syndrome | Enthesopathy of hip region | enthesopathy of hip NOS | Enthesopathy of knee region
Includes: Anterior tibial syndrome
[8C75] Distal myopathies
Definition: Distal myopathies are heterogeneous group of myopathies characterised clinically by progressive weakness and atrophy starting in distal muscles and progressing to proximal ones, and histologically by nonspecific myopathic features on muscle biopsy.
Also known as: Distal myopathies | Distal muscular dystrophy | Distal myopathy with anterior tibial onset | Markesbery-Griggs distal myopathy | Tibial muscular dystrophy
[8C11.4] Lesion of tibial nerve
Also known as: Lesion of tibial nerve | Lesion of medial popliteal nerve | Lesion of sural nerve
Excludes: Injury of tibial nerve at lower leg level
[FA5Z] Arthropathies, unspecified
Also known as: Arthropathies, unspecified | Disorders affecting predominantly peripheral joints | Disorders affecting predominantly peripheral limb joints | arthropathy NOS | arthropathic
[FA2Z] Inflammatory arthropathies, unspecified
Also known as: Inflammatory arthropathies, unspecified | polyarthritis NOS | inflammatory joint disease NOS | nonpyogenic arthritis NOS | arthritic nodosa
[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
[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
[FA34.3] Contracture of joint
Also known as: Contracture of joint | contracture of joint, site unspecified | joint contraction | joint contracture | abduction contracture joint
Excludes: Dupuytren contracture | contracture of tendon (sheath) without contracture of joint | acquired deformities of limbs
=== GRAPH WALKS ===
--- Walk 1 ---
[LB9A.1] Tibial hemimelia
Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.0] Amelia of lower limb
--- Walk 2 ---
[LB9A.1] Tibial hemimelia
Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.2] Fibular hemimelia
Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....
--- Walk 3 ---
[FA31.Y] Other specified acquired deformities of limbs
--PARENT--> [FA31] Other acquired deformities of limbs
--CHILD--> [FA31.0] Valgus deformity, not elsewhere classified
--- Walk 4 ---
[FA31.Y] Other specified acquired deformities of limbs
--PARENT--> [FA31] Other acquired deformities of limbs
--EXCLUDES--> [?] Structural developmental anomalies of the skeleton
Def: A deformation established before birth of an anatomical structure of one or more bones....
--- Walk 5 ---
[FB54.Y] Other specified enthesopathies of lower limb
--PARENT--> [FB54] Enthesopathies of lower limb
Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification....
--CHILD--> [FB54.0] Iliac crest spur
Def: This is a disorder characterised by bony exostosis at iliac muscle origins....
--- Walk 6 ---
[FB54.Y] Other specified enthesopathies of lower limb
--PARENT--> [FB54] Enthesopathies of lower limb
Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification....
--CHILD--> [FB54.0] Iliac crest spur
Def: This is a disorder characterised by bony exostosis at iliac muscle origins....
|
[
"[LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.0] Amelia of lower limb",
"[LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.2] Fibular hemimelia\n Def: Fibular hemimelia is a congenital longitudinal limb deficiency characterised by complete or partial absence of the fibula bone....",
"[FA31.Y] Other specified acquired deformities of limbs\n --PARENT--> [FA31] Other acquired deformities of limbs\n --CHILD--> [FA31.0] Valgus deformity, not elsewhere classified",
"[FA31.Y] Other specified acquired deformities of limbs\n --PARENT--> [FA31] Other acquired deformities of limbs\n --EXCLUDES--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....",
"[FB54.Y] Other specified enthesopathies of lower limb\n --PARENT--> [FB54] Enthesopathies of lower limb\n Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification....\n --CHILD--> [FB54.0] Iliac crest spur\n Def: This is a disorder characterised by bony exostosis at iliac muscle origins....",
"[FB54.Y] Other specified enthesopathies of lower limb\n --PARENT--> [FB54] Enthesopathies of lower limb\n Def: This is a group of disorders which refer to any abnormality of tendon and ligament insertion points of the leg. Abnormalities include inflammation and calcification....\n --CHILD--> [FB54.0] Iliac crest spur\n Def: This is a disorder characterised by bony exostosis at iliac muscle origins...."
] |
LB9A.1
|
Tibial hemimelia
|
[
{
"from_icd11": "LB9A.1",
"icd10_code": "Q7252",
"icd10_title": "Longitudinal reduction defect of left tibia"
},
{
"from_icd11": "LB9A.1",
"icd10_code": "Q725",
"icd10_title": "Longitudinal reduction defect of tibia"
},
{
"from_icd11": "8C75",
"icd10_code": "G718",
"icd10_title": "Other primary disorders of muscles"
},
{
"from_icd11": "8C11.4",
"icd10_code": "G574",
"icd10_title": "Lesion of medial popliteal nerve"
},
{
"from_icd11": "FA5Z",
"icd10_code": "M00-M25",
"icd10_title": ""
},
{
"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"
}
] |
Q7252
|
Longitudinal reduction defect of left tibia
|
On physical examination he looked ill, was haemodynamically stable and hypercapnic. His body temperature was 37.2 °C. His blood pressure was 154/66 mmHg, with a regular pulse of 116 beats min −1 . He was tachypneic, respiration rate of 27 min −1 , with a peripheral oxygen saturation of 97 % with a non-rebreathing mask. Lung auscultation revealed weak breath sounds. Further physical examination revealed a wound between his first and second toe on his right foot in which a great number of maggots were present . Signs of chronic venous insufficiency were present, but no signs of arterial insufficiency. The remaining physical examination was unremarkable. Haematological and biochemical investigations showed a white blood cell count of 17.9×10 9 l −1 [reference range (ref.) 4–10×10 9 l −1 ], with 81 % neutrophils (ref. 40–75 %), C-reactive protein 51 mg l −1 (ref. <10), glucose level of 257.6 mg dl −1 (ref. 72.1–115.1) and otherwise normal results for haemoglobin level, platelet count, liver enzymes, electrolytes and creatinine. Arterial blood-gas analysis showed a marked respiratory acidosis with a pH of 7.19 and pCO2 of 12.1 kPa. A chest X-ray did not reveal signs of pneumonia. He was admitted to our Intensive Care Unit and non-invasive ventilation was started with a diagnosis of exacerbation of his COPD without an apparent trigger, possibly upper respiratory tract infection. Steroids, bronchodilators and a broad-spectrum antibiotic (amoxicillin/clavulanic acid) were given. Two days later he was transferred to the pulmonology ward. Two blood culture sets each containing one aerobic and one anaerobic bottle (BACTEC Plus Aerobic/F and Anaerobic/F Culture Vials using the BACTEC FX system; Becton Dickinson) drawn upon admission revealed growth of Gram-negative rods in one of the aerobic bottles after incubation for 48 h. Upon subculturing of the Gram-negative rod, an oxidase-positive, aerobic, catalase-positive strain was found. Determination by Vitek2Combo with ID-GN card (bioMérieux) revealed Acinetobacter iwoffii with 98 % probabil ity. API NE tests (bioMérieux) could not assign the strain to a specific species. The above results were conflicting with colony morphology and oxidase reaction. A RapID-ANA test (Remel) was done to test for enzymatic reactions that could possibly provide a clue to the identification. Positive reactions for urease, arginine and serine hydrolysis were found. Although we even considered this strain to be a non-fermentative contaminant, the combination of the positive oxidase reaction and the growth characteristics finally let us consider Wohlfahrtiimonas species as we knew the patient had a wound full with maggots. However , a positive urease reaction is not compatible with Wohlfahrtiimonas . We offered the strain to an external laboratory (BaseClear, Leiden, The Netherlands) for identification by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (VITEK MS; bioMérieux) and MicroSEQ analysis, a 16S rRNA gene amplification and sequencing method (Life Technologies). MALDI-TOF MS did not reveal a reliable result (VITEK MS industry database v2.0) and even the MicroSEQ analysis with the validated database was unsuccessful. To our complete surprise a species of the genus Ignatzschineria was identified when the 489 basepair 16S rRNA gene sequence was blasted against the NCBI and SMARTgene databases. The colony morphology, growth characteristics, oxidase and urease reaction were all compatible with this identification as well as the clinical story. The complete 16S rRNA gene was amplified and analysed. The resulting sequence showed 98.7, 98.5 and 98.2 % similarity, respectively to the type strains of Ignatzschineria ureiclastica , Ignatzschineria larvae and Ignatzschineria indica . Fig. 2 shows a phylogenetic tree displaying the relations with close proximate species. The sequence was submitted to the GenBank database and assigned accession number KT355688 . Antimicrobial susceptibility testing performed by Etest (bioMérieux) revealed minimal inhibitory concentrations (MIC) for amoxicillin/clavulanic acid of 0.25 mg l −1 , amoxicillin 0.047 mg l −1 and ciprofloxacin 0.064 mg l −1 . A beta-lactamase test (Oxoid) was positive. According to EUCAST non-species related breakpoints all these antibiotics could be considered sensitive based on Pk/Pd data. The positive beta-lactamase test argues against amoxicillin as appropriate treatment. The in vitro sensitivity to amoxicillin by Etest in conjunction with a positive beta-lactamase test is suggestive of an inducible beta-lactamase. A culture of the wound on the right foot of the patient taken two days after start of antimicrobial treatment and admission did only reveal Providencia stuartii . Even with the knowledge of the blood culture result we could not find species of the genus Ignatzschineria in this culture. A two-week course of amoxicillin/clavulanic acid was completed with good clinical response. The wound on the patient's foot was successfully treated with application of povidone-iodine (betadine) and low adherent highly absorbent (melonin) dressings. His pulmonary condition improved, elevated glucose level and venous insufficiency were taken care of and he gradually improved and was discharged three weeks after admission.
| 4.042969
| 0.968262
|
sec[1]/p[1]
|
en
| 0.999998
|
28348762
|
https://doi.org/10.1099/jmmcr.0.005043
|
[
"amoxicillin",
"species",
"blood",
"culture",
"ignatzschineria",
"wound",
"aerobic",
"oxidase",
"strain",
"reaction"
] |
[
{
"code": "1F85",
"title": "Paragonimiasis"
},
{
"code": "1F6F",
"title": "Trichostrongyliasis"
},
{
"code": "1F86.Z",
"title": "Schistosomiasis due to unspecified or unknown Schistosoma species"
},
{
"code": "1C1B.Y",
"title": "Other specified forms of nocardiosis"
},
{
"code": "1B91",
"title": "Leptospirosis"
},
{
"code": "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 ===
[1F85] Paragonimiasis
Definition: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depending on the site where the parasite migrates to. Transmission is commonly by ingestion of undercooked contaminated crustaceans (crab or crayfish). Confirmation is commonly by identification of Paragonimus eggs in a sputum or faecal sample.
Also known as: Paragonimiasis | Pulmonary distomiasis | Parasitic haemoptysis | Oriental lung fluke disease | Endemic haemoptysis
Includes: lung fluke disease | infection due to paragonimus species | Infestation due to Paragonimus species
[1F6F] Trichostrongyliasis
Definition: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion of contaminated food or water. Confirmation is by identification of Trichostrongylus eggs in a faecal sample.
Also known as: Trichostrongyliasis | trichostrongylosis | infection by trichostrongylus | infection by trichostrongylus species | trichostrongylus infestation
[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species
Also known as: Schistosomiasis due to unspecified or unknown Schistosoma species | Schistosomiasis | Bilharziasis | snail fever | acute schistosomiasis
[1C1B.Y] Other specified forms of nocardiosis
Also known as: Other specified forms of nocardiosis | Encephalitis due to Nocardia species | Meningitis due to Nocardia species
[1B91] Leptospirosis
Definition: A disease caused by an infection with the gram-negative bacteria Leptospira. In the first phase, this disease is characterised by generalised illness (fever, chills, or myalgias) or individuals may be asymptomatic; in the second phase, the heart, liver, kidneys, or brain may be affected by the infection (symptoms are dependent on the site affected). Transmission is by ingestion of contaminated food or water, droplet transmission, or direct cutaneous contact. Confirmation is by identification of
Also known as: Leptospirosis | Nanukayami disease | Nanukayami fever | seven-day fever | EIA - [equine infectious anaemia]
[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 ---
[1F85] Paragonimiasis
Def: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depend...
--PARENT--> [?] Diseases due to trematodes
--CHILD--> [1F81] Dicrocoeliasis
Def: A disease caused by an infection with the parasitic worm Dicrocoelium dendriticum. This disease is commonly asymptomatic. This disease may present with cholecystitis, liver abscesses, or upper abdomin...
--- Walk 2 ---
[1F85] Paragonimiasis
Def: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depend...
--PARENT--> [?] Diseases due to trematodes
--PARENT--> [?] Helminthiases
--- Walk 3 ---
[1F6F] Trichostrongyliasis
Def: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion...
--PARENT--> [?] Diseases due to nematodes
--CHILD--> [1F60] Angiostrongyliasis
Def: A disease caused by an infection with the parasitic worm Angiostrongylus. This disease commonly presents with fever, headache, stiffness of the neck and back, tingling or painful feelings in the skin,...
--- Walk 4 ---
[1F6F] Trichostrongyliasis
Def: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion...
--PARENT--> [?] Diseases due to nematodes
--CHILD--> [1F61] Anisakiasis
Def: A disease caused by an infection with the parasitic worm Anisakis. This disease presents with severe abdominal pain, nausea, vomiting, or a hypersensitivity reaction. Transmission is by ingestion of u...
--- Walk 5 ---
[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species
--PARENT--> [1F86] Schistosomiasis
Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....
--CHILD--> [1F86.0] Schistosomiasis due to Schistosoma haematobium
Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als...
--- Walk 6 ---
[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species
--PARENT--> [1F86] Schistosomiasis
Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....
--PARENT--> [?] Diseases due to trematodes
|
[
"[1F85] Paragonimiasis\n Def: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depend...\n --PARENT--> [?] Diseases due to trematodes\n --CHILD--> [1F81] Dicrocoeliasis\n Def: A disease caused by an infection with the parasitic worm Dicrocoelium dendriticum. This disease is commonly asymptomatic. This disease may present with cholecystitis, liver abscesses, or upper abdomin...",
"[1F85] Paragonimiasis\n Def: A disease caused by an infection with the parasitic worm Paragonimus. This disease is characterised by cough or haemoptysis, or may be asymptomatic. This disease may present with other symptoms depend...\n --PARENT--> [?] Diseases due to trematodes\n --PARENT--> [?] Helminthiases",
"[1F6F] Trichostrongyliasis\n Def: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion...\n --PARENT--> [?] Diseases due to nematodes\n --CHILD--> [1F60] Angiostrongyliasis\n Def: A disease caused by an infection with the parasitic worm Angiostrongylus. This disease commonly presents with fever, headache, stiffness of the neck and back, tingling or painful feelings in the skin,...",
"[1F6F] Trichostrongyliasis\n Def: A disease caused by an infection with the parasitic worm Trichostrongylus. This disease is characterised by abdominal pain, diarrhoea, weight loss, or may be asymptomatic. Transmission is by ingestion...\n --PARENT--> [?] Diseases due to nematodes\n --CHILD--> [1F61] Anisakiasis\n Def: A disease caused by an infection with the parasitic worm Anisakis. This disease presents with severe abdominal pain, nausea, vomiting, or a hypersensitivity reaction. Transmission is by ingestion of u...",
"[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --CHILD--> [1F86.0] Schistosomiasis due to Schistosoma haematobium\n Def: A disease caused by an infection with the parasitic worm Schistosoma haematobium. This disease is characterised by haematuria, scarring, calcification, or squamous cell carcinoma. This disease may als...",
"[1F86.Z] Schistosomiasis due to unspecified or unknown Schistosoma species\n --PARENT--> [1F86] Schistosomiasis\n Def: An infestation caused by helminths of the genus Schistosoma. The clinical features vary according to the species involved but the principal organs affected are the gastrointestinal tract and bladder....\n --PARENT--> [?] Diseases due to trematodes"
] |
1F85
|
Paragonimiasis
|
[
{
"from_icd11": "1F85",
"icd10_code": "B664",
"icd10_title": "Paragonimiasis"
},
{
"from_icd11": "1F6F",
"icd10_code": "B812",
"icd10_title": "Trichostrongyliasis"
},
{
"from_icd11": "1F86.Z",
"icd10_code": "B659",
"icd10_title": "Schistosomiasis, unspecified"
},
{
"from_icd11": "1F86.Z",
"icd10_code": "B658",
"icd10_title": "Other schistosomiasis"
},
{
"from_icd11": "1F86.Z",
"icd10_code": "B65",
"icd10_title": "Schistosomiasis [bilharziasis]"
},
{
"from_icd11": "1B91",
"icd10_code": "A279",
"icd10_title": "Leptospirosis, unspecified"
},
{
"from_icd11": "1B91",
"icd10_code": "A27",
"icd10_title": "Leptospirosis"
},
{
"from_icd11": "1B91",
"icd10_code": "A270",
"icd10_title": "Leptospirosis icterohemorrhagica"
},
{
"from_icd11": "1B91",
"icd10_code": "A278",
"icd10_title": "Other forms of leptospirosis"
},
{
"from_icd11": "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"
}
] |
B664
|
Paragonimiasis
|
A 12-year-old girl presented to our clinic with left knee joint pain that had lasted for 7 days. The patient had no symptoms of fever, skin purpura, dry mouth, dry eyes, or parotitis. There was no past history of neck or face radiotherapy. Her physical examination revealed swelling in the left knee joint. Other physical findings were normal. Laboratory testing indicated normal complete blood counts and an erythrocyte sedimentation rate (ESR) of 33 mm (0–20 mm/h). The patient tested positive for glucosuria upon urine screening, but was negative for hematuria and proteinuria. Then, we administered an oral glucose tolerance test (OGTT) and measured glycosylated hemoglobin A-1c(HbA1c) to evaluate glucose intolerance. Eventually,she was diagnosed as having renal glucosuria (RG) with normal glucose tolerance and normal HbA1c. She also tested positive for anti-nuclear antibody (ANA) (1:100), anti-Sjögren syndrome B (anti-SSB/Ro), Perinuclear antineutrophil cytoplasmic antibody(P-ANCA)(1:10), and ESR (33 mm/h). Tests for anti-Sjögren syndrome A (anti-SSA/La), anti-Sm, anti-double stranded DNA (anti-dsDNA), anti-ribonnucleoprotein (anti-RNP), ani-Scl70, anti-phospholipid, anti-Jo-1, anti-myeloperoxidase antineutrophil cytoplasmic antibody (anti-MPO-ANCA), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibody, hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), IgG, IgA, IgM, C3, and C4 were negative or normal. Ophthalmological assessment revealed her schirmer’s test was positive. Ultrasonography of shallow lymph glands showed enlarged lymph nodes in the bilateral parotid gland. Histopathological analysis of minor salivary gland biopsy showed a lymphocytic infiltrate around the ducts and acinus in the small area . Renal biopsy showed tubular interstitial damage . Light microscopy demonstrated previously unapparent proliferation of glomerular mesangial cells, increases in mesangial matrix, tubular interstitial and acinus damage, renal tubule epithelial cell swelling and degeneration, focal tubular atrophy, and tubular epithelial cell fusion (< 5%), while an interstitial lymphoplasmacytic infiltrate was not obvious. Electron microscopy revealed partial foot process fusion and no other significant ultrastructural abnormalities. Immunofluorescence showed no deposition of immunoglobulins (IgG, IgA, and IgM) or complement (C3, C4, and C1q), and the kappa and lambda chains were also negative. Based on the 2012 American College of Rheumatology Classification (ACR) criteria for Sjögren syndrome and kidney biopsy, she was diagnosed as primary Sjogren syndrome (pSS) with tubular interstitial damage. Her treatment consisting of celebrex (200 mg/d) and hydroxychloroquine (100 mg/d) was administered during the first week, with hydroxychloroquine (200 mg/d) and sulfasalazine enteric-coated tablets (400 mg/d) during the next half year of treatment. After the first 2 months of treatment, the girl’s joint pain was in complete remission and the complete blood counts and erythrocyte sedimentation rate were all normal. Three months later, she developed temporal headache, which was intermittent,being worst in the afternoon and relieved in the morning. The next day, she began to have a fever of 38.8 °C with nausea and vomiting. With worsening symptoms, the patient came to our hospital directly, where an MRI scan of the brain was normal . Her physical examination showed superficial sensation disorder in the upper limbs and Kernig signs. Complete blood counts,c-reactive protein, procalcitonin, and the erythrocyte sedimentation rate were all unremarkable. For further investigation, lumbar puncture was performed, which revealed normal cerebrospinal fluid (CSF) pressure (> 125 mmH 2 O). High leucocyte counts of 30 cells 10^6 L with lymphocytic predominance (60%),a CSF glucose level of 3.1 mmol/L,a chlorine level of 126.1 mmol/L, and a CSF protein level of 206 mg/L were noted. Cytology of the CSF showed large lymphocytes and occasional histiocytic cells with normal morphology. Bacterial culture of the CSF was negative. Virus antibody testing of the CSF was negative for herpes simplex 1 and 2, cytomegalovirus, echovirus, coxsackievirus, and Epstein-Barr virus. Cryptococcus neoformans and Mycobacterium tuberculosis were also not found in the CSF. After these test results, she was diagnosed with aseptic meningoencephalitis but we could not exclude the possibility of viral meningitis. Therefore, the patient was treated with intravenous acyclovir. However,due to drug allergy,we stopped acyclovir treatment early. After 3 days, her headache and rash were significantly relieved. Based on the patient’s medical history, CSF examination, and treatment, we speculate that the disorders of the nervous system were more likely caused by the pSS. During the follow up of 1.5 years, her renal function was stable and no residual nervous system damage was apparent. She underwent low dose prednisone therapy (5-10 mg/d) for half a year because of persistent renal glucosuria. Fig. 1 minor salivary gland biospy Fig. 2 Kidney biopsy specimen Fig. 3 T1-weighted and T2-weighted image showing normal signal intensity in the parenchymal and cerebellum. No abnormally was found in the shape, size and position of ventricle, cistern and sulci
| 4.164063
| 0.956543
|
sec[1]/p[0]
|
en
| 0.999997
|
32448292
|
https://doi.org/10.1186/s12969-020-00431-y
|
[
"anti",
"renal",
"antibody",
"virus",
"tubular",
"complete",
"counts",
"glucose",
"biopsy",
"interstitial"
] |
[
{
"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": "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 ===
[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
[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 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.2] Maternal care for signs of fetal hypoxia
--- Walk 2 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.1] Maternal care for hydrops fetalis
--- Walk 3 ---
[MB23.1] Antisocial behaviour
Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....
--PARENT--> [MB23] Symptoms or signs involving appearance or behaviour
--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 --CHILD--> [JA86.2] Maternal care for signs of fetal hypoxia",
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.1] Maternal care for hydrops fetalis",
"[MB23.1] Antisocial behaviour\n Def: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated....\n --PARENT--> [MB23] Symptoms or signs involving appearance or behaviour\n --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": "GB6Z",
"icd10_code": "N19",
"icd10_title": "Unspecified kidney failure"
}
] |
O26841
| |
A 17-year-old female patient without any medical history was transferred to the endodontic practice (Adult and Child Dentistry, Cliniques Universitaires Saint-Luc, Brussels, Belgium) after initial consultation with an oral surgeon regarding a large radiolucent area detected in the apical region of the upper right incisors. The patient had reported in the previous year two episodes of palatal abscess, which were managed by antibiotic prescription. The type and dosage of the antibiotic prescriptions were unknown. According to the report of the oral surgeon, teeth #13-12-11-21 responded positively to cold test, negative to percussion and the patient was totally asymptomatic. The oral surgeon suspected a naso-palatine duct cyst, recommended surgical removal of the periapical lesion under local anaesthesia, followed by an oral pathology examination. Prior to intervention, the surgeon requested root canal treatment of teeth #11 and #12. At the pre-operative endodontic consultation, similar clinical observations to those of the oral surgeon were made, except that tooth #11 was negative to cold test. A periapical radiograph confirmed the presence of a large radiolucency around the apex of tooth #11 , which presented immature root formation. A slight discoloration could be observed on that tooth as compared to tooth #21 . The analysis of the clinical findings led to the clinical diagnosis of chronic apical periodontitis, secondary to pulp infection likely because of trauma more than 10 years before. A regenerative endodontic therapy was proposed to the patient instead of the surgery initially planned, and informed consent was obtained. Local anaesthesia without vasoconstrictor (Scandonest 3%; Septodont, Saint-Maur-des-Fossés, France) was administered for this procedure. Given the lack of clinical signs and symptoms, the case was considered as potentially eligible for a single-visit treatment, provided that the canal could be dried after completion of root canal disinfection. This option was discussed with the patient, who provided informed consent for this approach. Consequently, the protocol used in this case deviates from the ESE recommendations , because of the absence of a separate disinfection session followed by temporisation with intracanal medication. The treatment, however, took place before the publication of those guidelines. Rubber dam isolation was placed, and the canal was accessed. No signs of vitality could be observed in the canal, confirming the diagnosis. The working length was assessed by a combination of the apex locator (Propex II, Dentsply-Maillefer) and confirmatory periapical radiograph with a file in the root canal . The canal was abundantly irrigated with a 2.5% NaOCl solution without any instrumentation until no more debris could be seen coming out of the canal under microscope observation. The canal was then dried using paper points to evaluate the presence or absence of exudate or suppuration. Since the canal could be dried appropriately, a final irrigation of 3 min was performed with a commercial 15% EDTA solution (Largal Ultra, Septodont Saint-Maur-des-Fossés, France), followed by a thorough rinsing with NaOCl and drying with paper cone. Bleeding was induced within the canal using a size 35 file 2 mm beyond the apex. When the blood reached 3 mm below the cemento-enamel junction, a piece of haemostatic gelatine-based sponge (Roeko Gelatamp, Coltene) was placed in the root canal. When the sponge was soaked in blood, a fast-setting tricalcium-silicate cement (Biodentine, Septodont Saint-Maur-des-Fossés, France) was placed on top in the whole cavity . A final radiograph was taken for monitoring purposes . The patient was reviewed at 1 month for clinical evaluation; the tooth was totally asymptomatic, and the adjacent teeth remained positive to cold test. The tricalcium-silicate cement was then partly removed and covered with a resin-based composite. At the 6-month follow-up, a slight reduction of the periapical radiolucency could already be observed . One year later, a significant reduction of the radiolucency was observed and complete periapical bone healing was achieved two and a half years after completion of the revitalisation procedure . Apart from the slight and gradual increase in tooth discoloration, the clinical situation remained stable over the years. The patient consistently demonstrated good compliance throughout the entire treatment and follow-up process, and expressed great appreciation for the overall outcome, particularly for the avoidance of surgery. The patient remained asymptomatic at each annual check-up until an emergency visit 8 years after treatment, when she complained of chewing pain. No deterioration of the situation could be observed on the radiograph, with a clear recovery of the periodontal ligament indicated by a continuous lamina dura . The tooth appeared discoloured but no signs of infection could be detected; periodontal probing was normal. However, a crown-root fracture originating from the palatal side was detected . The level of fracture associated with important crown mobility and chewing pain was not compatible with conservative strategies, and an extraction was planned. After extraction, it could be observed that the facture occurred within the Biodentine material .
| 4
| 0.974609
|
sec[1]/sec[2]/p[0]
|
en
| 0.999995
|
40276380
|
https://doi.org/10.2340/biid.v12.43427
|
[
"canal",
"tooth",
"root",
"oral",
"surgeon",
"periapical",
"saint",
"that",
"radiograph",
"this"
] |
[
{
"code": "DB7Z",
"title": "Diseases of anal canal, unspecified"
},
{
"code": "LB17.Z",
"title": "Structural developmental anomalies of anal canal, unspecified"
},
{
"code": "DB51",
"title": "Stenosis of anal canal"
},
{
"code": "DB7Y",
"title": "Other specified diseases of anal canal"
},
{
"code": "LA22.2",
"title": "Aplasia or hypoplasia of external auditory canal"
},
{
"code": "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"
}
] |
=== ICD-11 CODES FOUND ===
[DB7Z] Diseases of anal canal, unspecified
Also known as: Diseases of anal canal, unspecified
[LB17.Z] Structural developmental anomalies of anal canal, unspecified
Also known as: Structural developmental anomalies of anal canal, unspecified | Structural developmental anomalies of anal canal | Malformations of anal canal
[DB51] Stenosis of anal canal
Also known as: Stenosis of anal canal | stricture of anal sphincter | anal stricture | anus occlusion | pectenosis
[DB7Y] Other specified diseases of anal canal
Also known as: Other specified diseases of anal canal
[LA22.2] Aplasia or hypoplasia of external auditory canal
Also known as: Aplasia or hypoplasia of external auditory canal | anomaly of osseous meatus | Congenital absence of external auditory canal | absence of external auditory canal | absence of auditory canal
Excludes: Microtia | Anotia
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[DB7Z] Diseases of anal canal, unspecified
--PARENT--> [?] Diseases of anal canal
--RELATED_TO--> [?] Structural developmental anomalies of anal canal
--- Walk 2 ---
[DB7Z] Diseases of anal canal, unspecified
--PARENT--> [?] Diseases of anal canal
--CHILD--> [DB70] Infections of the anal region
Def: Infections of anal canal caused by various microorganisms including bacteria, virus, fungus, parasite and the other specified agents....
--- Walk 3 ---
[LB17.Z] Structural developmental anomalies of anal canal, unspecified
--PARENT--> [LB17] Structural developmental anomalies of anal canal
--CHILD--> [LB17.2] Persistent cloaca
Def: A congenital anomaly in which the intestinal, urinary, and reproductive ducts open into a common cavity, a result of the failure of the urorectal septum to form during prenatal development. They occur...
--- Walk 4 ---
[LB17.Z] Structural developmental anomalies of anal canal, unspecified
--PARENT--> [LB17] Structural developmental anomalies of anal canal
--CHILD--> [LB17.2] Persistent cloaca
Def: A congenital anomaly in which the intestinal, urinary, and reproductive ducts open into a common cavity, a result of the failure of the urorectal septum to form during prenatal development. They occur...
--- Walk 5 ---
[DB51] Stenosis of anal canal
--PARENT--> [?] Acquired anatomical alterations of the anal canal
Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....
--CHILD--> [DB51] Stenosis of anal canal
--- Walk 6 ---
[DB51] Stenosis of anal canal
--PARENT--> [?] Acquired anatomical alterations of the anal canal
Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....
--RELATED_TO--> [?] Haemorrhage of anus and rectum
Def: Bleeding from anus and anal canal. The bleeding due to specific diseases classified elsewhere (haemorrhoid, cancer, infection etc) is excluded from here....
|
[
"[DB7Z] Diseases of anal canal, unspecified\n --PARENT--> [?] Diseases of anal canal\n --RELATED_TO--> [?] Structural developmental anomalies of anal canal",
"[DB7Z] Diseases of anal canal, unspecified\n --PARENT--> [?] Diseases of anal canal\n --CHILD--> [DB70] Infections of the anal region\n Def: Infections of anal canal caused by various microorganisms including bacteria, virus, fungus, parasite and the other specified agents....",
"[LB17.Z] Structural developmental anomalies of anal canal, unspecified\n --PARENT--> [LB17] Structural developmental anomalies of anal canal\n --CHILD--> [LB17.2] Persistent cloaca\n Def: A congenital anomaly in which the intestinal, urinary, and reproductive ducts open into a common cavity, a result of the failure of the urorectal septum to form during prenatal development. They occur...",
"[LB17.Z] Structural developmental anomalies of anal canal, unspecified\n --PARENT--> [LB17] Structural developmental anomalies of anal canal\n --CHILD--> [LB17.2] Persistent cloaca\n Def: A congenital anomaly in which the intestinal, urinary, and reproductive ducts open into a common cavity, a result of the failure of the urorectal septum to form during prenatal development. They occur...",
"[DB51] Stenosis of anal canal\n --PARENT--> [?] Acquired anatomical alterations of the anal canal\n Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....\n --CHILD--> [DB51] Stenosis of anal canal",
"[DB51] Stenosis of anal canal\n --PARENT--> [?] Acquired anatomical alterations of the anal canal\n Def: This group incorporates disorders principally due to morphological changes of the anus and anal canal....\n --RELATED_TO--> [?] Haemorrhage of anus and rectum\n Def: Bleeding from anus and anal canal. The bleeding due to specific diseases classified elsewhere (haemorrhoid, cancer, infection etc) is excluded from here...."
] |
DB7Z
|
Diseases of anal canal, unspecified
|
[
{
"from_icd11": "LB17.Z",
"icd10_code": "Q423",
"icd10_title": "Congenital absence, atresia and stenosis of anus without fistula"
},
{
"from_icd11": "LB17.Z",
"icd10_code": "Q422",
"icd10_title": "Congenital absence, atresia and stenosis of anus with fistula"
},
{
"from_icd11": "LB17.Z",
"icd10_code": "Q420",
"icd10_title": "Congenital absence, atresia and stenosis of rectum with fistula"
},
{
"from_icd11": "LB17.Z",
"icd10_code": "Q421",
"icd10_title": "Congenital absence, atresia and stenosis of rectum without fistula"
},
{
"from_icd11": "LB17.Z",
"icd10_code": "Q428",
"icd10_title": "Congenital absence, atresia and stenosis of other parts of large intestine"
},
{
"from_icd11": "LB17.Z",
"icd10_code": "Q429",
"icd10_title": "Congenital absence, atresia and stenosis of large intestine, part unspecified"
},
{
"from_icd11": "LB17.Z",
"icd10_code": "Q436",
"icd10_title": "Congenital fistula of rectum and anus"
},
{
"from_icd11": "DB51",
"icd10_code": "K624",
"icd10_title": "Stenosis of anus and rectum"
},
{
"from_icd11": "LA22.2",
"icd10_code": "Q161",
"icd10_title": "Congenital absence, atresia and stricture of auditory canal (external)"
},
{
"from_icd11": "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"
}
] |
Q423
|
Congenital absence, atresia and stenosis of anus without fistula
|
Radiation therapy is a common adjunctive modality used in the treatment of soft tissue sarcomas after surgical ablation. Although radiotherapy has shown benefit in reducing sarcoma recurrence and improves survival, it has associated risks. Complications of radiation therapy may involve the skin, lymphatics, peripheral vasculature, and peripheral nervous system. The most common symptoms in the arm include skin changes, reduced mobility of the arm, or secondary lymphedema, and they usually occur after local high-dose radiation. A less common but potentially more serious complication is radiation-induced brachial neuropathy. The clinical manifestations include gradually progressive paresthesias and sensory loss, weakness and atrophy, and pain. Symptom onset ranges from 1 month to 18 years after radiation exposure . The main theme of this case is the progressive late polyneuropathy after two courses of therapeutic radiotherapy. Hand function has progressively deteriorated. As the first course of radiotherapy was in 1986, 22 years ago, and the second course in 1991, 17 years ago, this case illustrates the severe and progressive late effects many years after radiotherapy. Multiple surgeries, the humeral fracture and three courses of chemotherapy may also have contributed to the neuropathy. The key evidence in favour of radiation-induced injury is the fibrosis located within the field of prior radiation therapy. During sarcoma surgeries, there was no evidence of infiltration of any major nerves and MRI of his right arm showed fibrotic infiltrate and volume loss in the right arm with nodular ill-defined median, radial and ulnar nerves with no focal masses, consistent with postradiation changes. Chemotherapy is known to increase the the risk of neuropathy. Olsen et al. observed that patients receiving additional chemotherapy have a higher incidence of neuropathy than patients receiving radiotherapy alone . The development of fibrosis is a gradual process with a median interval between radiotherapy and occurrence of brachial neuropathy ranging between 1-4 years . In most patients, electrophysiologic studies show abnormal motor and sensory nerve conduction and large motor unit potentials with reduced recruitment. Myokymic discharges are found in up to 63% of patients and are helpful in distinguishing radiation-induced neuropathies from neoplastic neuropathies . Predisposing factors for the development of radiation-induced neuropathy include the total radiation dose and dose per fraction with a total tolerance dose of 60 Gy and with doses greater than 2 Gy per fraction . Size and localisation of the irradiated area also play a crucial role. In this case the total dose given in two therapies was 80 Gy and thus exceeded the accepted tolerance dose of 60 Gy . The dose per fraction was 2 Gy and within accepted tolerance limits . Side effects of radiotherapy can be subdivided into early and late effects. Early effects occur two days after nerve irradiation and include bioelectrical alterations, enzyme changes, abnormal microtubule assembly and altered vascular permeability. The late effects occur between 1 year and decades post-irradiation and they can be split into two phases. The first phase includes changes in electrophysiology and histochemistry of neurones and glial cells and the second phase includes fibrosis of the tissue surrounding the nerves. Indirect ischaemic damage due to microvascular injury also harms neurones and glial cells. It is important though to stress that the major damage caused in neurones, DNA damage, takes place immediately at the instant of ionization. As the mitotic rate of these cells is very slow, the damage is normally not expressed until the cell tries to divide. Therefore, this damage is latent for periods ranging from days to decades. These changes lead to the the clinical manifestations that this patient suffered from, including gradually progressive paresthesias, hypoaesthesias and dysaesthesias, paresis and atrophy, hyporeflexia, pain and oedema. Adverse complications in bones include fracture, osteoradionecrosis with potential creation of sequestra. It is always important in individual patients to balance the aggressiveness of the radiotherapy with its potential and severe complications against the risk of potential recurrences. The occurrence of radiation-induced brachial plexopathy should be considered in patients presenting with upper extremity pain or weakness even many years after radiation therapy. The course of the radiation-induced neuropathy is one of steady progression or stabilisation in 90% of patients, although cases of improvement have been reported . No treatment is available to reverse or improve the nerve injury, although surgical intervention, such as neurolysis or neurolysis with omental grafting, has been performed in some patients with variable improvement in symptoms . Radiation-induced brachial plexopathy is an uncommon complication of radiation treatment of fibrosarcoma, which can occur years after the initial exposure. The risk of these complications is expected to decrease with the use of modern state-of-the-art radiation techniques. In patients with symptoms, including pain, sensory loss, or weakness, who have received prior radiation, injury to nerves should be considered.
| 4.4375
| 0.45752
|
sec[2]/p[0]
|
en
| 0.999997
|
19918550
|
https://doi.org/10.4076/1757-1626-2-6838
|
[
"radiation",
"patients",
"radiotherapy",
"induced",
"neuropathy",
"include",
"changes",
"this",
"effects",
"damage"
] |
[
{
"code": "NF00",
"title": "Effects of radiation, not elsewhere classified"
},
{
"code": "QC48.Y",
"title": "Other specified personal history of medical treatment"
},
{
"code": "EK90.Y",
"title": "Other discrete epidermal dysplasias"
},
{
"code": "CA82.1",
"title": "Chronic or other pulmonary manifestations due to radiation"
},
{
"code": "DA25.32",
"title": "Radiation oesophageal ulcer"
},
{
"code": "PL14.C",
"title": "Patient received diagnostic test or treatment intended for another patient"
},
{
"code": "QB14",
"title": "Unavailability or inaccessibility of health care facilities"
},
{
"code": "PL14.2",
"title": "Problem associated with physical transfer of patient"
},
{
"code": "QB12.0",
"title": "Organ transplant candidate"
},
{
"code": "QA15.1",
"title": "Counselling related to sexual behaviour and orientation or sexual relationships of the person"
}
] |
=== ICD-11 CODES FOUND ===
[NF00] Effects of radiation, not elsewhere classified
Also known as: Effects of radiation, not elsewhere classified | radiation complications | infrared rays injury | Radiation sickness
Excludes: Sunburn | Burns | specified adverse effects of radiation, such as leukaemia
[QC48.Y] Other specified personal history of medical treatment
Also known as: Other specified personal history of medical treatment | Personal history of contraception | history of contraception | Personal history of long-term use of medicaments other than anticoagulants | personal history of long term current use of medicaments
[EK90.Y] Other discrete epidermal dysplasias
Also known as: Other discrete epidermal dysplasias | Actinic cheilitis | Photochemotherapy-induced keratosis | Thermal keratosis | Chronic radiation keratosis
[CA82.1] Chronic or other pulmonary manifestations due to radiation
Definition: A chronic inflammatory reaction of the lung ultimately resulting in fibrosis in response to repeated or high dose radiation exposure.
Also known as: Chronic or other pulmonary manifestations due to radiation | Fibrosis of lung following radiation | radiation fibrosis of lung | Chronic radiation pulmonary fibrosis
[DA25.32] Radiation oesophageal ulcer
Also known as: Radiation oesophageal ulcer
[PL14.C] Patient received diagnostic test or treatment intended for another patient
Also known as: Patient received diagnostic test or treatment intended for another patient | wrong patient | incorrect patient
Excludes: Procedure undertaken at wrong site or wrong side, as mode of injury or harm
[QB14] Unavailability or inaccessibility of health care facilities
Also known as: Unavailability or inaccessibility of health care facilities | unavailability of medical facilities | Unavailability of outpatient clinic | Unavailability or inaccessibility of residential aged care service
Excludes: bed unavailable
[PL14.2] Problem associated with physical transfer of patient
Also known as: Problem associated with physical transfer of patient
[QB12.0] Organ transplant candidate
Also known as: Organ transplant candidate | patient waiting for organ availability | health services provided because of need for organ transplant | organ transplant candidate awaiting organ availability | person on organ transplant waiting list
[QA15.1] Counselling related to sexual behaviour and orientation or sexual relationships of the person
Also known as: Counselling related to sexual behaviour and orientation or sexual relationships of the person | advice on sexual behaviour or orientation | counselling on sexual behaviour or orientation | promiscuity counselling | patient concerned regarding sexual orientation
=== GRAPH WALKS ===
--- Walk 1 ---
[NF00] Effects of radiation, not elsewhere classified
--EXCLUDES--> [?] Burns
Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...
--EXCLUDES--> [?] Adverse effects of phototherapy
--- Walk 2 ---
[NF00] Effects of radiation, not elsewhere classified
--EXCLUDES--> [?] Sunburn
Def: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight....
--CHILD--> [?] Sunburn erythema
--- 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.Y] Other specified personal history of medical treatment
--- Walk 5 ---
[EK90.Y] Other discrete epidermal dysplasias
--PARENT--> [EK90] Actinic keratosis and other discrete epidermal dysplasias
Def: A group of conditions characterised by varying degrees of keratinocytic atypia resulting from damage to keratinocyte DNA. They carry a small propensity to develop into invasive squamous cell carcinoma...
--CHILD--> [EK90.0] Actinic keratosis
Def: Actinic keratoses (AKs) are focal areas of abnormal keratinocyte proliferation and differentiation induced by chronic exposure to ultraviolet radiation. They are very common on sun-exposed skin of fai...
--- Walk 6 ---
[EK90.Y] Other discrete epidermal dysplasias
--PARENT--> [EK90] Actinic keratosis and other discrete epidermal dysplasias
Def: A group of conditions characterised by varying degrees of keratinocytic atypia resulting from damage to keratinocyte DNA. They carry a small propensity to develop into invasive squamous cell carcinoma...
--CHILD--> [EK90.0] Actinic keratosis
Def: Actinic keratoses (AKs) are focal areas of abnormal keratinocyte proliferation and differentiation induced by chronic exposure to ultraviolet radiation. They are very common on sun-exposed skin of fai...
|
[
"[NF00] Effects of radiation, not elsewhere classified\n --EXCLUDES--> [?] Burns\n Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...\n --EXCLUDES--> [?] Adverse effects of phototherapy",
"[NF00] Effects of radiation, not elsewhere classified\n --EXCLUDES--> [?] Sunburn\n Def: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight....\n --CHILD--> [?] Sunburn erythema",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.Z] Personal history of medical treatment, unspecified",
"[QC48.Y] Other specified personal history of medical treatment\n --PARENT--> [QC48] Personal history of medical treatment\n --CHILD--> [QC48.Y] Other specified personal history of medical treatment",
"[EK90.Y] Other discrete epidermal dysplasias\n --PARENT--> [EK90] Actinic keratosis and other discrete epidermal dysplasias\n Def: A group of conditions characterised by varying degrees of keratinocytic atypia resulting from damage to keratinocyte DNA. They carry a small propensity to develop into invasive squamous cell carcinoma...\n --CHILD--> [EK90.0] Actinic keratosis\n Def: Actinic keratoses (AKs) are focal areas of abnormal keratinocyte proliferation and differentiation induced by chronic exposure to ultraviolet radiation. They are very common on sun-exposed skin of fai...",
"[EK90.Y] Other discrete epidermal dysplasias\n --PARENT--> [EK90] Actinic keratosis and other discrete epidermal dysplasias\n Def: A group of conditions characterised by varying degrees of keratinocytic atypia resulting from damage to keratinocyte DNA. They carry a small propensity to develop into invasive squamous cell carcinoma...\n --CHILD--> [EK90.0] Actinic keratosis\n Def: Actinic keratoses (AKs) are focal areas of abnormal keratinocyte proliferation and differentiation induced by chronic exposure to ultraviolet radiation. They are very common on sun-exposed skin of fai..."
] |
NF00
|
Effects of radiation, not elsewhere classified
|
[
{
"from_icd11": "NF00",
"icd10_code": "T66XXXA",
"icd10_title": "Radiation sickness, unspecified, initial encounter"
},
{
"from_icd11": "NF00",
"icd10_code": "T66XXXS",
"icd10_title": "Radiation sickness, unspecified, sequela"
},
{
"from_icd11": "NF00",
"icd10_code": "T66",
"icd10_title": "Radiation sickness, unspecified"
},
{
"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": "CA82.1",
"icd10_code": "J701",
"icd10_title": "Chronic and other pulmonary manifestations due to radiation"
},
{
"from_icd11": "QB14",
"icd10_code": "Z753",
"icd10_title": "Unavailability and inaccessibility of health-care facilities"
},
{
"from_icd11": "QA15.1",
"icd10_code": "F66",
"icd10_title": "Other sexual disorders"
},
{
"from_icd11": "QA15.1",
"icd10_code": "F660",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F661",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F662",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F668",
"icd10_title": ""
}
] |
T66XXXA
|
Radiation sickness, unspecified, initial encounter
|
The physical examination of the patient was unremarkable. With suspicion to insulinoma and MEN-1, several blood tests were ordered, which are presented in Table 1 . Decreased level of blood sugar and increased level of insulin and C-peptide indicated insulinoma. A raised calcium and PTH level suggested primary hyperparathyroidism Abdominal ultrasound and CT scan were also performed. Ultrasonography revealed two hypoechoic mass-like lesions measuring 27*20 and 10*7 mm near together adjacent to the tail of pancreas, and spiral abdominal CT scan disclosed two enhancing well-defined masses 27*20 mm and 37*30 mm in the tail and body of the pancreases, respectively, calcified areas in larger mass, and a 36*15 mm mass in the left adrenal gland (seven Hounsfield units) . Results of the blood and urine examinations on second admission are presented in Table 2 . By considering MEN1, plasma cortisol after overnight dexamethasone suppression test and urinary free cortisol were requested, which were increased. Also, ACTH level was measured which wasdecreased, indicating primary hypercortisolism. Dynamic pituitary MRI was revealed a partial empty sella . Bone mineral density (BMD) was performed, which is presented in Table 3 . Endoscopic ultrasound (EUS) showed 21*22 mm hypoechoic round lesion with well-defined border in pancreatic body, it was hyper vascular in Doppler and its elastic ratio was 7. Fine needle aspiration (FNA) using EUS from the pancreas masses was performed and an expert pathologist reported neoplastic process with neuroendocrine feature with KI-67 < 2%. Hence, in the patient with the diagnosis of MEN-1 with components of primary hyperparathyroidism, prolactinoma, insulinoma, and CS due to possible adrenal adenoma a spleen-preserving distal pancreatectomy and a left adrenalectomy was performed by a hepatobiliary surgeon. The whole left adrenal gland was enormously enlarged, measuring 100 × 60 × 20 mm. On sectioning, an adrenal tissue with nodular appearance was observed, the maximum of the nodule reached to 60 × 10 mm, which indicated macronodular hyperplasia (H&E,X400, Nikon microscope, Eclipse E100) |. In addition, two nodular masses 30 × 30 mm and 20 × 20 mm in the head and tail of pancreas were detected, respectively (H&E, X100, Nikon microscope, Eclipse E100) . Tumors were confined to pancreas and all margins were free of tumor. Lymphovascular and perineural invasion were not identified and the tumors stages were T2 NO M x . After transient hyperglycemia during four days following the surgery that managed with insulin, the level of BS was returned to within reference range. The results of the cortisol and urine free cortisol following the surgery are shown in Table 4 . Considering the high level of prolactin at the time of discharge from the hospital (466 ng/ml), low bone mass, the presence of empty sella, and the long duration of amenorrhea, the patient was recommended for 1 mg per week Cabergoline and hormone replacement therapy. Finally, parathyroidectomy was considered for the patients as well. Table 1 Blood examination on first admission Variables value Normal range cortisol 4PM (ug/dl) 7.7 6–18.4 Random blood sugar (mg/dl) 43 60–100 Insulin (μIU /ml) 80.6 2.6–24.9 C-peptide (ng/ml) 9.3 1.1–4.4 Prolactin (ng /pml) 20.2 1.9–25 TSH (μIU/mL) 1.52 0.3–5 FT4 (ng/dL) 5.31 0.67–1.5 calcium (mg/dl) 10.3 8.6–10.3 phosphorus ( mg/dl) 3.1 2.6–4.5 PTH (pg/ml) 280 15–65 ALP (ng/ml) 564 64–306 FSH (mIU/ml) 5 1–9 LH (mIU/ml) 5.8 1.68–15 Fig. 1 Without contrast ( a ) and with contrast ( b ), axial contrast-enhanced CT of the abdomen shows the hyperenhancing pancreatic body mass (red arrows) as well as indeterminate left adrenal nodules (yellow arrows) Table 2 Blood and urine examinations for assessing MEN-1 Variables value Normal range cortisol 8AM (ug/dl) 18.6 6–18.4 ACTH (pg/ml) 17 Up to 64 24-h urine free cortisol (μg/24 h) 281 50–190 dexamethasone suppression test (ug/dl) 3.5 < 5.0 DHEAS (ug/dl) 30.3 95.8–511.7 gastrin (pg/ml) 78.4 13–115 urine 24-h metanephrine (μg/24 h) 99 < 350 normetanephrine (μg/24 h) 299 < 600 Vanyl mandelic acid (mg/24 h) 5.1 < 13.6 calcium (mg/dl) 10.2 8.6–10.3 phosphorus ( mg/dl) 2.4 2.6–4.5 PTH (pg/ml) 323 15–65 vitamin D (nmol/l) 3 30–100 Fig. 2 Pituitary MRI revlead partially empty sella Table 3 BMD of lumbar, spine, hip, and forearm on the HOLOGIC explorer QDR series DXA yScan BMD (g/cm 2 ) T-score Fracture risk Z-score Lumbar spine 0.757 -3.1 High -3.2 Total femur 0.916 -0.2 Low -0.2 Femoral neck 0.747 -0.9 Low -0.8 Forearm 0.525 -2.8 High -2.6 Fig. 3 A Macronodular adrenal hyperplasia showing nodules composed of clear and compact cells with variable lipid (H&E,X400, Nikon microscope, Eclipse E100) ( B ) Normal pancreas( right side) and lesion ( left side) (H&E, X100, Nikon microscope, Eclipse E100) Table 4 Trend of adrenal tests from 14 days before the surgery to 4 months after the surgery Tests Reference range Two weeks before the surgery One week before the surgery One week after the surgery Three weeks after the surgery Two months after the surgery Four months after the surgery ACTH (pg/ml) Up to 64 15 17 9.9 Cortisol morning (µg/dl) 6.2–19.4 7.7 18.6 26.7 16.4 24-h urine free cortisol (µg/dl) 50–190 281 736 390.3 8.7 6.3 Overnight dexamethasone suppression test (µg/dl) < 5.0 3.5 0.7
| 4.113281
| 0.96582
|
sec[1]/p[1]
|
en
| 0.999998
|
PMC9022315
|
https://doi.org/10.1186/s12902-022-01022-6
|
[
"cortisol",
"adrenal",
"blood",
"urine",
"which",
"pancreas",
"free",
"well",
"nikon",
"microscope"
] |
[
{
"code": "5A70.Y",
"title": "Other specified Cushing syndrome"
},
{
"code": "5A70.Z",
"title": "Cushing syndrome, unspecified"
},
{
"code": "5A76.Y",
"title": "Other specified disorders of adrenal gland"
},
{
"code": "5A74.0",
"title": "Acquired adrenocortical insufficiency"
},
{
"code": "5A7Z",
"title": "Disorders of the adrenal glands or adrenal hormone system, unspecified"
},
{
"code": "5A74.Z",
"title": "Adrenocortical insufficiency, unspecified"
},
{
"code": "5A74.Y",
"title": "Other specified adrenocortical insufficiency"
},
{
"code": "LC8Z",
"title": "Structural developmental anomalies of the adrenal glands, unspecified"
},
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[5A70.Y] Other specified Cushing syndrome
Also known as: Other specified Cushing syndrome | ACTH-dependent Cushing syndrome | ACTH-independent Cushing syndrome | ACTH-independent Cushing syndrome due to bilateral adrenocortical hyperplasia | ACTH-independent macronodular adrenal hyperplasia
[5A70.Z] Cushing syndrome, unspecified
Also known as: Cushing syndrome, unspecified | Cushing syndrome | Hyperadrenocorticism | Hypercortisolism | Cushing syndrome NOS
[5A76.Y] Other specified disorders of adrenal gland
Also known as: Other specified disorders of adrenal gland | Suprarenal gland abscess | Suprarenal abscess | Adrenal gland inflammation | adrenal glandular inflammation
[5A74.0] Acquired adrenocortical insufficiency
Definition: This is a acquired condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol; but may also include impaired production of aldosterone (a mineralocorticoid), which regulates sodium conservation, potassium secretion, and water retention.
Also known as: Acquired adrenocortical insufficiency | Addison disease | Chronic acquired adrenal insufficiency | Autoimmune Addison disease | Primary Addison disease
Excludes: Amyloidosis
[5A7Z] Disorders of the adrenal glands or adrenal hormone system, unspecified
Also known as: Disorders of the adrenal glands or adrenal hormone system, unspecified | Adrenal gland disease, not elsewhere classified | adrenal cortex disease | adrenal cortical disease | adrenal glandular disease
[5A74.Z] Adrenocortical insufficiency, unspecified
Also known as: Adrenocortical insufficiency, unspecified | Adrenocortical insufficiency | adrenal failure NOS | Hypoadrenocorticism | adrenocortical hypofunction
[5A74.Y] Other specified adrenocortical insufficiency
Also known as: Other specified adrenocortical insufficiency | Congenital adrenocortical insufficiency | Congenital isolated ACTH deficiency | Familial adrenal hypoplasia | Familial hypoadrenocorticism
[LC8Z] Structural developmental anomalies of the adrenal glands, unspecified
Also known as: Structural developmental anomalies of the adrenal glands, unspecified | adrenal anomaly | adrenal gland anomaly | congenital anomaly of adrenal gland | congenital malformation of adrenal gland
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[5A70.Y] Other specified Cushing syndrome
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--CHILD--> [5A70.0] Pituitary-dependent Cushing disease
Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...
--- Walk 2 ---
[5A70.Y] Other specified Cushing syndrome
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--CHILD--> [5A70.0] Pituitary-dependent Cushing disease
Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...
--- Walk 3 ---
[5A70.Z] Cushing syndrome, unspecified
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--CHILD--> [5A70.1] Ectopic ACTH syndrome
--- Walk 4 ---
[5A70.Z] Cushing syndrome, unspecified
--PARENT--> [5A70] Cushing syndrome
Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...
--CHILD--> [5A70.0] Pituitary-dependent Cushing disease
Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...
--- Walk 5 ---
[5A76.Y] Other specified disorders of adrenal gland
--PARENT--> [5A76] Certain specified disorders of adrenal gland
--CHILD--> [5A76.Y] Other specified disorders of adrenal gland
--- Walk 6 ---
[5A76.Y] Other specified disorders of adrenal gland
--PARENT--> [5A76] Certain specified disorders of adrenal gland
--PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system
|
[
"[5A70.Y] Other specified Cushing syndrome\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.0] Pituitary-dependent Cushing disease\n Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...",
"[5A70.Y] Other specified Cushing syndrome\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.0] Pituitary-dependent Cushing disease\n Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...",
"[5A70.Z] Cushing syndrome, unspecified\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.1] Ectopic ACTH syndrome",
"[5A70.Z] Cushing syndrome, unspecified\n --PARENT--> [5A70] Cushing syndrome\n Def: Cushing syndrome results from excess of corticosteroid hormones in the body due to overstimulation of the adrenal glands by excessive amounts of the hormone ACTH, secreted either by a tumuor of the pi...\n --CHILD--> [5A70.0] Pituitary-dependent Cushing disease\n Def: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hyp...",
"[5A76.Y] Other specified disorders of adrenal gland\n --PARENT--> [5A76] Certain specified disorders of adrenal gland\n --CHILD--> [5A76.Y] Other specified disorders of adrenal gland",
"[5A76.Y] Other specified disorders of adrenal gland\n --PARENT--> [5A76] Certain specified disorders of adrenal gland\n --PARENT--> [?] Disorders of the adrenal glands or adrenal hormone system"
] |
5A70.Y
|
Other specified Cushing syndrome
|
[
{
"from_icd11": "5A70.Z",
"icd10_code": "E242",
"icd10_title": "Drug-induced Cushing's syndrome"
},
{
"from_icd11": "5A70.Z",
"icd10_code": "E249",
"icd10_title": "Cushing's syndrome, unspecified"
},
{
"from_icd11": "5A70.Z",
"icd10_code": "E248",
"icd10_title": "Other Cushing's syndrome"
},
{
"from_icd11": "5A70.Z",
"icd10_code": "E24",
"icd10_title": "Cushing's syndrome"
},
{
"from_icd11": "5A74.0",
"icd10_code": "E273",
"icd10_title": "Drug-induced adrenocortical insufficiency"
},
{
"from_icd11": "5A74.0",
"icd10_code": "E271",
"icd10_title": "Primary adrenocortical insufficiency"
},
{
"from_icd11": "5A74.0",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E2740",
"icd10_title": "Unspecified adrenocortical insufficiency"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E2749",
"icd10_title": "Other adrenocortical insufficiency"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E279",
"icd10_title": "Disorder of adrenal gland, unspecified"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E27",
"icd10_title": "Other disorders of adrenal gland"
},
{
"from_icd11": "5A7Z",
"icd10_code": "E274",
"icd10_title": "Other and unspecified adrenocortical insufficiency"
},
{
"from_icd11": "LC8Z",
"icd10_code": "Q891",
"icd10_title": "Congenital malformations of adrenal gland"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
}
] |
E242
|
Drug-induced Cushing's syndrome
|
The patient was a 65-year-old man who developed symmetrical limb weakness without an obvious cause in February 2023; he paid no attention. In June 2023, he further developed numbness at the distal ends of both upper limbs and came to our hospital for treatment. Electromyography revealed extensive neurogenic abnormalities involving the cervical, thoracic, lumbar, and medullary segments. The left extensor digitorum brevis branch of the common peroneal nerve showed complete damage, while the rest showed incomplete damage. A small number of tested sensory nerve conduction velocities were within the normal lower limit, while some tested motor nerve conduction velocities slowed down and compound muscle action potential amplitudes decreased. The myositis antibody spectrum was negative. Brain magnetic resonance imaging (MRI) revealed multiple chronic ischemic changes in the bilateral paraventricular white matter and frontal lobe, with mild brain atrophy . Cervical MRI indicated spondylosis with disc herniation in the 3 to 4, 4 to 5, 5 to 6, 6 to 7 cervical vertebrae and partial fusion in the 5 to 6 cervical vertebrae. The spinal cord signal was uniform and there were no abnormal signs in the accessory and paravertebral soft tissues . Cerebrospinal fluid examination showed protein at 0.77 g/L, Pandy test (+), and nucleated cells (0/µL). The limb muscle strength was level 4, with symmetrical weakening of the bilateral biceps, triceps, radial membrane, and knee Achilles tendon reflexes. He was diagnosed with CIDP and received methylprednisolone shock therapy and long-term oral administration (40 mg qd), while also taking methylcobalamin and vitamin B1 tablets, after which the patient symptoms improved. In September 2023, the patient experienced worsening limb weakness, accompanied by numbness and pain at the distal end of the limbs. Electromyography showed peripheral neuropathy, involvement of motor and sensory fibers, and axonal lesions combined with demyelinating lesions. We administered methylprednisolone shock therapy again, pregabalin capsules, and MMF capsules (500 mg, bid). The patient was discharged after his symptoms had improved. In November 2023, the patient condition worsened again, with significant weakness in both lower limbs, difficulty in standing and walking, and an inability to stand up after squatting. In addition, he developed a fever with a body temperature as high as 38.5°C, significant fatigue, and poor appetite. On November 22nd, the patient was admitted to our hospital for treatment. He coughed with a white sticky phlegm accompanied by shortness of breath. Auscultation showed weakened breathing sounds in the left lung and moist rales in both lungs. The muscle strength of both upper limbs was level 5, whereas that of the lower limbs was level 4, and the muscle tension was normal. Pathological signs were not observed. Computed tomography (CT) of the lung showed patchy consolidation shadows in the lower left lung, with multiple patchy and nodular high-density shadows in both lungs; cavities could be seen within some lesions . Blood gas analysis indicated type I respiratory failure, and drugs such as meropenem and linezolid were administered for anti-infection treatment. On November 27th, sputum culture revealed Nocardia, and a metagenomic next-generation sequencing test of bronchoalveolar lavage fluid reported Nocardia gelsenkirchen. The patient was diagnosed with pulmonary nocardiosis, and sulfamethoxazole/trimethoprim (SMX/TMP) was administered to treat the infection. After treatment, the patient respiratory symptoms improved, significant absorption of bilateral lung lesions was observed underwent 3 lung CT scans after being hospitalized in November, November 23rd, December 6th, and December 18th . Based on the imaging results, the patient had the most severe infection on November 23rd and gradually improved. Respiratory symptoms also improved, and he was able to get out of bed and move around. On December 20th, the patient suddenly developed a cough and weakness accompanied by dyspnea, and mechanical ventilation was required. The patient limb weakness worsened; the muscle strength of both upper limbs was level 1, and that of both lower limbs was 0. It was considered a progression of the primary disease, and muscle weakness led to aggravated respiratory failure. This was clearly not caused by the gradual worsening of the infection, as the imaging and clinical symptoms reflecting the severity of the infection were gradually improving. Moreover, from an imaging perspective, the patient did not require mechanical ventilation during the most severe infection on November 23, but had to go on a ventilator on December 20, which also confirmed that sudden respiratory muscle paralysis and worsening limb weakness were caused by CIDP. The patient underwent tracheostomy and assisted breathing, and IVIG (400 mg/kg/d for 5 days) was administered. However, there was no significant improvement in the condition, and the patient died. To avoid progression and recurrence of CIDP, the patient did not stop using MMF or methylprednisolone during hospitalization. Many other antibacterial drugs such as amikacin and moxifloxacin have also been used. The exact antimicrobials and their duration of administration are shown in Tab. 1 .
| 3.9375
| 0.981934
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC11175944
|
https://doi.org/10.1097/MD.0000000000038544
|
[
"weakness",
"both",
"limbs",
"muscle",
"november",
"infection",
"limb",
"improved",
"lung",
"respiratory"
] |
[
{
"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"
},
{
"code": "LB99.6",
"title": "Acheiria"
},
{
"code": "MB51.Z",
"title": "Diplegia of upper extremities, unspecified"
},
{
"code": "LB9A.4",
"title": "Apodia"
},
{
"code": "LB51",
"title": "Anorchia or microorchidia"
},
{
"code": "9D90.2",
"title": "Moderate vision impairment"
}
] |
=== ICD-11 CODES FOUND ===
[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
[LB99.6] Acheiria
Definition: A condition caused by failure of one or both hands to develop during the antenatal period.
Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist
[MB51.Z] Diplegia of upper extremities, unspecified
Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs
[LB9A.4] Apodia
Definition: A condition caused by failure of the foot to develop during the antenatal period.
Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side
[LB51] Anorchia or microorchidia
Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging.
Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis
[9D90.2] Moderate vision impairment
Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision]
Includes: visual impairment category 2, in both eyes
=== GRAPH WALKS ===
--- Walk 1 ---
[MG22] Fatigue
Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...
--EXCLUDES--> [?] Exhaustion due to exposure
--PARENT--> [?] Effects of other deprivation
--- Walk 2 ---
[MG22] Fatigue
Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...
--EXCLUDES--> [?] Exhaustion due to exposure
--PARENT--> [?] Effects of other deprivation
--- Walk 3 ---
[FB32.Y] Other specified disorders of muscles
--PARENT--> [FB32] Certain specified disorders of muscle
Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....
--EXCLUDES--> [?] Alcoholic myopathy
Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa...
--- Walk 4 ---
[FB32.Y] Other specified disorders of muscles
--PARENT--> [FB32] Certain specified disorders of muscle
Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....
--EXCLUDES--> [?] Myalgia
Def: This is a disorder characterised by pain in a muscle or group of muscles....
--- Walk 5 ---
[MB5Z] Paralytic symptoms, unspecified
--PARENT--> [?] Paralytic symptoms
--CHILD--> [MB52] Diplegia of lower extremities
--- Walk 6 ---
[MB5Z] Paralytic symptoms, unspecified
--PARENT--> [?] Paralytic symptoms
--CHILD--> [MB50] Tetraplegia
|
[
"[MG22] Fatigue\n Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...\n --EXCLUDES--> [?] Exhaustion due to exposure\n --PARENT--> [?] Effects of other deprivation",
"[MG22] Fatigue\n Def: A feeling of exhaustion, lethargy, or decreased energy, usually experienced as a weakening or depletion of one's physical or mental resource and characterised by a decreased capacity for work and redu...\n --EXCLUDES--> [?] Exhaustion due to exposure\n --PARENT--> [?] Effects of other deprivation",
"[FB32.Y] Other specified disorders of muscles\n --PARENT--> [FB32] Certain specified disorders of muscle\n Def: This is an impairment of health or a condition of abnormal functioning of the muscle that does not fit in another category....\n --EXCLUDES--> [?] Alcoholic myopathy\n Def: Myopathy secondary to alcohol use and includes acute and chronic alcoholic myopathy. Several forms have been described: acute necrotizing myopathy, acute hypokalaemic myopathy, chronic alcoholic myopa...",
"[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....",
"[MB5Z] Paralytic symptoms, unspecified\n --PARENT--> [?] Paralytic symptoms\n --CHILD--> [MB52] Diplegia of lower extremities",
"[MB5Z] Paralytic symptoms, unspecified\n --PARENT--> [?] Paralytic symptoms\n --CHILD--> [MB50] Tetraplegia"
] |
MG22
|
Fatigue
|
[
{
"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"
},
{
"from_icd11": "MG22",
"icd10_code": "R53",
"icd10_title": "Malaise and fatigue"
},
{
"from_icd11": "FB32.Y",
"icd10_code": "M6281",
"icd10_title": "Muscle weakness (generalized)"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8384",
"icd10_title": "Todd's paralysis (postepileptic)"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8331",
"icd10_title": "Monoplegia, unspecified affecting right dominant side"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8389",
"icd10_title": "Other specified paralytic syndromes"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8383",
"icd10_title": "Posterior cord syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8381",
"icd10_title": "Brown-Sequard syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8382",
"icd10_title": "Anterior cord syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8332",
"icd10_title": "Monoplegia, unspecified affecting left dominant side"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8334",
"icd10_title": "Monoplegia, unspecified affecting left nondominant side"
}
] |
R5382
|
Chronic fatigue, unspecified
|
The current case report demonstrates the association of thymoma with MG and achalasia. This case replicates the previous finding reported by other studies that described two cases with a similar association of the three conditions with different ages of presentation. In other case reports, thymoma was associated with neuromuscular conditions, such as megaesophagus, without any neurological evidence of MG . Moreover, MG was reported to be associated with megaesophagus without thymoma or MG with achalasia without thymoma [ 13 – 15 ]. Furthermore, achalasia could be a complication of radiotherapy for thymoma that cause MG . The cases of MG with achalasia with and without thymoma [ 11 , 13 – 17 ] are summarized in Table 1 . Table 1 A literature review of case reports with MG and achalasia with and without thymoma Kaminski Kornizky et al. Rison Desuter et al. Seabi and Mokgoko Vinod The current study Gender and age F/ 75 F/ 69 M/ 83 M/ 79 M/ 35 M/ 11 M/ 43 Ethnicity Unknown Unknown USA Unknown Unknown Indian Egyptian GIT symptoms Food sticking in the upper chest and regurgitation of undigested food Dysphagia and occasional non-specific retrosternal pain Painless secretions in the back of his throat inhibit swallowing Aphagia, followed by nasogastric feeding, then percutaneous endoscopic gastrostomy Dysphagia Persistent vomiting, difficulty swallowing, and regurgitation Dysphagia (food sticking in the upper chest and regurgitation of undigested food) Other associated conditions No Polymyositis DM2, arthritis, cervical spinal stenosis. Past peptic ulcers with a previous gastrointestinal bleed secondary to past steroid use. Left nephrectomy secondary to prior staghorn calculi, previous lumbar spine surgery, previous cholecystectomy, and previous bariatric surgery No No No No Acetylcholine antibody titer 4.4 nmol/ L (negative if < 0.4 nmol/l) Positive 7.94 nmol/ L (negative if < 0.4 nmol/l) N/A N/A 0.69 nmol/l (serum reference value < 0.25 nmol/l) 7.9 nmol/l (negative if < 0.4 nmol/l) CT chest Unremarkable Unremarkable Unremarkable Unremarkable N/A Dilated esophagus Anterior mediastinal soft tissue mass iso-dense in the non-contrast study with minute foci of calcification with homogenous enhancement in the post-contrast study Treatment of MG Anticholinesterase medication Six session PE Pyridostigmine Pyridostigmine (60 mg PO q 4 h) and azathioprine (50 mg PO bid, for the last 8–9 years). PE in case of MG crisis Anticholinesterase medication Anticholinesterase inhibitor and immunosuppression with prednisone and azathioprine Steroids, Acetylcholinesterase inhibitor (pyridostigmine), and nifedipine Acetylcholinesterase inhibitor (pyridostigmine). Immunosuppression with prednisolone and azathioprine. PE in case of MG crisis Thymoma/type Yes/ resection of mixed epithelial and lymphocytic thymoma one year before the symptoms Recurrent thymoma and carcinoid tumor in the lung No thymoma No thymoma No thymoma Yes/ resection of thymoma in 2017 No thymoma Yes/ resection of thymoma in 2022. Thymoma type B2, p T1 Esophageal motility study Absence of lower esophageal sphincter relaxation with multiple peristalses and simultaneous contraction of the body Absent peristaltic waves in the esophageal body, with a normal pressure in the LES (17 mmHg, normal 15–30) Not done Not done Not done Failure of the lower esophageal sphincter to relax, elevated basal pressure, and peristalsis of the esophageal body suggestive of achalasia cardia HRM showed achalasia type II. Failure of LES relaxation, high resting LES pressure, and absent esophageal peristalsis (100%) with panesophageal pressurization to greater than 30 mmHg Barium swallow/esophageal transit study Moderate esophageal dilatation Marked dilated esophageal body with a beak-like narrowing of the terminal portion Prominent cricopharyngeal sphincter with incomplete relaxation and no evidence of any cricopharyngeal bar N/A N/A Dilated esophagus Dilated esophagus with bird beak appearance Endoscopy findings Not done Not done Not done Primary aspiration did not reveal regurgitation or UES blockage, but it did identify a significant lack of hypopharyngeal contraction N/A Dilated esophagus Dilated esophagus with retained fluid and spastic cardia Pathology/ histopathology Loss of myenteric ganglion cells was confirmed/ no antibody binds to the Auerbach plexus Not done Not done Not done Not done Not done Management of dysphagia/ response to the treatment Botulinum toxin injection Laparoscopic Heller myotomy. Improvement in swallowing and weight loss after the procedure Prednisone and methotrexate. Some improvement in the dysphagia Direct laryngoscopy followed by esophagoscopy with mechanical dilation of the cricopharyngeal sphincter. The patient’s swallowing markedly improved Medical treatment of MG (pyridostigmine). The 4-year follow-up showed no deterioration in his oral feeding ability N/A Medical treatment for MG improves the dysphagia Elective pneumatic balloon dilatation was successful and remarkably improved the patient’s symptoms CT computed tomography, DM2 diabetes mellitus type 2, F female, GIT gastrointestinal, HRM high-resolution esophageal manometry, LES lower esophageal sphincter, MG myasthenia gravis, M male, N/A not available, PO per oral, PE plasma exchange, UES upper esophageal sphincter
| 4.222656
| 0.928711
|
sec[2]/p[1]
|
en
| 0.999996
|
PMC10016158
|
https://doi.org/10.1186/s41983-023-00636-4
|
[
"thymoma",
"esophageal",
"nmol",
"achalasia",
"dysphagia",
"dilated",
"sphincter",
"without",
"esophagus",
"pyridostigmine"
] |
[
{
"code": "2C27.2",
"title": "Thymoma"
},
{
"code": "3A61.Y",
"title": "Other specified acquired pure red cell aplasia"
},
{
"code": "4B40.2",
"title": "Good syndrome"
},
{
"code": "2C27.0",
"title": "Carcinoma of thymus"
},
{
"code": "8C60.Y",
"title": "Other specified myasthenia gravis"
},
{
"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 ===
[2C27.2] Thymoma
Definition: A thymoma that has an aggressive clinical course (capsular invasion, infiltration of the surrounding tissues) and can metastasize. Although any morphologic subtype of thymoma may eventually have a malignant clinical course, this term is most often associated with thymoma types B3 and C.
Also known as: Thymoma | malignant thymoma (deprecated) | benign thymoma (deprecated) | Thymoma type A of thymus | malignant type A thymoma
[3A61.Y] Other specified acquired pure red cell aplasia
Also known as: Other specified acquired pure red cell aplasia | Decreased erythroid precursor production | Red cell aplasia with thymoma
[4B40.2] Good syndrome
Definition: This is a condition that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and benign thymoma may develop almost simultaneously.
Also known as: Good syndrome | Thymoma immunodeficiency
[2C27.0] Carcinoma of thymus
Definition: A diverse group of carcinomas of the thymus gland, previously known as thymoma type C. It includes morphologic variants derived from purely epithelial cells, as well as from cells with neuroendocrine differentiation.
Also known as: Carcinoma of thymus | Adenocarcinoma of thymus | Adenosquamous carcinoma of thymus | Malignant Type C Thymoma | Mucoepidermoid carcinoma of thymus
[8C60.Y] Other specified myasthenia gravis
Also known as: Other specified myasthenia gravis | Myasthenia gravis, AChR antibody positive | Myasthenia gravis, MuSK antibody positive | Myasthenia gravis, other antibodies positive | Myasthenia gravis, seronegative
[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 ---
[2C27.2] Thymoma
Def: A thymoma that has an aggressive clinical course (capsular invasion, infiltration of the surrounding tissues) and can metastasize. Although any morphologic subtype of thymoma may eventually have a mal...
--PARENT--> [2C27] Malignant neoplasms of thymus
Def: Primary malignant neoplasm involving the thymus. This category includes malignant thymomas, primary thymic carcinomas and carcinoid tumour or other neuroendocrine neoplasms of thymus....
--CHILD--> [2C27.1] Carcinoid tumour or other neuroendocrine neoplasms of thymus
Def: Thymic neuroendocrine carcinoma is a type of thymic epithelial neoplasm displaying evidence of neuroendocrine differentiation....
--- Walk 2 ---
[2C27.2] Thymoma
Def: A thymoma that has an aggressive clinical course (capsular invasion, infiltration of the surrounding tissues) and can metastasize. Although any morphologic subtype of thymoma may eventually have a mal...
--PARENT--> [2C27] Malignant neoplasms of thymus
Def: Primary malignant neoplasm involving the thymus. This category includes malignant thymomas, primary thymic carcinomas and carcinoid tumour or other neuroendocrine neoplasms of thymus....
--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 3 ---
[3A61.Y] Other specified acquired pure red cell aplasia
--PARENT--> [3A61] Acquired pure red cell aplasia
Def: A condition characterised by the near absence of red blood cell precursors in bone marrow, often associated with thymomas and autoimmune disorders...
--PARENT--> [?] Pure red cell aplasia
Def: A condition caused by determinates arising during the antenatal period, after birth or genetically inherited factors, leading to a change in the formation of erythrocytes. This condition is characteri...
--- Walk 4 ---
[3A61.Y] Other specified acquired pure red cell aplasia
--PARENT--> [3A61] Acquired pure red cell aplasia
Def: A condition characterised by the near absence of red blood cell precursors in bone marrow, often associated with thymomas and autoimmune disorders...
--CHILD--> [3A61.0] Acute acquired pure red cell aplasia
Def: This refers to transient (acute) and acquired type of anaemia affecting the precursors to red blood cells but not to white blood cells. In PRCA, the bone marrow ceases to produce red blood cells....
--- Walk 5 ---
[4B40.2] Good syndrome
Def: This is a condition that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and benign thymoma may develop almost simultaneously....
--PARENT--> [4B40] Diseases of thymus
--EXCLUDES--> [?] Myasthenia gravis
Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a...
--- Walk 6 ---
[4B40.2] Good syndrome
Def: This is a condition that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and benign thymoma may develop almost simultaneously....
--PARENT--> [4B40] Diseases of thymus
--EXCLUDES--> [?] Myasthenia gravis
Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a...
|
[
"[2C27.2] Thymoma\n Def: A thymoma that has an aggressive clinical course (capsular invasion, infiltration of the surrounding tissues) and can metastasize. Although any morphologic subtype of thymoma may eventually have a mal...\n --PARENT--> [2C27] Malignant neoplasms of thymus\n Def: Primary malignant neoplasm involving the thymus. This category includes malignant thymomas, primary thymic carcinomas and carcinoid tumour or other neuroendocrine neoplasms of thymus....\n --CHILD--> [2C27.1] Carcinoid tumour or other neuroendocrine neoplasms of thymus\n Def: Thymic neuroendocrine carcinoma is a type of thymic epithelial neoplasm displaying evidence of neuroendocrine differentiation....",
"[2C27.2] Thymoma\n Def: A thymoma that has an aggressive clinical course (capsular invasion, infiltration of the surrounding tissues) and can metastasize. Although any morphologic subtype of thymoma may eventually have a mal...\n --PARENT--> [2C27] Malignant neoplasms of thymus\n Def: Primary malignant neoplasm involving the thymus. This category includes malignant thymomas, primary thymic carcinomas and carcinoid tumour or other neuroendocrine neoplasms of thymus....\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...",
"[3A61.Y] Other specified acquired pure red cell aplasia\n --PARENT--> [3A61] Acquired pure red cell aplasia\n Def: A condition characterised by the near absence of red blood cell precursors in bone marrow, often associated with thymomas and autoimmune disorders...\n --PARENT--> [?] Pure red cell aplasia\n Def: A condition caused by determinates arising during the antenatal period, after birth or genetically inherited factors, leading to a change in the formation of erythrocytes. This condition is characteri...",
"[3A61.Y] Other specified acquired pure red cell aplasia\n --PARENT--> [3A61] Acquired pure red cell aplasia\n Def: A condition characterised by the near absence of red blood cell precursors in bone marrow, often associated with thymomas and autoimmune disorders...\n --CHILD--> [3A61.0] Acute acquired pure red cell aplasia\n Def: This refers to transient (acute) and acquired type of anaemia affecting the precursors to red blood cells but not to white blood cells. In PRCA, the bone marrow ceases to produce red blood cells....",
"[4B40.2] Good syndrome\n Def: This is a condition that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and benign thymoma may develop almost simultaneously....\n --PARENT--> [4B40] Diseases of thymus\n --EXCLUDES--> [?] Myasthenia gravis\n Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a...",
"[4B40.2] Good syndrome\n Def: This is a condition that occurs in adults in whom hypogammaglobulinemia, deficient cell-mediated immunity, and benign thymoma may develop almost simultaneously....\n --PARENT--> [4B40] Diseases of thymus\n --EXCLUDES--> [?] Myasthenia gravis\n Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a..."
] |
2C27.2
|
Thymoma
|
[
{
"from_icd11": "4B40.2",
"icd10_code": "E32",
"icd10_title": "Diseases of thymus"
},
{
"from_icd11": "DA2Z",
"icd10_code": "K228",
"icd10_title": "Other specified diseases of esophagus"
},
{
"from_icd11": "DA2Z",
"icd10_code": "K229",
"icd10_title": "Disease of esophagus, unspecified"
},
{
"from_icd11": "DA2Z",
"icd10_code": "K22",
"icd10_title": "Other diseases of esophagus"
},
{
"from_icd11": "DA2Z",
"icd10_code": "K20-K31",
"icd10_title": ""
},
{
"from_icd11": "DA2Z",
"icd10_code": "K23",
"icd10_title": "Disorders of esophagus in diseases classified elsewhere"
},
{
"from_icd11": "DA2Z",
"icd10_code": "K238",
"icd10_title": ""
},
{
"from_icd11": "DA24.Z",
"icd10_code": "K208",
"icd10_title": "Other esophagitis"
},
{
"from_icd11": "DA24.Z",
"icd10_code": "K209",
"icd10_title": "Esophagitis, unspecified"
},
{
"from_icd11": "DA24.Z",
"icd10_code": "K200",
"icd10_title": "Eosinophilic esophagitis"
},
{
"from_icd11": "DA24.Z",
"icd10_code": "K210",
"icd10_title": "Gastro-esophageal reflux disease with esophagitis"
},
{
"from_icd11": "DA24.Z",
"icd10_code": "K20",
"icd10_title": "Esophagitis"
},
{
"from_icd11": "DA20.0",
"icd10_code": "K222",
"icd10_title": "Esophageal obstruction"
},
{
"from_icd11": "DA25.Z",
"icd10_code": "K2211",
"icd10_title": "Ulcer of esophagus with bleeding"
},
{
"from_icd11": "DA25.Z",
"icd10_code": "K2210",
"icd10_title": "Ulcer of esophagus without bleeding"
}
] |
E32
|
Diseases of thymus
|
In July 2020, a 70-year-old man was submitted to our emergency department with a 1-week history of left-sided hemiparesis and homonymous hemianopia. Upon admission, the patient was fully alert and denied complaints such as headache, nausea, vomiting, or B symptoms. CRP (2.4 mg/mL; reference value < 5.0 mg/mL) and WBC count (10.33n/L) were normal, but he demonstrated a relevant lymphopenia (1.38/nL) and thrombocytopenia (72/nL). MRI revealed an intracerebral ring-enhancing lesion in the right occipital lobe with marked perifocal edema . Prior history included evacuation of an abscess-like lesion in the left occipital lobe in January 2017 in our department. By that time, the histological evaluation revealed CNS tissue with dense T-cell dominated inflammatory infiltrates suggesting a necrotizing encephalitis. No conclusive results with respect to bacterial or viral pathogens were obtained in 2017. In fact, immunohistological stainings showed no expression of HIV-, HSV1-, HSV2-, CMV-, EBV-, JCV-, and Toxoplasma gondii -associated antigens (data not shown). Additional multiplex PCR analysis revealed no detection of CMV, EBV, HSV, VZV, or JCV. PAS and Grocott staining demonstrated no fungi and Gram staining showed no bacteria (data not shown). The patient was discharged without treatment. In July 2020, the patient presented a new abscess-like lesion in the contralateral (right) occipital lobe provoking a mass effect . Intraoperatively, the lesion appeared purulent. Subsequently, intravenous broad-spectrum antibiotics including vancomycin and meropenem were initiated. All blood cultures yielded negative results, without evidence for bacterial or viral pathogens. HIV, SARS-CoV-2 testing as well as tuberculosis screening were negative. Interdisciplinary work-up excluded lymph node enlargement, pulmonary infiltrates, dental infections, or cancer metastases by whole body CT and abdominal MRI. Autoimmune testing showed no conclusive results. TEE excluded cardiac valve vegetation. Lumbar puncture was performed 11 days postoperatively and non-conclusive. Follow-up MRI 5 days after craniotomy and evacuation showed persisting edema with GTR. Antibiotic treatment was continued, and oral dexamethasone 3 × 8 mg/day administered due to edema and persisting neurological deficits, and down-tapered according to institutional SOPs. Histopathological analysis revealed a central necrosis with adjacent dense lymphocytic infiltrates . Immunohistochemical stainings showed that the majority of lymphocytes were of T-cell origin expressing CD3, CD2, CD5, and CD4 . Only rare CD20 and CD79a expressing B-cells were present. The lymphocytic infiltrate showed a Ki67-index of 40% , which is why a lymphoma was considered as a differential diagnosis this time. The material was sent to a reference center for Hematopathology. Additional immunophenotyping revealed an aberrant T-cell immunophenotype with partial loss of CD7 expression . The majority of T-cells expressed the beta (β) chain of the T-cell receptor (TCR). Only few T-cells (approx. 1%) expressed CD30 or PD1. There was neither evidence for a latent EBV-infection in the EBER in-situ hybridization, nor for expression of CD56, CD57, terminal deoxynucleotidyl transferase (TdT) or perforin. Further molecular analysis revealed presence of a monoclonal TCR gamma gene rearrangement. Re-evaluation of the previous lesion´s material revealed similar immunohistochemical results as well as evidence of a clonal expansion of T-cells after TCR gamma gene rearrangement analysis. The obtained amplificates from both biopsies were different in size, a fact that has been described in occasional cases of T-cell lymphoma relapse . Antibiotics were discontinued. Our tumor board proposed initiation of high-dose MTX after additional diagnostic work-up including bone marrow biopsy for detection of occult systemic lymphoma involvement, which proved to be negative. Diagnosis of a T-cell lymphoma not otherwise specified (NOS) was made and CNS-directed systemic therapy (high-dose MTX) following a modified PRIMAIN protocol was initiated . From October 2020 to February 2021 six cycles were issued resulting in a complete remission. The patient is currently in follow-up, his condition has improved substantially (KPS 80%, month 5 post-chemotherapy). Fig. 1 Post-gadolinium magnetic resonance imaging (MRI). T1 gadolinium-enhanced MRI from January 2017 ( A – C ) and July 2020 ( D – F ) showed abscess-like lesion with involvement of the left occipital lobe in January 2017 ( A , white arrow) and right occipital lobe in 2020 ( D , white arrowhead). Note the old, cyst-like cortical defect in the left occipital lobe in 2020 ( D , white arrow), vasogenic edema and mass effect with displacement of the temporal horn of the right lateral ventricle Fig. 2 Histological evaluation of the lesion in 2020. The H&E staining revealed extensive areas of necrosis ( A ) with adjacent dense infiltrates composed of numerous small to medium-sized lymphoid cells ( B , C ). The lymphoid cells were identified to belong to the T-cell lineage and expressed CD3 ( D ), CD2 ( E ), CD5 ( F ) and CD4 ( G ) but not CD8 ( H ). Several of these T-cells demonstrated loss of CD7 expression ( I ). The growth fraction as detected by an antibody against Ki67 was up to 40% ( J )
| 4.101563
| 0.969727
|
sec[1]/p[0]
|
en
| 0.999998
|
35366191
|
https://doi.org/10.1007/s13760-022-01928-x
|
[
"lesion",
"cell",
"cells",
"occipital",
"lobe",
"edema",
"like",
"infiltrates",
"expression",
"lymphoma"
] |
[
{
"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": "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 ===
[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
[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 ---
[FA5Z] Arthropathies, unspecified
--PARENT--> [?] Arthropathies
--CHILD--> [?] Osteoarthritis
Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...
--- Walk 2 ---
[FA5Z] Arthropathies, unspecified
--PARENT--> [?] Arthropathies
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--- Walk 3 ---
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders
--- Walk 4 ---
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--EXCLUDES--> [?] Pregnancy, childbirth or the puerperium
Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...
--- Walk 5 ---
[ME60.Z] Skin lesion of unspecified nature
--PARENT--> [ME60] Skin lesion of uncertain or unspecified nature
Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...
--CHILD--> [ME60.1] Pigmented skin lesion of uncertain nature
Def: This denotes the presence of a pigmented skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....
--- Walk 6 ---
[ME60.Z] Skin lesion of unspecified nature
--PARENT--> [ME60] Skin lesion of uncertain or unspecified nature
Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
|
[
"[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --CHILD--> [?] Osteoarthritis\n Def: Osteoarthritis (OA) can be defined as a group of distinct, but overlapping diseases, which may have different etiologies, but similar biological, morphological, and clinical outcomes affecting the art...",
"[FA5Z] Arthropathies, unspecified\n --PARENT--> [?] Arthropathies\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....",
"[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders",
"[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...",
"[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --CHILD--> [ME60.1] Pigmented skin lesion of uncertain nature\n Def: This denotes the presence of a pigmented skin lesion but uncertainty as to its nature. No inference as to whether the lesion might be of serious significance (e.g. suspected skin cancer) is made....",
"[ME60.Z] Skin lesion of unspecified nature\n --PARENT--> [ME60] Skin lesion of uncertain or unspecified nature\n Def: To be used where there is either significant uncertainty or alternatively no information as to the nature of a circumscribed skin lesion. This is of particular importance with regard to whether or not...\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis...."
] |
FA5Z
|
Arthropathies, unspecified
|
[
{
"from_icd11": "FA5Z",
"icd10_code": "M00-M25",
"icd10_title": ""
},
{
"from_icd11": "FC0Z",
"icd10_code": "XIII",
"icd10_title": ""
},
{
"from_icd11": "ME60.Z",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "MD41",
"icd10_code": "R911",
"icd10_title": "Solitary pulmonary nodule"
},
{
"from_icd11": "MD41",
"icd10_code": "R91",
"icd10_title": "Abnormal findings on diagnostic imaging of lung"
},
{
"from_icd11": "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]"
}
] |
M00-M25
| |
A 13-year-old boy was admitted to the First Affiliated Hospital of Ningbo University in February 2023 with complaints of cough and chest pain. He had no history of disease or poultry contact. Physical examination showed that he was 173 cm tall and weighed 80 kg, with clear consciousness, a scar of Bacille Calmette-Guerin vaccination, and slightly moist rales in the right lung. There were no abnormalities in routine blood test or blood chemistry. Immunoglobulin and complement tests showed normal IgE levels and lymphocyte subsets. The erythrocyte sedimentation rate was 2 mm/h, and the tuberculosis-SPOT test was negative. The results of the rheumatoid test, as well as the tests for syphilis, hepatitis B, and human immunodeficiency virus (HIV) antibodies, were all negative. In addition, the 13 respiratory pathogen tests also yielded negative results. The aspergillus IgG antibody and galactomannan tests were both negative. However, the serum cryptococcal antigen (CrAg) test, performed by gold immunochromatography assay was positive 2 days after admission. Both routine and biochemical test of cerebrospinal fluid (CSF) showed normal results, and india ink staining for Cryptococcus was negative. Blood culture, CSF culture, and sputum culture were all negative. Cardiac ultrasound, electrocardiogram, cerebral magnetic resonance imaging, and fiber bronchoscopy revealed no significant abnormalities. A chest ultrasound revealed heterogeneous echoes in the right thoracic cavity with possible inflammatory wrapping. The chest computed tomography (CT) demonstrated a lesion and cavities in the right lower lobe of the lung . Bronchoscopy showed that the cavity was unobstructed. In light of the unexplained pulmonary cavitation, absence of abnormalities in the appearance of the tracheal structure, and a positive blood CrAg test, alveolar lavage fluid was subjected to next-generation sequencing (NGS) for a definitive diagnosis. This was done to exclude false positives and determine the underlying cause of the disease. BALF samples with a total cell concentration of ≥1 × 10 6 cells/mL underwent pre-processing for host removal using sample release reagent (Genskey Co., Ltd., Beijing, China). Subsequently, DNA was extracted from 0.3 mL BALF samples following the instructions of the DNA Extraction and Purification Kit (Genskey Co., Ltd., Beijing, China). The DNA library was generated after cDNA synthesis, and its quality was assessed through Qubit detection. Finally, the qualified library was sequenced on an MGISEQ200 platform (MGI Tech Co., Ltd., Shenzhen, China). Adapters and low-quality reads (Q, 20) were removed from raw data with 50-bp single-end reads using fastp software. Human sequence data were excluded by mapping onto the human reference database (hg38, YH genome, T2T-CHM13 genome) through Burrows Wheeler Aligner (BWA) software. The remaining sequence reads, aligned to the Dian Diagnostics Pathogenic Microorganism Genome Database by BWA, underwent annotation and statistical analysis. Negative controls (Genskey Co., Ltd., Beijing, China) underwent the same sequencing and bioinformatics analysis procedures as the clinical samples. Synthesized sequences were used as a positive control, serving as indicators for the detection process in each batch. For homogenized species-specific sequences, the prevalence of microbiota was determined according to the mNGS criteria. For clinical core pathogens and bacteria difficult to detect, including firmicutes and intracellular bacteria, reads ≥1 were considered positive. For other clinically relevant bacteria, fungi, and viruses, reads ≥3, exceeding those in the negative controls of the same batch, were considered positive. For bacteria, fungi, and viruses not clinically reported or isolated, reads ≥20, surpassing those in the negative controls of the same batch, were considered positive. The NGS test detected Cryptococcus species in the bronchoalveolar lavage fluid at 3 days after admission (Table 1 ). As the cryptococcal infection was confined to the lungs, PC was the definitive diagnosis. He was treated with intravenous injection of fluconazole at 400 mg once a day for 8 days, followed by continuous oral administration of fluconazole capsules at 400 mg once a day for 6 months. The child’s symptoms, including chest pain, were significantly relieved. He was discharged 10 days after admission without coughing or chest pain. Chest CT revealed that the lesion in the lower lobe of the right lung reduced after taking fluconazole for 1 month . The lesion in lung diminished and reexamination of serum CrAg turned positive after taking fluconazole for 4 months . Fig. 1 Images. a CT on admission showed a lesion and cavities in the right lower lobe of the lung, suggesting infection. b CT on the recovery phase (after taking fluconazole orally for 1 month) showed the lesion in the lower lobe of the right lung had reduced. c CT on the recovery phase (after taking fluconazole orally for 4 month) showed the inflammation in the lower lobe of the right lung had well absorbed Table 1 Next-generation sequencing of the bronchoalveolar lavage fluid Generic Specific Generic name Relative abundance Sequence number specific name confidence coefficient Sequence number Cryptococcus 66.10% 22 Cryptococcus neoformans 99% 19
| 4.238281
| 0.754395
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC10845742
|
https://doi.org/10.1186/s12879-024-09061-1
|
[
"lung",
"chest",
"reads",
"fluconazole",
"lesion",
"lobe",
"blood",
"fluid",
"cryptococcus",
"china"
] |
[
{
"code": "CB40.Y",
"title": "Other specified diseases of the respiratory system"
},
{
"code": "LA75.1",
"title": "Agenesis of lung"
},
{
"code": "CA40.Z",
"title": "Pneumonia, organism unspecified"
},
{
"code": "CB41",
"title": "Respiratory failure"
},
{
"code": "NB32.3Y",
"title": "Other injury of lung"
},
{
"code": "CB7Z",
"title": "Diseases of the respiratory system, unspecified"
},
{
"code": "CB27",
"title": "Pleural effusion"
},
{
"code": "CA44",
"title": "Pyothorax"
},
{
"code": "MD30.Z",
"title": "Chest pain, unspecified"
},
{
"code": "NA80.Y&XJ1C6",
"title": "Thoracic haematoma"
}
] |
=== ICD-11 CODES FOUND ===
[CB40.Y] Other specified diseases of the respiratory system
Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum
[LA75.1] Agenesis of lung
Definition: This refers to the absence or rudimentary residua of an undeveloped lung.
Also known as: Agenesis of lung | Pulmonary agenesis | absence of lung | aplasia of lung | apulmonism
[CA40.Z] Pneumonia, organism unspecified
Also known as: Pneumonia, organism unspecified | Pneumonia | infectious pneumonia | PN - [pneumonia] | lobar pneumonia NOS
[CB41] Respiratory failure
Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high.
Also known as: Respiratory failure | lung failure NOS | pulmonary failure
Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn
[NB32.3Y] Other injury of lung
Also known as: Other injury of lung | Haematoma of lung | Traumatic hydropneumothorax | Acute traumatic lung congestion | Rupture of lung
[CB7Z] Diseases of the respiratory system, unspecified
Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS
[CB27] Pleural effusion
Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.
Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate
Includes: Pleurisy with effusion
Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy
[CA44] Pyothorax
Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection.
Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula
Includes: empyema | pyopneumothorax
Excludes: due to tuberculosis
[MD30.Z] Chest pain, unspecified
Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure
=== GRAPH WALKS ===
--- Walk 1 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--RELATED_TO--> [?] Pulmonary sporotrichosis
Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled.
Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...
--- Walk 2 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality
--- Walk 3 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies of the respiratory system
--- Walk 4 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.2] Congenital hypoplasia of lung
--- Walk 5 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii
Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...
--- Walk 6 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--CHILD--> [CA40.0] Bacterial pneumonia
Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala...
|
[
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...",
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Airway obstruction in the neonate due to airway abnormality",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the respiratory system",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Pulmonary toxoplasmosis due to Toxoplasma gondii\n Def: In immunodeficient patients, toxoplasmosis most often occurs in persons with defects in T cell–mediated immunity such as those receiving corticosteroids, anti–tumour necrosis factor (TNF) therapies, o...",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --CHILD--> [CA40.0] Bacterial pneumonia\n Def: A disease of the pulmonary system, caused by an infection with a bacterial source. This disease is characterised by fever, lethargy, headache, myalgia, vomiting, or coughing. Transmission is by inhala..."
] |
CB40.Y
|
Other specified diseases of the respiratory system
|
[
{
"from_icd11": "LA75.1",
"icd10_code": "Q333",
"icd10_title": "Agenesis of lung"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J189",
"icd10_title": "Pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J181",
"icd10_title": "Lobar pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J188",
"icd10_title": "Other pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J168",
"icd10_title": "Pneumonia due to other specified infectious organisms"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J180",
"icd10_title": "Bronchopneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J17",
"icd10_title": "Pneumonia in diseases classified elsewhere"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J182",
"icd10_title": "Hypostatic pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J16",
"icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J171",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J173",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J178",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J18",
"icd10_title": "Pneumonia, unspecified organism"
},
{
"from_icd11": "CB41",
"icd10_code": "J9622",
"icd10_title": "Acute and chronic respiratory failure with hypercapnia"
},
{
"from_icd11": "CB41",
"icd10_code": "J9620",
"icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia"
}
] |
Q333
|
Agenesis of lung
|
The patient was in compliance with the Declaration of Helsinki. A 59-year-old farmer with a personal history of a lump on his right scapula for the past five years was admitted to hospital. In two years prior to the first hospital visit, the lump had grown significantly and had restricted the activity of the right shoulder. The patient did not have a family history of tumors.Physical examination indicated no apparent spread to the superficial lymph nodes. There was a huge, irregular lump in the region of the right shoulder, with the superior border reaching the acromion, the left border reaching to 1 cm from the spinal column, the inferior border reaching the seventh rib, and the lateral border reaching the midaxillary line. The lump was nodular, hard and caused a pressing pain. There was an obscure boundary between the tumor and the surrounding tissues, the skin around the tumor was red but there was no venous engorgement or vascular pulsation . Fifty degree abduction of the right shoulder joint, 0° adduction, 30° flexion, 40° extension and 10° external and internal rotation were observed. The pulsation of the right ulnar artery and the right radial artery were good. Myodynamia of the main right upper extremities were as follows: supraspinatus at level III, deltoid at level IV, muscles of biceps brachii at level IV, extensor carpi at level IV, flexor digitorum profundus at level IV and abductor digiti quinti at level IV.The results of the vascular ultrasound of the right clavicle and the axilla were as follows: the axillary artery was visible in front of the tumor with smoothly flowing blood; there was an obvious boundary between the subclavian artery and the tumor with smoothly flowing blood. The results of the X-ray and computer tomography (CT) scan were as follows: a large high-density mass was seen in the right scapula and the surrounding tissue with multifocal calcification. As can be seen in the X-ray and the CT scan, the entire scapula was involved. In addition, the scapula showed osteolytic destruction without normal structure and the remaining scapula was embedded in the tumor tissue. There were no abnormalities adjacent to the ribs, humerus and thoracic vertebra. The isotope bone scan showed the concentration of radioactivity in the right scapular area with abnormal mineral metabolism in the bones. The biopsy indicated grade II (out of III) chondrosarcoma. The diagnosis was as follows: chondrosarcoma in right scapular, Malawer S1 S2 district, Enniking II B district, grade II chondrosarcoma.Two weeks after hospitalization, the patient was treated with the Malawer III limb-reserving surgery under general anesthesia. The levator scapulae, rhomboid, supraspinatus, infraspinatus and teres muscles along the medial walls of the scapula were stripped and resected in an order based on the principles of wide resection. Simultaneously, the nerves and blood vessels that enter the tumor tissue were excised. The tumor was widely adherent to the surrounding soft tissue. Also, its relationship with the axillary artery and the subclavian artery was obscure. It was difficult to directly turn the rib. Under these circumstances, the incision was extended, the clavicle was resected and then the teres was moved downward. There was quite a close relationship between the subclavian artery, the axillary artery and the tumor, but there was some separation with soft tissue envelope. The serratus anterior was partly cut down to completely expose the tumor . The scapular was entirely embedded in the tumor tissue, hence it was removed while the tumor was resected. The size of the tumor was 33 × 28 × 25 cm. There was no involvement of the proximal humerus and the thoracic vertebrae. Then, the lesions and the surrounding tissue were obtained for pathological analysis. As the pathology results of the surrounding tissue were negative, the humerus was attached to the second rib with a steel wire, then the supraspinatus, infraspinatus, teres minor and the rhomboid muscles were sutured. The trapezius, ectopectoralis and deltoid were sutured together. The brachialis, musculus biceps brachii and musculus triceps brachii were sutured together and fixed to the first rib. The brachycephaly of musculus biceps brachii was fixed to the second rib to ensure the balance of the shoulder joint . The patient was required to maintain his elbow in a flexed position with a bandage for three weeks. The postoperative X-ray showed that no tumor tissue remained . On the first postoperative day, the myodynamia and sensation of the major muscles under the right shoulder were the same as prior to the operation. On the third postoperative day, the patient exercised his hand and wrist functions with a patient controlled epidural analgesia. At postoperative week three, partly loading functional training was performed and at the sixth week, fully loading functional training was performed. The stitches were removed two weeks postoperatively without any complications. The pathology report was almost the same as that prior to the operation . The MSTS (Musculoskeletal Tumor Society Score) score was 22 one year after the surgery. Postoperative radiography at 3, 6 and 18 months detected no tumor recurrence. There was no evidence of metastasis at the follow-up end point.
| 3.996094
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999997
|
24976133
|
https://doi.org/10.1186/1477-7819-12-196
|
[
"tumor",
"tissue",
"artery",
"scapula",
"shoulder",
"surrounding",
"postoperative",
"lump",
"border",
"reaching"
] |
[
{
"code": "2F9Z",
"title": "Neoplasms of unknown behaviour of unspecified site"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "2E6Z",
"title": "Carcinoma in situ of unspecified site"
},
{
"code": "2F91.1",
"title": "Neoplasms of unknown behaviour of trachea, bronchus or lung"
},
{
"code": "2F92",
"title": "Neoplasms of unknown behaviour of skin"
},
{
"code": "FB6Z",
"title": "Soft tissue disorders, unspecified"
},
{
"code": "MC85",
"title": "Gangrene"
},
{
"code": "FB56.6",
"title": "Other specified soft tissue disorders"
},
{
"code": "GB61.Z",
"title": "Chronic kidney disease, stage unspecified"
},
{
"code": "4A43.3",
"title": "Mixed connective tissue disease"
}
] |
=== ICD-11 CODES FOUND ===
[2F9Z] Neoplasms of unknown behaviour of unspecified site
Also known as: Neoplasms of unknown behaviour of unspecified site | neoplasia | neoplasm growth NOS | tumour of unspecified site | tumourlet of unspecified site
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Definition: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature
Also known as: Subcutaneous swelling, mass or lump of uncertain or unspecified nature | localised swelling, mass or lump of skin and subcutaneous tissue | localised subcutaneous nodules | subcutaneous nodules | superficial subcutaneous nodules
Excludes: localized adiposity | mass and lump: breast | enlarged lymph nodes
[2E6Z] Carcinoma in situ of unspecified site
Also known as: Carcinoma in situ of unspecified site | carcinoma in situ of unspecified site | carcinoma in situ NOS | carcinoma in situ | in situ neoplasm
[2F91.1] Neoplasms of unknown behaviour of trachea, bronchus or lung
Also known as: Neoplasms of unknown behaviour of trachea, bronchus or lung | trachea, bronchus or lung tumour NOS | Intravascular bronchial alveolar tumour of unspecified site | Bronchial adenoma of unknown behaviour of unspecified site | Intravascular bronchial alveolar tumour unknown behaviour of unspecified site
[2F92] Neoplasms of unknown behaviour of skin
Also known as: Neoplasms of unknown behaviour of skin | skin tumour NOS
[FB6Z] Soft tissue disorders, unspecified
Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS
[MC85] Gangrene
Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply.
Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene
Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis
[FB56.6] Other specified soft tissue disorders
Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia
[GB61.Z] Chronic kidney disease, stage unspecified
Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease
[4A43.3] Mixed connective tissue disease
Definition: Mixed connective tissue disease is an overlapping syndrome combining features of systemic lupus erythematosus, systemic sclerosis, and polymyositis with the presence of autoantibodies to U1-ribonucleoprotein. Raynaud’s phenomenon is seen in nearly all patients and pulmonary arterial hypertension is the most common cause of death in MCTD patients.
Also known as: Mixed connective tissue disease | Sharp syndrome | MCTD - [mixed connective tissue disease] | Paediatric-onset mixed connective tissue disease | Paediatric-onset Sharp syndrome
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--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--> [2F92] Neoplasms of unknown behaviour of skin
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [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--> [2F92] Neoplasms of unknown behaviour of skin",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs"
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
A 46-year-old Japanese male patient with a medical history of severe intellectual disability and epilepsy was admitted to a support facility for persons with disabilities. The patient fell down and struck his chin in January 2020. Even before the injury, the patient had problems with verbal communication. He was self-reliant in performing activities of daily living and experienced no swallowing difficulty before the injury. He had been consuming normal food before the injury. He received treatment with carbamazepine 800 mg/day, risperidone 6 mg/day, chlorpromazine phenolphthalinate 300 mg/day, lorazepam 3 mg/day, sodium valproate 1000 mg/day, magnesium oxide 1000 mg/day, and flunitrazepam 2 mg/day. He was initially referred to another hospital and was diagnosed with mandibular fracture. Hence, open reduction and internal fixation (ORIF) was considered. However, the patient should be treated first at a psychopathic ward. Next, he was referred to another university hospital because of a significant risk of self-mutilation. However, the psychiatric ward was full. Finally, he was referred to our department and was accompanied by his mother and facility staff, 10 days after sustaining the injury. Clinical examination at the initial visit revealed productive cough and sialorrhea. In addition, there was conspicuous oral contamination with phlegm. The patient could not close his mouth because of anterior open bite and a significant gap between the left lower first and second premolars . Panoramic radiography and computed tomography (CT) scan revealed left mandibular body and right condylar head fractures . Moreover, chest radiography and CT scan showed infiltrative shadow in the lower lobe of both lungs. Blood tests had the following results: white blood cell count of 15,400/μL and C-reactive protein level of 14.74 mg/dL (normal range 0.00–0.50 mg/dL). He was diagnosed with mandibular fracture and aspiration pneumonitis and was admitted to the medical psychiatric unit (MPU) of our hospital. He had eaten liquid food before admission to our hospital, and a feeding tube was inserted at the time of admission to ORIF. After receiving ampicillin/sulbactam 12 g/day for 5 days for aspiration pneumonitis, ORIF using the submandibular approach for left mandibular body fracture was performed under general anesthesia, 16 days after sustaining the injury. Then, normal occlusion was achieved . The patient received conservative treatment for right condylar head fracture. Although oral intake was resumed a day after surgery, he could not properly swallow a jelly, and enteral feeding via a nasogastric tube was again required. Videoendoscopic examination of swallowing was performed by a nutrition support team 2 days after surgery. Results showed significant saliva retention at the epiglottic vallecula and piriform fossa . Moreover, delayed elicitation of pharyngeal swallowing and poor transfer from the oral cavity to the pharynx were observed. The jelly was transferred from the oral cavity to the pharynx by gravity. He was then diagnosed with postoperative dysphagia owing to disuse atrophy of muscles for swallowing. Although oral care, thermal–tactile stimulation, and cervical range of motion training were continued, adequate dysphagia rehabilitation, including direct and indirect training, could not be facilitated. Re-evaluation of swallowing function was performed 21 days after surgery. However, there was no improvement in postoperative dysphagia. Practically, test of swallowing thickened water as a direct training was performed. Choking and wet hoarseness were not observed. However, an abnormal swallowing sound was heard, and most of the jelly was aspirated from the pharynx after swallowing. Therefore, percutaneous endoscopic gastrostomy was performed 23 days after surgery. Then, the patient was transferred to the original support facility for persons with disabilities 52 days after surgery. Medical restraint was recommended by psychiatrists and the MPU staff to prevent heavy self-mutilation and harming medical staff during hospitalization according to the Act on Mental Health and Welfare for the Mentally Disabled (Japanese Mental Health Law). Fig. 1 Facial image obtained during the initial visit showing that the patient could not close his mouth Fig. 2 Intraoral image obtained during the initial visit showing anterior open bite and a significant gap between the left lower first and second premolars Fig. 3 Panoramic image obtained during the initial visit showing left mandibular body (white arrowhead) and right condylar head (white arrow) fracture Fig. 4 Three-dimensional computed tomography findings obtained during the initial visit showed fracture characterized by severe deviation of the left mandibular body Fig. 5 Intraoperative image showing that ORIF for left mandibular body fracture using a submandibular approach was performed Fig. 6 Intraoral image obtained after ORIF showing that normal occlusion was achieved Fig. 7 Three-dimensional computed tomographic findings obtained after ORIF showing that adequate reduction and fixation were obtained Fig. 8 Findings of videoendoscopic examination of swallowing performed 21 days after surgery revealing significant saliva and jelly retention at the epiglottic vallecula and piriform fossa
| 3.824219
| 0.98291
|
sec[1]/p[0]
|
en
| 0.999996
|
34980242
|
https://doi.org/10.1186/s13256-021-03116-6
|
[
"swallowing",
"mandibular",
"fracture",
"orif",
"injury",
"visit",
"oral",
"body",
"however",
"jelly"
] |
[
{
"code": "MD93",
"title": "Dysphagia"
},
{
"code": "DD90.1",
"title": "Functional swallowing disorder"
},
{
"code": "ND73.Z",
"title": "Foreign body in alimentary tract, unspecified"
},
{
"code": "KB8A",
"title": "Neonatal haematemesis or melaena due to swallowed maternal blood"
},
{
"code": "DA0E.6",
"title": "Dentofacial functional abnormalities"
},
{
"code": "DA0E.8",
"title": "Temporomandibular joint disorders"
},
{
"code": "DA0E.0Y&XA51B7",
"title": "Mandibular hypoplasia"
},
{
"code": "QB51.6",
"title": "Presence of tooth-root or mandibular implants"
},
{
"code": "LD2F.16",
"title": "Otomandibular dysplasia"
},
{
"code": "NA02.7Z",
"title": "Fracture of mandible, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[MD93] Dysphagia
Definition: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the pharynx and upper oesophageal sphincter; and oesophageal dysphagia due to malfunction of the oesophagus.
Also known as: Dysphagia | Difficulty in swallowing | difficulty swallowing | difficulty in swallowing NOS | swallowing problem
Includes: Difficulty in swallowing
Excludes: Functional swallowing disorder
[DD90.1] Functional swallowing disorder
Definition: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or passing abnormally through the oesophagus.
Also known as: Functional swallowing disorder | Functional dysphagia | failure of swallowing function
Includes: Functional dysphagia
Excludes: dysphagia NOS
[ND73.Z] Foreign body in alimentary tract, unspecified
Also known as: Foreign body in alimentary tract, unspecified | Foreign body in alimentary tract | foreign body in digestive tract | foreign body of digestive structure | ingestion of foreign body
[KB8A] Neonatal haematemesis or melaena due to swallowed maternal blood
Definition: A less serious, self-limiting case of haematemesis and melena which can occur in newborns two to three days after delivery, due to swallowed maternal blood.
Also known as: Neonatal haematemesis or melaena due to swallowed maternal blood | Swallowed blood syndrome in newborn | Neonatal gastrointestinal pseudo-haemorrhage | Neonatal melaena | Melaena in newborn NOS
[DA0E.6] Dentofacial functional abnormalities
Definition: Temporomandibular joint disorder (TMJ) is the name given to a group of symptoms that cause pain in the head, face, and jaw. The symptoms include headaches, soreness in the chewing muscles, and clicking or stiffness of the joints. They often have psychological as well as physical causes.
Also known as: Dentofacial functional abnormalities | dentofacial functional anomaly | dentofacial functional abnormality NOS | Abnormal jaw closure | Abnormal jaw opening
Includes: Abnormal jaw closure
Excludes: teeth-grinding NOS | bruxism | teeth clenching
[DA0E.8] Temporomandibular joint disorders
Definition: 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.
Also known as: Temporomandibular joint disorders | temporomandibular joint disease | temporomandibular jaw disorder | TMJ - [temporomandibular joint] disorder | temporomandibular developmental disorder of jaw
Includes: Temporomandibular joint-pain-dysfunction syndrome | Derangement of temporomandibular joint | Chronic temporomandibular disorder pain
Excludes: current temporomandibular joint: strain | current temporomandibular joint: dislocation
[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
[LD2F.16] Otomandibular dysplasia
Definition: Any condition characterised by malformation of facial bones and muscles. These conditions may present with eyes that slant downward, sparse eyelashes, eyelid coloboma, hearing loss, underdeveloped or absent vertebrae, or cleft palate.
Also known as: Otomandibular dysplasia | Oculo-auriculo-vertebral spectrum with radial defects | Auriculo-condylar syndrome | Goldenhar syndrome | Hemifacial microsomia
[NA02.7Z] Fracture of mandible, unspecified
Also known as: Fracture of mandible, unspecified | Fracture of mandible | fracture of lower jaw | mandibular fracture | jaw fracture
=== GRAPH WALKS ===
--- Walk 1 ---
[MD93] Dysphagia
Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...
--EXCLUDES--> [?] Functional swallowing disorder
Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...
--EXCLUDES--> [?] Dysphagia
Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...
--- Walk 2 ---
[MD93] Dysphagia
Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...
--EXCLUDES--> [?] Functional swallowing disorder
Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...
--PARENT--> [?] Functional oesophageal or gastroduodenal disorders
Def: This group incorporates oesophageal and gastroduodenal disorders which principally present unpleasant upper gastrointestinal complaints without apparent morphological changes of oesophagus and gastrod...
--- Walk 3 ---
[DD90.1] Functional swallowing disorder
Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...
--EXCLUDES--> [?] Dysphagia
Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...
--CHILD--> [?] Dysphagia, oropharyngeal phase
--- Walk 4 ---
[DD90.1] Functional swallowing disorder
Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...
--PARENT--> [DD90] Functional oesophageal or gastroduodenal disorders
Def: This group incorporates oesophageal and gastroduodenal disorders which principally present unpleasant upper gastrointestinal complaints without apparent morphological changes of oesophagus and gastrod...
--CHILD--> [DD90.0] Globus
Def: Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat unrelated to swallowing without structural or motor disorder of the pharynx and/or oesophagus, ofte...
--- Walk 5 ---
[ND73.Z] Foreign body in alimentary tract, unspecified
--PARENT--> [ND73] Foreign body in alimentary tract
--EXCLUDES--> [?] Foreign body in pharynx
Def: Objects that inadvertently enter the pharynx from the environment....
--- Walk 6 ---
[ND73.Z] Foreign body in alimentary tract, unspecified
--PARENT--> [ND73] Foreign body in alimentary tract
--CHILD--> [ND73.2] Foreign body in stomach
Def: Mechanical impaction or retention of foreign body in the stomach....
|
[
"[MD93] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --EXCLUDES--> [?] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --EXCLUDES--> [?] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...",
"[MD93] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --EXCLUDES--> [?] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --PARENT--> [?] Functional oesophageal or gastroduodenal disorders\n Def: This group incorporates oesophageal and gastroduodenal disorders which principally present unpleasant upper gastrointestinal complaints without apparent morphological changes of oesophagus and gastrod...",
"[DD90.1] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --EXCLUDES--> [?] Dysphagia\n Def: Difficulty in swallowing which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the phar...\n --CHILD--> [?] Dysphagia, oropharyngeal phase",
"[DD90.1] Functional swallowing disorder\n Def: Functional dysphagia is a disorder having no structural abnormalities and absence of gastroesophageal reflux for dysphagia, characterised by sense of solid and/or liquid foods sticking, lodging, or pa...\n --PARENT--> [DD90] Functional oesophageal or gastroduodenal disorders\n Def: This group incorporates oesophageal and gastroduodenal disorders which principally present unpleasant upper gastrointestinal complaints without apparent morphological changes of oesophagus and gastrod...\n --CHILD--> [DD90.0] Globus\n Def: Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat unrelated to swallowing without structural or motor disorder of the pharynx and/or oesophagus, ofte...",
"[ND73.Z] Foreign body in alimentary tract, unspecified\n --PARENT--> [ND73] Foreign body in alimentary tract\n --EXCLUDES--> [?] Foreign body in pharynx\n Def: Objects that inadvertently enter the pharynx from the environment....",
"[ND73.Z] Foreign body in alimentary tract, unspecified\n --PARENT--> [ND73] Foreign body in alimentary tract\n --CHILD--> [ND73.2] Foreign body in stomach\n Def: Mechanical impaction or retention of foreign body in the stomach...."
] |
MD93
|
Dysphagia
|
[
{
"from_icd11": "MD93",
"icd10_code": "R1312",
"icd10_title": "Dysphagia, oropharyngeal phase"
},
{
"from_icd11": "MD93",
"icd10_code": "R1319",
"icd10_title": "Other dysphagia"
},
{
"from_icd11": "MD93",
"icd10_code": "R1313",
"icd10_title": "Dysphagia, pharyngeal phase"
},
{
"from_icd11": "MD93",
"icd10_code": "R1314",
"icd10_title": "Dysphagia, pharyngoesophageal phase"
},
{
"from_icd11": "MD93",
"icd10_code": "R1311",
"icd10_title": "Dysphagia, oral phase"
},
{
"from_icd11": "MD93",
"icd10_code": "R130",
"icd10_title": "Aphagia"
},
{
"from_icd11": "MD93",
"icd10_code": "R1310",
"icd10_title": "Dysphagia, unspecified"
},
{
"from_icd11": "MD93",
"icd10_code": "R13",
"icd10_title": "Aphagia and dysphagia"
},
{
"from_icd11": "DD90.1",
"icd10_code": "K30",
"icd10_title": "Functional dyspepsia"
},
{
"from_icd11": "ND73.Z",
"icd10_code": "T189XXA",
"icd10_title": "Foreign body of alimentary tract, part unspecified, initial encounter"
},
{
"from_icd11": "ND73.Z",
"icd10_code": "T188XXA",
"icd10_title": "Foreign body in other parts of alimentary tract, initial encounter"
},
{
"from_icd11": "ND73.Z",
"icd10_code": "T18",
"icd10_title": "Foreign body in alimentary tract"
},
{
"from_icd11": "ND73.Z",
"icd10_code": "T188",
"icd10_title": "Foreign body in other parts of alimentary tract"
},
{
"from_icd11": "ND73.Z",
"icd10_code": "T189",
"icd10_title": "Foreign body of alimentary tract, part unspecified"
},
{
"from_icd11": "KB8A",
"icd10_code": "P541",
"icd10_title": "Neonatal melena"
}
] |
R1312
|
Dysphagia, oropharyngeal phase
|
A 58-year-old Japanese male, who was diagnosed with T4N2M0 p16-positive oropharyngeal SCC at the right lingual tonsis sulcus in the first computed tomography (CT), received cisplatin 80 mg/m 2 IV every 3 weeks in 3 cycles and concurrent radiotherapy 70.4 Gy. SCC with multiple pulmonary nodular lesions recurred at 1 year and 2 months after completing the radiotherapy. Tumor analysis on the biopsy specimen collected at the initial diagnosis of oropharyngeal SCC revealed a PD-L1 combined positive score of 5. The patient was then treated with cisplatin 100 mg/m 2 and pembrolizumab 200 mg, both on day 1 every 3 weeks for 5 cycles, as well as 5-fluorouracil 1,000 mg/m²/day on days 1 to 4 every 3 weeks for 5 cycles, followed by treatment with pembrolizumab 400 mg every 6 weeks. The patient complained of appetite loss and upper abdominal pain at 11 months after initiating treatment with pembrolizumab plus cisplatin and 5-fluorouracil. Upper gastrointestinal endoscopy (UGE) revealed a severe ulcer in the angular incisure and antrum of the stomach , which was treated with esomeprazole 20 mg/day. Whole-body CT after the first UGE showed mural thickening of the stomach, not detected in whole-body CT before initiating treatment with pembrolizumab plus cisplatin and 5-fluorouracil, without imaging evidence of any tumor progression. At 12 months, the patient was admitted to our hospital with a history of progressive upper abdominal pain and a 5-kg weight loss over 14 days. After admission, the second UGE revealed exacerbated hemorrhagic gastritis, evenly spreading over the entire gastric mucosa and deep ulceration. The endoscope could not pass through the duodenum due to ulceration-induced stenosis of the pyloric ring . Histopathology revealed lymphoplasmacytic infiltration into the fundic gland mucosa without evidence of infection or malignant neoplasia . Immunohistochemical results indicated that most lymphocytes were CD8 + T cells , suggesting pembrolizumab-induced gastritis. Therefore, pembrolizumab treatment was discontinued. After administering oral prednisolone 1 mg/kg, the symptoms gradually improved within a few weeks, and the dose was tapered over the subsequent 2 months. Follow-up UGE performed at 2 months later showed an improved ulcer and mucosal healing. Nevertheless, pyloric ring stenosis caused solid food dysphagia. During the course of maintenance therapy with prednisolone 10 mg/day for pembrolizumab-induced gastritis in the outpatient setting, the patient developed delayed severe hepatitis without deteriorating subjective symptoms and was readmitted to our hospital. The patient was diagnosed with “Grade 4 aspartate aminotransferase (AST) increase” and “Grade 4 alanine aminotransferase (ALT) increase”—AE grades defined in Common Terminology Criteria for Adverse Events version 5.0 ( 6 ). Whole-body CT and abdominal ultrasonography ruled out metastatic liver involvement; no sign of biliary tract disease was apparent. Viral causes of hepatitis (hepatitis A, B, and C viruses, cytomegalovirus, Epstein-Barr virus, herpes simplex virus, and varicella zoster virus) were excluded by serological tests. The patient was negative for the antinuclear antibody and antimitochondrial antibody. Although we did not conduct liver biopsy whose role in patients with suspected liver injury due to ICIs is controversial ( 7 ), the immunological origin of delayed severe hepatitis was strongly suspected based on the abovementioned test results and the development of delayed severe hepatitis during the treatment of pembrolizumab-induced gastritis. Hence, pulse corticosteroid therapy with intravenous methylprednisolone (1,000 mg/day) was administered for 3 days, followed by co-treatment with oral prednisolone (2 mg/kg/day) and oral mycophenolate mofetil (MMF) (2,000 mg/day) due to refractoriness to corticosteroid therapy. After 1 week of co-treatment with high-dose prednisolone and MMF, impaired liver function failed to improve substantially. Subsequently, oral tacrolimus, administered 8 days after the start date of MMF and reaching targeting serum trough concentrations of 8–10 ng/mL, gradually improved the AE grades of AST and ALT from “Grade 4” to “Grade 1.” The oral prednisolone dose was slowly tapered under close blood monitoring . The patient was discharged 60 days after hospitalization and had no indication of solid food dysphagia at 2 months after initiating tacrolimus treatment. Oral prednisolone and MMF were discontinued at 8 and 6 months of treatment, respectively. The oral tacrolimus dose was slowly tapered over 4 months, with treatment terminated 7 months after initiation. Follow-up UGE conducted at 7 months of immunosuppressant therapy with MMF and tacrolimus revealed improvement in pyloric ring stenosis, and the endoscope could pass through the pylorus. Treatment with pembrolizumab was not resumed. CT conducted at 10 months after discontinuing pembrolizumab revealed metastases to the mediastinal nodes and right hilar lymph nodes, as well as right pleural dissemination, although the primary tumor remained in remission. The patient preferred best supportive care despite chemotherapy with paclitaxel and cetuximab was proposed as the next treatment and died of cancer progression at 17 months after discontinuing pembrolizumab.
| 4.054688
| 0.971191
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC10213227
|
https://doi.org/10.3389/fonc.2023.1164236
|
[
"pembrolizumab",
"oral",
"prednisolone",
"hepatitis",
"cisplatin",
"every",
"over",
"gastritis",
"induced",
"grade"
] |
[
{
"code": "MD11.8Z",
"title": "Mouth breathing, unspecified"
},
{
"code": "DA01.00",
"title": "Oral leukoplakia"
},
{
"code": "DA01.10",
"title": "Oral aphthae or aphtha-like ulceration"
},
{
"code": "MD80.1",
"title": "Symptom or complaint of the mouth, tongue or lip"
},
{
"code": "DA01.1Y",
"title": "Other specified noninfectious erosive or ulcerative disorders of oral mucosa"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[MD11.8Z] Mouth breathing, unspecified
Also known as: Mouth breathing, unspecified | Mouth breathing | breathing orally | mouth respiration
[DA01.00] Oral leukoplakia
Definition: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or mucosal surfaces of the urinary tract and genitals.
Also known as: Oral leukoplakia | Leukoplakia of gingiva | leukoplakia of oral epithelium | leucoplakia of oral mucosa | leukokeratosis of oral mucosa
Includes: Leukoplakia of gingiva
Excludes: Hairy leukoplakia
[DA01.10] Oral aphthae or aphtha-like ulceration
Definition: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencement after adolescence, with fever, with a strong family history, or failing to resolve with age.
Also known as: Oral aphthae or aphtha-like ulceration | Recurrent aphthous stomatitis | Recurrent oral aphthae | Major recurrent aphthous stomatitis | major aphthous stomatitis
[MD80.1] Symptom or complaint of the mouth, tongue or lip
Also known as: Symptom or complaint of the mouth, tongue or lip | Mouth swelling | mouth oedema | swollen mouth | Lip swelling
[DA01.1Y] Other specified noninfectious erosive or ulcerative disorders of oral mucosa
Also known as: Other specified noninfectious erosive or ulcerative disorders of oral mucosa | Oral ulceration due to immunobullous disease | Oral mucosal involvement by immunobullous disorder classified elsewhere | Oral ulceration due to physical injury | Mechanical oral ulceration
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[MD11.8Z] Mouth breathing, unspecified
--PARENT--> [MD11.8] Mouth breathing
Def: Breathing through mouth. Nasal obstruction may also necessitate mouth breathing, which itself can precipitate obstructive apnoea. Breathing through the mouth may also increase risk for OSA by its effe...
--CHILD--> [MD11.80] Stertor
Def: Stertor is a heavy snoring or gasping sound on inspiration occurring in coma or deep sleep that may be caused by partial obstruction of airway, choanal stenosis, enlarged tonsils and/or adenoids, and ...
--- Walk 2 ---
[MD11.8Z] Mouth breathing, unspecified
--PARENT--> [MD11.8] Mouth breathing
Def: Breathing through mouth. Nasal obstruction may also necessitate mouth breathing, which itself can precipitate obstructive apnoea. Breathing through the mouth may also increase risk for OSA by its effe...
--CHILD--> [MD11.80] Stertor
Def: Stertor is a heavy snoring or gasping sound on inspiration occurring in coma or deep sleep that may be caused by partial obstruction of airway, choanal stenosis, enlarged tonsils and/or adenoids, and ...
--- Walk 3 ---
[DA01.00] Oral leukoplakia
Def: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or m...
--EXCLUDES--> [?] Hairy leukoplakia
Def: Oral hairy leukoplakia is a focal epithelial hyperplasia of the oral mucosa associated with Epstein-Barr virus. It is closely associated with HIV and occurs in both immunocompromised and immunocompete...
--CHILD--> [?] Hairy leukoplakia of tongue
--- Walk 4 ---
[DA01.00] Oral leukoplakia
Def: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or m...
--EXCLUDES--> [?] Hairy leukoplakia
Def: Oral hairy leukoplakia is a focal epithelial hyperplasia of the oral mucosa associated with Epstein-Barr virus. It is closely associated with HIV and occurs in both immunocompromised and immunocompete...
--PARENT--> [?] Skin disorders associated with Human immunodeficiency virus infection
Def: The skin manifestations of human immunodeficiency virus infection are manifold and are frequently the presenting sign of initial infection or of advanced disease. Other retroviruses, especially HTLV-1...
--- Walk 5 ---
[DA01.10] Oral aphthae or aphtha-like ulceration
Def: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencem...
--RELATED_TO--> [?] Oropharyngeal ulceration due to Behçet disease
--PARENT--> [?] Mucocutaneous Behçet disease
--- Walk 6 ---
[DA01.10] Oral aphthae or aphtha-like ulceration
Def: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencem...
--RELATED_TO--> [?] Oropharyngeal ulceration due to Behçet disease
--PARENT--> [?] Mucocutaneous Behçet disease
|
[
"[MD11.8Z] Mouth breathing, unspecified\n --PARENT--> [MD11.8] Mouth breathing\n Def: Breathing through mouth. Nasal obstruction may also necessitate mouth breathing, which itself can precipitate obstructive apnoea. Breathing through the mouth may also increase risk for OSA by its effe...\n --CHILD--> [MD11.80] Stertor\n Def: Stertor is a heavy snoring or gasping sound on inspiration occurring in coma or deep sleep that may be caused by partial obstruction of airway, choanal stenosis, enlarged tonsils and/or adenoids, and ...",
"[MD11.8Z] Mouth breathing, unspecified\n --PARENT--> [MD11.8] Mouth breathing\n Def: Breathing through mouth. Nasal obstruction may also necessitate mouth breathing, which itself can precipitate obstructive apnoea. Breathing through the mouth may also increase risk for OSA by its effe...\n --CHILD--> [MD11.80] Stertor\n Def: Stertor is a heavy snoring or gasping sound on inspiration occurring in coma or deep sleep that may be caused by partial obstruction of airway, choanal stenosis, enlarged tonsils and/or adenoids, and ...",
"[DA01.00] Oral leukoplakia\n Def: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or m...\n --EXCLUDES--> [?] Hairy leukoplakia\n Def: Oral hairy leukoplakia is a focal epithelial hyperplasia of the oral mucosa associated with Epstein-Barr virus. It is closely associated with HIV and occurs in both immunocompromised and immunocompete...\n --CHILD--> [?] Hairy leukoplakia of tongue",
"[DA01.00] Oral leukoplakia\n Def: Leukoplakia is a condition where areas of keratosis appear as adherent white patches on the mucous membranes of the oral cavity. Leukoplakia may affect other gastrointestinal tract mucosal sites, or m...\n --EXCLUDES--> [?] Hairy leukoplakia\n Def: Oral hairy leukoplakia is a focal epithelial hyperplasia of the oral mucosa associated with Epstein-Barr virus. It is closely associated with HIV and occurs in both immunocompromised and immunocompete...\n --PARENT--> [?] Skin disorders associated with Human immunodeficiency virus infection\n Def: The skin manifestations of human immunodeficiency virus infection are manifold and are frequently the presenting sign of initial infection or of advanced disease. Other retroviruses, especially HTLV-1...",
"[DA01.10] Oral aphthae or aphtha-like ulceration\n Def: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencem...\n --RELATED_TO--> [?] Oropharyngeal ulceration due to Behçet disease\n --PARENT--> [?] Mucocutaneous Behçet disease",
"[DA01.10] Oral aphthae or aphtha-like ulceration\n Def: This is a frequent small, shallow, painful ulceration in the oral mucosa. Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencem...\n --RELATED_TO--> [?] Oropharyngeal ulceration due to Behçet disease\n --PARENT--> [?] Mucocutaneous Behçet disease"
] |
MD11.8Z
|
Mouth breathing, unspecified
|
[
{
"from_icd11": "MD11.8Z",
"icd10_code": "R065",
"icd10_title": "Mouth breathing"
},
{
"from_icd11": "DA01.00",
"icd10_code": "K1329",
"icd10_title": "Other disturbances of oral epithelium, including tongue"
},
{
"from_icd11": "DA01.00",
"icd10_code": "K1321",
"icd10_title": "Leukoplakia of oral mucosa, including tongue"
},
{
"from_icd11": "DA01.00",
"icd10_code": "K132",
"icd10_title": "Leukoplakia and other disturbances of oral epithelium, including tongue"
},
{
"from_icd11": "DA01.10",
"icd10_code": "K120",
"icd10_title": "Recurrent oral aphthae"
},
{
"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"
}
] |
R065
|
Mouth breathing
|
Wandering spleen is a rare clinical entity characterized by splenic hypermobility from its left hypochondriac position to any other abdominal or pelvic position caused by absent or abnormal laxity of the suspensory ligaments . The first case of wandering spleen was reported by Von Horne in 1667. So far less than 600 cases are reported world wide . Anatomically a normal spleen is found in the left hypochondriac region suspended by ligaments to the stomach, kidney, pancreas, colon and left hemi-diaphram by the gastrosplenic, splenorenal, pancreaticosplenic, splenocolic, splenophreni ligaments and presplenic folds . Our patient presented with RLQ palpable abdominal mass which is against the commonest presentation being in the LLQ of the abdomen . It could result from either a developmental failure of the embryonic septum transversum to fuse properly with the posterior abdominal wall which results in absent/lax ligaments or from acquired conditions that result in lax suspensory ligaments as in pregnancy or connective tissue disorders . The spleen is found in any quadrant of the abdomen or the pelvis though mostly in the left quadrants attached only by a long and loose vascular pedicle. Our patient presented with RLQ mass. It is mostly seen in multiparous women though the incidence is found to be nearly equal in both sexes in the prepubertal age group . Our patient was a Para 1 mother and presented with 01 year history of abdominal pain which got worse in the past 06 months. Otherwise she had no any other pressure symptoms. She had visible umbilical area mass which was mobile up on examination Wandering spleen can have different presentation ranging from asymptomatic incidental finding on imaging or upon surgical exploration for other surgical conditions to a presentation that mimics acute abdomen . Mostly it presents as an on and of type acute/ subacute non-specific abdominal pain due to torsion and spontaneous de-torsion of the loose splenic pedicle . This chronic torsion results in congestion and splenomegaly . Hence patients could have palpable mobile mass which is the typical presentation of this patient. The other presentations are usually related to the mass effect of the enlarged spleen and patients could present with GOO, bowel obstruction, pancreatitis and urinary symptoms . In some cases it is reported to be associated with some other disorders like gastric volvulus and distal pancreatic volvulus . Ultrasound is one of the imaging modalities to investigate patients whom we suspect had wandering spleen. It usually shows absent spleen in the splenic fossa and a comma shaped spleen in the abdomen or pelvis . Doppler study might help us see the vascular condition and ads up to a better preoperative plan. CT scan shows absence of the spleen in the left upper quadrant, ovoid or comma-shaped abdominal mass, enlarged spleen, a whirled appearance of non-enhancing splenic vessels and signs of splenic hypo-perfusion: homogenous or heterogeneous decreased enhancement depending on the degree of infarction . Our patient was scanned with US and showed 13*8 cm large midline abdomino-pelvic well defined oval mass which was predominantly solid with areas of cystic component with absent color Doppler flow. Otherwise the spleen was not visualized in the splenic fossa. Bilateral kidney and liver has multiple different sized cystic lesions. With this image Abdomino-pelvic CT was done and shows spleen is located in the lower abdomen and appears to have torsed vascular pedicle and the whole splenic parenchyma is hypodense and no enhancement seen. Majority of the renal parenchyma is almost replaced with different sized cystic lesions with imperceptible wall causing bilateral renal enlargement. The whole liver is filled with cystic lesions with imperceptible wall. The portal veins were not visualized and replaced by periportal enlarged collateral vessels . Usually surgical management is the rule once a patient is diagnosed with wandering spleen . Most patients; 65% as reported in some studies will have torsion of the vascular pedicle at some point of their life . Hence splenopexy or splenectomy shall be considered when a wandering spleen is found incidentally up on surgical exploration for some other purposes . Complicated wandering spleen like infarcted, signs of hypersplenism, huge in size and splenic vein thrombosis needs splenectomy while others can be managed with splenopexy . Nowadays though laparoscopic technique is the gold standard, open technique can be used for splenopexy and splenectomy . Partial infraction of a wandering spleen might necessitate partial splenectomy and splenopexy or splenectomy and splenic implantation . The spleen might get fixed by different methods . Simple splenic fixation involves simple tacking the splenic capsule to the peritoneum Retroperitoneal pouch splenopexy- Tissue /Mesh splenopexy (sandwich technique) . Omental and peritoneal pouch splenic fixation . In our case, Spleen was absent from the normal anatomic splenic fossa and the spleen in the abdomino-pelvic area looks infarcted. Hence she was managed with splenectomy and the patient was extubated on table and having a stable postoperative course . Fig. 6 Absent spleen in the splenic fossa Fig. 7 Spleen seen in the abdomino-pelvic cavity
| 4.253906
| 0.803711
|
sec[2]/p[0]
|
en
| 0.999998
|
38790071
|
https://doi.org/10.1186/s13256-024-04580-6
|
[
"spleen",
"splenic",
"wandering",
"abdominal",
"absent",
"which",
"splenopexy",
"splenectomy",
"pelvic",
"ligaments"
] |
[
{
"code": "3B8Z",
"title": "Diseases of spleen, unspecified"
},
{
"code": "LA8Z",
"title": "Structural developmental anomaly of heart or great vessels, unspecified"
},
{
"code": "3B81.Y",
"title": "Other specified acquired disorders of spleen"
},
{
"code": "LB22.Y",
"title": "Other specified structural developmental anomalies of spleen"
},
{
"code": "3B81.2",
"title": "Atrophy of spleen"
},
{
"code": "GB90.0",
"title": "Nephroptosis"
},
{
"code": "1F67",
"title": "Gnathostomiasis"
},
{
"code": "LB22.2",
"title": "Ectopic spleen"
},
{
"code": "BC9Y",
"title": "Other specified cardiac arrhythmia"
},
{
"code": "6D86.6",
"title": "Wandering in dementia"
}
] |
=== ICD-11 CODES FOUND ===
[3B8Z] Diseases of spleen, unspecified
Also known as: Diseases of spleen, unspecified | splenic disease | splenopathy
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease
[3B81.Y] Other specified acquired disorders of spleen
Also known as: Other specified acquired disorders of spleen | Peliosis of spleen | Congestion of spleen | splenic congestion | Lymphoid hyperplasia of spleen
[LB22.Y] Other specified structural developmental anomalies of spleen
Also known as: Other specified structural developmental anomalies of spleen | Congenital malformation of spleen | malformations of spleen NOS | Aberrant spleen | Congenital lobulation of spleen
[3B81.2] Atrophy of spleen
Definition: A disease caused by determinants arising after birth, during the antenatal period or by genetically inherited factors. This disease is characterised by partial or complete degradation of the spleen. This disease may present with increased susceptibility to infection. Confirmation is through medical imaging.
Also known as: Atrophy of spleen | hyposplenism | splenic atrophy | Hyposplenism due to previous infarction of spleen | Degenerative diseases of the spleen
[GB90.0] Nephroptosis
Definition: Enhanced mobility of the kidney, resulting in ptosis when the patient is upright. More common on the right, associated with a longer renal artery, and debatably associated with fibromuscular hyperplasia and hypertension.
Also known as: Nephroptosis | floating kidney | mobile kidney | wandering kidney
[1F67] Gnathostomiasis
Definition: A disease caused by an infection with the parasitic worm Gnathostoma. This disease is characterised by painful, itchy swelling under the skin from movement of the parasite under the skin. This disease may also initially present with fever, lethargy, abdominal pain, vomiting, or diarrhoea, and may infect other parts of the body (lungs, bladder, eyes, ears, nervous system). Transmission is commonly by ingestion of undercooked contaminated freshwater fish, eels, frogs, birds, or reptiles, or ingest
Also known as: Gnathostomiasis | Gnathostomosis | Wandering swelling | Gnathostomiasis due to Gnathostoma spinigerum | Gnathostoma spinigerum infestation
Includes: Wandering swelling
[LB22.2] Ectopic spleen
Also known as: Ectopic spleen | Congenital malposition of spleen | Congenital spleen displacement | Wandering spleen | Lien mobilis
[BC9Y] Other specified cardiac arrhythmia
Also known as: Other specified cardiac arrhythmia | Ectopic arrhythmia | ectopic cardiac arrhythmia | ectopic atrial pacemaker | ectopic rhythm NOS
[6D86.6] Wandering in dementia
Definition: In addition to the cognitive disturbances characteristic of dementia, the current clinical picture includes clinically significant wandering that puts the person at risk of harm.
Also known as: Wandering in dementia
=== GRAPH WALKS ===
--- Walk 1 ---
[3B8Z] Diseases of spleen, unspecified
--PARENT--> [?] Diseases of spleen
--CHILD--> [3B8Z] Diseases of spleen, unspecified
--- Walk 2 ---
[3B8Z] Diseases of spleen, unspecified
--PARENT--> [?] Diseases of spleen
--CHILD--> [3B8Z] Diseases of spleen, unspecified
--- Walk 3 ---
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--RELATED_TO--> [?] Congenital great vessel related acquired abnormality
Def: Any postnatal pathological change in form or function of the heart and/or great vessels consequent to the presence of congenital cardiovascular disease....
--- Walk 4 ---
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--RELATED_TO--> [?] Congenital great vessel related acquired abnormality
Def: Any postnatal pathological change in form or function of the heart and/or great vessels consequent to the presence of congenital cardiovascular disease....
--- Walk 5 ---
[3B81.Y] Other specified acquired disorders of spleen
--PARENT--> [3B81] Acquired disorders of spleen
Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....
--CHILD--> [3B81.0] Tumour-like conditions of spleen
Def: Any condition caused by determinants acquired after birth, in the antenatal period or genetically inherited factors, leading to tumour-like conditions of the spleen. Confirmation is through medical im...
--- Walk 6 ---
[3B81.Y] Other specified acquired disorders of spleen
--PARENT--> [3B81] Acquired disorders of spleen
Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....
--RELATED_TO--> [?] Malignant neoplasms of the spleen
|
[
"[3B8Z] Diseases of spleen, unspecified\n --PARENT--> [?] Diseases of spleen\n --CHILD--> [3B8Z] Diseases of spleen, unspecified",
"[3B8Z] Diseases of spleen, unspecified\n --PARENT--> [?] Diseases of spleen\n --CHILD--> [3B8Z] Diseases of spleen, unspecified",
"[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --RELATED_TO--> [?] Congenital great vessel related acquired abnormality\n Def: Any postnatal pathological change in form or function of the heart and/or great vessels consequent to the presence of congenital cardiovascular disease....",
"[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....\n --RELATED_TO--> [?] Congenital great vessel related acquired abnormality\n Def: Any postnatal pathological change in form or function of the heart and/or great vessels consequent to the presence of congenital cardiovascular disease....",
"[3B81.Y] Other specified acquired disorders of spleen\n --PARENT--> [3B81] Acquired disorders of spleen\n Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....\n --CHILD--> [3B81.0] Tumour-like conditions of spleen\n Def: Any condition caused by determinants acquired after birth, in the antenatal period or genetically inherited factors, leading to tumour-like conditions of the spleen. Confirmation is through medical im...",
"[3B81.Y] Other specified acquired disorders of spleen\n --PARENT--> [3B81] Acquired disorders of spleen\n Def: Any condition caused by determinants acquired after birth, leading to dysfunction of the spleen....\n --RELATED_TO--> [?] Malignant neoplasms of the spleen"
] |
3B8Z
|
Diseases of spleen, unspecified
|
[
{
"from_icd11": "3B8Z",
"icd10_code": "D7389",
"icd10_title": "Other diseases of spleen"
},
{
"from_icd11": "3B8Z",
"icd10_code": "D7381",
"icd10_title": "Neutropenic splenomegaly"
},
{
"from_icd11": "3B8Z",
"icd10_code": "D739",
"icd10_title": "Disease of spleen, unspecified"
},
{
"from_icd11": "3B8Z",
"icd10_code": "D73",
"icd10_title": "Diseases of spleen"
},
{
"from_icd11": "3B8Z",
"icd10_code": "D738",
"icd10_title": "Other diseases of spleen"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q248",
"icd10_title": "Other specified congenital malformations of heart"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q893",
"icd10_title": "Situs inversus"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q212",
"icd10_title": "Atrioventricular septal defect"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q249",
"icd10_title": "Congenital malformation of heart, unspecified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q246",
"icd10_title": "Congenital heart block"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q242",
"icd10_title": "Cor triatriatum"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q219",
"icd10_title": "Congenital malformation of cardiac septum, unspecified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q208",
"icd10_title": "Other congenital malformations of cardiac chambers and connections"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q897",
"icd10_title": "Multiple congenital malformations, not elsewhere classified"
},
{
"from_icd11": "LA8Z",
"icd10_code": "Q209",
"icd10_title": "Congenital malformation of cardiac chambers and connections, unspecified"
}
] |
D7389
|
Other diseases of spleen
|
A 31-year-old lady presented to the antenatal clinic at 34 weeks of gestation with increasing shortness of breath. She was a known case of rheumatic heart disease with mitral stenosis and had undergone balloon mitral valvotomy 12 years ago and closed mitral commissurotomy 7 years ago. She was gravida 8, para 2 with 5 spontaneous abortions and had undergone caesarean section twice since the commissurotomy but had only one living issue who was 3 years old. The other had died a neonatal death. She was on oral Digoxin 0.25 mg od and penicillin prophylaxis since the past seven years. During the present pregnancy, her dyspnea had progressed from NYHA class II to class III. She was put on bed rest and started on diuretics. As part of her workup for elective caesarean section for obstetric reasons, she presented for preanaesthesia evaluation. On auscultation of the heart, she had a mid-diastolic murmur in the mitral area and loud P2. She had no signs of congestive cardiac failure. Her electrocardiogram showed a normal sinus rhythm with a heart rate of 80/min. She had a normal coagulation profile with prothrombin time 13/13, activated partial thromboplastin time 29/31, and platelet count 210 × 10 9 /litre. Her haemoglobin was 11.7 g%. She was advised a fresh echocardiograph and the risk of anaesthesia was explained to her. The next day she presented for emergency CS with onset of preterm labour and a nonreassuring fetal heart rate. She was immediately taken to the operating room. On examination, the patient was dyspneic at rest and unable to lie supine. She had pedal edema and her jugular venous pulse was raised. A 2D echocardiography done only that morning revealed critical mitral stenosis with mitral valve area of 0.7 cm 2 , severe tricuspid regurgitation, mild aortic regurgitation, and pulmonary artery hypertension. Her ejection fraction was 60%. She was propped up with 2 pillows and given O 2 by face mask at 12 L/min. An intravenous access was secured with an 18G cannula, Ringer lactate was started, and a defibrillator was kept ready. ECG, NIBP, and SpO 2 monitors were attached. Her pulse was irregularly irregular and the ECG showed atrial fibrillation with a ventricular rate of 142/min. Her blood pressure (BP) was 106/60 mmHg. Her respiratory rate was 32/min but her chest was clear and saturation was 100% with oxygen therapy. A 20G arterial cannula was inserted in the radial artery for invasive blood pressure monitoring. The arterial blood gas analysis showed pH 7.5, PO 2 98 mmHg, PCO 2 30 mmHg, HCO 3 20 mmol/L, Na + 134 mmol/L, and K + 3.8 mmol/L. Combined spinal epidural (CSE) anesthesia was planned for the surgery. An 18G CSE was inserted in the first attempt at L3/4 intervertebral space using loss of resistance to air in the sitting position. In the subarachnoid block, 6 mg (1.2 mL) of 0.5% Bupivacaine with 25 μ g fentanyl was injected through a 27G needle after CSF aspiration. The epidural catheter was inserted 5 cm into the epidural space and fixed. The patient was made to lie over 2 pillows as she could not tolerate a supine position. A wedge was also placed below her right hip to allow left uterine displacement to prevent aortocaval compression. Her BP dropped to 72/50 mmHg which increased to 92/54 mmHg with 6 mg ephedrine. The sensory level achieved was T10 and epidural top up of 3 mL of 2% Xylocaine with adrenaline was given in aliquots of 1 mL to achieve a level of T6 when the surgery commenced. She required one more dose of 6 mg Ephedrine to maintain her systolic BP above 90 mmHg. Her ventricular rate rose to 172/min during this period. The baby was delivered within 5 minutes of abdominal incision. The 2.2 kg male baby had aspirated thick meconium and required endotracheal intubation, tracheobronchial suctioning, and mechanical ventilation. After delivery of the baby, 10 units of oxytocin was added to the mother's drip. Her BP was 92/60 mmHg and keeping all preparations ready for emergency cardioversion, she was given 15 mg of Diltiazem injection in 5 mg boluses to obtain a ventricular rate of 90/min. Her ECG reverted to sinus rhythm. Her systolic BP rose to 110 mmHg and she did not require any further vasopressors. A peripherally inserted central venous catheter was inserted to measure the central venous pressure. The rest of the surgery was uneventful. She received 500 mL of RL including 10 units of oxytocin and her urine output was 50 mL. She was shifted to the ICU for postoperative observation and monitoring. In the ICU, she received oxygen therapy, diuretics, epidural analgesia, and intravenous fluids guided by central venous pressure. Invasive BP monitoring was continued for 24 hours. An infusion of amiodarone was used to maintain sinus rhythm and rate. Postoperatively, continuous hemodynamic monitoring was done with invasive monitors, intra-arterial blood pressure, and central venous pressure monitoring. She remained hemodynamically stable and had no episode of tachyarrhythmia, pulmonary edema, or thromboembolism during her stay. The next day, she was started on oral diltiazem and subcutaneous low molecular weight heparin and shifted to the ward on the postoperative day 2 from where she was discharged 7 days later. The neonate developed meconium aspiration pneumonia and died on day 3 of life.
| 3.75
| 0.981934
|
sec[0]/p[0]
|
en
| 0.999997
|
23781350
|
https://doi.org/10.1155/2013/807624
|
[
"mmhg",
"mitral",
"pressure",
"venous",
"monitoring",
"epidural",
"heart",
"blood",
"rest",
"sinus"
] |
[
{
"code": "BB60.Z",
"title": "Mitral valve stenosis, unspecified"
},
{
"code": "LA89.2",
"title": "Mitral atresia"
},
{
"code": "BB6Z",
"title": "Mitral valve disease, unspecified"
},
{
"code": "LA87.11",
"title": "Congenital mitral valvar stenosis"
},
{
"code": "LA87.10",
"title": "Congenital mitral regurgitation"
},
{
"code": "EH90.Z",
"title": "Pressure ulcer of unspecified grade"
},
{
"code": "MB23.L",
"title": "Pressured speech"
},
{
"code": "MD30.Z",
"title": "Chest pain, unspecified"
},
{
"code": "CB22.Y",
"title": "Other specified diseases of mediastinum, not elsewhere classified"
},
{
"code": "BA2Z",
"title": "Hypotension, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[BB60.Z] Mitral valve stenosis, unspecified
Also known as: Mitral valve stenosis, unspecified | Mitral valve stenosis | MS - [mitral stenosis] | mitral stenosis | mitral valvular stricture
[LA89.2] Mitral atresia
Definition: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve.
Also known as: Mitral atresia | Mitral atresia with absent atrioventricular connection | absent left atrioventricular connection or junction | absent left atrioventricular connection in laevocardia | mitral atresia with absent valvar annulus
[BB6Z] Mitral valve disease, unspecified
Also known as: Mitral valve disease, unspecified | noninfective endocarditis of mitral valve | rheumatic heart disease of mitral valve, unspecified | mitral valvulopathy | mitral valve cardiopathy
[LA87.11] Congenital mitral valvar stenosis
Definition: A congenital cardiovascular malformation of the mitral valve in which there is narrowing or stricture of the valvar orifice (obstruction to flow).
Also known as: Congenital mitral valvar stenosis | Duroziez disease | congenital mitral stenosis | congenital stenosis of mitral valve | congenital mitral valve stricture
[LA87.10] Congenital mitral regurgitation
Definition: A congenital cardiovascular finding in which there is backward flow through the mitral valve.
Also known as: Congenital mitral regurgitation | congenital insufficiency of mitral valve | congenital mitral insufficiency | congenital mitral valve incompetence | congenital mitral valve insufficiency
[EH90.Z] Pressure ulcer of unspecified grade
Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer
[MB23.L] Pressured speech
Definition: Speech in which the person feels undue pressure to get the words out. The person’s speech is usually rapid, loud, and emphatic and may be difficult or impossible to interrupt. Frequently, the person talks without any social stimulation and may continue to talk even though no one is listening.
Also known as: Pressured speech
Excludes: Schizophrenia or other primary psychotic disorders | Bipolar or related disorders
[MD30.Z] Chest pain, unspecified
Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure
[CB22.Y] Other specified diseases of mediastinum, not elsewhere classified
Also known as: Other specified diseases of mediastinum, not elsewhere classified | Hernia of mediastinum | mediastinal hernia | mediastinal herniation | Infectious mediastinitis
[BA2Z] Hypotension, unspecified
Also known as: Hypotension, unspecified | hypopiesis | low blood pressure | arterial hypotension NOS | decreased blood pressure
=== GRAPH WALKS ===
--- Walk 1 ---
[BB60.Z] Mitral valve stenosis, unspecified
--PARENT--> [BB60] Mitral valve stenosis
--RELATED_TO--> [?] Postprocedural mitral valve stenosis
--- Walk 2 ---
[BB60.Z] Mitral valve stenosis, unspecified
--PARENT--> [BB60] Mitral valve stenosis
--EXCLUDES--> [?] Mitral valve stenosis with insufficiency
Def: This is a valvular heart disease characterised by the narrowing of the orifice of the mitral valve of the heart, with regurgitation....
--- Walk 3 ---
[LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--PARENT--> [LA89] Functionally univentricular heart
Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--- Walk 4 ---
[LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--PARENT--> [LA89] Functionally univentricular heart
Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...
--CHILD--> [LA89.2] Mitral atresia
Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....
--- Walk 5 ---
[BB6Z] Mitral valve disease, unspecified
--PARENT--> [?] Mitral valve disease
Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...
--EXCLUDES--> [?] Congenital anomaly of mitral valve
Def: A congenital cardiac malformation in which there is an abnormality of the mitral valve....
--- Walk 6 ---
[BB6Z] Mitral valve disease, unspecified
--PARENT--> [?] Mitral valve disease
Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...
--RELATED_TO--> [?] Injury to mitral valve
|
[
"[BB60.Z] Mitral valve stenosis, unspecified\n --PARENT--> [BB60] Mitral valve stenosis\n --RELATED_TO--> [?] Postprocedural mitral valve stenosis",
"[BB60.Z] Mitral valve stenosis, unspecified\n --PARENT--> [BB60] Mitral valve stenosis\n --EXCLUDES--> [?] Mitral valve stenosis with insufficiency\n Def: This is a valvular heart disease characterised by the narrowing of the orifice of the mitral valve of the heart, with regurgitation....",
"[LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....",
"[LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --CHILD--> [LA89.2] Mitral atresia\n Def: A congenital cardiovascular malformation with absence of the mitral valvar annulus (connection/junction) or an imperforate mitral valve....",
"[BB6Z] Mitral valve disease, unspecified\n --PARENT--> [?] Mitral valve disease\n Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...\n --EXCLUDES--> [?] Congenital anomaly of mitral valve\n Def: A congenital cardiac malformation in which there is an abnormality of the mitral valve....",
"[BB6Z] Mitral valve disease, unspecified\n --PARENT--> [?] Mitral valve disease\n Def: This is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. It is the abnormal leaking of blood from the left ventricle through the mitral valve i...\n --RELATED_TO--> [?] Injury to mitral valve"
] |
BB60.Z
|
Mitral valve stenosis, unspecified
|
[
{
"from_icd11": "BB60.Z",
"icd10_code": "I050",
"icd10_title": "Rheumatic mitral stenosis"
},
{
"from_icd11": "BB60.Z",
"icd10_code": "I342",
"icd10_title": "Nonrheumatic mitral (valve) stenosis"
},
{
"from_icd11": "LA89.2",
"icd10_code": "Q232",
"icd10_title": "Congenital mitral stenosis"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I059",
"icd10_title": "Rheumatic mitral valve disease, unspecified"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I058",
"icd10_title": "Other rheumatic mitral valve diseases"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I348",
"icd10_title": "Other nonrheumatic mitral valve disorders"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I349",
"icd10_title": "Nonrheumatic mitral valve disorder, unspecified"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I05-I09",
"icd10_title": ""
},
{
"from_icd11": "BB6Z",
"icd10_code": "I05",
"icd10_title": "Rheumatic mitral valve diseases"
},
{
"from_icd11": "BB6Z",
"icd10_code": "I390",
"icd10_title": ""
},
{
"from_icd11": "BB6Z",
"icd10_code": "I34",
"icd10_title": "Nonrheumatic mitral valve disorders"
},
{
"from_icd11": "LA87.10",
"icd10_code": "Q233",
"icd10_title": "Congenital mitral insufficiency"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89623",
"icd10_title": "Pressure ulcer of left heel, stage 3"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89621",
"icd10_title": "Pressure ulcer of left heel, stage 1"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89899",
"icd10_title": "Pressure ulcer of other site, unspecified stage"
}
] |
I050
|
Rheumatic mitral stenosis
|
On day 9, the dog visited Department of Pituitary Surgery, Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University for the preparation of pituitary surgery to treat PDH. The dog’s complete blood count (CBC) on day 9 showed no obvious stress steroid pattern or abnormal values (Table 1 ). In contrast, the biochemical blood test showed elevated levels of ALP , lipase (221 U/L), and triglycerides (229 mg/dL) (Table 2 ). Blood endocrinology testing revealed endogenous ACTH (30.1 pg/dL) levels within the reference range, but high ACTH (564 pg/dL) levels post-stimulation with CRH (Table 3 ) . On day 10, the dog showed a sudden loss of energy and appetite, frequent bloody diarrhea and vomiting, and a decreased level of consciousness. As no improvement was observed on day 11, the dog was referred back to the referral hospital and treated with maropitant (Selenia Injection, Zoetis Inc., 1 mg/kg, sc) for gastrointestinal signs. The dog was also treated with bismuth subnitrate (Diabuster, Kyoritsu Seiyaku Corporation, 200 mg/head, po, bid) and cimetidine (Sawai Pharmaceutical Co., Ltd., 8.3 mg/kg, po, bid) on days 12–15. Table 1 Results of the complete blood count performed at Department of Pituitary Surgery, Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University Unit Day 9 (First visit) Day 16 Day 51 (Pre-TSS) Day 58 (Post-TSS 6 days) Day 64 (Post-TSS 12 days) Day 104 (Post-TSS 52 days) Day 240 (Post-TSS 188 days) Reference range RBC × 10 6 /μl 7.45 8.37 7.39 6.11 5.81 6.58 6.26 5.5–8.5 PCV % 52.3 58.2 51.3 47 42.2 47.5 45.9 37–55 Hb g/dl 17.3 19.3 17.6 14.8 14.7 15.7 15.4 12–18 MCV fl 70.2 69.5 69.4 71.0 72.6 72.2 73.3 60–77 MCHC g/dl 33.1 33.2 34.3 34.1 34.8 33.1 33.6 32–36 WBC /μl 9700 10,700 8900 11,100 14,600 14,600 11,000 6000–17,000 Band /μl 0 0 0 – – 0 0 0–300 Seg /μl 7663 9016 7788 – – 9928 9790 3000–11,500 Lym /μl 1358 893 534 – – 1606 660 1000–4800 Mon /μl 485 362 267 – – 2190 495 150–1350 Eos /μl 97 429 312 – – 876 55 100–1250 Bas /μl 97 0 0 – – 0 0 rare PLT ×10 4 /μl 23.4 27.6 34.9 33.3 19.6 a 51.4 41.0 20–50 TSS Trans-sphenoidal surgery, RBC Red blood cell, PCV Packed cell volume, Hb Hemoglobin, MCV Mean corpuscular volume, MCHC Mean corpuscular hemoglobin concentration, WBC White blood cell, Band Band neutrophil, Seg Segmented neutrophil, Lym Lymphocyte, Mon Monocyte, Eos Acidophilic leukocyte, Bas Basophilic cell, PLT Platelets a We confirmed the distribution of platelets as aggregated and the presence of sufficient numbers of platelets in the blood on the glass slide Table 2 Results of the biochemical blood test performed at Department of Pituitary Surgery, Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University Unit Day 9 (First visit) Day 16 Day 51 (Pre-TSS) Day 58 (Post-TSS 6 days) Day 64 (Post-TSS 12 days) Day 240 (Post-TSS 188 days) Reference range LDH U/L 63 68 104 58 85 121 20–119 AST U/L 17 18 21 12 38 27 14–44 ALT U/L 31 32 40 77 111 82 14–68 ALP U/L 4278 1633 3307 3261 3785 7499 47–254 GGT U/L 5 6 5 23 17 19 2–15 T-BIL mg/dL 0.1 0.1 0.1 0.1 0.1 0.1 0–0.2 D-BIL mg/dL 0 0 0 0 0 0.1 0–0.1 TBA μmol/L 0.8 0.9 9.6 4.3 48.0 7.2 0.1–20.0 TP g/dL 6.9 5.9 6.8 6.4 5.8 6.7 4.9–7.2 ALB g/dL 3.5 2.9 3.6 3.3 3.1 3.5 2.0–3.2 CK U/L 72 72 73 38 91 102 47–168 AMY U/L 700 722 717 476 534 664 248–2284 LIP U/L 221 386 233 401 488 599 16–160 BUN mg/dL 14.4 14.7 18.9 48.7 34.2 15.7 9.2–29.2 CRE mg/dL 0.67 0.74 0.68 0.94 0.49 0.66 0.40–1.45 Ca mg/dL 10.4 10.2 10.7 11.1 10.0 10.9 9.1–12.3 IP mg/dL 2.7 2.7 3.3 6.5 4.5 3.2 1.9–5.0 GLU mg/dL 111 154 99 83 102 115 75–128 TG mg/dL 229 129 303 337 1272 164 17–113 T-CHO mg/dL 261 165 258 219 235 254 105–322 Na mEq/L 146 142 146 147 144 143 141–152 K mEq/L 4.1 4.2 4.8 4.2 3.8 4.2 3.8–5.1 Cl mEq/L 109 109 108 99 103 98 102–117 CRP mg/dL 0.18 0.97 0.15 0.81 0.27 0.13 0–1.00 TSS Trans sphenoidal surgery, LDH Lactate dehydrogenase, AST Aspartate aminotransferase, ALT Alanine aminotransferase, ALP Alkaline phosphatase, GGT γ- glutamyltransferase, T-BIL Total bilirubin, D-BIL Direct bilirubin, TBA Total bile acid, TP Total protein, ALB Albumin, CK Creatine kinase, AMY Amylase, LIP Lipase, BUN Blood urea nitrogen, CRE Creatinine, Ca Calcium, IP Inorganic phosphorus, GLU Glucose, TG Triglyceride, T-CHO Total cholesterol, CRP C-reactive protein Table 3 Results of the blood endocrinology results performed at Department of Pituitary Surgery, Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University Unit Day 9 (First visit) Day 51 (Pre-TSS) Day 58 (Post-TSS 6 days) Day 64 (Post-TSS 12 days) Day 104 (Post-TSS 52 days) Day 240 (Post-TSS 188 days) Reference range CRH test Endogenous ACTH pg/dL 30.1 28.5 13.1 12.8 < 0.1 7.4 5.0–36.0 Post-stimulation ACTH pg/dL 564.0 – – – – – 1.9–153.4 a ACTH stimulation test Endogenous cortisol 1.23 – 0.78 0.10 < 0.1 < 0.1 1.0–7.8 Post-stimulation cortisol μg/dL – – – 7.65 – – 5.0–20.0 T4 μg/dL 1.95 – < 0.50 0.55 4.37 1.21 1.1–3.6 FT4 ng/dL 1.23 – < 0.30 0.43 4.02 0.77 0.50–3.00 TSH ng/dL 0.20 – 0.04 – < 0.03 0.06 0.08–0.32 TSS Trans-sphenoidal surgery, CRH Corticotropin-releasing hormone, ACTH Adrenocorticotropic hormone, T4 Thyroid hormone, FT4 Free thyroxine hormone, TSH Thyroid-stimulating hormone a Normal dog data obtained from Tanaka et al.
| 4.144531
| 0.822266
|
sec[1]/p[1]
|
en
| 0.999998
|
36369011
|
https://doi.org/10.1186/s12917-022-03502-2
|
[
"blood",
"veterinary",
"acth",
"pituitary",
"hormone",
"department",
"teaching",
"nippon",
"life",
"science"
] |
[
{
"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": "5A74.Y",
"title": "Other specified adrenocortical insufficiency"
},
{
"code": "5A70.1",
"title": "Ectopic ACTH syndrome"
},
{
"code": "5A70.Z",
"title": "Cushing syndrome, unspecified"
},
{
"code": "5A70.Y",
"title": "Other specified Cushing syndrome"
},
{
"code": "5A70.0",
"title": "Pituitary-dependent Cushing disease"
}
] |
=== ICD-11 CODES FOUND ===
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
[MA12.4] Finding of steroid agent in blood
Also known as: Finding of steroid agent in blood | steroid in blood
[MA12.2] Finding of hallucinogen in blood
Also known as: Finding of hallucinogen in blood | hallucinogen in blood
[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
[5A70.1] Ectopic ACTH syndrome
Also known as: Ectopic ACTH syndrome | Cushing syndrome secondary to ectopic ACTH-secretion | Ectopic Cushing syndrome | hypercortisolism due to nonpituitary tumour | ectopic ACTH - [adrenocorticotropic hormone] secretion
[5A70.Z] Cushing syndrome, unspecified
Also known as: Cushing syndrome, unspecified | Cushing syndrome | Hyperadrenocorticism | Hypercortisolism | Cushing syndrome NOS
[5A70.Y] Other specified Cushing syndrome
Also known as: Other specified Cushing syndrome | ACTH-dependent Cushing syndrome | ACTH-independent Cushing syndrome | ACTH-independent Cushing syndrome due to bilateral adrenocortical hyperplasia | ACTH-independent macronodular adrenal hyperplasia
[5A70.0] Pituitary-dependent Cushing disease
Definition: Pituitary-dependent Cushing disease is caused by a pituitary tumour, generally benign (adenoma) but rarely malignant (carcinoma), which secretes adrenocorticotropin (ACTH) autonomously, leading to hypercortisolism. The condition is associated with increased morbidity and mortality that can be mitigated by treatments that result in sustained endocrine remission. Transsphenoidal pituitary surgery (TSS) remains the mainstay of treatment for this disease but requires considerable neurosurgical exper
Also known as: Pituitary-dependent Cushing disease | Overproduction of pituitary ACTH | Pituitary-dependent hyperadrenocorticism | Corticotroph pituitary adenoma | ACTH- [adrenocorticotropic hormone] secreting pituitary adenoma
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Diseases of the immune system
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.0] Finding of opiate drug in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --PARENT--> [?] ICD-11 for Mortality and Morbidity Statistics",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Diseases of the immune system",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --PARENT--> [?] Clinical findings in blood, blood-forming organs, or the immune system",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.0] Finding of opiate drug in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
We presented a case of a pregnant woman presenting with a large right intraventricular Libman–Sacks endocarditis, in the context of APS, that was surgically removed. She delivered at 35 weeks of gestation and her pregnancy was complicated by preeclampsia and fetal growth restriction. This case raises several points of discussion. Firstly, our patient was in her sixth pregnancy and she had an obstetric history complicated by previous stillbirths and fetal growth restrictions, but the reasons for such complications have not been investigated before. There is actually no consensus about the possibility of offering a thrombophilia screening in the case of obstetric complications such as stillbirths, intrauterine demise, preeclampsia, and fetal growth restriction . However, our case supports the importance of this screening in order to prevent maternal life-threatening complications in subsequent pregnancies or later in life. The occurrence of Libman–Sacks endocarditis is infrequent and usually develops in the context of advanced malignancies and/or autoimmune diseases, such as APS. It is characterized by the deposition of sterile fibrinous and platelet aggregates that develop on the endocardial surface . Vegetations are mostly left-sided, with the mitral valve more frequently involved than the aortic valve . Isolated tricuspid valve Libman–Sacks endocarditis is quite rare , thus the surgical treatment of this condition is anecdotal, especially in the absence of concomitant significant valve impairment . This is likely because the Libman–Sacks vegetations are generally small (<0.5 cm) and therefore do not require surgical excision. Current therapeutic guidelines for APS do suggest long-term anticoagulation to prevent thromboembolic events, although high-quality evidence is limited . Since the treatment of right intracardiac mass is based on anecdotical experience , all therapeutic options were taken into account, including conservative therapy with anticoagulants, thrombolysis, or surgical excision. Adjusted-dose enoxaparin, administered twice a day for over 2 weeks, did not give appreciable results. A low-dose, slow infusion of tissue-type plasminogen activator appeared to be efficacious in pregnant women ; however, the stillbirth rate is about 20%. Indeed, though recombinant tissue plasminogen activator does not cross the placenta, it may induce bleeding complications, such as sub-placental bleeding. The risk evaluation of performing an early cardiac surgery compared to a delayed (at the end of pregnancy) approach needs to address both maternal and fetal perioperative risk and thromboembolic risk. The heterogeneity of clinical conditions leading to cardiac surgery during pregnancy limits the predictability of maternal and fetal outcomes during cardiopulmonary bypass . Risk factors for maternal mortality during cardiac surgery include the use of vasoactive drugs, age, type of surgery, reoperation, and maternal functional class . Risk factors for fetal mortality include maternal age >35 years, functional class, reoperation, emergency surgery, type of myocardial protection, and anoxic time . A recent review reported that the mortality rate after cardiac surgery during pregnancy is around 10% and 30% for the mother and the fetus, respectively . Therefore, it has been commonly suggested to postpone cardiac surgery after the delivery, when possible. On the other hand, in patients affected by nonbacterial thrombotic endocarditis, the occurrence of pulmonary emboli has been reported to be higher than 50% . In fact, unlike infective endocarditis, clinical manifestations of nonbacterial thrombotic endocarditis are deceitful and result more frequently in systemic emboli rather than valvular dysfunction. Finally, once agreed on the presumed high embolic risk, our multidisciplinary team considered the maternal and fetal perioperative mortality rates to be acceptable and decided to perform the surgical excision of the vegetation. Adverse pregnancy events are very frequent in women with APS, even if very recent published data says that 65% of high referral APS pregnancy cohorts resulted in term live delivery . The management of patients who are aPL carriers has not been standardized yet, but there is a general consensus that the patients who do not have thrombocytopenia, thromboembolic phenomena, or pregnancy morbidity should not be submitted to any treatment or should only take low doses of acetylsalicylic acid. In the presence of any one of the conditions above, various treatment regimens have been used (corticosteroids, dipyridamole, heparin, warfarin, cytotoxic drugs, plasmapheresis, high-dose human immunoglobulin) according to the severity and individuality of the case. In this case, due to the contraindication for the use of oral anticoagulants in a pregnant woman, we used heparin during pregnancy in association with aspirin and hydroxychloroquine. In conclusion, APS should be strongly suspected in any patient with echocardiographic evidence of valvular thickening or valve nodules and a history of pregnancy losses and/or thromboses. The indication and timing of the surgical intervention must be decided by a multidisciplinary team, cautiously addressing the risks and benefits of an early compared to a delayed approach.
| 4.300781
| 0.908691
|
sec[2]/p[0]
|
en
| 0.999998
|
36233742
|
https://doi.org/10.3390/jcm11195875
|
[
"pregnancy",
"fetal",
"maternal",
"endocarditis",
"risk",
"that",
"this",
"valve",
"cardiac",
"libman"
] |
[
{
"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": "LD9Z",
"title": "Developmental anomalies, unspecified"
},
{
"code": "KB20.Z",
"title": "Intrauterine hypoxia, unspecified"
},
{
"code": "3A50.4",
"title": "Hereditary persistence of fetal haemoglobin"
},
{
"code": "KB42",
"title": "Persistent pulmonary hypertension of the newborn"
},
{
"code": "LD2Z",
"title": "Multiple developmental anomalies or syndromes, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[LD9Z] Developmental anomalies, unspecified
Also known as: Developmental anomalies, unspecified | congenital malformations, deformations and chromosomal abnormalities | congenital malformation NOS | developmental abnormality NOS | fetal abnormality NOS
[KB20.Z] Intrauterine hypoxia, unspecified
Also known as: Intrauterine hypoxia, unspecified | Intrauterine hypoxia | fetal distress | fetal distress syndrome | intrauterine distress
[3A50.4] Hereditary persistence of fetal haemoglobin
Definition: Hereditary persistence of fetal haemoglobin (HPFH) associated with beta-thalassaemia is a haemoglobinopathy characterised by high haemoglobin (Hb)F levels and an increased number of fetal-Hb-containing cells. The association of HPFH with beta-thalassaemia mitigates the clinical manifestations which vary from a normal state to beta-thalassaemia intermedia.
Also known as: Hereditary persistence of fetal haemoglobin | HPFH - [Hereditary persistence of fetal haemoglobin] | fetal haemoglobin | persistence of fetal haemoglobin | persistent haemoglobin F
[KB42] Persistent pulmonary hypertension of the newborn
Definition: Persistent pulmonary hypertension of the newborn is a cardiopulmonary disorder characterised by systemic arterial hypoxemia secondary to pulmonary hypertension and extrapulmonary right-to-left shunting across the foramen ovale and ductus arteriosus.
Also known as: Persistent pulmonary hypertension of the newborn | persistent fetal circulation syndrome | fetal circulation | PFC - [persistent fetal circulation] syndrome | PPHN - [Persistent pulmonary hypertension of the newborn]
[LD2Z] Multiple developmental anomalies or syndromes, unspecified
Also known as: Multiple developmental anomalies or syndromes, unspecified | multiple congenital birth defects NOS | multiple congenital birth deformities NOS | multiple fetal abnormalities NOS | severe birth deformities NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[JA80.Z] Maternal care related to unspecified multiple gestation
--PARENT--> [JA80] Maternal care related to multiple gestation
--EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation
--- Walk 2 ---
[JA80.Z] Maternal care related to unspecified multiple gestation
--PARENT--> [JA80] Maternal care related to multiple gestation
--EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation
--- 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....
--CHILD--> [JA01.2] Ovarian pregnancy
Def: A condition characterised by implantation of the embryo within the ovary during 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--> [JA01.2] Ovarian pregnancy
Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....
--- Walk 5 ---
[QA40] Pregnancy examination or test
--PARENT--> [?] Contact with health services for reasons associated with reproduction
--CHILD--> [QA20] Contact with health services for concerns about pregnancy
--- 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 --EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation",
"[JA80.Z] Maternal care related to unspecified multiple gestation\n --PARENT--> [JA80] Maternal care related to multiple gestation\n --EXCLUDES--> [?] Maternal care related to complications specific to multiple gestation",
"[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--> [JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during 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--> [JA01.2] Ovarian pregnancy\n Def: A condition characterised by implantation of the embryo within the ovary during pregnancy....",
"[QA40] Pregnancy examination or test\n --PARENT--> [?] Contact with health services for reasons associated with reproduction\n --CHILD--> [QA20] Contact with health services for concerns about pregnancy",
"[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": "LD9Z",
"icd10_code": "Q898",
"icd10_title": "Other specified congenital malformations"
}
] |
O30
|
Multiple gestation
|
A 67-year-old European man was admitted to the Department of Urology in December 2019 with major complaints regarding recurrent hematuria, dysuria, pain, and enlargement of the left testicle, pain in the lumbar and sacral section of the spine, and hyperhidrosis. The patient also reported a recent loss of weight: around 3 kg down from 97 kg within the last month. A medical interview revealed occupational exposure to asbestos since the patient had been working in a factory producing asbestos seals for several years. His body mass index was 37.8 kg/m 2 , and body surface area was 2.09 m 2 . Physical examination revealed lower limb edema as well as painful and enlarged left testis of regular shape and firm consistency, without any palpable focal lesion. Owing to enlarged testis, ultrasonography imaging (USG) and blood tests were performed. USG revealed diffuse testis enlargement but did not reveal any focal malignancies originating from the testis. Results of the blood test showed an increased level of β-hCG (644.4 lU/l). The other tumor markers, that is, lactate dehydrogenase (LDH) α-fetoprotein (AFP), and prostate-specific antigen (PSA) remained within the normal range (230 U/ml, 1.58 U/ml, and 0.874 ng/ml, respectively). Surprisingly, the following magnetic resonance imaging (MRI) revealed a mass up to 62 mm in the posterior part of the prostatic gland, infiltrating seminal vesicles and anterior rectum wall together with bilaterally enlarged iliac lymph nodes. Additionally, computed tomography (CT) confirmed metastasis in pelvic lymph nodes. Cystoscopy was performed, and a biopsy specimen from tumor mass from prostate and bladder was taken. Histopathological examination of the specimens obtained in the cystoscopy revealed prostate and muscle of the bladder infiltration consisting of high-grade invasive urothelial carcinoma with trophoblastic differentiation and the presence of large syncytiotrophoblastic cells. Urothelial carcinoma cells were positive for cytokeratin 20 (CK20), GATA3, p63, and CKHMW but negative for PSA. Some of these large syncytiotrophoblastic cells inside the tumor showed positivity for β-hCG . Keeping in mind that urothelial cancer most often originates in the bladder, the patient was diagnosed with urothelial bladder cancer. However, reassessment of the radiographic imaging led to the conclusion that the tumor was predominantly located in the prostate, which suggested the prostate as the primary origin and established the diagnosis of urothelial prostate cancer with secondary bladder involvement. However, the treatment of urothelial cancer remains the same regardless of primary origin. As subsequent radiography imaging of the chest did not reveal any focal changes, the presence of metastasis in the chest was excluded. In March 2020, the patient started neoadjuvant chemotherapy with intravenous cisplatin 75 mg/m 2 on the first day and intravenous gemcitabine 1000 mg/m 2 on the 1st, 8th, and 15th repeating cycle every 4 weeks (cisplatin–gemcitabine protocol, PG). His symptoms improved significantly, and the β-hCG concentration decreased (205.2 mIU/ml) within the first 2 months of therapy. However, after two cycles, β-hCG level slightly increased (504.8 mIU/ml) and hyperhidrosis recurred. After four cycles, computed tomography (CT) revealed that local treatment could not be implemented owing to rectum infiltration. PG chemotherapy was continued up to six cycles. Four months later, after completion of PG chemotherapy, MRI showed disease progression. Pelvic tumor enlarged to 90 mm in diameter, and pelvic lymph nodes enlarged to maximum 21 mm in short-axis diameter . Simultaneously, β-hCG concentration increased to 9446 mIU/ml. In October 2020, palliative chemotherapy was implemented (paclitaxel 80 mg/m 2 once a week). After the fifth cycle of paclitaxel, the patient presented with polyneuropathy, so gabapentin was administered but withdrawn because of dizziness. However, the dizziness aggravated, so a CT scan of the brain was performed. It revealed small, diffuse metastases up to 8 mm in the pons. At that time, the β-hCG concentration reached the highest value of 31,163 mIU/ml. Palliative radiotherapy was planned, but owing to rapid deterioration of general condition (PS ¾), the patient did not manage to start the treatment. Eventually, the patient died in November 2020, 2 weeks after diagnosis of brain metastasis, because of disease progression. Fig. 1 Histopathological image of specimen from cystoscopy. A Gross picture of invasive high-grade urothelial carcinoma [hematoxylin and eosin staining (H&E); 10× magnification]. B Syncytiotrophoblastic cells in the urothelial carcinoma (H&E; 400× magnification). C Positive immunohistochemical (IHC) staining for cytokeratin 20 (CK20, DAKO) in nest of carcinoma cells (50× magnification). D Positive IHC reaction for β-human chorionic gonadotropin in large syncytiotrophoblastic cells inside the urothelial carcinoma (anti-β-hCG, DAKO, 100× magnification) Fig. 2 Imaging studies of patient’s urothelial tumor after progression on computed tomography (CT) ( A – C ) and magnetic resonance imaging (MRI) ( D ). A Longitudinal dimension of the tumor. B Short-axis diameter of pelvic lymph node. C Transverse dimension of tumor. D MRI of patient’s tumor in pelvis
| 4.144531
| 0.965332
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC9199117
|
https://doi.org/10.1186/s13256-022-03458-9
|
[
"urothelial",
"tumor",
"imaging",
"prostate",
"carcinoma",
"cells",
"enlarged",
"that",
"bladder",
"testis"
] |
[
{
"code": "2C94.2",
"title": "Urothelial carcinoma of bladder"
},
{
"code": "2C9Z",
"title": "Malignant neoplasms of urinary tract, unspecified"
},
{
"code": "2F35",
"title": "Benign neoplasm of urinary organs"
},
{
"code": "2C92.0",
"title": "Urothelial carcinoma of ureter"
},
{
"code": "2C91.0",
"title": "Urothelial carcinoma of renal pelvis"
},
{
"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 ===
[2C94.2] Urothelial carcinoma of bladder
Also known as: Urothelial carcinoma of bladder | TCC - [transitional cell carcinoma] of bladder | Non-papillary transitional cell carcinoma of the bladder
[2C9Z] Malignant neoplasms of urinary tract, unspecified
Also known as: Malignant neoplasms of urinary tract, unspecified | malignant neoplasm of unspecified urinary organ without mention of type | Transitional cell carcinoma of unspecified site | Urothelial cancer of unspecified site
[2F35] Benign neoplasm of urinary organs
Definition: A non-metastasizing neoplasm that arises from the organs that comprise the urinary system. Representative examples include renal oncocytoma, bladder inverted papilloma, and urothelial papilloma.
Also known as: Benign neoplasm of urinary organs | Benign neoplasm of kidney | renal benign neoplasm | benign renal tumour | benign tumour of kidney
[2C92.0] Urothelial carcinoma of ureter
Also known as: Urothelial carcinoma of ureter
[2C91.0] Urothelial carcinoma of renal pelvis
Also known as: Urothelial carcinoma of renal pelvis | Transitional cell carcinoma of renal pelvis
[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 ---
[2C94.2] Urothelial carcinoma of bladder
--PARENT--> [2C94] Malignant neoplasms of bladder
Def: A primary or metastatic malignant neoplasm involving the bladder....
--EXCLUDES--> [?] Malignant mesenchymal neoplasms
Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...
--- Walk 2 ---
[2C94.2] Urothelial carcinoma of bladder
--PARENT--> [2C94] Malignant neoplasms of bladder
Def: A primary or metastatic malignant neoplasm involving the bladder....
--CHILD--> [2C94.0] Adenocarcinoma of urinary bladder
Def: A rare adenocarcinoma arising from metaplastic bladder epithelium. It is frequently associated with long-standing local irritation. The majority of cases originate from the trigone and the posterior w...
--- Walk 3 ---
[2C9Z] Malignant neoplasms of urinary tract, unspecified
--PARENT--> [?] Malignant neoplasms of urinary tract
Def: A primary or metastatic malignant tumour involving the urinary system. Common tumour types include carcinomas, lymphomas, and sarcomas....
--EXCLUDES--> [?] Malignant mesenchymal neoplasms
Def: A usually aggressive malignant mesenchymal cell tumour most commonly arising from muscle, fat, fibrous tissue, bone, cartilage, and blood vessels. Sarcomas occur in both children and adults. The progn...
--- Walk 4 ---
[2C9Z] Malignant neoplasms of urinary tract, unspecified
--PARENT--> [?] Malignant neoplasms of urinary tract
Def: A primary or metastatic malignant tumour involving the urinary system. Common tumour types include carcinomas, lymphomas, and sarcomas....
--CHILD--> [2C90] Malignant neoplasms of kidney, except renal pelvis
Def: Cancer of the kidney amounts to 2% of the total human cancer burden, with approximately 190,000 new cases diagnosed each year. They occur in all world regions, with a preference for developed countrie...
--- Walk 5 ---
[2F35] Benign neoplasm of urinary organs
Def: A non-metastasizing neoplasm that arises from the organs that comprise the urinary system. Representative examples include renal oncocytoma, bladder inverted papilloma, and urothelial papilloma....
--PARENT--> [?] Benign neoplasms except of mesenchymal origin
--CHILD--> [2E90] Benign neoplasm of lip, oral cavity or pharynx
--- Walk 6 ---
[2F35] Benign neoplasm of urinary organs
Def: A non-metastasizing neoplasm that arises from the organs that comprise the urinary system. Representative examples include renal oncocytoma, bladder inverted papilloma, and urothelial papilloma....
--PARENT--> [?] Benign neoplasms except of mesenchymal origin
--CHILD--> [2E92] Benign neoplasm of digestive organs
Def: A neoplasm of the digestive system which is characterised by the absence of morphologic features associated with malignancy (severe cytologic atypia, tumour cell necrosis, and high mitotic rate). Beni...
|
[
"[2C94.2] Urothelial carcinoma of bladder\n --PARENT--> [2C94] Malignant neoplasms of bladder\n Def: A primary or metastatic malignant neoplasm involving the bladder....\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...",
"[2C94.2] Urothelial carcinoma of bladder\n --PARENT--> [2C94] Malignant neoplasms of bladder\n Def: A primary or metastatic malignant neoplasm involving the bladder....\n --CHILD--> [2C94.0] Adenocarcinoma of urinary bladder\n Def: A rare adenocarcinoma arising from metaplastic bladder epithelium. It is frequently associated with long-standing local irritation. The majority of cases originate from the trigone and the posterior w...",
"[2C9Z] Malignant neoplasms of urinary tract, unspecified\n --PARENT--> [?] Malignant neoplasms of urinary tract\n Def: A primary or metastatic malignant tumour involving the urinary system. Common tumour types include carcinomas, lymphomas, and sarcomas....\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...",
"[2C9Z] Malignant neoplasms of urinary tract, unspecified\n --PARENT--> [?] Malignant neoplasms of urinary tract\n Def: A primary or metastatic malignant tumour involving the urinary system. Common tumour types include carcinomas, lymphomas, and sarcomas....\n --CHILD--> [2C90] Malignant neoplasms of kidney, except renal pelvis\n Def: Cancer of the kidney amounts to 2% of the total human cancer burden, with approximately 190,000 new cases diagnosed each year. They occur in all world regions, with a preference for developed countrie...",
"[2F35] Benign neoplasm of urinary organs\n Def: A non-metastasizing neoplasm that arises from the organs that comprise the urinary system. Representative examples include renal oncocytoma, bladder inverted papilloma, and urothelial papilloma....\n --PARENT--> [?] Benign neoplasms except of mesenchymal origin\n --CHILD--> [2E90] Benign neoplasm of lip, oral cavity or pharynx",
"[2F35] Benign neoplasm of urinary organs\n Def: A non-metastasizing neoplasm that arises from the organs that comprise the urinary system. Representative examples include renal oncocytoma, bladder inverted papilloma, and urothelial papilloma....\n --PARENT--> [?] Benign neoplasms except of mesenchymal origin\n --CHILD--> [2E92] Benign neoplasm of digestive organs\n Def: A neoplasm of the digestive system which is characterised by the absence of morphologic features associated with malignancy (severe cytologic atypia, tumour cell necrosis, and high mitotic rate). Beni..."
] |
2C94.2
|
Urothelial carcinoma of bladder
|
[
{
"from_icd11": "2C9Z",
"icd10_code": "C689",
"icd10_title": "Malignant neoplasm of urinary organ, unspecified"
},
{
"from_icd11": "2C9Z",
"icd10_code": "C64-C68",
"icd10_title": ""
},
{
"from_icd11": "2C9Z",
"icd10_code": "C68",
"icd10_title": "Malignant neoplasm of other and unspecified urinary organs"
},
{
"from_icd11": "2F35",
"icd10_code": "D3002",
"icd10_title": "Benign neoplasm of left kidney"
},
{
"from_icd11": "2F35",
"icd10_code": "D3000",
"icd10_title": "Benign neoplasm of unspecified kidney"
},
{
"from_icd11": "2F35",
"icd10_code": "D3001",
"icd10_title": "Benign neoplasm of right kidney"
},
{
"from_icd11": "2F35",
"icd10_code": "D303",
"icd10_title": "Benign neoplasm of bladder"
},
{
"from_icd11": "2F35",
"icd10_code": "D30",
"icd10_title": "Benign neoplasm of urinary organs"
},
{
"from_icd11": "2F35",
"icd10_code": "D300",
"icd10_title": "Benign neoplasm of kidney"
},
{
"from_icd11": "2F35",
"icd10_code": "D301",
"icd10_title": "Benign neoplasm of renal pelvis"
},
{
"from_icd11": "2F35",
"icd10_code": "D302",
"icd10_title": "Benign neoplasm of ureter"
},
{
"from_icd11": "2F35",
"icd10_code": "D304",
"icd10_title": "Benign neoplasm of urethra"
},
{
"from_icd11": "2F35",
"icd10_code": "D307",
"icd10_title": ""
},
{
"from_icd11": "2F35",
"icd10_code": "D309",
"icd10_title": "Benign neoplasm of urinary organ, unspecified"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
}
] |
C689
|
Malignant neoplasm of urinary organ, unspecified
|
A 55-year-old woman of Algerian descent presented to our medical center in August 2008 with a chief complaint of worsening bone pain. She began suffering from a mild degree of diffuse bone pain 13 years ago. The pain was described as constant and as affecting her lumbar spine, knees, pelvic bones and feet. The pain was managed rather well until her time of presentation using non-steroidal anti-inflammatory drugs. At the time of presentation, the pain had intensified to a degree which prevented her to stand from a sitting position. The patient had a past medical history of diabetes insipidus for which she was diagnosed 12 years prior to her current presentation and also suffered from recurrent urinary tract infections. Her physical examination was unremarkable aside from periorbital xanthelasma-like lesions . Abnormal laboratory findings included a microcytic iron deficiency anemia (hemoglobin: 11 g/dL, MCV: 77.5 fL, iron: 19 μg/dL) and an elevated ESR (98 mm/hr). Both protein electrophoresis and tumor markers were without pathological findings. A radiograph of the lower limbs was obtained and demonstrated bilateral involvement of the femurs and tibiae with cortical and periosteal thickening accompanied by a mixture of lytic and sclerotic lesions. These findings were even more apparent on CT . A 99m Tc bone scintigraphy revealed a multifocal bone disease characterized by bilateral, symmetric increased tracer uptake involving both tibiae, distal femurs and iliac bones. Also, an asymmetric increased tracer uptake was noted in both of the upper limbs, favoring the right humerus, radius and ulna . A CT guided biopsy of the right femur was performed. The specimen included cores of long bone showing focal fibrosis, foamy histiocytic infiltrate, inflammatory cells, giant cells and reactive cortical sclerosis. The histiocytes described were found to be CD68 positive and CD1a negative, a histological picture compatible with ECD. After her diagnosis was established in December 2009, the patient was treated with prednisone at an initial dosage of 60 mg/day which underwent gradual tapering to 5 mg/d over a period of one year. Five months after the initiation of prednisone, methotrexate was introduced at escalating dosages of 10 to 25 mg/week. This treatment protocol was successful in generating a transient decrease in bone pain which lasted for two years. However, during that period of time, the patient began experiencing extraskeletal symptoms: alternating hot flashes and cold bouts, blurred vision, headaches, nausea and vomiting. Last but not least, the patient’s most prominent complaint was dyspnea, as she suffered from frequent episodes of shortness of breath following even the slightest of physical efforts, rendering her unable to walk more than 100 meters. Assessment of the patient’s CNS included a brain MRI which was without pathological findings. The patient’s cardio-pulmonary evaluation included several echocardiography studies which revealed recurrent pericardial effusions of moderate to large proportions with associated fibrin. Contrast enhanced CT of the chest demonstrated periaortic infiltration (‘coated aorta’) of the aortic root as well as infiltration of the mediastinum adjacent to the right atrium and also confirmed the existence of a small loculated pleural effusion. In addition to the known pericardial effusion, gadolinium enhanced cardiac gated MRI revealed thickening of the pericardium, thickening of the wall of the ascending aorta (of up to 10 mm) and several lesions encasing the right atrium, right coronary artery and superior vena cava. These findings were also apparent on a whole body PET/CT scan which demonstrated increased tracer uptake in the lesions encasing the great vessels as well as in the osseous foci consistent with the former 99m Tc bone scintigraphy. Due to the multifocal progression of her disease, the patient was started on a combination therapy regimen of interferon-α (3 × 10 6 IU X2 to 3/week) and vinblastine (6 mg/m 2 /week). However, this regimen was tolerated very poorly by the patient, as she became severely neutropenic with an absolute neutrophil count of less than 500 cells/μL. The dual interferon-α - vinblastine regimen was consequently stopped after four weeks of treatment and replaced with vinblastine as a single agent regimen at a dosage of 6 to 8 mg/m 2 /week. Nevertheless, even this treatment was poorly tolerated and, thus, was stopped following an additional eight weeks of therapy. In parallel, the patient was tested for the V600E BRAF mutation and was found to be negative. Ultimately, a combination therapy regimen of infliximab (5 mg/kg/6 weeks) and methotrexate (20 mg/week) was initiated. Following six courses of treatment the patient improved clinically, with a notable decrease in the frequency and intensity of her pain, nausea and dyspnea. A marked reduction in the proportion of the pericardial effusion was noted on both echocardiography and computed tomography. However, despite treatment, the mediastinal lesions were found to be metabolically active on PET/CT and no reduction in their size was evident on CT. Most interestingly, this treatment resulted in better control of the patient’s diabetes insipidus, necessitating a decrease in the dosage of desmopressin.
| 4.03125
| 0.978516
|
sec[1]/sec[4]/p[0]
|
en
| 0.999996
|
25434739
|
https://doi.org/10.1186/s12916-014-0221-3
|
[
"bone",
"pain",
"which",
"lesions",
"regimen",
"included",
"both",
"this",
"well",
"time"
] |
[
{
"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": "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 ===
[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
[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 ---
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders
--- Walk 2 ---
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders
--- Walk 3 ---
[FB84.Z] Osteomyelitis or osteitis, unspecified
--PARENT--> [FB84] Osteomyelitis or osteitis
--CHILD--> [FB84.2] Subacute osteomyelitis
--- Walk 4 ---
[FB84.Z] Osteomyelitis or osteitis, unspecified
--PARENT--> [FB84] Osteomyelitis or osteitis
--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
--CHILD--> [FB80.1] Skeletal fluorosis
|
[
"[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders",
"[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....\n --RELATED_TO--> [?] Nonorgan specific systemic autoimmune disorders",
"[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --CHILD--> [FB84.2] Subacute osteomyelitis",
"[FB84.Z] Osteomyelitis or osteitis, unspecified\n --PARENT--> [FB84] Osteomyelitis or osteitis\n --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 --CHILD--> [FB80.1] Skeletal fluorosis"
] |
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 55-year-old man, a non-smoker, who described recurrent dry coughing over a year and fever for one day was examined at a local hospital on January 22, 2018. After fourth-line therapy, he was referred to our hospital. This patient weighed 62 kg and his PS score was 0. His PET-CT scan showed a space-occupying lesion in the right hilum with obstructive pneumonia . A PET-CT showed a soft mass in the left lower lobe with increased glucose metabolism (5.5 × 7.7 cm), and the parapulmonary trunk and left hilar lymph nodes showed increased glucose metabolism (maximum diameter 0.7 cm), a soft tissue density nodule in the right adrenal gland (2.1 × 2.6 cm) showed increased glucose metabolism, and increased local metabolism in the right superior pubic branch (1.0 cm) . The lesions were considered lung adenocarcinoma based on fiberoptic biopsy and hematoxylin-eosin staining . Molecular testing results showed that ALK and PD-L1 were positive, and ROS-1 and EGFR were negative. Finally, the patient was diagnosed with stage IV ALK -positive advanced lung adenocarcinoma with metastatic malignancy in the right adrenal gland. He was treated with crizotinib (250 mg BID) on February 14, 2018. The mass in the left lower lobe was reduced from 8.1 cm to 4.2 cm, and the right adrenal tumor was reduced from 2.6 cm to 0.7 cm on March 28, 2018, achieving partial response (PR) according to the Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria . On May 11, 2018, the mass in the left lower lobe shrank to 3.0 cm, while the right adrenal metastases disappeared with no recurrence up to follow-up time, and the response evaluation was still PR . But the left lower lobe mass increased to 4.5 cm, and the efficacy qualified as progressive disease (PD) after 5 months . The main side effects were vomiting and diarrhea, and disappeared after 2 months. Molecular testing showed an EML4-ALK (E18:A20) fusion, and PD-L1 positivity, with a tumor proportion score (TPS) of 10% on IHC. In view of the accessibility of drugs, medical insurance reporting and other factors, ceritinib was deemed the ideal treatment. From August 2018 to February 2019, the patient received the second-line treatment of ceritinib (450 mg PO QD), without significant adverse reactions during medication, and progressed after 6 months. On December 20, 2018, it continued to decrease to 2.4 cm, and was deemed PR. However, on February 12, 2019, the lesion in the left lower lung increased to 3.6 cm, and the disease progressed . From February 2019 to March 2019, alectinib (600 mg PO BID) was used as the third line therapy, while the efficacy was evaluated as PD . The NGS analysis revealed an EML4 exon20- ALK exon20 fusion. From April 2019 to November 2019, the patient received the fourth-line treatment, including 4 cycles of induction chemotherapy (pemetrexed 835 mg/carboplatin 500 mg/bevacizumab 485 mg), and maintenance therapy (pemetrexed 835 mg/bevacizumab 485 mg). After induction chemotherapy, the patient felt fatigue and anorexia. On August 7, 2019, the lesion in the left lower lung shrank was reduced to3.0 cm and evaluated as PR. However, the left lower lung lesion was enlarged (4.1 cm), and the response was evaluated as PD on October 9, 2019 . Molecular testing showed EGFR amplification and -EML4 - ALK fusion, the TMB was 1.6 muts/Mb and the tumor was PD-L1 positivewith a TPS of 3% on immunohistochemistry . The patient received the fifth line of treatment (cetuximab 700 mg/paclitaxel liposome 210 mg/nedaplatin 100 mg) for 1 cycle. After treatment, the patient had rash, fatigue, and anorexia. After 1 month, the left lower lung lesion enlarged to 9.1 cm . Then the patient received the sixth line of treatment (camrelizumab 200 mg/lorlatinib 100 mg QD) for 9 antitumor cycles, resulting in PR and gaining 15 kg in weight. Side effects included pain in both lower limbs, an NRS pain score of 6, with the disappearance of the above symptoms after 6 months . The PET-CT on August 21, 2020 showed patchy, increased radioactive uptake in the left lung mass and a radioactive uptake defect area in the central area of the mass. The left hilar lymph node, right adrenal gland, and right suprapubic branch showed no mass or radioactive uptake . After consultation with experts from thoracic surgery, interventional medicine, and the radiotherapy center, surgery was recommended. On September 23, 2020, thoracoscopic-assisted left pneumonectomy, lymph node dissection, and pleural adhesion ligation were performed and postoperative pathological analysis revealed massive necrosis of nodules in the upper and lower lobes of the left lung, no obvious cancer tissue, focal granulomatous inflammation, no cancer at the bronchial resection margin, and no metastasis of the lymph nodes. The pCR was achieved in the primary lung lesion . From October 2020 to now, the patient continues to receive maintenance treatment with lorlatinib (100 mg QD) with good tolerance, no side effects, and an Eastern Cooperative Oncology Group (ECOG) score of 1. The results of chest and abdomen CT and abdominal color Doppler ultrasound monitoring showed no new lesions. . During follow-up, this patient remains in cCR in the systemic lesion and a pCR in the primary lung lesion. The timeline of treatments is shown in Figure 6 .
| 3.970703
| 0.977051
|
sec[2]/p[0]
|
en
| 0.999996
|
PMC9745108
|
https://doi.org/10.3389/fonc.2022.967675
|
[
"lung",
"lesion",
"line",
"adrenal",
"score",
"lobe",
"metabolism",
"lymph",
"february",
"response"
] |
[
{
"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": "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 ===
[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
[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 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--CHILD--> [CB40.2] Pulmonary collapse
--- Walk 2 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--PARENT--> [12] Diseases of the respiratory system
--- Walk 3 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.2] Congenital hypoplasia of lung
--- Walk 4 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.0] Accessory lobe of lung
Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...
--- Walk 5 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--RELATED_TO--> [?] Congenital pneumonia
Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi....
--- Walk 6 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--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--> [CB40.2] Pulmonary collapse",
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --PARENT--> [12] Diseases of the respiratory system",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --RELATED_TO--> [?] Congenital pneumonia\n Def: Congenital pneumonia is an acute respiratory infection contracted prenatally or during the intrapartum period that is caused by a virus, bacteria, or fungi....",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --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
|
The girl weighting 3200 g was delivered spontaneously at 38-week of gestation to a gravida 1 para 1 mother with Apgar score of 10 at first minute. Her young, unconsanguineous parents were healthy, without any symptoms of immunodeficiency. She was vaccinated with BCG and Engerix B without complications. The patient was admitted to the hospital at the age of 31 days. Physical examination revealed erythrodermia, no hepatosplenomegaly and no lymphadenopathy. Apart from erythematous rash and exfoliation of the whole body skin, the signs of bilateral pneumonia were noted. In blood morphology elevated number of eosinophils was detected (Table 1 ). Liver and renal function tests were normal. Tests for cytomegalovirus (CMV) infection were positive (317,913 copy/ml in blood, 94,000 copy/ml in cerebrospinal fluid (BCG), polymerase chain reaction (PCR) method). Staphylococcus epidermidis MRSE, MLS and Enterococcus faecalis were cultured in the blood. Immunological tests revealed normal levels of serum immunoglobulins: IgG, IgA, IgM and high level of IgE. Flow cytometric analysis showed decreased absolute number of T cells (both CD4 + and CD8 + subpopulations), increased number of activated lymphocytes T (CD3 + /HLA − DR + ). The vast majority of T cells were CD45RO + . B lymphocytes were absent. Percentage and absolute number of NK cells were within the normal range. The response of lymphocytes to stimulation of mitogens in proliferation test was normal (Table 2 ). Maternal T-cell engraftment was excluded due to negative results of mother T lymphocytes chimerism test . On the basis of clinical and laboratory findings OS was the putative diagnosis. Therefore, the RAG1 and RAG2 genes were selected for sequence analysis. The child was bottle-fed but despite high protein diet (2.7 g/kg/24 h) the protein levels were still below the normal ranges. On admission she received two antibiotics. Co-trimoxazole, ketoconazole, ganciclovir sodium with foscarnet, methylprednisolone hemisuccinate (0.4 mg/kg) and IVIG substitution (every 3 weeks in dose 500 mg/kg) were included into therapy schedule. Shortly after the compatible unrelated donor was found, the child was transferred to Bone Marrow Transplantation Center. Table 1 The number of white blood cells (WBC) and their population at first examination in four our patients with RAG1 mutations WBC (cells/μl × 10 3 ) Patient 1 Patient 2 (age-matched normal values a ) Patient 3 Patient 4 Age-matched normal values for Patients 1, 3 and 4 21.9 9.5 ( 5.0 – 14.8 ) 28 19.6 6.0–16.3 % of WBC cells/μl × 10 3 % of WBC cells/μl × 10 3 % of WBC cells/μl × 10 3 % of WBC cells/μl × 10 3 % of WBC cells/μl × 10 3 Lymphocytes 43.3 9.5 1.5 ( 11 – 58 ) 0.14 ( 0.55 – 8.58 ) 56 15.68 8 1.57 21.3 – 69.8 0.9–5.2 Neutrophils 15.9 3.5 8.9 ( 30.4 – 78.6 ) 7.71 ( 1.52 – 11.63 ) 6 1.68 26 5.09 13.6 – 58.9 2.5 – 6.5 Eosinophils 26.2 5.7 0.0 ( 0 – 4.3 ) 0.0 ( 0 – 0.64 ) 35 9.8 62 12.15 0 – 5.7 0 – 0.6 Monocytes 13.8 3.0 10.9 ( 3.3 – 13.9 ) 1.04 ( 0.16 – 2.06 ) 3 0.84 4 0.78 2.4 – 19.6 0.1 – 1 a Age-matched normal values for Patient 2 (shown in brackets) were presented together with his results and correspond to patient’ age that differ from the remaining patients (age-matched normal values for Patient 1, 3 and 4 were shown in the last column) Table 2 Humoral and cellular immunity parameters at first examination in patients with RAG1 mutations Parameter Patient 1 Patient 2 (age-matched normal values a ) Patient 3 Patient 4 Age-matched normal values for Patients 1, 3 and 4 Serum immunoglobulins(g/l) IgG 8.45 4.80 ( 3.83 – 10.1 ) 5.67 9.59 6.80–15.30 IgA 0.09 0.60 ( 0.17 – 1.05 ) <0.06 0.08 0.00–0.05 IgM 0.34 1.39 ( 0.29 – 1.50 ) 0.34 0.73 0.00–0.17 IgE total (IU/ml) 3640 <16.4 ( 0.0 – 60.0 ) 32,000 38,000 0.00–1.50 Lymphocyte subpopulations % of lymph cells/μl % of lymph cells/μl % of lymph cells/μl % of lymph cells/μl % of lymph cells/μl CD3 59 1575 c 20 ( 53 – 75 ) 119 90 9000 70 1190 53–84 2500–5500 CD4 57 1521 15 ( 32 – 51 ) 89 38 3800 58 986 35–64 1600–4000 CD8 2 53 3 ( 14 – 30 ) 18 46 4600 11 187 12–28 560–1700 CD19 1 27 27 ( 16 – 35 ) 27 1 4 2 78 6–32 300–2000 CD22 0.17 5 nd nd nd nd nd nd 6–32 300–2000 CD20 0.19 5 nd nd nd nd nd nd 6–32 300–2000 HLA-DR 61 1628 6 ( 5 – 8 ) 36 ( 135 – 232 ) 76 6840 56 1638 5–8 135–232 CD3/CD45RO 99 2642 c nd nd 99.8 8982 98.6 1173 4.9–15.1 30–180 NK cells CD3 − CD16 + CD56 + 36 961 50 ( 3 – 15 ) 298 ( 180 – 920 ) 3 300 12 204 4–18 170–1100 Lymphocyte proliferation (cpm) Control group b Medium 955 780 768 616 1367±1110 PHA 18,143 3527 7722 2026 51,899±2969 Anti - CD3 10,655 3099 8477 655 48,785±24,025 PWM 9644 2243 8660 2033 50,255±21,594 PHA phytohaemagglutinin, PWM pokeweed mitogen, nd not determined a As in Table 1 b Control group: healthy 34 children (18 girls and 16 boys), the medium age 2.1 ± 1.1 years c Analysis performed in separate days Fig. 1 Distribution of peaks representing amplification of STR loci in Patient 1 and his mother ( A , B D21S11; C , D D19S433; E , F TH01; G , H FGA). Informative loci used to determine maternal-child’s chimerism are represented by filled peaks . In the panel 2 and 4 : there are maternal peaks A , C , F , G observed in child’s sample but there are no other maternal peaks ( B , D , E , H ) characteristic to the particular STR loci
| 4.195313
| 0.902344
|
sec[1]/sec[0]/sec[0]/p[0]
|
en
| 0.999999
|
28083621
|
https://doi.org/10.1007/s00005-016-0447-1
|
[
"cells",
"matched",
"number",
"lymphocytes",
"patients",
"lymph",
"blood",
"maternal",
"peaks",
"mother"
] |
[
{
"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": "QA83",
"title": "Mismatched blood used in transfusion without injury or harm"
},
{
"code": "4B0Z",
"title": "Immune system disorders involving white cell lineages, unspecified"
},
{
"code": "4B00",
"title": "Disorders of neutrophil number"
},
{
"code": "4B00.Y",
"title": "Other specified disorders of neutrophil number"
},
{
"code": "LD50.Z",
"title": "Number anomalies of chromosome X, 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
[QA83] Mismatched blood used in transfusion without injury or harm
Definition: Blood product (e.g. packed red blood cells, platelets, plasma) improperly matched with patient; wrong blood product administered to patient without documented injury or harm.
Also known as: Mismatched blood used in transfusion without injury or harm | Blood product improperly matched with patient without documented injury or harm | wrong blood product administered to patient without documented injury or harm
Excludes: Mismatched blood used in transfusion
[4B0Z] Immune system disorders involving white cell lineages, unspecified
Also known as: Immune system disorders involving white cell lineages, unspecified
[4B00] Disorders of neutrophil number
Also known as: Disorders of neutrophil number
Excludes: Decreased white blood cell count
[4B00.Y] Other specified disorders of neutrophil number
Also known as: Other specified disorders of neutrophil number | Agranulocytosis | chronic agranulocytosis | pernicious agranulocytosis | Periodic agranulocytosis
[LD50.Z] Number anomalies of chromosome X, unspecified
Also known as: Number anomalies of chromosome X, unspecified | Number anomalies of chromosome X
=== 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
--RELATED_TO--> [?] Mucolipidosis type 4
Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...
--PARENT--> [?] Mucolipidosis
--- Walk 4 ---
[5C56.20] Mucolipidosis
--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--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Clinical findings on antenatal screening of mother\n Def: Any sign characterised by an abnormality detected during an antenatal screening of the mother....",
"[5C56.20] Mucolipidosis\n --RELATED_TO--> [?] Mucolipidosis type 4\n Def: Mucolipidosis type IV (ML IV) is a lysosomal storage disease characterised clinically by psychomotor retardation and visual abnormalities including corneal clouding, retinal degeneration, or strabismu...\n --PARENT--> [?] Mucolipidosis",
"[5C56.20] Mucolipidosis\n --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--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch..."
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "QA83",
"icd10_code": "XXI",
"icd10_title": ""
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72829",
"icd10_title": "Elevated white blood cell count, unspecified"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72819",
"icd10_title": "Decreased white blood cell count, unspecified"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72818",
"icd10_title": "Other decreased white blood cell count"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72828",
"icd10_title": "Other elevated white blood cell count"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72823",
"icd10_title": "Leukemoid reaction"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72821",
"icd10_title": "Monocytosis (symptomatic)"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72825",
"icd10_title": "Bandemia"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72810",
"icd10_title": "Lymphocytopenia"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D7289",
"icd10_title": "Other specified disorders of white blood cells"
},
{
"from_icd11": "4B0Z",
"icd10_code": "D72820",
"icd10_title": "Lymphocytosis (symptomatic)"
}
] |
D571
|
Sickle-cell disease without crisis
|
We present three cases of pregnant women in whom symptoms of severe dyspnea and hypoxemia due to acute asthma exacerbation were alleviated following NPPV in addition to standard therapy. Although NPPV is a ventilatory support that is being increasingly used during acute asthma attacks, 5 , 6 , 7 , 8 , 9 a definitive consensus is lacking in guidelines. 10 This is because, regarding the results of several previous reports, NPPV for asthma attacks are observational research and cohort research subjects, and only a small number of randomized controlled trials (RCTs) are on the scale of 10‐20 patients. 6 , 11 Furthermore, we believe that outcomes obtained from RCTs are mostly lung function improvement because clinically significant results such as decreased intubation and mortality rates have not been obtained. However, we believe that the effect of NPPV on asthma attacks cannot be completely denied. As clinical cases, a few case reports have described the use of NPPV for management of acute exacerbations related to asthma in pregnant women. 12 , 13 , 14 Moreover, we believe that hospital staff members are not necessarily proficient in administering NPPV. Therefore, it cannot be generally recommended to all pregnant women with asthma exacerbations, and careful case selection is therefore important. We have to keep in mind that NPPV is a supportive therapy that is used together with conventional pharmacological treatment, aiming at decreasing the respiratory muscle work that is much increased during the episodes of acute bronchoconstriction, to improve ventilation and decrease the sensation of dyspnea, and it may be able to avoid intubation and invasive mechanical ventilation. The ideal patient is the one who is fully conscious and cooperative. The facility should have an appropriate system for monitoring vital signs and preparation for emergency intubation and invasive mechanical ventilation within a critical care environment. Furthermore, the availability of expert respiratory care nurses capable of administering NPPV is crucial to ensure the success of NPPV in pregnant women with asthma exacerbations. Furthermore, the presence of experienced obstetrician and pulmonologist are recommended under such circumstances. 15 In the first two of our three cases, the patients suffered from type I respiratory failure. A recent report had used high‐flow oxygen therapy for asthma. 16 However, we attempted to use NPPV for asthmatic attacks because we expected the following four effects: (a) Applying positive pressure (Expiratory Positive Airway Pressure [EPAP]) in the trachea may cause bronchodilation and reduce airway resistance 17 ; (b) β‐2‐agonists use by incorporating them in the NPPV circuit using a respiratory gas mixer 18 ; (c) For the endogenous positive end‐expiratory pressure (endogenous PEEP) during an asthmatic attack, EPAP acts to counter endogenous PEEP to improve wheezing and labored exhalation; and (d) Respiratory muscle fatigued with tachypnea is assisted by inspiratory positive airway pressure (IPAP). 19 All three cases described in this report presented at the emergency department with hypoxemia and severe dyspnea under oxygen therapy. Nevertheless, all were fully conscious and cooperative. FHR was closely monitored by an experienced obstetrician using Doppler echocardiography. 15 Pregnant women and their spouses were informed of their physical status by the pulmonologist. Treatment with appropriate standard medications combined with NPPV therapy was initiated to alleviate hypoxemia and strong dyspnea. Patients were also informed about the potential need for intubation and invasive mechanical ventilation in case of respiratory failure or fatigue. Intubation and invasive mechanical ventilation are effective treatments for respiratory failure. However, intubation is risky in pregnant women due to pregnancy‐related airway hyperemia and aspiration during intubation. Moreover, the clinician should be aware that hypotension may follow positive pressure ventilation and sedation. Some sedatives are not safe for use during pregnancy. 20 The use of intubation and invasive mechanical ventilation was avoided in these cases in part because of the early initiation of NPPV (within 30 minutes). This approach led to dramatic improvements in parameters, such as oxygenation, hypercapnia, respiratory rate, heart rate, and dyspnea index. NPPV combined with asthma and medication therapies may become an effective treatment for asthma attacks in pregnant women although careful case selection is imperative. This report has certain limitations. We studied only three cases. Moreover, we were fortunate to achieve good clinical outcomes with all three patients. We emphasize that NPPV cannot be universally recommended for all pregnant women who present with acute asthma exacerbations. Moreover, NPPV via mask, which does not separate the trachea and esophagus, always carries a risk of aspiration while treating pregnant women. A key factor in all these cases was the availability of expert respiratory care nurses who were familiar with the application of NPPV masks as well as operation of necessary equipment. Moreover, the patients had access to a pulmonologist specializing in asthma treatment and management of respiratory failure.
| 4.265625
| 0.76416
|
sec[2]/p[0]
|
en
| 0.999997
|
31110708
|
https://doi.org/10.1002/ccr3.2117
|
[
"nppv",
"asthma",
"respiratory",
"pregnant",
"women",
"that",
"intubation",
"cases",
"ventilation",
"three"
] |
[
{
"code": "CA23.32",
"title": "Unspecified asthma, uncomplicated"
},
{
"code": "CA23",
"title": "Asthma"
},
{
"code": "CA23.3",
"title": "Unspecified asthma"
},
{
"code": "CA23.0",
"title": "Allergic asthma"
},
{
"code": "CA23.31",
"title": "Unspecified asthma with status asthmaticus"
},
{
"code": "CB7Z",
"title": "Diseases of the respiratory system, unspecified"
},
{
"code": "CB41",
"title": "Respiratory failure"
},
{
"code": "CB41.2Z",
"title": "Respiratory failure, unspecified"
},
{
"code": "CB40.Y",
"title": "Other specified diseases of the respiratory system"
},
{
"code": "MD11.Y",
"title": "Other specified abnormalities of breathing"
}
] |
=== ICD-11 CODES FOUND ===
[CA23.32] Unspecified asthma, uncomplicated
Also known as: Unspecified asthma, uncomplicated | asthmatic | asthma NOS | hypoxic asthma | asthma, unspecified, without stated status asthmaticus
Excludes: acute severe asthma
[CA23] Asthma
Definition: Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is characterised by an increased responsiveness of the trachea and bronchi to various stimuli and manifested by a widespread narrowing of the airways that change in severity either spontaneously or as a result of therapy. This leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.
Also known as: Asthma | Idiosyncratic asthma
Includes: Idiosyncratic asthma
Excludes: wood asthma | asthma with chronic obstructive pulmonary disease | miner’s asthma
[CA23.3] Unspecified asthma
Also known as: Unspecified asthma
[CA23.0] Allergic asthma
Definition: Allergic asthma is the most easily recognised asthma phenotype, which often commences in childhood and is associated with a past and/or family history of allergic diseases such as eczema, allergic rhinitis, or food or drug allergy. Examination of the induced sputum of these patients before treatment often reveals eosinophilic airway inflammation. The main trigger is the exposure to inhaled allergens, such as dust mite and pollens, to which the affected individual has previously been sensitized.
Also known as: Allergic asthma | Allergen-induced asthma | allergic asthma without stated status asthmaticus | Predominantly allergic asthma without stated status asthmaticus | predominantly allergic asthma
[CA23.31] Unspecified asthma with status asthmaticus
Definition: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asthma that does not respond to standard treatments of inhalative bronchodilators and steroids.
Also known as: Unspecified asthma with status asthmaticus | Asthma, unspecified, with stated status asthmaticus | status asthmaticus NOS | acute severe asthma | acute severe bronchial asthma
Excludes: acute asthma NOS | severe asthma NOS
[CB7Z] Diseases of the respiratory system, unspecified
Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS
[CB41] Respiratory failure
Definition: Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide (CO2) elimination. Respiratory failure may occur because of impaired gas exchange, decreased ventilation, or both. The level of oxygen in the blood becomes dangerously low or the level of carbon dioxide becomes dangerously high.
Also known as: Respiratory failure | lung failure NOS | pulmonary failure
Excludes: Acute respiratory distress syndrome | Respiratory arrest | Respiratory distress of newborn
[CB41.2Z] Respiratory failure, unspecified
Also known as: Respiratory failure, unspecified | Respiratory failure, unspecified as acute or chronic | respiration failure | respiratory failure NOS | respiration failed
[CB40.Y] Other specified diseases of the respiratory system
Also known as: Other specified diseases of the respiratory system | Secondary respiratory disorders | Respiratory disorders in diseases classified elsewhere | Diseases of bronchus, not elsewhere classified | Acquired bronchial diverticulum
[MD11.Y] Other specified abnormalities of breathing
Also known as: Other specified abnormalities of breathing | Bradypnoea | Choking sensation | Hypoventilation | hypoventilation syndrome NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[CA23.32] Unspecified asthma, uncomplicated
--EXCLUDES--> [?] Unspecified asthma with status asthmaticus
Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asth...
--EXCLUDES--> [?] Unspecified asthma, uncomplicated
--- Walk 2 ---
[CA23.32] Unspecified asthma, uncomplicated
--EXCLUDES--> [?] Unspecified asthma with status asthmaticus
Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asth...
--EXCLUDES--> [?] Unspecified asthma, uncomplicated
--- Walk 3 ---
[CA23] Asthma
Def: Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is characterised by an increased responsiveness of the trachea and bronchi to various...
--EXCLUDES--> [?] Chronic obstructive pulmonary disease
Def: Chronic Obstructive Pulmonary disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced ...
--EXCLUDES--> [?] Chronic bronchitis
--- Walk 4 ---
[CA23] Asthma
Def: Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is characterised by an increased responsiveness of the trachea and bronchi to various...
--EXCLUDES--> [?] Coal worker pneumoconiosis
Def: Coalworker pneumoconiosis, an interstitial lung disease due to inhalation of coal dust. The accumulation of coal in the lung leads to fibrosis and formation of coal macules which are seen on chest X-r...
--EXCLUDES--> [?] Tuberculosis
Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...
--- Walk 5 ---
[CA23.3] Unspecified asthma
--CHILD--> [CA23.31] Unspecified asthma with status asthmaticus
Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asth...
--EXCLUDES--> [?] Unspecified asthma, uncomplicated
--- Walk 6 ---
[CA23.3] Unspecified asthma
--CHILD--> [CA23.30] Unspecified asthma with exacerbation
Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute sudden worsening....
--PARENT--> [CA23.3] Unspecified asthma
|
[
"[CA23.32] Unspecified asthma, uncomplicated\n --EXCLUDES--> [?] Unspecified asthma with status asthmaticus\n Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asth...\n --EXCLUDES--> [?] Unspecified asthma, uncomplicated",
"[CA23.32] Unspecified asthma, uncomplicated\n --EXCLUDES--> [?] Unspecified asthma with status asthmaticus\n Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asth...\n --EXCLUDES--> [?] Unspecified asthma, uncomplicated",
"[CA23] Asthma\n Def: Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is characterised by an increased responsiveness of the trachea and bronchi to various...\n --EXCLUDES--> [?] Chronic obstructive pulmonary disease\n Def: Chronic Obstructive Pulmonary disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced ...\n --EXCLUDES--> [?] Chronic bronchitis",
"[CA23] Asthma\n Def: Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is characterised by an increased responsiveness of the trachea and bronchi to various...\n --EXCLUDES--> [?] Coal worker pneumoconiosis\n Def: Coalworker pneumoconiosis, an interstitial lung disease due to inhalation of coal dust. The accumulation of coal in the lung leads to fibrosis and formation of coal macules which are seen on chest X-r...\n --EXCLUDES--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...",
"[CA23.3] Unspecified asthma\n --CHILD--> [CA23.31] Unspecified asthma with status asthmaticus\n Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute exacerbation of asth...\n --EXCLUDES--> [?] Unspecified asthma, uncomplicated",
"[CA23.3] Unspecified asthma\n --CHILD--> [CA23.30] Unspecified asthma with exacerbation\n Def: This refers to an unspecified inflammatory disease of the airways characterised by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm, with an acute sudden worsening....\n --PARENT--> [CA23.3] Unspecified asthma"
] |
CA23.32
|
Unspecified asthma, uncomplicated
|
[
{
"from_icd11": "CA23.32",
"icd10_code": "J45909",
"icd10_title": "Unspecified asthma, uncomplicated"
},
{
"from_icd11": "CA23",
"icd10_code": "J4520",
"icd10_title": "Mild intermittent asthma, uncomplicated"
},
{
"from_icd11": "CA23",
"icd10_code": "J4541",
"icd10_title": "Moderate persistent asthma with (acute) exacerbation"
},
{
"from_icd11": "CA23",
"icd10_code": "J4550",
"icd10_title": "Severe persistent asthma, uncomplicated"
},
{
"from_icd11": "CA23",
"icd10_code": "J4551",
"icd10_title": "Severe persistent asthma with (acute) exacerbation"
},
{
"from_icd11": "CA23",
"icd10_code": "J4530",
"icd10_title": "Mild persistent asthma, uncomplicated"
},
{
"from_icd11": "CA23",
"icd10_code": "J4521",
"icd10_title": "Mild intermittent asthma with (acute) exacerbation"
},
{
"from_icd11": "CA23",
"icd10_code": "J4540",
"icd10_title": "Moderate persistent asthma, uncomplicated"
},
{
"from_icd11": "CA23",
"icd10_code": "J4531",
"icd10_title": "Mild persistent asthma with (acute) exacerbation"
},
{
"from_icd11": "CA23",
"icd10_code": "J4552",
"icd10_title": "Severe persistent asthma with status asthmaticus"
},
{
"from_icd11": "CA23",
"icd10_code": "J4522",
"icd10_title": "Mild intermittent asthma with status asthmaticus"
},
{
"from_icd11": "CA23",
"icd10_code": "J45",
"icd10_title": "Asthma"
},
{
"from_icd11": "CA23",
"icd10_code": "J458",
"icd10_title": ""
},
{
"from_icd11": "CA23",
"icd10_code": "J46",
"icd10_title": ""
},
{
"from_icd11": "CA23.3",
"icd10_code": "J45998",
"icd10_title": "Other asthma"
}
] |
J45909
|
Unspecified asthma, uncomplicated
|
On January 20, 2022, fever, headache, dizziness, walking instability, and sleep increase were observed in a previously healthy 6-year-old girl with a maximal 39.1°C body temperature but no apparent respiratory symptoms. After treatment with antibiotics for one day, her symptoms have not improved, her fever persisted, and her body temperature fluctuated at 39.0-40.0°C. On Jan 21, 2022, she was admitted at a local hospital with a suspected bacterial infection and treated with azithromycin, penicillin, cefoperazone, or ceftazidime for 3 days. However, she still had a persistent fever with a body temperature of up to 41.0°C with no improvement at all, and she became lethargic. On Jan 25, 2022, she rapidly developed symptoms typical of acute encephalitis including lethargy, impassive and mask-like face, limb weakness, vertigo, tremours, aphasia, torticollis, opisthotonus, epileptic seizures, and convulsion. Therefore, she was urgently transferred to the paediatric intensive care unit (PICU) of the affiliated hospital of Yangzhou university . On admission, she rapidly progressed to seizures and coma (Glasgow Coma Scale score, 7) and developed frequent apnoea and irregular breathing with low oxygen saturation, and was commenced non-invasive mechanical ventilation (Supplementary Tables). Physical examination revealed that positive for Brudzinski’s sign and bilateral Babinski’s sign, but negative for Kernig’s sign. Haematological examination revealed a significant increase in white cell (21.45 × 10 9 cells/L), neutrophils (18.31 × 10 9 cells/L), and lymphmonocytes (1.28 × 10 9 cells/L) ( Table 1 ). Blood biochemical parameters showed that markedly elevated alanine aminotransferase (68 U/L), aspartate aminotransferase (132 U/L), γ-glutamyl transpeptidase (143 U/L), lactate dehydrogenase , creatine kinase (269 U/L), and creatine kinase isoenzyme (294.9 U/L) ( Table 1 ). Chest radiograph indicated bilateral patchy shadows with consolidation in the right lung upper lobe . Chest computed tomography showed consolidation of the right lung upper lobe and mild consolidation of the bilateral lower lobe . MRI showed obvious abnormal signals in the right parietal lobe, bilateral frontal lobe, insula, and temporo-occipital lobe on the diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) images, and T2 fluid-attenuated inversion-recovery (T2-FLAIR) images . EEG presented the relative enhanced θ and δ activities . A lumbar puncture was performed, and CSF on day 6 of the illness was examined. CSF contained 2 × 10 6 /L of red blood cells, 546 × 10 6 /L of white cells (mononuclear cells dominant), and 1.291 g/L of protein (Supplementary Tables). Cytokine examination for the patient’s serum revealed that the levels of interleukins (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, and IL-12P70), interferon-α (IFN-α), tumour necrosis factor α (TNF-α) were significantly elevated ( Table 1 ). Figure 1. Timeline and chest imaging. Panel A is a timeline of the clinical course of the patient (PICU), paediatric intensive care unit; CSF, cerebrospinal fluid. Chest radiography (Day 6 of illness) indicated bilateral patchy shadows with consolidation in the right lung upper lobe (Panel B). Chest computed tomography showed consolidation of the right lung upper lobe (Panel C) and mild consolidation of the bilateral lower lobe near the pleura (Panel D). Figure 2. Brain imaging and Electroencephalogram (EEG). Panel A: Magnetic resonance imaging (MRI) of the brain performed on day 6 of the illness showed obvious abnormal signals on DWI (abnormally hyperintensity in the left insula and parietal lobe), ADC (abnormally hypointensity in the left insula and parietal lobe), and T2-FLAIR images (slightly hyperintensity in the left insula lobe) (marked with an arrow). Panel B: EEG on day 6 of the illness presented the relative enhanced θ and δ activities with the continuous asymmetrical low waves manifested spike, sharp, or slow wave complex (marked with a black line). Table 1. Clinical blood routine and blood biochemical parameters. Subjects Reference Sample collected time (Days of the illness) 5 6 7 10 12 16 20 WBC counts (x10 9 /L) 5.0–12.0 21.45 29.56 24.00 10.91 16.22 15.25 7.64 Neutrophils (x10 9 /L) 2–7 18.31 26.19 18.15 6.85 8.68 10.51 5.48 Ratio of neutrophils (%) 50–70 85.40 88.60 75.70 62.7 53.5 68.9 71.7 Lymphmonocytes (x10 9 /L) 0.12–0.8 1.28 2.36 2.33 1.01 1.45 1.03 0.43 Alanine aminotransferase (U/L) 9–52 68 86 55 36 36 38 45 Aspartate aminotransferase (U/L) 14–36 132 179 95 116 109 89 77 r-glutamyl transpeptidase (U/L) 12–43 143 169 136 90 84 65 55 Alkaline Phosphatase (U/L) 38–126 147 180 126 79 85 91 87 Lactate dehydrogenase (U/L) 101–240 1041 557 520 813 934 814 576 Creatine kinase (U/L) 30–135 269 75 49 34 59 72 / Creatine kinase isoenzyme (U/L) 0–16 294.9 26 22 25 18 17 / High-sensitivity c-reactive protein (mg/L) 0.1–8.2 71.0 90.08 43.78 5.66 1.73 0.31 0.37 IL-1β (pg/ml) 0–12.4 / / 20.90 / / / / IL-2 (pg/ml) 0–5.71 / / 7.57 / / / / IL-4 (pg/ml) 0–3.0 / / 7.46 / / / / IL-5 (pg/ml) 0–3.1 / / 6.47 / / / / IL-6 (pg/ml) 0–5.3 / / 11.10 / / / / IL-10 (pg/ml) 0–4.91 / / 11.65 / / / / IL-12P70 (pg/ml) 0–3.4 / / 12.40 / / / / IFN-α (pg/ml) 0–8.5 / / 29.36 / / / / TNF-α (pg/ml) 0–4.6 / / 5.78 / / / / Note: “/”, no examination.
| 4.160156
| 0.958984
|
sec[2]/sec[0]/p[0]
|
en
| 0.999996
|
36093829
|
https://doi.org/10.1080/22221751.2022.2122584
|
[
"lobe",
"cells",
"consolidation",
"panel",
"chest",
"illness",
"blood",
"aminotransferase",
"creatine",
"kinase"
] |
[
{
"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": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "5C56.20",
"title": "Mucolipidosis"
},
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "9A96.3",
"title": "Primary anterior uveitis"
},
{
"code": "3A61.Z",
"title": "Acquired pure red cell aplasia, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[CB40.2] 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
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[5C56.20] Mucolipidosis
Also known as: Mucolipidosis | Mucolipidosis type 3 | Pseudo-Hurler polydystrophy | Pseudo-Hurler disease | Mucolipidosis type 2
Excludes: Sialidosis (mucolipidosis type 1)
[3A51.1] Sickle cell disease without crisis
Definition: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may present with fatigue, shortness of breath, dizziness, headaches, pallor of skin or mucous membranes, and jaundice. This disorder is confirmed by identification of HbS mutation by genetic testing.
Also known as: Sickle cell disease without crisis | Hb-SS disease without crisis | HbSS without crisis | Sickle-cell anaemia without crisis | SCD - [sickle cell disease]
[9A96.3] Primary anterior uveitis
Definition: This refers to primary inflammation of the uvea. The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body, and choroid.
Also known as: Primary anterior uveitis | anterior chamber cell
[3A61.Z] Acquired pure red cell aplasia, unspecified
Also known as: Acquired pure red cell aplasia, unspecified | Acquired pure red cell aplasia | acquired red cell aplasia | red cell aplasia NOS | pure red cell aplastic anaemia
=== GRAPH WALKS ===
--- Walk 1 ---
[CB40.2] 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...
--CHILD--> [?] Tuberculosis of lung, bacteriologically or histologically negative
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 bacteriologically and histol...
--- Walk 2 ---
[CB40.2] Pulmonary collapse
--EXCLUDES--> [?] Primary atelectasis of newborn
Def: Failure of the lungs to expand after birth, as in stillborn infants or in liveborn infants who die before respiration is established...
--PARENT--> [?] Respiratory disorders specific to the perinatal or neonatal period
Def: A group of conditions occurring during the period of time around childbirth, especially the five months before and one month after birth which are associated with the cardiovascular or respiratory sys...
--- Walk 3 ---
[LA75.0] Accessory lobe of lung
Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.2] Congenital hypoplasia of lung
--- Walk 4 ---
[LA75.0] Accessory lobe of lung
Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--CHILD--> [LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--- Walk 5 ---
[MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
--PARENT--> [?] Clinical findings in the respiratory system
--PARENT--> [?] Symptoms, signs or clinical findings 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--> [MD41] Clinical findings on diagnostic imaging of lung
Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...
|
[
"[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Respiratory tuberculosis, 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 --CHILD--> [?] Tuberculosis of lung, bacteriologically or histologically negative\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 bacteriologically and histol...",
"[CB40.2] Pulmonary collapse\n --EXCLUDES--> [?] Primary atelectasis of newborn\n Def: Failure of the lungs to expand after birth, as in stillborn infants or in liveborn infants who die before respiration is established...\n --PARENT--> [?] Respiratory disorders specific to the perinatal or neonatal period\n Def: A group of conditions occurring during the period of time around childbirth, especially the five months before and one month after birth which are associated with the cardiovascular or respiratory sys...",
"[LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.2] Congenital hypoplasia of lung",
"[LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --CHILD--> [LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....",
"[MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us...\n --PARENT--> [?] Clinical findings in the respiratory system\n --PARENT--> [?] Symptoms, signs or clinical findings 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--> [MD41] Clinical findings on diagnostic imaging of lung\n Def: Clinical findings on diagnostic imaging of lung is findings on diagnostic imaging of the lung which don't appear in normal status of the body. Diagnostic imaging refers to technologies that doctors us..."
] |
CB40.2
|
Pulmonary collapse
|
[
{
"from_icd11": "CB40.2",
"icd10_code": "J9811",
"icd10_title": "Atelectasis"
},
{
"from_icd11": "CB40.2",
"icd10_code": "J9819",
"icd10_title": "Other pulmonary collapse"
},
{
"from_icd11": "CB40.2",
"icd10_code": "J981",
"icd10_title": "Pulmonary collapse"
},
{
"from_icd11": "LA75.0",
"icd10_code": "Q331",
"icd10_title": "Accessory lobe of lung"
},
{
"from_icd11": "MD41",
"icd10_code": "R911",
"icd10_title": "Solitary pulmonary nodule"
},
{
"from_icd11": "MD41",
"icd10_code": "R91",
"icd10_title": "Abnormal findings on diagnostic imaging of lung"
},
{
"from_icd11": "LA75.1",
"icd10_code": "Q333",
"icd10_title": "Agenesis of lung"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43123",
"icd10_title": "Velamentous insertion of umbilical cord, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43193",
"icd10_title": "Other malformation of placenta, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43122",
"icd10_title": "Velamentous insertion of umbilical cord, second trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43113",
"icd10_title": "Circumvallate placenta, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43192",
"icd10_title": "Other malformation of placenta, second trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43103",
"icd10_title": "Malformation of placenta, unspecified, third trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43101",
"icd10_title": "Malformation of placenta, unspecified, first trimester"
},
{
"from_icd11": "JA8A.1",
"icd10_code": "O43102",
"icd10_title": "Malformation of placenta, unspecified, second trimester"
}
] |
J9811
|
Atelectasis
|
Post-operatively, the patient gained full consciousness without neurological deficit. Five days later a second surgery for the remaining tumor was done uneventfully. A subsequent pathology report confirmed the diagnosis of medulloblastoma ( Table 1 ). Table 1 Summary of the literature review of skull fracture with or without epidural hematoma cases secondary to pin-type head fixation in children. Table 1 Author (year) Age, years, Sex Diagnosis HC Surgical procedure Release CSF Position Type of Device Complications On set of complication Treatment of complication Outcome Risk Factors Pang et al. 7 F Juvenile Cerebellar Astrocytoma + SCo - TR – Sitting Position Three pin head fixation Depressed skull fracture with scalp laceration and CSF leak Air embolism Subdural bifrontal pneumochepalus During surgery Air suction via intracardiac catheter and closing of the scalp and dural laceration VP shunt infection with significant cerebellar deficits Chronic hidrocephalus Thin calvarial bone Baerts et al. 10 F Frontal Lobe Glioma − RFtC - TR – Supine Mayfield Impressed skull fracture + Supratentorial epidural hematoma Delayed, ten days after surgery Small craniotomy and clot evacuation Favorable Chronic high intracranial pressure Lee et al. 8 F Medulloblastoma + SCo VP shunt Prone Mayfield Depressed skull fracture + Dural laceration with small cerebral contussion Immediate prior to surgical procedure Elevation of the bone fragment & exploration of duramater Favorable Hidrocephalus Thin calvarial bone 4 M Hypothalamic glioma FC - TR – Supine Sugita Depressed skull fracture + Dural laceration Immediate prior to surgical procedure Elevation of the bone fragment & exploration of duramater Favorable no data 3 F Brainstem glioma SCo - TR – Prone Mayfield Depressed skull fracture + Dural laceration Immediate prior to surgical procedure Elevation of the bone fragment & exploration of duramater Favorable no data 8 M Brainstem glioma + SCo - TR VP shunt Prone Sugita Depressed skull fracture + Dural laceration Delayed postoperative No surgical treatment Favorable no data 5 M Hypothalamic glioma FC – TR – Supine Sugita Depressed skull fracture + Dural laceration with cortical laceration Immediate prior to surgical procedure Elevation of the bone fragment & exploration of duramater Favorable no data Medina et al. 13 M Supratentorial cystic lesion − RPC, TP and removed the lesion – Supine Mayfield Supratentorial epidural hematoma During the surgery EC and CR Severe right hemiparesis and aphasia Abnormal thinness of the skull due to chronic high intracranial pressure Tang et al. 15 M Medulloblastoma + SCo + TR – Prone Mayfield Depressed skull fracture + Supratentorial epidural hematoma Delayed, seven hours after surgery EC and CR Favorable Chronic hydrocephalus Yan et al. 15 M Posterior fossa tumor (choroid plexus paplilloma) + SCo + TR EVD Prone Mayfield Impressed skull fracture + Supratentorial epidural hematoma Delayed, six hours after surgery EC and CR Favorable Chronic hydrocephalus Thin calvarial bone Vitali et al. 2,7 M Ependymoma + SCo + TR – Prone Mayfield Temporal skull fracture + Supratentorial epidural hematoma Immediately after surgery Emergency exploratory then craniotomy and CR Favorable no data 2,10 F Ependymoma + SCo + TR – Prone Mayfield Temporal skull fracture + Small epidural hematoma During the registration for frameless stereotaxy, prior to surgery CT Favorable no data 4,3 Medulloblastoma + SCo + TR – Prone Mayfield Temporal skull fracture + Small epidural hematoma Immediately after surgery CT Favorable no data 4,9 Pineoblastoma + SCo + TR – Prone Mayfield Temporal skull fracture + Massive epidural hematoma During surgery EC and CR Favorable no data 6,6 Medulloblastoma + SCo + TR EVD Prone Mayfield Temporal skull fracture + Large epidural hematoma EC and CR Favorable no data Martínez-Lage et al. 4 F Pilocytic cerebellar astrocytoma + SCo + TR EVD Prone Mayfield Depressed skull fracture + Pneumocephalus Immediately after surgery CT Favorable Chronic hydrocephalus Poli et al. 7 M Pilocytic cerebellar astrocytoma SCo + TR – Prone Mayfield Depressed skull fracture + Supratentorial epidural hematoma Immediately after surgery EC and CR Favorable no data Chen et al. 6 F Posterior fossa tumor + SCo + TR EVD Prone Mayfield Temporal depressed skull fracture + Epidural hematoma Immediately after surgery EC and CR Favorable no data Khrisnan et al. 12 F Posterior fossa tumor + SCo + TR EVD Prone Three pin head fixation Temporal depressed skull fracture + Epidural hematoma During surgery C1-C2 laminectomy EC and CR Residual ataxia and cerebellar signs no data Moutaokil et al. 17 M Medulloblastoma + SCo + TR VP shunt Prone Mayfield Parietal depressed skull fracture After surgery CT Favorable Chronic hydocephalus Present case 11 F Medulloblastoma + SCo + TR EVD Prone Mayfield Temporal depressed skull fracture + Epidural hematoma During surgery EC and CR Favorable Chronic hydrocephalus Thin calvarial bone SCo = Suboccipital Craniotomy; TR = Tumor Removal; EVD = External Ventricular Drain; VP = Ventriculoperitoneal; RPC = Right Parietal Craniotomy; TP = Transcortical Puncture; FC = Frontal Craniotomy; RFtC = Right Fronto-temporal Craniotomy; EC = Emergency Craniotomy; CR = Clot Removal; CT = Conservative Treatment.
| 4.1875
| 0.633789
|
sec[1]/sec[2]/p[0]
|
en
| 0.999996
|
31445499
|
https://doi.org/10.1016/j.ijscr.2019.07.079
|
[
"skull",
"fracture",
"favorable",
"mayfield",
"prone",
"epidural",
"hematoma",
"depressed",
"data",
"temporal"
] |
[
{
"code": "LB70.Z",
"title": "Structural developmental anomalies of cranium, unspecified"
},
{
"code": "NA01.2",
"title": "Laceration without foreign body of head"
},
{
"code": "LB70.0Y",
"title": "Other specified craniosynostosis"
},
{
"code": "LD2G",
"title": "Conjoined twins"
},
{
"code": "NA01.4",
"title": "Puncture wound without foreign body of head"
},
{
"code": "ND56.2",
"title": "Fracture of unspecified body region"
},
{
"code": "ND32",
"title": "Fractures involving multiple body regions"
},
{
"code": "NB52.Z",
"title": "Fracture of lumbar spine or pelvis, unspecified"
},
{
"code": "FB80.B",
"title": "Pathological fracture"
},
{
"code": "FB80.Y",
"title": "Other specified disorders of bone density or structure"
}
] |
=== ICD-11 CODES FOUND ===
[LB70.Z] Structural developmental anomalies of cranium, unspecified
Also known as: Structural developmental anomalies of cranium, unspecified | Structural developmental anomalies of cranium | Cranial malformations | Malformations of cranium | cranial abnormality NOS
[NA01.2] Laceration without foreign body of head
Also known as: Laceration without foreign body of head | laceration of skin of head | cranial laceration | skin tear without foreign body of head | Laceration without foreign body of ear
Includes: laceration of skin of head
[LB70.0Y] Other specified craniosynostosis
Also known as: Other specified craniosynostosis | Monosutural craniosynostosis | Scaphocephaly | Dolichocephaly | dolichocephalia
[LD2G] Conjoined twins
Definition: A condition characterised as twins that are physically united at some part or parts of their bodies at the time of birth.
Also known as: Conjoined twins | siamese twin | twin fusion | Thoracopagus | thorax-joined twins
[NA01.4] Puncture wound without foreign body of head
Also known as: Puncture wound without foreign body of head | punctured skull | punctured head | Puncture wound without foreign body of ear | Puncture wound without foreign body of nose
[ND56.2] Fracture of unspecified body region
Also known as: Fracture of unspecified body region | avulsion fracture of unspecified body site | comminuted fracture of unspecified body site | compression fracture of unspecified body site | fracture dislocation of unspecified body site
Excludes: multiple fractures NOS
[ND32] Fractures involving multiple body regions
Also known as: Fractures involving multiple body regions | multiple skeletal fractures | multiple fractures | multiple compression fractures | fracture of multiple bone sites
[NB52.Z] Fracture of lumbar spine or pelvis, unspecified
Also known as: Fracture of lumbar spine or pelvis, unspecified | Fracture of lumbar spine or pelvis | Fracture of pelvis, not elsewhere classified | fracture pelvis NOS | pelvic fracture
[FB80.B] Pathological fracture
Also known as: Pathological fracture | pathological bone fracture | Pathological fracture NOS | spontaneous fracture | spontaneous fracture with dislocation
Excludes: Collapsed vertebra, not elsewhere classified
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[LB70.Z] Structural developmental anomalies of cranium, unspecified
--PARENT--> [LB70] Structural developmental anomalies of cranium
Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period....
--RELATED_TO--> [?] Wide cranial sutures of newborn
Def: A paediatric condition characterised by abnormally large separation between the bones of the skull of a newborn....
--- Walk 2 ---
[LB70.Z] Structural developmental anomalies of cranium, unspecified
--PARENT--> [LB70] Structural developmental anomalies of cranium
Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period....
--CHILD--> [LB70.1] Wormian bones
Def: Also known as intrasutural bone, is an additional bony segment interlocked in an existing cranial suture. A special form: Interparietal bone or Inca bone is an interlocked irregular isolated bone at t...
--- Walk 3 ---
[NA01.2] Laceration without foreign body of head
--PARENT--> [NA01] Open wound of head
--EXCLUDES--> [?] Decapitation
--- Walk 4 ---
[NA01.2] Laceration without foreign body of head
--PARENT--> [NA01] Open wound of head
--CHILD--> [NA01.4] Puncture wound without foreign body of head
--- Walk 5 ---
[LB70.0Y] Other specified craniosynostosis
--PARENT--> [LB70.0] Craniosynostosis
Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...
--CHILD--> [LB70.0Z] Craniosynostosis, unspecified
--- Walk 6 ---
[LB70.0Y] Other specified craniosynostosis
--PARENT--> [LB70.0] Craniosynostosis
Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...
--CHILD--> [LB70.0Z] Craniosynostosis, unspecified
|
[
"[LB70.Z] Structural developmental anomalies of cranium, unspecified\n --PARENT--> [LB70] Structural developmental anomalies of cranium\n Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period....\n --RELATED_TO--> [?] Wide cranial sutures of newborn\n Def: A paediatric condition characterised by abnormally large separation between the bones of the skull of a newborn....",
"[LB70.Z] Structural developmental anomalies of cranium, unspecified\n --PARENT--> [LB70] Structural developmental anomalies of cranium\n Def: Any condition caused by failure of the cranium to correctly develop during the antenatal period....\n --CHILD--> [LB70.1] Wormian bones\n Def: Also known as intrasutural bone, is an additional bony segment interlocked in an existing cranial suture. A special form: Interparietal bone or Inca bone is an interlocked irregular isolated bone at t...",
"[NA01.2] Laceration without foreign body of head\n --PARENT--> [NA01] Open wound of head\n --EXCLUDES--> [?] Decapitation",
"[NA01.2] Laceration without foreign body of head\n --PARENT--> [NA01] Open wound of head\n --CHILD--> [NA01.4] Puncture wound without foreign body of head",
"[LB70.0Y] Other specified craniosynostosis\n --PARENT--> [LB70.0] Craniosynostosis\n Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...\n --CHILD--> [LB70.0Z] Craniosynostosis, unspecified",
"[LB70.0Y] Other specified craniosynostosis\n --PARENT--> [LB70.0] Craniosynostosis\n Def: Craniosynostosis consists of premature fusion of one or more cranial sutures, resulting in an abnormal head shape. It can be divided in several subgroups; the major different types are primary vs seco...\n --CHILD--> [LB70.0Z] Craniosynostosis, unspecified"
] |
LB70.Z
|
Structural developmental anomalies of cranium, unspecified
|
[
{
"from_icd11": "LB70.Z",
"icd10_code": "Q758",
"icd10_title": "Other specified congenital malformations of skull and face bones"
},
{
"from_icd11": "LB70.Z",
"icd10_code": "Q759",
"icd10_title": "Congenital malformation of skull and face bones, unspecified"
},
{
"from_icd11": "LB70.Z",
"icd10_code": "Q75",
"icd10_title": "Other congenital malformations of skull and face bones"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S0181XA",
"icd10_title": "Laceration without foreign body of other part of head, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S0101XA",
"icd10_title": "Laceration without foreign body of scalp, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S01111A",
"icd10_title": "Laceration without foreign body of right eyelid and periocular area, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S0191XA",
"icd10_title": "Laceration without foreign body of unspecified part of head, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S0101XD",
"icd10_title": "Laceration without foreign body of scalp, subsequent encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S0121XA",
"icd10_title": "Laceration without foreign body of nose, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S01512A",
"icd10_title": "Laceration without foreign body of oral cavity, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S01112A",
"icd10_title": "Laceration without foreign body of left eyelid and periocular area, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S01511A",
"icd10_title": "Laceration without foreign body of lip, initial encounter"
},
{
"from_icd11": "NA01.2",
"icd10_code": "S0181XD",
"icd10_title": "Laceration without foreign body of other part of head, subsequent encounter"
},
{
"from_icd11": "LD2G",
"icd10_code": "Q894",
"icd10_title": "Conjoined twins"
},
{
"from_icd11": "ND56.2",
"icd10_code": "T142",
"icd10_title": ""
}
] |
Q758
|
Other specified congenital malformations of skull and face bones
|
A 72-year-old male patient from rural area was referred to our specialized surgical unit because of swelling in his left armpit, which he had noticed since his early twenties. The swelling began as a painless mass the size of a lemon and gradually enlarged to cover the left side of his chest and flank. This mass caused discomfort and restricted his daily activities, leading him to seek medical help. Although the patient intermittently used traditional medicine on the nipple area of the swelling, this treatment resulted in partial destruction of the nipple and areola instead of reducing the swelling, leaving a pale, scarred area. Aside from the swelling, he did not report any systemic issues or previous surgeries, and he had no other underlying health conditions. On physical examination, a large, stalked, lobulated mass measuring 25x15x10 cm was identified in the left axilla. The mass was soft, non-tender, and had a smooth surface. The skin above it showed no discoloration, except for the nipple and areolar area, which were disrupted. The mass originated in the left axilla and extended laterally along the mid-axillary line to the left iliac crest . No significant lymphadenopathy was found, and both breasts appeared normal. The patient's vital signs were stable, and no abnormal physical findings were noted aside from those already mentioned. The initial clinical assessment suggested a large left axillary mass, likely related to accessory breast tissue, with a giant pedunculated lipoma as a possible alter- native diagnosis. The patient then underwent an ultrasound and fine needle aspiration cytology, both of which indicated that the mass was accessory breast tissue. The ultrasound displayed a well-defined, uniformly hypoechoic layer of subcutaneous fat with multiple thin, linear echogenic striations and small hypoechoic areas suggestive of fibroglandular tissue . The patient's complete blood count and electrocardiogram (ECG) were within normal limits. The excised mass was sent for histopathological examination, which confirmed it to be a Kajava Class I accessory breast, characterized by glandular tissue along with an areola and nipple, a condition rarely reported in elderly male in the literature. The macroscopic examination revealed a skin-covered, firm to hard mass with a smooth surface, measuring 24 × 20 × 9 cm. There was a central area of hypopigmented, amputated nipple scar measuring 1 × 1.6 cm. Upon sectioning, the mass was found to be predominantly composed of fatty tissue, with foci of fibrous tissue. Histologic section showed lobules of glandular tissue lined by bland single layered ductal and myo-epithelial cells diposited in fibrous growth back ground. There are foci of bland fat tissue histology . Based on consistent diagnostic findings from the ultrasound and fine needle aspiration cytology (FNAC) results, the mass was surgically excised under general anesthesia. Intraoperatively, a large pedunculated mass was identified, covering the left lateral chest and flank area. It originated from the axilla and extended laterally to the mid- axillary line, reaching the iliac crest. The mass was well-capsulated and did not invade the thoracic cavity . The operation proceeded without complications , and the patient experienced a smooth postoperative course, being discharged on the second day after surgery. He returned to his routine daily activities after the third day of the procedure and was smooth. We followed him for 06 months and Follow-up evaluations showed no signs of recurrence or surgical complications. The patient's clinical presentation, diagnostic approach, and treatment outcomes are summarized in Table 1 . Fig. 1 Preoperative photos. Fig. 1 Fig. 2 The red arrow demonstrate hypoechoic subcutaneous fat, the green arrow indicate echogenic areas with small hypoechoic regions representing fibroglandular tissue, and the yellow thin arrow show the echogenic superficial fascial layer. Fig. 2 Fig. 3 Histological specimen from the axillary mass. Fig. 3 Fig. 4 Intraoperative photograph of the excised mass. A giant 24 × 20 × 9 cm mass was extracted. Fig. 4 Fig. 5 Postoperative photograph. The mass was completely excised with-out damaging the surrounding tissue. Fig. 5 Table 1 A summary table that outlines the patient's clinical presentation, diagnostic workup, and outcomes. Table 1 Aspects Details Clinical presentation A 72-year-old male presented with swelling in his left armpit that had been present since his early twenties. A large, pedunculated and lobulated mass measuring 25x15x10 cm was identified in the left axilla. The mass was soft, non-tender, and had a smooth surface. No significant lymphadenopathy was detected. Diagnostic workup The ultrasound revealed a well-defined, hypoechoic subcutaneous fat layer containing fibroglandular tissue. Lobules of glandular tissue, lined by bland, single-layered ductal and myoepithelial cells, were observed in a fibrous growth background during the histopathologic examination. Treatment and postoperative outcomes The mass was surgically excised under general anesthesia. The patient was discharged on the second day and resumed daily activities by the third day. There were no signs of recurrence or complications during the six-month follow-up period.
| 3.976563
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999996
|
39642413
|
https://doi.org/10.1016/j.ijscr.2024.110666
|
[
"tissue",
"area",
"swelling",
"nipple",
"smooth",
"hypoechoic",
"excised",
"which",
"large",
"measuring"
] |
[
{
"code": "FB6Z",
"title": "Soft tissue disorders, unspecified"
},
{
"code": "MC85",
"title": "Gangrene"
},
{
"code": "FB56.6",
"title": "Other specified soft tissue disorders"
},
{
"code": "GB61.Z",
"title": "Chronic kidney disease, stage unspecified"
},
{
"code": "4A43.3",
"title": "Mixed connective tissue disease"
},
{
"code": "QF29",
"title": "Difficulty or need for assistance with major areas of life"
},
{
"code": "EH40.1Y",
"title": "Other specified infantile napkin dermatoses"
},
{
"code": "GA90",
"title": "Hyperplasia of prostate"
},
{
"code": "2B66.Z",
"title": "Malignant neoplasms of other or unspecified parts of mouth, unspecified"
},
{
"code": "EG63.Z",
"title": "Sacrococcygeal pilonidal disease, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[FB6Z] Soft tissue disorders, unspecified
Also known as: Soft tissue disorders, unspecified | disease of soft tissue NOS | unspecified soft tissue disorder, site unspecified | disorder of soft tissue | disorder of soft tissue NOS
[MC85] Gangrene
Definition: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply.
Also known as: Gangrene | gangrene NOS | dry gangrene | wet gangrene | ulcerative gangrene
Excludes: Pyoderma gangrenosum | Gas gangrene | Polymicrobial necrotising fasciitis
[FB56.6] Other specified soft tissue disorders
Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia
[GB61.Z] Chronic kidney disease, stage unspecified
Also known as: Chronic kidney disease, stage unspecified | Chronic kidney disease | chronic renal failure | chronic kidney failure | chronic renal disease
[4A43.3] Mixed connective tissue disease
Definition: Mixed connective tissue disease is an overlapping syndrome combining features of systemic lupus erythematosus, systemic sclerosis, and polymyositis with the presence of autoantibodies to U1-ribonucleoprotein. Raynaud’s phenomenon is seen in nearly all patients and pulmonary arterial hypertension is the most common cause of death in MCTD patients.
Also known as: Mixed connective tissue disease | Sharp syndrome | MCTD - [mixed connective tissue disease] | Paediatric-onset mixed connective tissue disease | Paediatric-onset Sharp syndrome
[QF29] Difficulty or need for assistance with major areas of life
Also known as: Difficulty or need for assistance with major areas of life | difficulty with major areas of life | need for assistance with major areas of life | Difficulty or need for assistance with education | Difficulty or needs for assistance with work and economic life
[EH40.1Y] Other specified infantile napkin dermatoses
Also known as: Other specified infantile napkin dermatoses | Infections of the napkin area
[GA90] Hyperplasia of prostate
Definition: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urinary urgency, nocturia, weak urine stream, straining while urinating, incomplete bladder emptying during urination, or increased frequency of urinary tract infection.
Also known as: Hyperplasia of prostate | Adenofibromatous hypertrophy of prostate | benign prostatic hyperplasia | prostate hyperplasia | prostatic area hypertrophy
Includes: Adenofibromatous hypertrophy of prostate
Excludes: Benign neoplasms of prostate
[2B66.Z] Malignant neoplasms of other or unspecified parts of mouth, unspecified
Also known as: Malignant neoplasms of other or unspecified parts of mouth, unspecified | Malignant neoplasms of other or unspecified parts of mouth | cancer of buccal mucosa | cancer of cheek mucosa | internal cheek cancer
[EG63.Z] Sacrococcygeal pilonidal disease, unspecified
Also known as: Sacrococcygeal pilonidal disease, unspecified | Sacrococcygeal pilonidal disease | pilonidal disease of sacrococcygeal area | sacrococcygeal pilonidal disease NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[FB6Z] Soft tissue disorders, unspecified
--PARENT--> [?] Soft tissue disorders
--CHILD--> [?] Miscellaneous specified soft tissue disorders
Def: This is a group of other disorders, which are not defined elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....
--- Walk 2 ---
[FB6Z] Soft tissue disorders, unspecified
--PARENT--> [?] Soft tissue disorders
--CHILD--> [?] Disorders of muscles
--- Walk 3 ---
[MC85] Gangrene
Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply....
--EXCLUDES--> [?] Gas gangrene
Def: Gas gangrene or clostridial myonecrosis is a potentially fatal, rapidly progressive necrotizing infection of muscle and soft tissue resulting from bacterial invasion of healthy muscle from adjacent tr...
--PARENT--> [?] Other bacterial diseases
--- Walk 4 ---
[MC85] Gangrene
Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply....
--EXCLUDES--> [?] Gas gangrene
Def: Gas gangrene or clostridial myonecrosis is a potentially fatal, rapidly progressive necrotizing infection of muscle and soft tissue resulting from bacterial invasion of healthy muscle from adjacent tr...
--PARENT--> [?] Other bacterial diseases
--- Walk 5 ---
[FB56.6] Other specified soft tissue disorders
--PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified
Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....
--CHILD--> [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified
--- Walk 6 ---
[FB56.6] Other specified soft tissue disorders
--PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified
Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....
--EXCLUDES--> [?] Mononeuropathy
|
[
"[FB6Z] Soft tissue disorders, unspecified\n --PARENT--> [?] Soft tissue disorders\n --CHILD--> [?] Miscellaneous specified soft tissue disorders\n Def: This is a group of other disorders, which are not defined elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....",
"[FB6Z] Soft tissue disorders, unspecified\n --PARENT--> [?] Soft tissue disorders\n --CHILD--> [?] Disorders of muscles",
"[MC85] Gangrene\n Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply....\n --EXCLUDES--> [?] Gas gangrene\n Def: Gas gangrene or clostridial myonecrosis is a potentially fatal, rapidly progressive necrotizing infection of muscle and soft tissue resulting from bacterial invasion of healthy muscle from adjacent tr...\n --PARENT--> [?] Other bacterial diseases",
"[MC85] Gangrene\n Def: Gangrene, not elsewhere classified is the death of tissues in the body which happens when a part of the body loses its blood supply....\n --EXCLUDES--> [?] Gas gangrene\n Def: Gas gangrene or clostridial myonecrosis is a potentially fatal, rapidly progressive necrotizing infection of muscle and soft tissue resulting from bacterial invasion of healthy muscle from adjacent tr...\n --PARENT--> [?] Other bacterial diseases",
"[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --CHILD--> [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified",
"[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --EXCLUDES--> [?] Mononeuropathy"
] |
FB6Z
|
Soft tissue disorders, unspecified
|
[
{
"from_icd11": "FB6Z",
"icd10_code": "M60-M79",
"icd10_title": ""
},
{
"from_icd11": "MC85",
"icd10_code": "R02",
"icd10_title": ""
},
{
"from_icd11": "MC85",
"icd10_code": "I96",
"icd10_title": "Gangrene, not elsewhere classified"
},
{
"from_icd11": "FB56.6",
"icd10_code": "M7981",
"icd10_title": "Nontraumatic hematoma of soft tissue"
},
{
"from_icd11": "FB56.6",
"icd10_code": "M7989",
"icd10_title": "Other specified soft tissue disorders"
},
{
"from_icd11": "FB56.6",
"icd10_code": "M798",
"icd10_title": "Other specified soft tissue disorders"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N183",
"icd10_title": "Chronic kidney disease, stage 3 (moderate)"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N189",
"icd10_title": "Chronic kidney disease, unspecified"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N250",
"icd10_title": "Renal osteodystrophy"
},
{
"from_icd11": "GB61.Z",
"icd10_code": "N18",
"icd10_title": "Chronic kidney disease (CKD)"
},
{
"from_icd11": "4A43.3",
"icd10_code": "M351",
"icd10_title": "Other overlap syndromes"
},
{
"from_icd11": "4A43.3",
"icd10_code": "M35",
"icd10_title": "Other systemic involvement of connective tissue"
},
{
"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"
}
] |
M60-M79
| |
A 66-year-old male was referred to our department because of cough, chest pain and weight loss. His past clinical history, family history were unremarkable. Given the persistency of symptoms, chest X-ray was performed and showed a subtle opacity at the upper segment of the right lower lung. Whole body computed tomography (CT) scan confirmed the presence of a pulmonary malignant-looking nodule without hilar lymphadenopathy. 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed avid uptake of the pulmonary nodule as well as oropharyngeal, sigmoid colon, and prostate gland uptake . Subsequently, the patient underwent video-assisted bronchoscopy, which revealed normal findings. Conversely, video-assisted laryngoscopy showed an infiltrative ulcerated lesion involving the base and both valves of the tongue. Oropharyngeal biopsy was performed and histology revealed an infiltrative squamous cell carcinoma. Subsequently, CT guided lung biopsy showed a lung adenocarcinoma. The patient underwent colonoscopy with polypectomy and histology revealed the presence of adenocarcinoma. Finally, specimen from the prostate gland revealed an adenocarcinoma (Gleason score: 3 + 3), too (Table 1 ). Abnormally enlarged lymph nodes in the abdomen up to 1.7 cm in diameter along with several non-specific lymph nodes have been identified. CT scan of the neck and facial bones showed a bulky mass in the right aspect of the oral cavity, infiltrating the base of the tongue with preservation of the adjacent mandibular cortical bone abutting the midline, given a horseshoe-like appearance of the tumor. There was infiltration of the muscles of the tongue base whereas the left mylohyoid muscle was preserved. Bilateral enlarged lymph nodes at level II and III have been identified. Given the presence of these multiple malignant tumors, multidisciplinary assessment was necessary. The laryngeal lesion was treated by radio and chemotherapy whereas the sigmoid and prostate tumors were treated by surgical excision. In regard to the pulmonary tumor, the decision about whether surgery or radiotherapy would be more appropriate was considered later. Consequently, chemotherapy and radiotherapy were started given almost complete resolution of the lung tumor; instead we observed progression of the sigmoid tumor along with two enlarged lymph nodes in the pelvis, whereas the tumor of the prostate gland did not change in size. The patient had left hemicolectomy and prostatectomy, which confirmed the presence of adenocarcinoma with features of vascular invasion, adipose tissue invasion, and no extramural or perineural involvement. Metastases were found in 10 out of 19 lymph nodes. As a result, the histological staging was pT3 N2B R0 B. Prostatic specimen confirmed the presence of adenocarcinoma with no infiltration of the urinary bladder. However, multifocal extension by the tumor to the adjacent tissues was observed. A 30-day interval follow-up PET-CT scan showed an avid focal uptake at segment 5 of the liver suspicious of a sigmoid adenocarcinoma metastasis and at the apical segment of the right lower lobe in accordance with the known pulmonary tumor. A further multidisciplinary assessment regarding the appropriate patient’s management suggests surgical treatment for the pulmonary lesion, stereotactic radiotherapy for the metastatic deposit in the liver and adjuvant chemotherapy for the sigmoid tumor of colon. Surgical specimen after right lower lobectomy showed a G3 type lung carcinoma with prevalent aspects of acinar growth and absence of pleural infiltration, vascular invasion, or necrosis. The tumor did not involve the bronchial or vascular surgical resection margins or adjacent lymph nodes. Immunocytochemistry was TTF1 (+) and CDX2 (−), whereas histopathological staging was pT1 N0. The patient received stereotactic radiotherapy for the liver metastasis and adjuvant chemotherapy for the sigmoid colonic tumor. An 18-month interval follow-up PET-CT scan demonstrated no recurrence. Fig. 1 Top left panel Axial non-contrast CT scan shows no significant mediastinal, hilar and axillary lymphadenopathy. Bottom left panel Axial non-contrast lung window setting CT shows a solid nodule at the upper segment of right lower lobe. Right panel Coronal view whole-body PET scan shows focal uptake of at the upper segment of right lower lobe, sigmoid colon and prostate gland Table 1 Clinical history of the patient: diagnosis and treatment Date (mm/dd/yrs) Examination Histology Date (mm/dd/yrs) Treatment 02/08/2013 Laringoscopy biopsy Vegetating lesion base of the tongue Infiltrating and ulcerating squamous cell carcinoma C2 – C3 From 03/12/2013 to 04/13/2013 2 cycles of TPF (taxotere/cisplatin/5-fluoruracil) plus rasdiation therapy on nodes PET + and loco regional (69.96 Gy) and on orofarinx (54.45 Gy) 02/08/2013 CT-guided pulmonary biopsy Subpleural lesion o f the right upper lobe Pulmonary Adenocarcinoma TTF1( + ) e CDX2( - ). pT1a N0 09/30/2013 Right lower lobectomy No chemotherapy 02/13/2013 Pancolonscopy Polipectomy Adenocarcinoma CDX2(+); TTF1(−). pT3a N2b R0 07/11/2013 Left hemicolectomy Adjuvant chemotherapy 03/07/2013 Prostatic biopsy Adenocarcinoma Grading Gleason score 4 + 3; pT3, N2b, R0B 07/11/2013 Prostatectomy No chemotherapy
| 3.958984
| 0.97998
|
sec[1]/p[0]
|
en
| 0.999997
|
26613933
|
https://doi.org/10.1186/s13104-015-1724-5
|
[
"tumor",
"adenocarcinoma",
"pulmonary",
"sigmoid",
"nodes",
"chemotherapy",
"lung",
"scan",
"lymph",
"segment"
] |
[
{
"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": "2D40",
"title": "Adenocarcinoma of unspecified site"
},
{
"code": "2C0Y",
"title": "Other specified malignant neoplasms of intestine"
},
{
"code": "2C25.0",
"title": "Adenocarcinoma of bronchus or lung"
},
{
"code": "2C94.0",
"title": "Adenocarcinoma of urinary bladder"
},
{
"code": "2B70.0Z",
"title": "Adenocarcinoma of oesophagus, 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
[2D40] Adenocarcinoma of unspecified site
Definition: A common cancer characterised by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreting product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell carcinoma, hepatocellular carcinoma (hepatoma), colon adenocarcinoma, and prostate adenocarcinoma.
Also known as: Adenocarcinoma of unspecified site | adenoacanthoma of unspecified site | adenocarcinoid of unspecified site | adenocarcinoid tumour of unspecified site | adenocarcinoma and carcinoid combined of unspecified site
[2C0Y] Other specified malignant neoplasms of intestine
Also known as: Other specified malignant neoplasms of intestine | Adenocarcinoma of intestine | adenocarcinoma of intestine NOS
[2C25.0] Adenocarcinoma of bronchus or lung
Definition: A carcinoma that arises from the lung and is characterised by the presence of malignant glandular epithelial cells. There is a male predilection with a male to female ratio of 2:1. Usually lung adenocarcinoma is asymptomatic and is identified through screening studies or as an incidental radiologic finding. If clinical symptoms are present they include shortness of breath, cough, hemoptysis, chest pain, and fever. Tobacco smoke is a known risk factor.
Also known as: Adenocarcinoma of bronchus or lung | primary lung adenocarcinoma | lung adenocarcinoma | bronchiolar adenocarcinoma of unspecified site | Mucinous adenocarcinoma of lung
[2C94.0] Adenocarcinoma of urinary bladder
Definition: A rare adenocarcinoma arising from metaplastic bladder epithelium. It is frequently associated with long-standing local irritation. The majority of cases originate from the trigone and the posterior wall of the bladder.
Also known as: Adenocarcinoma of urinary bladder | Adenocarcinoma of bladder
[2B70.0Z] Adenocarcinoma of oesophagus, unspecified
Also known as: Adenocarcinoma of oesophagus, unspecified | Adenocarcinoma of oesophagus | oesophageal adenocarcinoma
=== 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
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F92] Neoplasms of unknown behaviour of skin",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --RELATED_TO--> [?] Pathological fracture in neoplastic disease of unknown behaviour",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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 --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 79-year old woman with claudication in the right lower extremity which decreased her quality of life was referred to our hospital. Past medical history included hypertension, dyslipidemia and coronary artery disease. The ankle brachial index (ABI) on the right side was 0.71. Pre-procedural angiography showed severe stenosis from the middle-to-distal part of the right SFA and a drug-eluting stent (Eluvia, 7.0 × 150 mm) was placed without pre-dilation because the lesion was not severe calcified lesion. After stent placement, we performed adequate post-dilation, resulting in the optimal expansion of drug-eluting stent (Eluvia) . After drug-eluting stent (Eluvia) placement, the ABI increased from 0.71 to 0.85 and the patient’s symptoms improved. Since then, she has been taking dual antiplatelet therapy with aspirin (100 mg/day) and clopidogrel (75 mg/day). However, she had a recurrence of intermittent claudication in the right lower extremity 25 months after drug-eluting stent (Eluvia) placement. Angiography revealed de novo stenosis in the distal part of the popliteal artery and proximal in-stent restenosis at the drug-eluting stent (Eluvia) placement site . Subsequently, the patient underwent endovascular therapy (EVT) with plain balloon angioplasty for severe stenosis in the distal part of the popliteal artery and a drug-coated stent (Zilver PTX, 7.0 × 120 mm) was placed for the proximal in-stent restenosis of the drug-eluting stent (Eluvia). A completion angiogram showed an optimal angiographic result. In addition, intravascular ultrasound (IVUS, AltaView; Terumo, Tokyo, Japan) at the time of EVT revealed vessel enlargement with a maximum vessel diameter of 7.3–10.0 mm at the distal edge of the drug-eluting stent (Eluvia) placement site . Thereafter, the patient was symptom-free until intermittent claudication on the right side recurred 50 months after drug-eluting stent (Eluvia) placement. Angiography demonstrated de novo severe stenosis from the distal part of the SFA to the middle part of the popliteal artery. The popliteal artery lesion was dilated using a drug-coated balloon (INPACT Admiral, 4.0 × 80 mm; Medtronic plc., Santa Rosa, CA, USA) and the distal SFA lesion was dilated using a drug-coated balloon (INPACT Admiral, 6.0 × 120 mm), resulting in an adequate angiographic result. However, peri-stent contrast staining (PSS) was found by angiography at the distal part of the drug-eluting stent (Eluvia) placement site . IVUS showed a further enlargement of maximum vessel diameter to 12.0 mm at the distal edge of the drug-eluting stent (Eluvia) . Moreover, enlargement of the lumen and stent malapposition were also found, suggesting progressive aneurysmal degeneration 50 months after drug-eluting stent (Eluvia) placement. Similarly, duplex images showed a hypoechogenic halo suggestive of aneurysmal degeneration around the distal edge of the drug-eluting stent (Eluvia) . Fig. 1 Conventional angiogram. A : Initial angiography. Initial angiography revealing a severe stenosis from the middle-to-distal part of the right superficial femoral artery. B : Angiography immediately after drug-eluting stent (Eluvia) placement. Angiography showing optimal expansion after drug-eluting stent (Eluvia) placement. C : Angiography 25 months after drug-eluting stent (Eluvia) placement. Angiography revealing proximal in-stent restenosis at the drug-eluting stent (Eluvia) placement site (white arrows). D : Angiography 50 months after drug-eluting stent (Eluvia) placement. Angiography documenting peri-stent contrast staining at the distal part of the drug-eluting stent (Eluvia) placement site (red arrow) Fig. 2 Conventional angiogram and intravascular ultrasound (IVUS) immediately, 25 months, and 50 months after drug-eluting stent (Eluvia) placement. A: Angiography immediately after drug-eluting stent (Eluvia) placement. Angiography showing optimal expansion. B: Angiography 25 months after drug-eluting stent (Eluvia) placement. Angiography showing no significant stenosis or peri-stent contrast staining in the distal part of the right superficial femoral artery. C: Angiography 50 months after drug-eluting stent (Eluvia) placement. Angiography demonstrating peri-stent contrast staining in the distal part of the drug-eluting stent (Eluvia) placement site (red arrow). a-c: Images of IVUS immediately after drug-eluting stent (Eluvia) placement. IVUS demonstrating optimal expansion of drug-eluting stent (Eluvia) (a-c). Maximum vessel diameter was 7.3 mm at the distal edge of the drug-eluting stent (Eluvia) placement site (b). d-f: Images of IVUS 25 months after drug-eluting stent (Eluvia) placement. IVUS revealing vessel enlargement with a maximum vessel diameter of 10.0 mm at the distal edge of the drug-eluting stent (Eluvia) placement site (d-f). g-i: Images of IVUS 50 months after drug-eluting stent (Eluvia) placement. IVUS showing further enlargement of the maximum vessel diameter to 12.0 mm at the distal edge of the drug-eluting stent (Eluvia) placement site (g-i). Enlargement of the lumen and stent malapposition (g and h) Fig. 3 Duplex images 50 months after drug-eluting stent (Eluvia) placement. Duplex images showing a hypoechogenic halo around the distal edge of the drug-eluting stent (Eluvia) ( a and b )
| 3.941406
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999997
|
34216312
|
https://doi.org/10.1186/s42155-021-00245-3
|
[
"stent",
"drug",
"eluting",
"eluvia",
"placement",
"angiography",
"part",
"site",
"ivus",
"artery"
] |
[
{
"code": "PK93.2",
"title": "Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices"
},
{
"code": "QB51.1",
"title": "Presence of urogenital implants"
},
{
"code": "QB51.Y",
"title": "Presence of other specified devices other than cardiac or vascular implants"
},
{
"code": "QB51.3",
"title": "Presence of otological or audiological implants"
},
{
"code": "PL12.3",
"title": "Obstruction of device, as mode of injury or harm"
},
{
"code": "QE11.Z",
"title": "Hazardous drug use, unspecified"
},
{
"code": "6C4G.2Z",
"title": "Unknown or unspecified psychoactive substance dependence, substance and state of remission unspecified"
},
{
"code": "NE60",
"title": "Harmful effects of drugs, medicaments or biological substances, not elsewhere classified"
},
{
"code": "4A85.0Z",
"title": "Drug hypersensitivity of unspecified type"
},
{
"code": "6C4G.3",
"title": "Intoxication due to unknown or unspecified psychoactive substance"
}
] |
=== ICD-11 CODES FOUND ===
[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices
Also known as: Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices | Surgical operation with implant of artificial internal gastroenterology or urology device associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Surgical operation with gastroenterological or urological bypass or graft associated with abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure | Gastroenterology or urology devices associated with injury or harm, urethral or ureteral stents | Incrustation or calcification of indwelling ureteral stents
Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
[QB51.1] Presence of urogenital implants
Also known as: Presence of urogenital implants | Presence of bladder implant | bladder replaced by other means | replacement of bladder by artificial or mechanical device or prosthesis | Presence of urethral stent
[QB51.Y] Presence of other specified devices other than cardiac or vascular implants
Also known as: Presence of other specified devices other than cardiac or vascular implants | Presence of bone or tendon implants other than orthopaedic joint implants | replacement of tendon by artificial or mechanical device or prosthesis | presence of tendon implant | Presence of skull plate
[QB51.3] Presence of otological or audiological implants
Also known as: Presence of otological or audiological implants | presence of audiological implant | presence of hearing device implant | presence of hearing-aid implant | presence of otological implant
[PL12.3] Obstruction of device, as mode of injury or harm
Definition: Obstruction associated with prosthetic devices, grafts or implants
Also known as: Obstruction of device, as mode of injury or harm | occlusion shunt | blockage of device causing obstruction as mode of injury | blocked tube causing obstruction as mode of injury | occlusion of device causing obstruction as mode of injury
Excludes: Obstruction of device without injury or harm
[QE11.Z] Hazardous drug use, unspecified
Also known as: Hazardous drug use, unspecified | Hazardous drug use | chronic drug use NOS | chronic IV substance use | drug use nos
[6C4G.2Z] Unknown or unspecified psychoactive substance dependence, substance and state of remission unspecified
Also known as: Unknown or unspecified psychoactive substance dependence, substance and state of remission unspecified | Unknown or unspecified psychoactive substance dependence | Drug dependence 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
[4A85.0Z] Drug hypersensitivity of unspecified type
Also known as: Drug hypersensitivity of unspecified type | Drug or pharmacological agents hypersensitivity | medicinal hypersensitivity | drug sensitivity NOS
[6C4G.3] Intoxication due to unknown or unspecified psychoactive substance
Definition: Intoxication due to unknown or unspecified psychoactive substance is a transient condition that develops during or shortly after the administration of an unknown or unspecified psychoactive substance that is characterised by disturbances in level of consciousness, cognition, perception, affect or behaviour, or other psychophysiological functions and responses. This diagnosis should be made only when there is strong evidence that an unidentified substance has been taken and the features cannot be
Also known as: Intoxication due to unknown or unspecified psychoactive substance | psychoactive substance abuse | trance and possession disorders in psychoactive substance intoxication | drug intoxication NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft
--- Walk 2 ---
[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices
--EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
--PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm
--- Walk 3 ---
[QB51.1] Presence of urogenital implants
--PARENT--> [QB51] Presence of devices other than cardiac or vascular implants
--CHILD--> [QB51.2] Presence of intraocular lens
--- Walk 4 ---
[QB51.1] Presence of urogenital implants
--PARENT--> [QB51] Presence of devices other than cardiac or vascular implants
--CHILD--> [QB51.0] Presence of a neurostimulator
--- Walk 5 ---
[QB51.Y] Presence of other specified devices other than cardiac or vascular implants
--PARENT--> [QB51] Presence of devices other than cardiac or vascular implants
--EXCLUDES--> [?] Fitting, adjustment or management of devices
--- Walk 6 ---
[QB51.Y] Presence of other specified devices other than cardiac or vascular implants
--PARENT--> [QB51] Presence of devices other than cardiac or vascular implants
--CHILD--> [QB51.0] Presence of a neurostimulator
|
[
"[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --EXCLUDES--> [?] Mode of injury or harm associated with a surgical or other medical device, implant or graft",
"[PK93.2] Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices\n --EXCLUDES--> [?] Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm\n --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm",
"[QB51.1] Presence of urogenital implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --CHILD--> [QB51.2] Presence of intraocular lens",
"[QB51.1] Presence of urogenital implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --CHILD--> [QB51.0] Presence of a neurostimulator",
"[QB51.Y] Presence of other specified devices other than cardiac or vascular implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --EXCLUDES--> [?] Fitting, adjustment or management of devices",
"[QB51.Y] Presence of other specified devices other than cardiac or vascular implants\n --PARENT--> [QB51] Presence of devices other than cardiac or vascular implants\n --CHILD--> [QB51.0] Presence of a neurostimulator"
] |
PK93.2
|
Gastroenterology or urology devices associated with injury or harm, prosthetic or other implants, materials or accessory devices
|
[
{
"from_icd11": "PK93.2",
"icd10_code": "T83711A",
"icd10_title": "Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83718A",
"icd10_title": "Erosion of other implanted mesh to organ or tissue, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83728A",
"icd10_title": "Exposure of other implanted mesh into organ or tissue, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83719A",
"icd10_title": "Erosion of other prosthetic materials to surrounding organ or tissue, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83718S",
"icd10_title": "Erosion of other implanted mesh to organ or tissue, sequela"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83712A",
"icd10_title": "Erosion of implanted urethral mesh to surrounding organ or tissue, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83721A",
"icd10_title": "Exposure of implanted vaginal mesh into vagina, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T85590A",
"icd10_title": "Other mechanical complication of bile duct prosthesis, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83490A",
"icd10_title": "Other mechanical complication of implanted penile prosthesis, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T85598A",
"icd10_title": "Other mechanical complication of other gastrointestinal prosthetic devices, implants and grafts, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T85528A",
"icd10_title": "Displacement of other gastrointestinal prosthetic devices, implants and grafts, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T85520A",
"icd10_title": "Displacement of bile duct prosthesis, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83193A",
"icd10_title": "Other mechanical complication of other urinary stent, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83123A",
"icd10_title": "Displacement of other urinary stents, initial encounter"
},
{
"from_icd11": "PK93.2",
"icd10_code": "T83111A",
"icd10_title": "Breakdown (mechanical) of implanted urinary sphincter, initial encounter"
}
] |
T83711A
|
Erosion of implanted vaginal mesh to surrounding organ or tissue, initial encounter
|
In three days, the patient once again returned to the ED with worsening dental pain and now facial swelling. His blood pressure was 146/72 mm Hg, heart rate was 86/minute, respiratory rate was 18/minute, temperature was 36.7°C, and oxygen saturation was 99%. On examination, he had difficulty in controlling oral secretions and also had a muffled voice, stridor, and swelling on the left side of the face at the mandibular angle with tenderness and crepitus on palpation. There was gingival swelling of the left lower mandible and trismus, but no swelling or tenderness of the floor of the mouth was reported. His laboratory results revealed a leukocytosis of 18.7 x 10 3 /μL with 90.2% neutrophils and creatinine 1.4 mg/dL from a baseline of 1.0 mg/dL. A repeat CT scan of the neck with IV contrast was obtained . The patient was started on piperacillin-tazobactam, vancomycin, clindamycin, dexamethasone, and 500-mL bolus of crystalloid. The intensivist and general surgery were immediately consulted because of the concern of an impending airway compromise. The initial plan was to transport the patient directly to the operating room for a controlled intubation. By the time the patient arrived at the operating room, he had had difficulty in phonating and controlling his airway. Rapid sequence intubation was attempted in a lateral position by anesthesia with video laryngoscopy, but the endotracheal tube could not be passed through the pharynx due to severe edema. The general surgeon then attempted an emergency cricothyroidotomy, but again, because of severe edema of the neck, he was not able to pass the tube in two attempts. A tracheostomy was then attempted. The strap muscles were edematous but allowed for dissection and successful cannulation of the trachea. The patient was moved to the intensive care unit (ICU) in a stable condition for continued resuscitation. An Oral and maxillofacial surgeon was consulted. On hospital day 2, the oral and maxillofacial surgeon took the patient to the operating room for debridement of infected tissue. A surgical extraction of tooth numbers 17, 19, 21, and 22 was performed. The submandibular space and buccal space were entered, and a large volume of pus was evacuated. A 2.5-inch-long Penrose drain was placed in the submandibular space. The masticator and parapharyngeal spaces were reached by blunt dissection reflecting the lingual gingiva around the extraction socket of tooth number 17. The left masticator space was drained. Cultures were obtained, and a nasogastric tube was placed. On the third postoperative day, the cultures returned positive for Klebsiella pneumoniae, which was sensitive to piperacillin-tazobactam, Streptococcus viridans group, and coagulase-negative Staphylococcus aureus. The antibiotics were then consolidated to piperacillin-tazobactam. The patient passed the swallow evaluation on postoperative day 7 and was started on pureed foods. However, when the speech pathologist attempted a flexible laryngoscopy to evaluate swallowing, an unexpected nasopharyngeal mass was found, which precluded the passage of the laryngoscope. An otolaryngologist was consulted and the patient was taken to the operating room for mass excision and biopsy on hospital day 16. A pedunculated, lobular mass was found on the roof of the nasopharynx that was blocking half of the nasopharynx. The mass was excised and sent to pathology. The patient was transferred in a stable condition to the medical-surgical floor. The pathology report described the mass as hypertrophied benign lymphoid tissue. Two days after the nasopharyngeal mass excision, the patient began having intermittent minor bleeding from the mouth, as noted by the nursing staff. His aspirin and unfractionated heparin doses were stopped. On the third day after the mass excision, the patient began to have profuse oral bleeding and therefore rapid response was called. The otolaryngologist was also called, and the suspected bleeding from the biopsy site and the nasopharynx was packed at bedside with a norepinephrine-soaked balloon pack. The patient was also noted to have new swelling to the left side of the neck and was dyspneic. He was sedated, placed back on mechanical ventilation, and moved back to the ICU. The packing stopped the bleeding, but the source was not identified. Interventional radiology (IR) was consulted for possible embolization. That evening, on hospital day 19, the patient was taken to the IR suite. The radiologist discovered a large pseudoaneurysm of the left internal maxillary artery with active bleeding, which the radiologist was able to embolize, and no further bleeding was reported. Later, on hospital day 22, the patient suddenly developed atrial fibrillation with rapid ventricular response and was started on an amiodarone infusion, and a CT angiogram (CTA) of the chest was obtained. The CTA revealed a partially occlusive thrombus extending from the right main pulmonary artery into the lobar and segmental branches of the right lower and upper lobes. Anticoagulation at that point was contraindicated given a recent oral hemorrhage; therefore, on hospital day 24, an inferior vena cava filter was placed. The patient continued to recover and was discharged to a rehabilitation center on hospital day 31.
| 3.728516
| 0.977051
|
sec[1]/p[1]
|
en
| 0.999997
|
32431974
|
https://doi.org/10.7759/cureus.7695
|
[
"bleeding",
"swelling",
"oral",
"consulted",
"operating",
"room",
"attempted",
"space",
"neck",
"piperacillin"
] |
[
{
"code": "MG27",
"title": "Haemorrhage, not elsewhere classified"
},
{
"code": "GA21.0",
"title": "Postcoital or contact bleeding"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "DB98.A",
"title": "Hepatic haemorrhage"
},
{
"code": "GA20.3",
"title": "Abnormal regularity of uterine bleeding"
},
{
"code": "FA36.Z",
"title": "Effusion of joint, unspecified"
},
{
"code": "MA01.Z",
"title": "Enlarged lymph nodes, unspecified"
},
{
"code": "MD82",
"title": "Intra-abdominal or pelvic swelling, mass or lump"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "GB90.Y",
"title": "Other specified disorders of kidney or ureter"
}
] |
=== 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
[GA21.0] Postcoital or contact bleeding
Definition: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual bleeding after sexual intercourse. Confirmation is by transvaginal imaging to identify any structural abnormalities.
Also known as: Postcoital or contact bleeding | Postcoital bleeding | bleeding after intercourse | PCB - [postcoital bleeding] | postcoital haemorrhage
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[DB98.A] Hepatic haemorrhage
Definition: Traumatic or nontraumatic spontaneous bleeding in the liver. The most common cause of the latter is the rupture of liver tumours.
Also known as: Hepatic haemorrhage | haemorrhage of liver | hepatic bleeding | hepatorrhagia | liver haemorrhage
Excludes: Hepatic haemorrhage due to hepatocellular carcinoma
[GA20.3] Abnormal regularity of uterine bleeding
Definition: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days.
Also known as: Abnormal regularity of uterine bleeding | Irregular menstrual bleeding | irregular cycle menstruation | irregular menses | irregular menstrual cycle
[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
[MA01.Z] Enlarged lymph nodes, unspecified
Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy
[MD82] Intra-abdominal or pelvic swelling, mass or lump
Definition: This refers to the presence of abdominal or pelvic wall swelling, mass or tumour in the abdominal and pelvic regions. These mass or tumours can be recognised by visual examination and/or palpation.
Also known as: Intra-abdominal or pelvic swelling, mass or lump | Abdominal mass without further specification | mass in abdomen | intra-abdominal lump | intra-abdominal mass
Excludes: Abdominal distension | Ascites
[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
[GB90.Y] Other specified disorders of kidney or ureter
Also known as: Other specified disorders of kidney or ureter | Other secondary disorders of kidney or ureter | Other disorders of kidney and ureter NEC | Inflammatory diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis | Infectious diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis
=== GRAPH WALKS ===
--- Walk 1 ---
[MG27] Haemorrhage, not elsewhere classified
Def: Bleeding or escape of blood from a vessel....
--EXCLUDES--> [?] Obstetric haemorrhage
--CHILD--> [?] Antepartum haemorrhage
--- Walk 2 ---
[MG27] Haemorrhage, not elsewhere classified
Def: Bleeding or escape of blood from a vessel....
--PARENT--> [?] General symptoms
--CHILD--> [MG21] Chills
--- Walk 3 ---
[GA21.0] Postcoital or contact bleeding
Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...
--PARENT--> [GA21] Nonmenstrual bleeding disorders
--RELATED_TO--> [?] Postprocedural nonmenstrual uterine bleeding
Def: Uterine bleeding occurring after procedure (i.e. uterine surgery, induced abortion, …)...
--- Walk 4 ---
[GA21.0] Postcoital or contact bleeding
Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...
--PARENT--> [GA21] Nonmenstrual bleeding disorders
--PARENT--> [?] Abnormal uterine or vaginal bleeding
Def: A condition of the genital system, caused by hormonal disturbances, weight changes, neoplasms, or use of pharmacological agents. This condition is characterised by irregular or excessive shedding of t...
--- Walk 5 ---
[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 6 ---
[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
|
[
"[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --EXCLUDES--> [?] Obstetric haemorrhage\n --CHILD--> [?] Antepartum haemorrhage",
"[MG27] Haemorrhage, not elsewhere classified\n Def: Bleeding or escape of blood from a vessel....\n --PARENT--> [?] General symptoms\n --CHILD--> [MG21] Chills",
"[GA21.0] Postcoital or contact bleeding\n Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...\n --PARENT--> [GA21] Nonmenstrual bleeding disorders\n --RELATED_TO--> [?] Postprocedural nonmenstrual uterine bleeding\n Def: Uterine bleeding occurring after procedure (i.e. uterine surgery, induced abortion, …)...",
"[GA21.0] Postcoital or contact bleeding\n Def: A condition of the genital system, caused by infection, cervical ectropion, cervical or endometrial polyps, cancer, or trauma to the cervix or vagina. This condition is characterised by non-menstrual ...\n --PARENT--> [GA21] Nonmenstrual bleeding disorders\n --PARENT--> [?] Abnormal uterine or vaginal bleeding\n Def: A condition of the genital system, caused by hormonal disturbances, weight changes, neoplasms, or use of pharmacological agents. This condition is characterised by irregular or excessive shedding of t...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --CHILD--> [MF50.4Z] Haematuria, unspecified"
] |
MG27
|
Haemorrhage, not elsewhere classified
|
[
{
"from_icd11": "MG27",
"icd10_code": "R58",
"icd10_title": "Hemorrhage, not elsewhere classified"
},
{
"from_icd11": "GA21.0",
"icd10_code": "N930",
"icd10_title": "Postcoital and contact bleeding"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R3129",
"icd10_title": "Other microscopic hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R3121",
"icd10_title": "Asymptomatic microscopic hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R311",
"icd10_title": "Benign essential microscopic hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R319",
"icd10_title": "Hematuria, unspecified"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R31",
"icd10_title": "Hematuria"
},
{
"from_icd11": "DB98.A",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
},
{
"from_icd11": "DB98.A",
"icd10_code": "K7689",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB98.A",
"icd10_code": "K768",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "GA20.3",
"icd10_code": "N926",
"icd10_title": "Irregular menstruation, unspecified"
},
{
"from_icd11": "GA20.3",
"icd10_code": "N925",
"icd10_title": "Other specified irregular menstruation"
},
{
"from_icd11": "FA36.Z",
"icd10_code": "M25471",
"icd10_title": "Effusion, right ankle"
}
] |
R58
|
Hemorrhage, not elsewhere classified
|
We report a 60-year-old Caucasian male attended our hospital with a bulky lymph node mass in the right axilla. Extirpation of the lymph node conglomerate revealed 5 melanoma lymph node metastases - a primary melanoma was not found. Thoracic and abdominal computed tomography showed a liver metastasis (diameter: 3.8 cm), several retroperitoneal metastases, bilateral metastases in the lung hilus, and prepectoral subcutaneous metastases (Stage IV; pTx, N3, M1c; BRAF V600E mutated/KIT wildtype; ECOG = 0). Cranial magnetic resonance tomography did not reveal pathological findings. Lactate dehydrogenase (LDH) and S100B were slightly elevated with 357 U/I (135–225 U/I) and 0.38 μg/l (cut-off: 0.11 μg/l), respectively. According to the tumour board recommendation, combination therapy of nivolumab (1 mg/kg BW) and ipilimumab (3 mg/kg BW) was started after having performed electrocardiography and extensive lab investigations. Beside, slight elevation of the TSH receptor antibody, no relevant pathology was detected. Three weeks after the first combination therapy he developed slight erythema, paraesthesia and pain on the fingertips of both hands . Ten days later, paraesthesia had worsened and livid erythema was observed in particular on digitus 2 and 3 of both hands. Both cold and warmth was not well tolerated by the patient. He had no prior history of trauma, cardiovascular illnesses, snake-bite, haematological disorders, rheumatologic disorders, hypertension, diabetes or smoking. He gave no history of having visited very high altitudes, or being exposed to very low temperatures which could have caused frostbite. On examination there were no clinical signs for rheumatic diseases such as systemic sclerosis (e.g., skin hardening, tightening of the facial skin, telangiectases, decreased oral aperture, and sicca-syndrome). Duplex-sonography of the hand arteries was unremarkable. Nail fold capillaroscopy did not demonstrate pathological findings. Lab tests including antithrombin III, fibrinogen, protein S and C did not reveal pathologies. Blood test was also negative for antinuclear antibodies, antineutrophil cytoplasmic antibody, rheumatoid factor, and cryoglobulins, and hepatitis (B and C) serology. Immunoglobulins and circulating immune complexes were within the normal range. Antiphospholipid and anticardiolipin antibodies (both IgG and IgM) and platelet count were within normal limits. Treatment was initiated with intravenous alprostadil 20 μg twice daily and oral prednisolone 50 mg in tapering dosage. However, alprostadil was stopped after the first applications because the pain increased during infusion. The second course of nivolumab and ipilimumab was administered. About 2 weeks later, the patient presented with progressive pain and small subungual necrosis. We treated the patient with oral analgetics and intravenous prednisolone 500 mg in tapering dosage. Combination immunotherapy was discontinued. On digital substraction angiography occlusion of all arteries of the fingers was demonstrated . Several nitroglycerin applications during angiography did not favor a functional cause of ischemia. Further rheologic treatments (ilomedine, nifedipine etc.) and targeted therapy with a combination of a BRAF and MEK inhibitor was refused by the patient. About 2 months after the second course of nivolumab and ipilimumab combination therapy several fingers showed severe gangrene . Amputations were finally performed on end phalanges of the right digitus III and left digiti III and IV. Histopathology predominantly revealed beside normal skin altered tissue with strong inflammatory infiltrates including lymphocytes, plasma cells, and neutrophils. The CD4/CD8 ratio was 3:1 . Moreover, severe fibrosis and necrosis was observed. However, there was no evidence for vasculitis or other primary vascular pathologies. During the following 2 months the patient experienced dramatic progress of his metastatic disease and finally died at multi-organ failure. Fig. 1 Twenty-five days after the first application of ipilimumab/nivolumab combination therapy the patient reported paraesthesia and pain in the fingertips; a slight erythema is visible on the fingertip of digitus 4 of the left hand ( a ). Five days after the second course ipilimumab/nivolumab combination therapy, a violaceous erythema was observed on digitus 3 and 4 of the left hand ( b ). Paraesthesia and pain also deteriorated Fig. 2 On digital substraction angiography an almost complete occlusion of digiti 2–5 was observed on the left hand ( a ). Nitroglycerin applications during angiography did not result in vasodilatation ( b ) Fig. 3 Twenty days after the second application of ipilimumab/nivolumab combination therapy the violaceous erythema was increased ( a ). The patient suffered from paraesthesia and strong pain. Six weeks later a severe gangrene was observed on digitus 3 of the left hand ( b ) Fig. 4 Histopathology of the skin assessed near the necrotic border of digitus 3 of the left hand predominantly revealed altered tissue with fibrosis and strong mainly perivascular inflammatory infiltrates including lymphocytes, plasma cells, and neutrophils ( a , b ). The inflammatory infiltrate was dominated by CD4+ cells ( c ) when compared to CD8+ lymphocytes ( d )
| 4.035156
| 0.976563
|
sec[1]/p[0]
|
en
| 0.999999
|
28499411
|
https://doi.org/10.1186/s12885-017-3313-6
|
[
"combination",
"nivolumab",
"ipilimumab",
"pain",
"digitus",
"hand",
"erythema",
"paraesthesia",
"metastases",
"both"
] |
[
{
"code": "4A01.1Z",
"title": "Combined immunodeficiencies, unspecified"
},
{
"code": "PB29",
"title": "Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances"
},
{
"code": "8A40.Z",
"title": "Multiple sclerosis, unspecified"
},
{
"code": "6C4F.3",
"title": "Intoxication due to multiple specified psychoactive substances"
},
{
"code": "PH49",
"title": "Exposure to or harmful effects of undetermined intent of multiple drugs, medicaments or biological substances"
},
{
"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 ===
[4A01.1Z] Combined immunodeficiencies, unspecified
Also known as: Combined immunodeficiencies, unspecified | Combined immunodeficiencies | Combined T and B cell immunodeficiency | combined immunity deficiency | combined immunodeficiency syndrome
[PB29] Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances
Also known as: Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances | accidental overdose of multiple drugs, medicaments or biological substances | accidental poisoning by multiple drugs, medicaments or biological substances | multiple drugs, medicaments or biological substances taken in error | combined drug toxicity NOS
Includes: accidental overdose of multiple drugs, medicaments or biological substances
[8A40.Z] Multiple sclerosis, unspecified
Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis
[6C4F.3] Intoxication due to multiple specified psychoactive substances
Definition: Intoxication due to multiple specified psychoactive substances is a clinically significant transient condition that develops during or shortly after the consumption of multiple specified substances or medications that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of the multiple specified psychoactive substances and their intensity is closely related to the amount of
Also known as: Intoxication due to multiple specified psychoactive substances | mixed drug intoxication NOS | combined drug intoxication NOS | acute mixed drug intoxication NOS | acute combined drug intoxication NOS
[PH49] Exposure to or harmful effects of undetermined intent of multiple drugs, medicaments or biological substances
Also known as: Exposure to or harmful effects of undetermined intent of multiple drugs, medicaments or biological substances | mixed substance toxicity NOS | acute combined drug toxicity
[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 ---
[4A01.1Z] Combined immunodeficiencies, unspecified
--PARENT--> [4A01.1] Combined immunodeficiencies
--CHILD--> [4A01.12] Major histocompatibility complex class II deficiency
Def: Immunodeficiency by defective expression of HLA class II is an autosomal recessive primary immune deficiency, manifesting by recurrent viral and bacterial infections, often leading to chronic diarrhoe...
--- Walk 2 ---
[4A01.1Z] Combined immunodeficiencies, unspecified
--PARENT--> [4A01.1] Combined immunodeficiencies
--CHILD--> [4A01.10] Severe combined immunodeficiencies
Def: Severe combined immunodeficiency (SCID) comprises a group of rare monogenic primary immunodeficiency disorders characterised by a lack of functional peripheral T lymphocytes resulting in early-onset s...
--- Walk 3 ---
[PB29] Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances
--PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances
--CHILD--> [PB21] Unintentional exposure to or harmful effects of sedative hypnotic drugs or other CNS depressants
--- Walk 4 ---
[PB29] Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances
--PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances
--CHILD--> [PB20] Unintentional exposure to or harmful effects of opioids or related analgesics
--- Walk 5 ---
[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 6 ---
[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
|
[
"[4A01.1Z] Combined immunodeficiencies, unspecified\n --PARENT--> [4A01.1] Combined immunodeficiencies\n --CHILD--> [4A01.12] Major histocompatibility complex class II deficiency\n Def: Immunodeficiency by defective expression of HLA class II is an autosomal recessive primary immune deficiency, manifesting by recurrent viral and bacterial infections, often leading to chronic diarrhoe...",
"[4A01.1Z] Combined immunodeficiencies, unspecified\n --PARENT--> [4A01.1] Combined immunodeficiencies\n --CHILD--> [4A01.10] Severe combined immunodeficiencies\n Def: Severe combined immunodeficiency (SCID) comprises a group of rare monogenic primary immunodeficiency disorders characterised by a lack of functional peripheral T lymphocytes resulting in early-onset s...",
"[PB29] Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances\n --PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances\n --CHILD--> [PB21] Unintentional exposure to or harmful effects of sedative hypnotic drugs or other CNS depressants",
"[PB29] Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances\n --PARENT--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances\n --CHILD--> [PB20] Unintentional exposure to or harmful effects of opioids or related analgesics",
"[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",
"[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"
] |
4A01.1Z
|
Combined immunodeficiencies, unspecified
|
[
{
"from_icd11": "4A01.1Z",
"icd10_code": "D8189",
"icd10_title": "Other combined immunodeficiencies"
},
{
"from_icd11": "4A01.1Z",
"icd10_code": "D819",
"icd10_title": "Combined immunodeficiency, unspecified"
},
{
"from_icd11": "4A01.1Z",
"icd10_code": "D81",
"icd10_title": "Combined immunodeficiencies"
},
{
"from_icd11": "4A01.1Z",
"icd10_code": "D815",
"icd10_title": "Purine nucleoside phosphorylase [PNP] deficiency"
},
{
"from_icd11": "4A01.1Z",
"icd10_code": "D818",
"icd10_title": "Other combined immunodeficiencies"
},
{
"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": "MG3Z",
"icd10_code": "R52",
"icd10_title": "Pain, unspecified"
},
{
"from_icd11": "MG3Z",
"icd10_code": "R529",
"icd10_title": ""
},
{
"from_icd11": "MG31.Z",
"icd10_code": "R520",
"icd10_title": ""
},
{
"from_icd11": "MG30.Z",
"icd10_code": "R521",
"icd10_title": ""
},
{
"from_icd11": "MG30.Z",
"icd10_code": "R522",
"icd10_title": ""
},
{
"from_icd11": "FB56.2",
"icd10_code": "M7918",
"icd10_title": "Myalgia, other site"
},
{
"from_icd11": "FB56.2",
"icd10_code": "M7910",
"icd10_title": "Myalgia, unspecified site"
}
] |
D8189
|
Other combined immunodeficiencies
|
A 75-year-old woman was admitted to our hospital due to rapid progressive cognitive impairment. During the previous year, the patient had shown mild cognitive impairment due to moderate leukoariosis, thought to be associated with arterial hypertension and hypercholesterolemia. There was no positive family history of dementia or dementia-like symptoms in the anamnesis. Ten days before admission, her husband observed a temporal disorientation and confusion, e.g. the patient could not recall the present date and put a saltshaker into the refrigerator. When admitted to our care the patient was conscious but disorientated to place, time and person. The initial neurological examination and an extensive neuropsychological evaluation showed significant impairments in almost all tested cognitive domains including attention, concentration, memory, executive function and visual-constructional ability. In addition, there was evidence of a right-sided visual neglect, aphasia in terms of language comprehension disorder and pronounced apraxic impairments corresponding to dysfunctions of her left-sided parietal circuits. All other neurological functions including motor, sensory and coordinative function were intact. An initial electroencephalography showed unspecific encephalopathy patterns. The MRI showed multiple microangiopathic lesions: left-sided lesions in the thalamus, parietooccipital, temporo mesial, thalamic, frontal and parietal cortices, as well as right-sided lesions in the basal ganglia. The brain-SPECT showed hypometabolism in the frontoparietal and parietooccipital cortices, more obvious on the left side, with normal nuclide accumulation in motor and occipital cortex. The primary investigation of cerebrospinal fluid revealed a pleocytosis of 7 Leukocytes/μl [<5 Leukocytes/μl] with a Total Protein of 701 mg/l [<450 mg/l] and 2,31 mmol/l Lactate [1,2-2,1 mmol/l]. Simultaneously, thyroperoxidase antibodies were detected. It was initially concluded based on these results that the patient was suffering from autoimmune encephalitis, believed to be caused by autoimmune thyroiditis. High dosage intravenous methylprednisolone therapy was initiated . Despite treatment however, the patient continued to exhibit cognitive and neuropsychological symptoms and presented the first tonic-clonic seizure, leading to the initiation of Levetiracetam therapy. The ongoing diagnostic workup included a broad search for potential autoimmune diseases. Serum and CSF were tested for antibodies to the following antigens: CASPR2, LGI1, NMDAR, GAD65, GAD67, GABABR, AMPAR1/2, GlyR and onconeural antigens, whereby CASPR2-antibodies were detected . This result was interpreted as support for the hypothesis of ongoing autoimmune encephalitis. Treatment was now escalated to eight tryptophan immunoadsorptions processing two liters plasma per session. Although immunoadsorption effectively reduced the titre of CASPR2-antibodies (serum titre 1:32), the patient’s cognitive and general neurological condition worsened. A positron emission tomography was now added to disclose malignancies. Apart from cystic structures in kidneys and liver, no underlying oncological disease was detected. Four weeks after the first MRI, follow up imaging now revealed new hyperintensities in the basal ganglia and both dorsal thalami [Figure 2 right]. Furthermore, the EEG now presented a generalized periodic pattern with triphasic waves. Continuous CSF studies now showed normalization of Leukocytes (1/μl) and Total Protein (292 mg/l), but increased Tau and 14-3-3 proteins leading to the suspicion of a possible Creutzfeldt-Jakob disease . The patient continued to detoriate over the following month after discharge, dying approximately one year after the onset of symptoms. The postmortem examination showed signs of spongiform encephalopathy [Figure 3 ], supporting our diagnosis of a definitive Creutzfeldt-Jakob disease . Figure 1 MRI formation of symmetrical hyperintensities in the putamen and caudate head within two months seen on T2-weighted and FLAIR images. Figure 2 Cell based assays for demonstration of CASPR2 antibodies (Euroimmun, Lübeck, Germany). (A) Serum of patient diluted 1:15 incubated with HEK cells transfected with CASPR2; the antibodies are visualized by a Alexa 594 anti-human-IgG antibody; mild counterstaining with Hoechst 33342. (B) Serum of a patient with classical limbic encephalitis and CASPR2 antibodies, technical details as in A. (C) Serum of patient incubated with control cells not expressing CASPR2 (negative result), technical details as in A. These images demonstrate that the patient’s serum does not bind non-specifically to the CASPR2 expressing HEK cells in A. Figure 3 Frontal cortex (lower side towards pia mater; upper side towards white matter), PrP; Scale bar 100 um. Note the confluent spongiosis and the diffuse synaptic PrP deposits. Brains were fixed in 4% formalin and paraffin-embedded tissue samples of frontal cortex were cut into 3 μm thick serial sections, mounted on glass slides and processed for immunhistochemical staining using specific antibodies to PrP. Visualization of primary antibody was achieved using the diaminobenzidine streptavidin-biotin horseradish peroxidase method on an automated stainer (Ventana/Roche).
| 4.238281
| 0.956543
|
sec[1]/p[0]
|
en
| 0.999996
|
25434587
|
https://doi.org/10.1186/s12883-014-0227-7
|
[
"antibodies",
"serum",
"cognitive",
"sided",
"autoimmune",
"neurological",
"lesions",
"frontal",
"side",
"cortex"
] |
[
{
"code": "JA86.Y",
"title": "Maternal care for other specified fetal problems"
},
{
"code": "MA14.14",
"title": "Anti-nuclear antibody positive"
},
{
"code": "MA14.13",
"title": "Anti-nuclear antibody negative"
},
{
"code": "JA86.0",
"title": "Maternal care for red cell antibodies"
},
{
"code": "MA14.1C",
"title": "Raised antibody titre"
},
{
"code": "NE80.3",
"title": "Other serum reactions"
},
{
"code": "5D0Y",
"title": "Other specified metabolic disorders"
},
{
"code": "5B91.0",
"title": "Hypercalcaemia"
},
{
"code": "4A84.Y",
"title": "Other specified anaphylaxis"
},
{
"code": "5C50.F2",
"title": "Homocarnosinosis"
}
] |
=== ICD-11 CODES FOUND ===
[JA86.Y] Maternal care for other specified fetal problems
Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS
[MA14.14] Anti-nuclear antibody positive
Also known as: Anti-nuclear antibody positive | ANA - [anti-nuclear antibody] positive
[MA14.13] Anti-nuclear antibody negative
Also known as: Anti-nuclear antibody negative | ANA - [anti-nuclear antibody] negative
[JA86.0] Maternal care for red cell antibodies
Definition: Maternal care for rhesus or other isoimmunization
Also known as: Maternal care for red cell antibodies | Maternal care for rhesus isoimmunization | Rh factor immunization affecting management of pregnancy | Rh incompatibility | Rh incompatibility with hydrops fetalis
[MA14.1C] Raised antibody titre
Also known as: Raised antibody titre | antibody titre above reference range | high antibody titre | increased antibody titre
Excludes: isoimmunization, in pregnancy affecting fetus or newborn
[NE80.3] Other serum reactions
Also known as: Other serum reactions | Allergic reaction to serum | serum allergy | Complications of vaccination, protein sickness | Protein sickness
Excludes: serum hepatitis
[5D0Y] Other specified metabolic disorders
Also known as: Other specified metabolic disorders | Disorders of plasma-protein metabolism, not elsewhere classified | abnormal protein transport | dysproteinaemia | Absence of albumin in blood
[5B91.0] Hypercalcaemia
Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms
Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome
[4A84.Y] Other specified anaphylaxis
Also known as: Other specified anaphylaxis | Latex-induced anaphylaxis | Anaphylaxis due to latex | Latex anaphylaxis | Anaphylactic shock due to serum
[5C50.F2] Homocarnosinosis
Definition: Homocarnosinosis is a metabolic defect characterised by progressive spastic diplegia, intellectual deficit and retinitis pigmentosa. This extremely rare disorder has been reported in only one family, namely a woman and three of her children. The latter showed but their mother was symptom free. It is therefore uncertain whether there is a relationship between the biochemical defect and the clinical symptoms. Inheritance in the reported family seems to be autosomal dominant.
Also known as: Homocarnosinosis | Homocarnosinase deficiency | Serum carnosinase deficiency
=== GRAPH WALKS ===
--- Walk 1 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--CHILD--> [JA86.1] Maternal care for hydrops fetalis
--- Walk 2 ---
[JA86.Y] Maternal care for other specified fetal problems
--PARENT--> [JA86] Maternal care for other fetal problems
Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....
--EXCLUDES--> [?] Placental transfusion syndromes
--- Walk 3 ---
[MA14.14] Anti-nuclear antibody positive
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.10] Abnormal reaction to tuberculin test
--- Walk 4 ---
[MA14.14] Anti-nuclear antibody positive
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.12] Anticitrullinated protein antibody positive
--- Walk 5 ---
[MA14.13] Anti-nuclear antibody negative
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.12] Anticitrullinated protein antibody positive
--- Walk 6 ---
[MA14.13] Anti-nuclear antibody negative
--PARENT--> [MA14.1] Certain specified immunological findings
--CHILD--> [MA14.11] Anticitrullinated protein antibody negative
|
[
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --CHILD--> [JA86.1] Maternal care for hydrops fetalis",
"[JA86.Y] Maternal care for other specified fetal problems\n --PARENT--> [JA86] Maternal care for other fetal problems\n Def: A condition characterised by the provision of health interventions to the mother due to any other issue that is either suspected or known to be present in the fetus....\n --EXCLUDES--> [?] Placental transfusion syndromes",
"[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.10] Abnormal reaction to tuberculin test",
"[MA14.14] Anti-nuclear antibody positive\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.12] Anticitrullinated protein antibody positive",
"[MA14.13] Anti-nuclear antibody negative\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.12] Anticitrullinated protein antibody positive",
"[MA14.13] Anti-nuclear antibody negative\n --PARENT--> [MA14.1] Certain specified immunological findings\n --CHILD--> [MA14.11] Anticitrullinated protein antibody negative"
] |
JA86.Y
|
Maternal care for other specified fetal problems
|
[
{
"from_icd11": "JA86.Y",
"icd10_code": "O26841 ",
"icd10_title": ""
},
{
"from_icd11": "JA86.Y",
"icd10_code": "O26843 ",
"icd10_title": ""
},
{
"from_icd11": "JA86.Y",
"icd10_code": "O26849 ",
"icd10_title": ""
},
{
"from_icd11": "JA86.Y",
"icd10_code": "O3680X0 ",
"icd10_title": ""
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360930",
"icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360920",
"icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360130",
"icd10_title": "Maternal care for anti-D [Rh] antibodies, third trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360932",
"icd10_title": "Maternal care for other rhesus isoimmunization, third trimester, fetus 2"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360922",
"icd10_title": "Maternal care for other rhesus isoimmunization, second trimester, fetus 2"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360990",
"icd10_title": "Maternal care for other rhesus isoimmunization, unspecified trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360110",
"icd10_title": "Maternal care for anti-D [Rh] antibodies, first trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360120",
"icd10_title": "Maternal care for anti-D [Rh] antibodies, second trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360910",
"icd10_title": "Maternal care for other rhesus isoimmunization, first trimester, not applicable or unspecified"
},
{
"from_icd11": "JA86.0",
"icd10_code": "O360",
"icd10_title": "Maternal care for rhesus isoimmunization"
},
{
"from_icd11": "MA14.1C",
"icd10_code": "R760",
"icd10_title": "Raised antibody titer"
}
] |
O26841
| |
She was referred to our hospital 3 days after the administration of ceftriaxone. Her blood pressure, temperature, and heart rate were 127/65 mmHg, 37.5 °C, and 88 beats/min, respectively. She had abdominal tenderness in the left lower quadrant without muscular defense and no diarrhea. Computed tomography (CT) showed edematous thickening of the intestinal wall from the descending colon to the rectum, with increased densities of the surrounding fat tissues . Moreover, the laboratory results were as follows: white blood cell (WBC) count, 12,200/μL; hemoglobin, 11.2 g/dL; platelet (PLT) count, 18.3 × 10 4 /μL; C-reactive protein (CRP), 2.32 mg/dL; T-bil, 0.77 IU/L; AST, 17 IU/L; ALT, 11 IU/L; BUN, 10.6 mg/dL; creatinine, 0.49 mg/dL; albumin, 3.3 g/dL; FDP, 4.0 μg/dL; and prothrombin time (PT), 13.4 s (PT-INR, 1.13). She began to have light pink mucous stool immediately after the visit and was admitted to our hospital on the suspicion of ischemic colitis. She was followed conservatively with fasting, but the abdominal pain persisted with watery diarrhea. On the third day of hospitalization, she experienced septic shock with a systolic blood pressure of 60 mmHg and temperature of 38.6 °C. The WBC count and hemoglobin and CRP levels were 26,800/μL, 11.0 g/dL, and 19.3 mg/dL, respectively. She was transferred to the intensive care unit and administered meropenem on the suspicion of bacterial enteritis. On the fourth day, the inflammatory response further worsened with a WBC count of 34,400/μL and CRP of 22.8 mg/dL. Other laboratory results were as follows: hemoglobin, 11.2 g/dL; PLT count, 20.3 × 10 4 /μL; T-bil, 0.29 IU/L; AST, 13 IU/L; ALT, 9 IU/L; BUN, 9.7 mg/dL; creatinine, 0.51 mg/dL; albumin, 1.5 g/dL; FDP, 6.6 μg/dL; fibrinogen quantity, 389 mg/dL; and PT, 15.5 s (PT-INR, 1.31). Disseminated intravascular coagulation (DIC) score was 2 according to criterion of the Scientific Subcommittee on DIC of the International Society for Thrombosis and Haemostasis (ISTH). CT was repeated and demonstrated the extended wall thickening throughout the entire colon and increased ascites . Vancomycin was additionally administered intravenously as empirical treatment on the suspicion of severe enteritis. Moreover, metronidazole was intravenously administered considering the possibility of CD colitis. At this point, the physician consulted with the surgeon about the treatment strategy. Emergent sigmoidoscopy showed yellow-white purulent plaques on the mucosal surfaces of the rectum . Soon after the endoscopic examination, she was intubated due to exacerbated circulatory and respiratory conditions. As colitis was judged to be severe, we decided to perform an emergency surgery. Surgical findings showed that much ascites was found in the abdomen and that the entire colon was markedly edematous and dilated with no obvious necrotic changes. Subtotal proctocolectomy from the cecum to the lower rectum was performed with ileostomy formation. After a drain tube was inserted at the pelvic bottom, the abdomen was closed. Perioperative outcomes were as follows: operation time, 250 min; loss of bleeding, 200 mL; complications, none; and length of hospital stay after surgery, 22 days. Severe pseudomembranous changes were observed on the mucosal surface of the entire colon and rectum in the resected specimen . The diagnosis of pseudomembranous colitis was also supported by the typical microscopic appearances . She was additionally treated with intravenous metronidazole administration until 10 days after surgery and discharged 22 days after surgery. The enzyme immunoassay tests of the stool specimen obtained on the third day were negative for toxin A/B but positive for C. difficile glutamate dehydrogenase. It indicated that C. difficile was present but CD toxin was not detected. There were two possibilities: a non-CD toxin-producing strain or a false-negative strain due to the low sensitivity of the CD toxin test, which is actually a CD toxin-producing. Culture on the specimen with high sensitivity and specificity yielded C. difficile , which was toxin A-positive, toxin B-positive, and binary toxin-positive. The isolate was further identified as ribotype 027 . Fig. 1 CT shows progressively worsening edematous changes in the intestinal wall and increased ascites from the first ( a ) to the fourth ( b ) hospital day Fig. 2 Urgent sigmoidoscopy shows widespread yellow-white purulent plaques on the surfaces of the sigmoid–rectal mucosa Fig. 3 The resected specimen has the highly edematous mucosa. A yellowish-white pseudomembrane is widely formed in a patchy or cohesive form on the mucosa of the entire colon and rectum Fig. 4 The microscopic findings. a There is a volcanic eruption image, in which the pseudomembrane component is ejected into the intestinal lumen at the mucosal defect. The pseudomembrane histologically consists of fibrin, mucus, neutrophils, and nuclear debris. b The expanded frame of the crypt remains on the mucosa of the pseudomembrane attachment site, and the dropped-out epithelial cells are seen in the lumen Fig. 5 PCR-ribotype pattern of the isolate recovered from the present case. Lane M, 100-bp ladder as a DNA size marker; lane 1, the isolate from our case; lane a, ribotype 027; lane b, ribotype 078
| 3.892578
| 0.977539
|
sec[1]/p[1]
|
en
| 0.999994
|
34101061
|
https://doi.org/10.1186/s40792-021-01220-9
|
[
"toxin",
"colon",
"rectum",
"count",
"edematous",
"white",
"colitis",
"entire",
"specimen",
"ribotype"
] |
[
{
"code": "8D88.3",
"title": "Autonomic disorder due to toxins"
},
{
"code": "8A00.2Y",
"title": "Other specified secondary parkinsonism"
},
{
"code": "8A02.1Y",
"title": "Other specified secondary dystonia"
},
{
"code": "8A01.1Y",
"title": "Other specified secondary chorea"
},
{
"code": "8D43.0Y",
"title": "Other specified encephalopathy due to toxicity"
},
{
"code": "1A40.0&XA03U9",
"title": "Colon inflammation"
},
{
"code": "DB30.Y&XA03U9",
"title": "Obstructed colon"
},
{
"code": "NB91.81",
"title": "Laceration of colon"
},
{
"code": "DD3Z",
"title": "Ischaemic vascular disorders of intestine, unspecified"
},
{
"code": "DB32.2Z&XA03U9",
"title": "Colonic dilatation"
}
] |
=== ICD-11 CODES FOUND ===
[8D88.3] Autonomic disorder due to toxins
Also known as: Autonomic disorder due to toxins | Autonomic dysfunction due to medications | Autonomic dysfunction due to heavy metal exposure | Autonomic dysfunction due to Vacor exposure | Autonomic dysfunction due to Acrylamide exposure
[8A00.2Y] Other specified secondary parkinsonism
Also known as: Other specified secondary parkinsonism | Parkinsonism associated with hydrocephalus | Toxin-induced parkinsonism | secondary parkinsonism due to other external agents | Manganese-induced Parkinsonism
[8A02.1Y] Other specified secondary dystonia
Also known as: Other specified secondary dystonia | Dystonia due to perinatal cerebral injury | Dystonia due to cerebral anoxia | Dystonia due to encephalitis | postencephalitic dystonia
[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
[8D43.0Y] Other specified encephalopathy due to toxicity
Also known as: Other specified encephalopathy due to toxicity | Encephalopathy due to arsenic | Encephalopathy due to carbon monoxide | delayed encephalopathy due to carbon monoxide | Encephalopathy due to lead
[NB91.81] Laceration of colon
Definition: A tear or wound of large intestine.
Also known as: Laceration of colon
[DD3Z] Ischaemic vascular disorders of intestine, unspecified
Also known as: Ischaemic vascular disorders of intestine, unspecified | Vascular disorder of intestine, not elsewhere classified | vascular disorder of intestine | vascular bowel disease | ischaemic gut NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[8D88.3] Autonomic disorder due to toxins
--PARENT--> [8D88] Autonomic neuropathies
--CHILD--> [8D88.0] Autonomic neuropathy due to sodium channelopathies
--- Walk 2 ---
[8D88.3] Autonomic disorder due to toxins
--PARENT--> [8D88] Autonomic neuropathies
--CHILD--> [8D88.1] Autonomic neuropathy due to diabetes mellitus
Def: Dysfunction of the autonomic nervous system due to diabetes mellitus that presents as functional complications such as resting tachycardia, exercise intolerance, orthostatic hypotension, constipation,...
--- Walk 3 ---
[8A00.2Y] Other specified secondary parkinsonism
--PARENT--> [8A00.2] Secondary parkinsonism
Def: Secondary parkinsonism is a term used to describe Parkinsonism due to a known agent such as drugs, infections, toxins or structural lesions....
--CHILD--> [8A00.20] Parkinsonism due to heredodegenerative disorders
Def: Parkinsonism may occur as a result of more widespread heredodegenerative disorders. It is accompanied by other neurological findings such as dystonia, ataxia and dementia. Other family members may be ...
--- Walk 4 ---
[8A00.2Y] Other specified secondary parkinsonism
--PARENT--> [8A00.2] Secondary parkinsonism
Def: Secondary parkinsonism is a term used to describe Parkinsonism due to a known agent such as drugs, infections, toxins or structural lesions....
--CHILD--> [8A00.22] Infectious or postinfectious parkinsonism
Def: A syndrome caused by an infection with a bacterial, viral, fungal, or parasitic source, which occurs during or after the acute phase of the infection. This condition is characterised by tremors, slow ...
--- Walk 5 ---
[8A02.1Y] Other specified secondary dystonia
--PARENT--> [8A02.1] Secondary dystonia
Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....
--CHILD--> [8A02.11] Dystonia-plus
Def: This is a group of heterogenous syndromes present with dystonia – a disorder of involuntary muscle contractions – along with other clinical features, but not in tandem with a neurodegenerative disease...
--- Walk 6 ---
[8A02.1Y] Other specified secondary dystonia
--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....
|
[
"[8D88.3] Autonomic disorder due to toxins\n --PARENT--> [8D88] Autonomic neuropathies\n --CHILD--> [8D88.0] Autonomic neuropathy due to sodium channelopathies",
"[8D88.3] Autonomic disorder due to toxins\n --PARENT--> [8D88] Autonomic neuropathies\n --CHILD--> [8D88.1] Autonomic neuropathy due to diabetes mellitus\n Def: Dysfunction of the autonomic nervous system due to diabetes mellitus that presents as functional complications such as resting tachycardia, exercise intolerance, orthostatic hypotension, constipation,...",
"[8A00.2Y] Other specified secondary parkinsonism\n --PARENT--> [8A00.2] Secondary parkinsonism\n Def: Secondary parkinsonism is a term used to describe Parkinsonism due to a known agent such as drugs, infections, toxins or structural lesions....\n --CHILD--> [8A00.20] Parkinsonism due to heredodegenerative disorders\n Def: Parkinsonism may occur as a result of more widespread heredodegenerative disorders. It is accompanied by other neurological findings such as dystonia, ataxia and dementia. Other family members may be ...",
"[8A00.2Y] Other specified secondary parkinsonism\n --PARENT--> [8A00.2] Secondary parkinsonism\n Def: Secondary parkinsonism is a term used to describe Parkinsonism due to a known agent such as drugs, infections, toxins or structural lesions....\n --CHILD--> [8A00.22] Infectious or postinfectious parkinsonism\n Def: A syndrome caused by an infection with a bacterial, viral, fungal, or parasitic source, which occurs during or after the acute phase of the infection. This condition is characterised by tremors, slow ...",
"[8A02.1Y] Other specified secondary dystonia\n --PARENT--> [8A02.1] Secondary dystonia\n Def: This is dystonia – a disorder of involuntary muscle contractions – of an acquired nature. Causes include substance toxicity, injury, hypoxia and tumours....\n --CHILD--> [8A02.11] Dystonia-plus\n Def: This is a group of heterogenous syndromes present with dystonia – a disorder of involuntary muscle contractions – along with other clinical features, but not in tandem with a neurodegenerative disease...",
"[8A02.1Y] Other specified secondary dystonia\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...."
] |
8D88.3
|
Autonomic disorder due to toxins
|
[
{
"from_icd11": "DD3Z",
"icd10_code": "K559",
"icd10_title": "Vascular disorder of intestine, unspecified"
},
{
"from_icd11": "DD3Z",
"icd10_code": "K558",
"icd10_title": "Other vascular disorders of intestine"
},
{
"from_icd11": "DD3Z",
"icd10_code": "K55-K64",
"icd10_title": ""
},
{
"from_icd11": "DD3Z",
"icd10_code": "K55",
"icd10_title": "Vascular disorders of intestine"
}
] |
K559
|
Vascular disorder of intestine, unspecified
|
He underwent CT-guided placement of a chest tube into the left pleural space and a surgical drain into the left chest wall mass for diagnostic and therapeutic purposes. Results of the fluid analysis ( Table 1 ) revealed two distinct fluid phenotypes. A broad array of microbiological testing on pleural fluid and serum was sent ( Table 2 ). Sputum culture was ordered by was not obtainable due to inability to expectorate at that time. Bronchoscopy was not deemed necessary because patient was eupneic and saturating well on room air. Fungal smear of the pleural fluid revealed broad based budding yeast and subsequent combined serum Histoplasma/Blastomyces enzyme immunoassay (EIA) and fluid PCR was positive for Blastomyces dermatitidis . The patient was started on liposomal Amphotericin B (5 mg/kg IV daily) for 10 days of induction therapy with concurrent itraconazole loading (200 mg 3 times daily for 3 days). He was subsequently discharged with close Infectious Disease follow-up. Fungal cultures grew Blastomyces species complex confirming the diagnosis of Blastomycosis empyema necessitans. An outpatient sinogram 10 days after chest tube placement demonstrated complete resolution of his chest wall collection. Repeat serum Blastomyces antigen was undetectable. He developed refractory hypokalemia due to Amphotericin B and it was stopped after 10 days. He continued Itraconazole with plans to complete 1 year of therapy. At 2 month follow up, the patient had reported complete resolution of his fevers and shortness of breath. On physical examination, his left chest wall mass had resolved. His itraconazole level was 1.6 mcg/mL (ref range: >1 mcg/mL). Further imaging was deferred given his clinical improvement. Table 1 Left pleural and chest wall abscess fluid characteristics. Table 1 Lab Value Left Pleural Space Chest Wall Abscess Appearance Serous Slightly Bloody pH 7.4 < 6.80 Total Cells (per mcl) 62 224,280 Neutrophils (%) 1 85 Lymphocytes (%) 89 0 Monocytes (%) 6 15 Eosinophils (%) 4 0 Lactate Dehydrogenase (U/L) 207 > 9000 Fluid Protein (g/dl) 4.9 5.7 Triglycerides (mg/dL) 18 0 Glucose (mg/dl) 63 2 Table 2 Microbiological evaluations. Table 2 Left Pleural Fluid Studies Test Result Gram Stain Negative Bacterial Culture No growth after 5 days of incubation Fungal Smear Organisms resembling Blastomyces species complex Fungal Culture Blastomyces species complex AFB Smear Negative MTB Complex PCR Negative Mycobacterial Culture No growth after 42 days of incubation Actinomyces Culture No growth after 14 days of incubation Nocardia Stain Negative Broad Range Bacterial PCR + Sequencing Negative Histoplasma/Blastomyces PCR Positive for Blastomyces dermatitidis/gilchristii Other Serological Testing Test Result Blood Cultures No growth after 5 days QuantiFERON-TB Gold Plus Negative HIV−1/−2 Ag and Ab Screen Negative Urine Legionella Antigen Negative Urine Streptococcus pneumoniae Antigen Negative MRSA nasal swab PCR Negative Table 3 Review of the literature. Table 3 Title Author, Year, Journal Presentation CT Findings Diagnostics Treatment and Outcomes A Rapidly Expanding Chest Wall Mass in an Adolescent With COVID−19 Klair et al., 2023, Clinical Pediatrics 15 y/o male with two days of mild, dry cough and expanding chest mass near left upper sternal border. Dense consolidation appreciated in left upper lobe with extension into the pleural cavity and chest wall with associated intramuscular abscesses. Grocott Methenamine Silver: budding yeast Periodic Acid-Schiff Stain: budding yeast Blastomyces Urine EIA: positive Blastomyces Serum EIA: positive Fungal Culture: Blastomyces DNA Sequencing: Blastomyces gilchristii 400 mg Itraconazole for 6 months with complete resolution of symptoms. A Case of Pulmonary Blastomycosis Mimicking Pulmonary Tuberculosis Byung Woo Jhun et al., 2012, Tuberculosis and Respiratory Diseases 45 y/o male with chronic cough. CT scan revealed right upper lobe lesion, which was biopsied, showing granulomatous inflammation. Patient was treated with anti-tuberculosis therapy with no improvement. Bacterial/Mycobacterial cultures were negative. Mass-like infiltrative lesion in the right upper lobe with surrounding nodules. A well-defined low-density lesion in communication with subcutaneous tissue present near anterior right upper chest wall. Gomori Methenamine Silver: budding yeast DNA Sequencing: Blastomyces dermatitidis 400 mg Itraconazole for 3 months with complete resolution of symptoms. A Case of Chest Wall Blastomycosis Matthew Nemoy et al., 2023, CHEST 2023 Annual Meeting Abstract 40 y/o male who presented to primary care clinic for persistent non-productive cough and dyspnea. Chest radiograph revealed left sided consolidation and associated pleural effusion and he was treated with amoxicillin/clavulanic acid without improvement. He subsequently was referred to the Emergency Department. A chest tube was placed and 1.5 liters of fluid was removed. Bacterial cultures and Cytology was negative. Small residual effusion and lytic lesion of 9th rib. Repeat CT chest (4 weeks) showed new 4 × 7 cm mass along posterior left chest wall. Needle Aspiration: granulomas, fungal forms Fungal Culture: Blastomyces dermatitidis 400 mg Itraconazole for 6 months with complete resolution of symptoms.
| 4.101563
| 0.947754
|
sec[1]/p[3]
|
en
| 0.999996
|
40035057
|
https://doi.org/10.1016/j.idcr.2025.e02185
|
[
"chest",
"blastomyces",
"wall",
"fluid",
"pleural",
"culture",
"fungal",
"itraconazole",
"complete",
"resolution"
] |
[
{
"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": "1F22",
"title": "Blastomycosis"
},
{
"code": "1F2E.Z",
"title": "Paracoccidioidomycosis, unspecified"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[CB7Z] Diseases of the respiratory system, unspecified
Also known as: Diseases of the respiratory system, unspecified | disorder of respiratory system | respiratory disease NOS | respiratory tract disease | respiratory disorder NOS
[CB27] Pleural effusion
Definition: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces.
Also known as: Pleural effusion | PE - [pleural effusion] | Pleurisy with effusion | pleurisy with effusion NOS | pleural effusion with transudate
Includes: Pleurisy with effusion
Excludes: Tuberculosis of the respiratory system | Chylous effusion | Pleurisy
[CA44] Pyothorax
Definition: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or penetrating trauma with a secondary infection.
Also known as: Pyothorax | empyema | pyopneumothorax | Pyothorax with fistula | empyema with fistula
Includes: empyema | pyopneumothorax
Excludes: due to tuberculosis
[MD30.Z] Chest pain, unspecified
Also known as: Chest pain, unspecified | Pain in throat or chest | chest pain NOS | pain in chest | chest pressure
[1F22] Blastomycosis
Definition: A disease caused by an infection with the fungi Blastomyces dermatitidis. This disease is characterised by fever, chills, cough, myalgia, arthralgia, or chest pain. This disease may also present in the skin and bones. Transmission is by inhalation of fungal spores. Confirmation is by identification of Blastomyces dermatitidis in a urine, cerebrospinal fluid, or blood sample.
Also known as: Blastomycosis | North American blastomycosis | Gilchrist disease | Chicago disease or disorder | infection by blastomyces dermatitidis
Excludes: Brazilian blastomycosis | keloidal blastomycosis
[1F2E.Z] Paracoccidioidomycosis, unspecified
Also known as: Paracoccidioidomycosis, unspecified | Paracoccidioidomycosis | Brazilian blastomycosis | Lutz disease | Brazilian blastomycotic
[LB0Y] Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord
Also known as: Other specified structural developmental anomalies of the diaphragm, abdominal wall or umbilical cord | Congenital deformity of abdominal wall | abdominal wall defect NOS
[PA82] Unintentional striking against stationary object
Also known as: Unintentional striking against stationary object | striking against stationary object | striking against or struck by other objects | Walked into wall
=== GRAPH WALKS ===
--- Walk 1 ---
[CB7Z] Diseases of the respiratory system, unspecified
--PARENT--> [12] Diseases of the respiratory system
--CHILD--> [?] 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 ...
--- Walk 2 ---
[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 3 ---
[CB27] Pleural effusion
Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....
--PARENT--> [?] Pleural, diaphragm or mediastinal disorders
Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...
--CHILD--> [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 4 ---
[CB27] Pleural effusion
Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....
--EXCLUDES--> [?] Tuberculosis of the respiratory system
Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....
--PARENT--> [?] Tuberculosis
Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...
--- Walk 5 ---
[CA44] Pyothorax
Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...
--EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...
--EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation
Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba...
--- Walk 6 ---
[CA44] Pyothorax
Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...
--PARENT--> [?] Lung infections
Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....
--RELATED_TO--> [?] Influenza
Def: Any disease of the respiratory system, caused by an infection with influenza virus. These diseases are characterised by fever, cough, headache, myalgia, arthralgia, or malaise. Transmission is by inha...
|
[
"[CB7Z] Diseases of the respiratory system, unspecified\n --PARENT--> [12] Diseases of the respiratory system\n --CHILD--> [?] 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 ...",
"[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....",
"[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --PARENT--> [?] Pleural, diaphragm or mediastinal disorders\n Def: Pleural, diaphragm and mediastinal disorders are disorders of the potential space between the two pleura (visceral and parietal) of the lungs, disorders of the diaphragm and mediastinum. The mediastin...\n --CHILD--> [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...",
"[CB27] Pleural effusion\n Def: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces....\n --EXCLUDES--> [?] Tuberculosis of the respiratory system\n Def: This is a progressive or chronic disease resulting from infection with the bacterium Mycobacterium tuberculosis or other bacteria in the M. tuberculosis complex: M. bovis, M. africanum, M. canetti, M....\n --PARENT--> [?] Tuberculosis\n Def: A disease caused by an infection with bacteria of the Mycobacterium tuberculosis complex. This disease presents with symptoms depending on the site of infection. Transmission is commonly by inhalation...",
"[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --EXCLUDES--> [?] Tuberculous pleurisy, without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis, with an inflammation of the pleura. This diagnosis is with...\n --EXCLUDES--> [?] Primary respiratory tuberculosis without mention of bacteriological or histological confirmation\n Def: This is a common, and in many cases lethal, infectious disease of the respiratory caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is without mention of ba...",
"[CA44] Pyothorax\n Def: Suppurative inflammation of the pleural space, typically due to acute bacterial infection. It can occur as a complication of pneumonia, thoracotomy, abscesses (lung, hepatic, or subdiaphragmatic), or ...\n --PARENT--> [?] Lung infections\n Def: Any condition of the lungs, caused by an infection with a bacterial, viral, fungal, or parasitic source....\n --RELATED_TO--> [?] Influenza\n Def: Any disease of the respiratory system, caused by an infection with influenza virus. These diseases are characterised by fever, cough, headache, myalgia, arthralgia, or malaise. Transmission is by inha..."
] |
CB7Z
|
Diseases of the respiratory system, unspecified
|
[
{
"from_icd11": "CB7Z",
"icd10_code": "J989",
"icd10_title": "Respiratory disorder, unspecified"
},
{
"from_icd11": "CB7Z",
"icd10_code": "X",
"icd10_title": ""
},
{
"from_icd11": "CB7Z",
"icd10_code": "J09-J18",
"icd10_title": ""
},
{
"from_icd11": "CB27",
"icd10_code": "J910",
"icd10_title": "Malignant pleural effusion"
},
{
"from_icd11": "CB27",
"icd10_code": "J918",
"icd10_title": "Pleural effusion in other conditions classified elsewhere"
},
{
"from_icd11": "CB27",
"icd10_code": "J90",
"icd10_title": "Pleural effusion, not elsewhere classified"
},
{
"from_icd11": "CB27",
"icd10_code": "J90-J94",
"icd10_title": ""
},
{
"from_icd11": "CB27",
"icd10_code": "J91",
"icd10_title": "Pleural effusion in conditions classified elsewhere"
},
{
"from_icd11": "CA44",
"icd10_code": "J869",
"icd10_title": "Pyothorax without fistula"
},
{
"from_icd11": "CA44",
"icd10_code": "J860",
"icd10_title": "Pyothorax with fistula"
},
{
"from_icd11": "CA44",
"icd10_code": "J85-J86",
"icd10_title": ""
},
{
"from_icd11": "CA44",
"icd10_code": "J86",
"icd10_title": "Pyothorax"
},
{
"from_icd11": "MD30.Z",
"icd10_code": "R0781",
"icd10_title": "Pleurodynia"
},
{
"from_icd11": "MD30.Z",
"icd10_code": "R0782",
"icd10_title": "Intercostal pain"
},
{
"from_icd11": "MD30.Z",
"icd10_code": "R079",
"icd10_title": "Chest pain, unspecified"
}
] |
J989
|
Respiratory disorder, unspecified
|
The index case, a 25-year-old Caucasian man who consulted the otolaryngology outpatient clinic for a presumed viral upper respiratory tract infection, was referred 2 days later to the hematology outpatient clinic because of the suspicion of an hemolytic anemia with an hemoglobin level of 129 g/L. Other than atopic rhinitis, the patient had an uneventful medical history. He started xylometazoline nose drops and saline nasal irrigation 2 days before the hematology consultation in the context of the presumed viral upper respiratory tract infection. In addition, his medication comprised mometasone nasal spray for the atopic rhinitis. The patient had no oral medication, did not smoke, and consumed alcohol occasionally and only moderately. He is a student, living with his parents in Switzerland. Clinical and laboratory characteristics at the time of the hematology consultation are reported in Table 1 . Notably, the patient had scleral icterus and moderate splenomegaly. The rest of the physical examination was normal. Laboratory analyses revealed mild macrocytic anemia with high reticulocyte count. Unconjugated bilirubin and lactate dehydrogenase (LDH) were elevated. Haptoglobin was undetectable. DAT test was negative. Blood smear examination revealed anisopoikilocytosis, polychromasia, bite cells, and basophilic stippling . However, no Heinz bodies were detected. Although basophilic stippling is not a feature of glucose-6-phosphate dehydrogenase deficiency (G6PD), this diagnostic possibility was investigated and excluded , leading us to suspect an unstable hemoglobinopathy. Hb analysis was initiated by cellulose acetate electrophoresis (Helena) and high-performance liquid chromatography (HPLC) (VARIANT II, Bio-Rad Laboratories, Hercules), and confirmed by automated capillary electrophoresis (CapillaryS2 Flex Piercing, Sebia). Sanger sequencing was performed using exon-specific primers. HPLC and capillary electrophoresis showed slightly increased HbA2, normal fetal Hb (HbF), and a variant hemoglobin . DNA sequencing revealed a heterozygous mutation c430delC in the beta-globin gene hallmark of Hb Montreal II and a heterozygous mutation c287C>T in the alpha-globin gene corresponding to Hb G-Georgia [ 6 – 11 ], indicative of the not yet described combination of double-heterozygous Hb Montreal II and Hb G-Georgia variants. Owing to the likelihood that drugs with oxidative effects may aggravate hemolysis in our patient, we recommended him to avoid drugs contraindicated in G6PD deficiency ( www.g6pd.org ). Table 1 Laboratory and clinical characteristics of the first reported case of Hb Montreal II variant and the largest family affected by the Hb Montreal II and the G-Georgia Hb variants Characteristics Normal range (females) Mother (II.1) Normal range (males) Initial case Montreal II Brother (III.2) Index patient (III.3) Father (II.2) Normal range for age Nephew (IV.1) Hb variant No Montreal II No Montreal II Montreal II/ G-Georgia Montreal II/ G-Georgia G-Georgia No NA Splenomegaly No Yes No Yes Yes Yes Na No NA Splenectomy No No No No Yes No No No No RBC (T/L) 3.9–5.0 4.11 4.2–5.7 5.04 3.28 4.66 4.52 4.5–5.3 3.97 Hb (g/L) 121–154 129 135–168 148 89 132 13.9 130–170 104 MCV (fL) 80–98 105 80–98 90.7 87 102 88 71–83 85.6 MCH (pg) 27–33 32 27–33 29.3 27 30 31 23.1–28.2 26.2 MCHC (g/L) 320–360 299 320–360 323 312 305 351 320–359 306 RDW (%) 11.5–14.5 14.1 11.5–14.5 14.9 17.1 13 11.8 11.5–13.1 NA Reticulocytes (%) 0.5–2.0 9.8 0.5–1.6 6.8 10.3 19.8 1.2 0.5–1.6 NA Heinz bodies (%) No NA No 1 NA 0 NA Absent NA Bite cells No NA No Rare NA Rare NA Absent NA Basophilic stippling (%) No 5 No 10 5 7 0 No 5 LDH (U/L) < 480 728 < 480 297 582 2342 325 < 480 NA Conjugated bilirubin (µmol/L) < 5 13 < 5 6 7 6 6 < 5 NA Total bilirubin (µmol/L) < 17 48 < 17 49 22 83 2 < 17 NA Haptoglobin (g/L) 0.3–2.0 < 0.01 0.3–2.0 < 0.06 NA < 0.01 1.78 0.3–2.0 NA AST (U/L) < 50 27 < 50 NA 22 91 NA < 50 NA ALT (U/L) < 50 18 < 50 NA 27 24 NA < 50 NA Ferritin (μg/L) 20–250 174 20–250 NA 771 76 NA 20–250 NA Pyruvate kinase (U/g Hb) 7.0–13.5 Normal 8.7–16.2 Normal Normal Normal Normal - NA G6PD (U/g Hb) 6.75–11.95 Normal 6.75–11.95 Normal Normal Normal Normal - NA HbA (%) 95–96 Yes 95–96 59.4 97.5 64.0 97.5 - NA HbA2 (%) 1.8–3.2 No 1.8–3.2 3.3 2.5 3.8 2.5 - NA HbF (%) < 1.5% Yes < 1.5% 2.7 < 1 1.1 < 1 - NA Abnormal Hb (%) No 4.11 No 26.1 0 22.8 0 No NA ALT alanine aminotransferase, AST aspartate aminotransferase, G6PD glucose-6-phosphate dehydrogenase, Hb hemoglobin, HbF fetal Hb, MCV mean corpuscular volume, MCH mean corpuscular hemoglobin, MCHC mean corpuscular hemoglobin concentration, LDH lactate dehydrogenase, NA not available, RBC red blood cell, RDW red blood cell distribution width. Fig. 2 Diagnostic process. A Blood smear of the index patient showing bite cells (black arrow head) and basophilic stippling (blank arrow head). B High-performance liquid chromatography (HPLC) of the index patient showing the values for HbA2, HbF, and variant hemoglobin (red arrow), with the same retention time as for HbA1c (0.693 minutes) in HPLC. C Capillary electrophoresis of the index patient showing two peaks for HbF and an abnormal peak for HbA (adult hemoglobin). These findings are consistent with a high suspicion of a variant hemoglobin
| 4.246094
| 0.905762
|
sec[1]/p[0]
|
en
| 0.999995
|
PMC8994883
|
https://doi.org/10.1186/s13256-022-03374-y
|
[
"montreal",
"hemoglobin",
"variant",
"georgia",
"index",
"dehydrogenase",
"blood",
"basophilic",
"stippling",
"electrophoresis"
] |
[
{
"code": "3A51.1",
"title": "Sickle cell disease without crisis"
},
{
"code": "3A51.Z",
"title": "Sickle cell disorders or other haemoglobinopathies, unspecified"
},
{
"code": "MA18.4",
"title": "Low haemoglobin"
},
{
"code": "3A50.4",
"title": "Hereditary persistence of fetal haemoglobin"
},
{
"code": "3A51.A",
"title": "Haemoglobin E disease"
},
{
"code": "4A00.0Y",
"title": "Other specified functional neutrophil defects"
},
{
"code": "8A40.Y",
"title": "Other specified multiple sclerosis"
},
{
"code": "8E4A.0",
"title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord"
},
{
"code": "8E01.2",
"title": "Variant Creutzfeldt-Jakob Disease"
},
{
"code": "5C56.00",
"title": "Gangliosidosis"
}
] |
=== ICD-11 CODES FOUND ===
[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]
[3A51.Z] Sickle cell disorders or other haemoglobinopathies, unspecified
Also known as: Sickle cell disorders or other haemoglobinopathies, unspecified | Sickle cell disorders or other haemoglobinopathies | Sickle-cell disease or disorder with elliptocytosis | sickle-cell hemoglobin disease with elliptocytosis | sickle-cell elliptocytosis
[MA18.4] Low haemoglobin
Also known as: Low haemoglobin
Excludes: Low affinity haemoglobin
[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
[3A51.A] Haemoglobin E disease
Definition: Haemoglobin E disease is characterised by the synthesis of an abnormal haemoglobin called haemoglobin E (HbE), instead of the normal haemoglobin A (HbA). Subjects heterozygous for HbE (AE) have an asymptomatic condition with no clinical relevance, except for the risk of transmitting E/beta thalassemia if the other parent carries beta thalassemia. The severity of these E/beta thalassemia forms is very variable, the clinical picture ranging from that of beta thalassemia minor through to thalassemi
Also known as: Haemoglobin E disease | Homozygous HbE carriers | Compound HbE or other Hb mutant heterozygotes
[4A00.0Y] Other specified functional neutrophil defects
Also known as: Other specified functional neutrophil defects | Chronic granulomatous disease | Chronic septic granulomatosis | CGD - [chronic granulomatous disease] | chronic granulomatous disorder
[8A40.Y] Other specified multiple sclerosis
Also known as: Other specified multiple sclerosis | Certain specified rare variants of multiple sclerosis | Multiple sclerosis, Marburg variant | Myelinoclastic diffuse sclerosis | Schilder disease
[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord
Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem
Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis
[8E01.2] Variant Creutzfeldt-Jakob Disease
Definition: A disease of the brain, that is suspected to be caused by a prion associated with Bovine Spongiform Encephalopathy. This disease is characterised by a long incubation period, psychiatric symptoms followed by neurological deficits, and is fatal. Transmission may be by ingestion of food (with a bovine origin) contaminated with infected brain or spinal cord from an infected cow, or blood transfusion. Confirmation is by pathological examination of the brain.
Also known as: Variant Creutzfeldt-Jakob Disease | vCJD - [Variant Creutzfeldt-Jakob Disease]
[5C56.00] Gangliosidosis
Also known as: Gangliosidosis | GM1 gangliosidosis | Landing disease | GM1 gangliosidosis type 1 | Generalised gangliosidosis
=== GRAPH WALKS ===
--- Walk 1 ---
[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 2 ---
[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. ...
--- Walk 3 ---
[3A51.Z] Sickle cell disorders or other haemoglobinopathies, unspecified
--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 4 ---
[3A51.Z] Sickle cell disorders or other haemoglobinopathies, unspecified
--PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies
Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...
--CHILD--> [3A51.1] Sickle cell disease without crisis
Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...
--- Walk 5 ---
[MA18.4] Low haemoglobin
--EXCLUDES--> [?] Low affinity haemoglobin
Def: A disease caused by determinants arising after birth, in the antenatal period or by genetically inherited factors leading to low oxygen affinity haemoglobin. This disease is characterised by abnormali...
--PARENT--> [?] Other haemoglobinopathies
Def: Any disease caused by determinants leading to abnormalities the integral structure of the haemoglobin molecule. This disease is characterised by decreased levels of red blood cells in the body. Confir...
--- Walk 6 ---
[MA18.4] Low haemoglobin
--EXCLUDES--> [?] Low affinity haemoglobin
Def: A disease caused by determinants arising after birth, in the antenatal period or by genetically inherited factors leading to low oxygen affinity haemoglobin. This disease is characterised by abnormali...
--PARENT--> [?] Other haemoglobinopathies
Def: Any disease caused by determinants leading to abnormalities the integral structure of the haemoglobin molecule. This disease is characterised by decreased levels of red blood cells in the body. Confir...
|
[
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --PARENT--> [?] Anaemias or other erythrocyte disorders",
"[3A51.1] Sickle cell disease without crisis\n Def: A disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may pr...\n --PARENT--> [3A51] Sickle cell disorders or other haemoglobinopathies\n Def: Any disorder caused by a HbS mutation in the haemoglobin gene. This disorder is characterised by abnormal rigid sickle-shaped red blood cells decreasing its ability to carry oxygen. This disorder may ...\n --CHILD--> [3A51.0] Sickle cell trait\n Def: A disease caused by genetic inheritance of one abnormal allele of the haemoglobin gene. This disease does not display the severe symptoms of sickle cell disease that occurs in homozygous individuals. ...",
"[3A51.Z] Sickle cell disorders or other haemoglobinopathies, unspecified\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.Z] Sickle cell disorders or other haemoglobinopathies, unspecified\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...",
"[MA18.4] Low haemoglobin\n --EXCLUDES--> [?] Low affinity haemoglobin\n Def: A disease caused by determinants arising after birth, in the antenatal period or by genetically inherited factors leading to low oxygen affinity haemoglobin. This disease is characterised by abnormali...\n --PARENT--> [?] Other haemoglobinopathies\n Def: Any disease caused by determinants leading to abnormalities the integral structure of the haemoglobin molecule. This disease is characterised by decreased levels of red blood cells in the body. Confir...",
"[MA18.4] Low haemoglobin\n --EXCLUDES--> [?] Low affinity haemoglobin\n Def: A disease caused by determinants arising after birth, in the antenatal period or by genetically inherited factors leading to low oxygen affinity haemoglobin. This disease is characterised by abnormali...\n --PARENT--> [?] Other haemoglobinopathies\n Def: Any disease caused by determinants leading to abnormalities the integral structure of the haemoglobin molecule. This disease is characterised by decreased levels of red blood cells in the body. Confir..."
] |
3A51.1
|
Sickle cell disease without crisis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D57411",
"icd10_title": "Sickle-cell thalassemia with acute chest syndrome"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D57412",
"icd10_title": "Sickle-cell thalassemia with splenic sequestration"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D57419",
"icd10_title": "Sickle-cell thalassemia with crisis, unspecified"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D5740",
"icd10_title": "Sickle-cell thalassemia without crisis"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D57819",
"icd10_title": "Other sickle-cell disorders with crisis, unspecified"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D5780",
"icd10_title": "Other sickle-cell disorders without crisis"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D57811",
"icd10_title": "Other sickle-cell disorders with acute chest syndrome"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D57",
"icd10_title": "Sickle-cell disorders"
},
{
"from_icd11": "3A51.Z",
"icd10_code": "D578",
"icd10_title": "Other sickle-cell disorders"
},
{
"from_icd11": "3A50.4",
"icd10_code": "D564",
"icd10_title": "Hereditary persistence of fetal hemoglobin [HPFH]"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3183",
"icd10_title": "Dementia with Lewy bodies"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G2581",
"icd10_title": "Restless legs syndrome"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3184",
"icd10_title": "Mild cognitive impairment, so stated"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G9349",
"icd10_title": "Other encephalopathy"
}
] |
D571
|
Sickle-cell disease without crisis
|
A 31-year-old female presented to the emergency room with severe dyspnea, palpitation, acute generalized abdominal pain, and vomiting without blood or bile in February 2019. Upon reviewing systems and past medical and surgical history, she admitted to a 5 kg weight loss over the past month. She had a cesarean section 18 months ago without any complications. She had no history of hypertension (HTN), diabetes mellitus (DM), and cigarette smoking. Her drug history was negative, especially for illegal drugs, such as methamphetamines and cocaine. Her symptoms started 5-6 hours before admission. Initial vital signs included a blood pressure of 80/50 mmHg, heart rate of 130 beats per minute (bpm), respiratory rate of 30 per minute, O 2 saturation of 81% on room air, and temperature of 38.1°C. Physical examination revealed diffuse bilateral crackles but no decreased breath sounds at the base. Generally, the patient appeared confused and unstable. During the initial physical examination, she had a cardiac arrest, and cardiopulmonary resuscitation was done for 10 minutes, and it was successful. After that, she was sent to the intensive care unit (ICU). At this time, ECG showed sinus tachycardia, and transthoracic echocardiogram (TTE) demonstrated severe left ventricular (LV) systolic dysfunction with ejection fraction (EF) of 10%, normal LV size, mild to moderate mitral regurgitation, mild tricuspid regurgitation, and moderate pericardial effusion. Laboratory data are shown in Table 1 . She received norepinephrine (starting infusion rates of 0.025 μ g/kg/min), meropenem (500 mg IV every 8 hours), and ciprofloxacin (500 mg IV every 12 hours). On the fourth day, norepinephrine was discontinued, and hemodynamic stability was maintained even after discontinuation of vasopressor support. However, her fever continued to peak at 39°C. Tracheal aspirate, blood, and urine cultures were taken, and abdominal ultrasonography was performed due to non-specific abdominal discomfort. Ultrasonography showed a well-defined hypoechoic mass (44 × 57 mm) with internal vascularity in the right adrenal gland. In the next step, on the seventh day, abdominal computed tomography (CT) and catecholamine urine tests were requested for suspicion of an adrenal tumor. Abdominal CT showed a heterogeneous right adrenal mass measuring 47 × 54 mm . The adrenal mass on the unenhanced images had a density of 36 Hounsfield units. Laboratory values were notable for a 24-hour urine metanephrine of 2510 µ g/day (normal <315 µ g/day), normetanephrine of 8657 µ g/day (normal <670 µ g/day), adrenaline of 386 µ g/day (normal < 20 µ g/day), noradrenaline of 1044 µ g/day (normal < 90 µ g/day), and vanillylmandelic acid of 70 mg/day (normal < 13.6 mg/day). Indeed, all cultures were negative for infectious organisms. These findings were consistent with the diagnosis of pheochromocytoma. She was started on phenoxybenzamine 10 mg twice a day, and the dosage was increased by 10 mg every three days to a maximum dosage of 20 mg twice a day. On the tenth day, she complained of acute-onset progressive muscle weakness in the lower limbs, followed by the upper limbs. The muscle strength examination showed severe weakness in four limbs with a Medical Research Council (MRC) scale of 1/5 in proximal and 2/5 in distal of the upper extremities and 2/5 in proximal and 2/5 in distal of the lower limbs. She had no spine sensory level. Deep tendon reflexes were absent. Upper motor neuron disorders and meningeal irritation signs were absent. Lumbar puncture for cerebrospinal fluid (CSF) analysis was performed, and study results are shown in Table 2 . Brain magnetic resonance imaging (MRI) was done and showed a normal finding except for a few foci of cortical and subcortical infarction. Electromyography (EMG) and nerve conduction velocity (NCV) showed acute predominantly motor axonal polyneuropathy. Therefore, the diagnosis of GBS was made, and the patient was treated with intravenous immunoglobulin (IVIG) 2 g/kg divided over five days. After that, muscle weakness gradually improved. On the fourteenth day, propranolol was prescribed with a dose of 10 mg every 8 hours. Then, the right adrenalectomy was performed without any surgical complications, and the postoperative histopathologic report was in agreement with a diagnosis of pheochromocytoma. No complications were reported in the postoperative period. Predischarge TTE showed LVEF of 40%, normal LV size, mild mitral regurgitation, mild tricuspid regurgitation, and no pericardial effusion. She was followed in an outpatient setting regularly. Two weeks after adrenalectomy, the patient had no evidence of the disease. Laboratory values were notable for a 24-hour urine metanephrine of 107 µ g/day (normal <315 µ g/day), normetanephrine of 210 µ g/day (normal <670 µ g/day), adrenaline of 15 µ g/day (normal < 20 µ g/day), noradrenaline of 34 µ g/day (normal < 90 µ g/day), and vanillylmandelic acid of 7.1 mg/day (normal < 13.6 mg/day). Today, 18 months after hospital discharge, her general condition is good, and the catecholamine urine test results are negative for pheochromocytoma. The latest echocardiography demonstrates the LVEF to be 50%, and other echocardiographic measurements are within the normal values.
| 3.982422
| 0.977539
|
sec[1]/p[0]
|
en
| 0.999996
|
34123439
|
https://doi.org/10.1155/2021/6691095
|
[
"abdominal",
"urine",
"hours",
"regurgitation",
"every",
"adrenal",
"limbs",
"without",
"blood",
"complications"
] |
[
{
"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": "MF9Y",
"title": "Other specified clinical findings on examination of urine, without diagnosis"
},
{
"code": "MF50.6Z",
"title": "Difficulties with micturition, unspecified"
},
{
"code": "MF50.0",
"title": "Frequent micturition"
},
{
"code": "MF50.3",
"title": "Retention of urine"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[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
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
Also known as: Other specified clinical findings on examination of urine, without diagnosis | Methaemoglobinuria | Other and unspecified abnormal findings in urine | Calciuria | Cells and casts in urine
[MF50.6Z] Difficulties with micturition, unspecified
Also known as: Difficulties with micturition, unspecified | Other difficulties with micturition | difficulty passing urine NOS | difficulty urinating NOS | other difficulties with urination
[MF50.0] Frequent micturition
Definition: Needing to urinate more often than normal.
Also known as: Frequent micturition | Urinary frequency | Frequency of micturition NOS | Frequent urination | Micturition frequency
Excludes: Pollakiuria
[MF50.3] Retention of urine
Definition: Incomplete emptying of the bladder
Also known as: Retention of urine | bladder retention of urine | not passing urine | unable to empty bladder | unable to pass urine
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[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....
--EXCLUDES--> [?] Flatulence and related conditions
Def: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus and other conditions associated with the production or presence of gas in the GI tract....
--- 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.Y] Other specified ascites
--- Walk 6 ---
[ME04.Z] Ascites, unspecified
--PARENT--> [ME04] Ascites
Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...
--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 --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 --EXCLUDES--> [?] Flatulence and related conditions\n Def: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus and other conditions associated with the production or presence of gas in the GI tract....",
"[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.Y] Other specified ascites",
"[ME04.Z] Ascites, unspecified\n --PARENT--> [ME04] Ascites\n Def: Accumulation or retention of free fluid in the abdominal peritoneal cavity between the tissues lining the abdomen and abdominal organs. The fluid may be serous, haemorrhagic, or the result of inflamma...\n --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": "MF50.6Z",
"icd10_code": "R3915",
"icd10_title": "Urgency of urination"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3911",
"icd10_title": "Hesitancy of micturition"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3914",
"icd10_title": "Feeling of incomplete bladder emptying"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3912",
"icd10_title": "Poor urinary stream"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R39198",
"icd10_title": "Other difficulties with micturition"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3916",
"icd10_title": "Straining to void"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3919",
"icd10_title": "Other difficulties with micturition"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R3913",
"icd10_title": "Splitting of urinary stream"
},
{
"from_icd11": "MF50.6Z",
"icd10_code": "R391",
"icd10_title": "Other difficulties with micturition"
},
{
"from_icd11": "MF50.0",
"icd10_code": "R351",
"icd10_title": "Nocturia"
}
] |
R100
|
Acute abdomen
|
Lung cancer has the highest incidence and mortality among malignant tumors, which seriously threatens human health and life. Every year, over 1 million new cases of lung cancer occur worldwide, of which SCLC accounts for 15 to 20%. SCLC can be divided into limited stage and extensive stage ones. Extensive stage SCLC accounts for 60 to 70% of all SCLC and most cases have reached stage III–IV at the time of diagnosis. The 5-year survival of patients with extensive stage SCLC is <10%, and combined chemotherapy has become the main treatment. Therefore, how to improve the efficiency of chemotherapy, prolong the survival time, reduce the side effects, and improve the patient’s quality of life have become the main problems in treating extensive stage SCLC. Dr Li has inherited his family’s knowledge and accumulated rich experience in the treatment of various types of cancer with TCM as adjuvant therapy to adiotherapy and chemotherapy, which has achieved better curative effects. In this case, at the initial diagnosis, the patient had irritable cough, yellowish and sticky phlegm, dark red tongue, yellow and greasy coating, and stringy, slippery, and rapid pulse. Considering the phlegm and toxin accumulation in the lung, the patient was prescribed with large quantities of lung clearing, heat clearing, phlegm reducing, and detoxicating TCM. The treatment aimed at clearing away heat and detoxification, clearing lung and reducing phlegm, and resolving hard lumps. Qianjin Weijin Decoction, Wuwei Xiaodu Decoction, Xiaoxianxiong Decoction, and Xiaochengqi Decoction were included and modified accordingly. In Xiaoxianxiong Decoction, Trichosanthes is used to relax chest, relieve lumps, clear lung, and remove phlegm, whereas Coptis chinensis specializes in clearing heart and relieving heat, supplemented by Gardenia jasminoides for removing the source of heat. In Qianjin Weijin Decoction, the reed root and wax gourd seed are used to clear lung and reduce phlegm. Besides, in combination with Trichosanthes kirilowii , the goal of clearing lung, reducing phlegm, relaxing chest, and resolving lumps can be achieved. In Wuwei Xiaodu Decoction, honeysuckle and Chrysanthemum indicum are good at clearing heat, detoxification, and resolving lumps. Honeysuckle functions on the lung and stomach, which can relieve the heat toxin at middle and upper jiaos. Chrysanthemum indicum functions on the liver channel to clear the heat of liver and gallbladder. The 2 drugs combined are good at clearing Qi and dividing heat concentrations. Dandelion is used to clear away heat and toxin, and eliminate the dampness and heat of lower jiao. Begonia fimbristipula Hance is replaced by Solanum nigrum to clear away heat, detoxicate, resolve lumps, and activate blood circulation. The combination of the 5 herbs can clear both Qi and blood, treat the 3 jiaos simultaneously, and dividing the heat concentrations of the 3 jiaos. Xiaochengqi Decoction was taken to bring medicine downward, give pathogenic factors an outlet, and discharge turbidity toxin by excretion. In it, Hedyotis diffusa , Radix stemonae, and Fritillaria thunbergii can clear lung, reduce phlegm, and relieve cough; Radix asparagi, Radix Ophiopogonis , and Radix Scrophulariae are used to nourish yin, clear and moisten lung, which rapidly purge to preserve yin, eliminate pathogenic factors without hurting health; raw Rehmannia glutinosa and peony bark are used to clear away heat and cool blood. Tumors are often caused by interacting phlegm stasis and turbidity toxin. In this case, this cause was possibly revealed by the patient’s dark tongue. As a result, walnut kernel, Scutellaria barbata , and Ranunculus ternatus are used to regulate Qi, activate blood circulation, reduce stasis, and resolve lumps. Chronic diseases tend to consume yin blood inwardly, when combined with radiotherapy and chemotherapy, bone marrow suppression can be obvious. At the second hospital visit, Caulis Spatholobus and Paris polyphylla were added in the prescription. Caulis Spatholobi is bitter, sweet, and warm, which functions on blood and is good at nourishing blood, warming channels, and activating collaterals. Paris polyphylla promotes the power of clearing. At the third visit, the patient had a dry mouth and occasional fever at night. So Bupleurum in the recipe of Xiaochaihu Decoction was added to clear away the heat. The follow-up checks revealed stable conditions for the patient, so the original prescription was used. Another check during the period showed brain metastasis, so Ligusticum wallichii was added to promote Qi, activate blood circulation, relieve pain, and carry other drugs upward. At the later stage, the patient had obvious rib pain, and bone scan showed bone metastasis. Therefore, Corydalis was added in the original prescription. Corydalis functions on the liver channel and is good at promoting Qi and relieving pain, which can also lead medicine inward. The whole prescription also has the clearing and nourishing effect of Baihe Gujin Decoction and the clearing effect of Shengdi Danpi Decoction. In this case, the combination of various drugs had the effect of clearing away heat and toxin, clearing lung and reducing phlegm, and resolving hard lumps, thereby removing the disease.
| 4.148438
| 0.758301
|
sec[2]/p[0]
|
en
| 0.999997
|
39833064
|
https://doi.org/10.1097/MD.0000000000041291
|
[
"heat",
"clearing",
"lung",
"decoction",
"phlegm",
"clear",
"blood",
"which",
"stage",
"lumps"
] |
[
{
"code": "NF01.Z",
"title": "Effects of heat, unspecified"
},
{
"code": "QD71.1",
"title": "Inadequate housing"
},
{
"code": "NF01.Y",
"title": "Other specified effects of heat"
},
{
"code": "EE02.Y",
"title": "Other specified forms of miliaria"
},
{
"code": "NF01.0",
"title": "Heat stroke"
},
{
"code": "2F21.Y",
"title": "Other specified benign keratinocytic acanthomas"
},
{
"code": "2C73.00",
"title": "Clear cell adenocarcinoma of ovary"
},
{
"code": "2D12.1",
"title": "Adenocarcinoma of other endocrine glands or related structures"
},
{
"code": "2C25.Y",
"title": "Other specified malignant neoplasms of bronchus or lung"
},
{
"code": "2C25.2",
"title": "Squamous cell carcinoma of bronchus or lung"
}
] |
=== ICD-11 CODES FOUND ===
[NF01.Z] Effects of heat, unspecified
Also known as: Effects of heat, unspecified | Effects of heat | heat exhaustion | heat prostration NOS | effects of hot weather
[QD71.1] Inadequate housing
Also known as: Inadequate housing | lack of adequate housing | problem with inadequate housing | restriction of housing space | unsatisfactory surroundings
Excludes: Problems associated with the natural environment or human-made changes to the environment
[NF01.Y] Other specified effects of heat
Also known as: Other specified effects of heat | Heat exhaustion due to salt depletion | salt deficiency causing heat exhaustion or prostration | sodium depletion causing heat exhaustion or prostration | effects of heat exhaustion due to salt depletion
[EE02.Y] Other specified forms of miliaria
Also known as: Other specified forms of miliaria | Miliaria crystallina | Sudamina | Miliaria rubra | Heat rash
[NF01.0] Heat stroke
Definition: Elevation of core body temperature above 40.6 degrees centigrade due to environmental heat exposure and a failure of thermoregulation. This is a potentially fatal disorder, particularly in infants and children.
Also known as: Heat stroke | heat-induced hyperthermia | heat apoplexy | heat pyrexia | heat stress
Excludes: Exertional heat stroke
[2F21.Y] Other specified benign keratinocytic acanthomas
Also known as: Other specified benign keratinocytic acanthomas | Stucco keratosis | Inverted follicular keratosis | Warty dyskeratoma | Clear cell acanthoma
[2C73.00] Clear cell adenocarcinoma of ovary
Definition: A malignant glandular epithelial tumour characterised by the presence of clear and hobnail cells. The tumour is highly associated with ovarian endometriosis, pelvic endometriosis and paraendocrine hypercalcemia.
Also known as: Clear cell adenocarcinoma of ovary | clear cell carcinoma of ovary
[2D12.1] Adenocarcinoma of other endocrine glands or related structures
Also known as: Adenocarcinoma of other endocrine glands or related structures | Adenocarcinoma of parathyroid gland | water clear cell adenocarcinoma of unspecified site | water clear cell carcinoma of unspecified site | Adenocarcinoma of pituitary gland
[2C25.Y] Other specified malignant neoplasms of bronchus or lung
Also known as: Other specified malignant neoplasms of bronchus or lung | Bronchial endocrine tumour | Bronchial neuroendocrine tumour | Bronchial carcinoid tumour | Bronchiolo-alveolar carcinoma of lung
[2C25.2] Squamous cell carcinoma of bronchus or lung
Definition: A carcinoma arising from malignant squamous bronchial epithelial cells and characterised by the presence of keratinization and/or intercellular bridges. Cigarette smoking and arsenic exposure are strongly associated with squamous cell lung carcinoma.
Also known as: Squamous cell carcinoma of bronchus or lung | Papillary squamous cell carcinoma of lung | Basaloid squamous cell carcinoma of lung | Clear cell squamous cell carcinoma of lung | Squamous cell cancer of lung
=== GRAPH WALKS ===
--- Walk 1 ---
[NF01.Z] Effects of heat, unspecified
--PARENT--> [NF01] Effects of heat
Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...
--EXCLUDES--> [?] Burns
Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...
--- Walk 2 ---
[NF01.Z] Effects of heat, unspecified
--PARENT--> [NF01] Effects of heat
Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...
--EXCLUDES--> [?] Burns
Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...
--- Walk 3 ---
[QD71.1] Inadequate housing
--EXCLUDES--> [?] Problems associated with the natural environment or human-made changes to the environment
--EXCLUDES--> [?] Occupational exposure to risk-factors
--- Walk 4 ---
[QD71.1] Inadequate housing
--EXCLUDES--> [?] Problems associated with the natural environment or human-made changes to the environment
--PARENT--> [?] Problems associated with the environment
--- Walk 5 ---
[NF01.Y] Other specified effects of heat
--PARENT--> [NF01] Effects of heat
Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...
--CHILD--> [NF01.2] Heat exhaustion due to fluid depletion
Def: A failure of thermoregulatory sweating on exposure to heat as a result of water deprivation and/or inadequate replacement of fluids lost through sweating or by other means (e.g. severe diarrhoea). If ...
--- Walk 6 ---
[NF01.Y] Other specified effects of heat
--PARENT--> [NF01] Effects of heat
Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...
--CHILD--> [NF01.1] Heat syncope
Def: Fainting attributable to exposure to heat...
|
[
"[NF01.Z] Effects of heat, unspecified\n --PARENT--> [NF01] Effects of heat\n Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...\n --EXCLUDES--> [?] Burns\n Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...",
"[NF01.Z] Effects of heat, unspecified\n --PARENT--> [NF01] Effects of heat\n Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...\n --EXCLUDES--> [?] Burns\n Def: A burn is an injury to the tissues caused by a pathological flux of energy which causes cellular destruction and irreversible denaturation of proteins and is primarily caused by thermal or other acute...",
"[QD71.1] Inadequate housing\n --EXCLUDES--> [?] Problems associated with the natural environment or human-made changes to the environment\n --EXCLUDES--> [?] Occupational exposure to risk-factors",
"[QD71.1] Inadequate housing\n --EXCLUDES--> [?] Problems associated with the natural environment or human-made changes to the environment\n --PARENT--> [?] Problems associated with the environment",
"[NF01.Y] Other specified effects of heat\n --PARENT--> [NF01] Effects of heat\n Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...\n --CHILD--> [NF01.2] Heat exhaustion due to fluid depletion\n Def: A failure of thermoregulatory sweating on exposure to heat as a result of water deprivation and/or inadequate replacement of fluids lost through sweating or by other means (e.g. severe diarrhoea). If ...",
"[NF01.Y] Other specified effects of heat\n --PARENT--> [NF01] Effects of heat\n Def: Adverse effects resulting from a failure to maintain normal body core temperature on exposure to excessive heat. Vigorous exercise, insulation by clothing (e.g. protective clothing) or an inability to...\n --CHILD--> [NF01.1] Heat syncope\n Def: Fainting attributable to exposure to heat..."
] |
NF01.Z
|
Effects of heat, unspecified
|
[
{
"from_icd11": "NF01.Z",
"icd10_code": "T678XXA",
"icd10_title": "Other effects of heat and light, initial encounter"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T675XXA",
"icd10_title": "Heat exhaustion, unspecified, initial encounter"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T67",
"icd10_title": "Effects of heat and light"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T672",
"icd10_title": "Heat cramp"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T674",
"icd10_title": "Heat exhaustion due to salt depletion"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T675",
"icd10_title": "Heat exhaustion, unspecified"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T677",
"icd10_title": "Heat edema"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T678",
"icd10_title": "Other effects of heat and light"
},
{
"from_icd11": "NF01.Z",
"icd10_code": "T679",
"icd10_title": "Effect of heat and light, unspecified"
},
{
"from_icd11": "QD71.1",
"icd10_code": "Z591",
"icd10_title": "Inadequate housing"
},
{
"from_icd11": "NF01.0",
"icd10_code": "T670XXA",
"icd10_title": ""
},
{
"from_icd11": "NF01.0",
"icd10_code": "T670",
"icd10_title": "Heatstroke and sunstroke"
}
] |
T678XXA
|
Other effects of heat and light, initial encounter
|
A 61-year-old female was admitted to The First Affiliated Hospital of Kunming Medical University, Yunnan, China, complaining of a lump in the right breast which had appeared 2 days earlier and had been increasing in tenderness for a week. During the physical examination, the patient’s breasts were found to be bilaterally symmetrical, without any skin retraction. The two nipples were on the same horizontal line without discharge nor retraction. A mass was palpable in the upper-outer quadrant about 5 cm away from the right nipple, with an approximate size of 1.5 cm × 1 cm. The mass was tough in texture, irregular in shape, unclear in boundary and slightly adhesive to the surrounding tissues. There were no positive findings in the left breast. The superficial lymph nodes were not palpable in the bilateral axillary and clavicular fossa. The patient had no history of smoking or alcohol consumption and there was no family history of any types of tumor.Ultrasonography revealed an ill-defined mass in the right breast, and its internal echo was non-homogenous. Mammography revealed a small irregular dense shadow in the upper outer quadrant of the right breast . The boundary of the shadow was unclear and the glands around were gathered without obvious internal calcification. The emission computed tomography (ECT) of whole-body bone imaging and the CT of brain, liver and lung imaging showed no signs of tumor metastasis. Evaluation of tumor markers showed that serum carbohydrate antigen (CA) CA 15–3 was 37.6 U/ml (the normal range is 0–35 U/ml). Other tumor markers were within normal ranges. A simple lumpectomy was performed in the hospital.Grossly, the well-circumscribed pale-tan nodule measured 1.6cm × 1.2cm × 0.5cm and lacked a distinct capsule. Histologically, the nodule was composed of two obscure lobules without evidence of a capsule on low-power examination . One of the lobules consisted of small tubular ducts formed by two phenotypically distinct cell layers. The inner epithelial cells exhibited eosinophilic cytoplasm and the outer myoepithelial cells were clear. Tubular structures predominated in this lobule and formed an expansile circumscribed, partially-encapsulated mass, although focally infiltrated into adjacent fat tissue . A papillary component was also noted in some areas. In addition, atypia was obvious in both epithelial and myoepithelial cells with moderate degree of nuclear pleomorphism, prominent nucleoli, high nuclear cytoplasmic ratio and increased mitotic figures (11/10HPF) . These histological features support the diagnosis of malignant adenomyoepithelioma.The other lobule of the mass exhibited typical histological image of adenoid cystic carcinoma which consisted of tubular and cribriform structure and had infiltrative borders. The epithelial and myoepithelial cells, whose difference was not as obvious as in adenomyoepithelioma, were polarized around two types of spaces: true glandular spaces (contain mucoid material) and pseudolumens (contain basement membrane material) . The myoepithelial cells of adenoid cystic carcinoma were smaller, had a more hyperchromatic and basaloid character and had much less cytoplasm than those of adenomyoepithelioma, and the invagination of stroma was frequently present. Transition from adenomyoepithelioma to adenoid cystic carcinoma was gradual. And we can also see adenomyoepithelioma and adenoid cystic carcinoma combined in some areas.Immunohistochemistry can distinguish the two different cell types. In both lesions, the myoepithelial cells were highlighted by CK5/6, smooth muscle actin (SMA) and p63, while the epithelial cells were positive for CK18 . Immunostains for estrogen (ER) and progesterone (PR) were negative in AME and ACC but positive in surrounding normal ductal epithelial, and human epidermal growth factor receptor 2 (Her2) were also negative in this case. Nevertheless, CD117 expression was found in adenoid cystic carcinoma in contrast to adenomyoepithelioma, where CD117 was not expressed . Figure 1 Imaging inspection. Mammography revealed a small irregular dense shadow in the upper outer quadrant of the right breast. Figure 2 Low-power examination. The nodule was composed of two obscure lobules on low-power examination. The left one was adenoid cystic carcinoma and the right one was malignant adenomyoepithelioma. HE, ×10. Figure 3 High-power examination to the malignant adenomyoepithelioma. Atypia was obvious in both epithelial and myoepithelial cells with moderate degree of nuclear pleomorphism, prominent nucleoli, high nuclear cytoplasmic ratio and increased mitotic figures (arrow). HE, ×200. Figure 4 High-power examination to the adenoid cystic carcinoma. The cribriform structure in adenoid cystic carcinoma contains true glandular spaces and pseudolumens. HE, ×200. Figure 5 The immunohistochemistry panel of malignant adenomyoepithelioma (A, B, C) and adenoid cystic carcinoma (D, E, F). CK18 was expressed in epithelial cells of malignant adenomyoepithelioma (A) and adenoid cystic carcinoma (D) . P63 was expressed in myoepithelial cells of malignant adenomyoepithelioma (B) and adenoid cystic carcinoma (E) , CD117 was negative in malignant adenomyoepithelioma (C) and positive in adenoid cystic carcinoma (F) . ×100.
| 4.171875
| 0.961914
|
sec[1]/p[0]
|
en
| 0.999998
|
25056281
|
https://doi.org/10.1186/1746-1596-9-148
|
[
"adenomyoepithelioma",
"adenoid",
"cystic",
"carcinoma",
"cells",
"epithelial",
"myoepithelial",
"malignant",
"breast",
"power"
] |
[
{
"code": "2F30.Y",
"title": "Other specified benign neoplasm of breast"
},
{
"code": "2C6Y",
"title": "Other specified malignant neoplasms of breast"
},
{
"code": "CA0F.Y",
"title": "Other specified chronic diseases of tonsils or adenoids"
},
{
"code": "CA0Y&XA5AS8",
"title": "Acute adenoiditis"
},
{
"code": "CA0F.1",
"title": "Hypertrophy of adenoids"
},
{
"code": "NA0Z&XA5AS8",
"title": "Injury of adenoid"
},
{
"code": "CA0J.Y&XA5AS8",
"title": "Polyp of adenoid tissue"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[2F30.Y] Other specified benign neoplasm of breast
Also known as: Other specified benign neoplasm of breast | Benign cystosarcoma phyllodes | Breast apocrine adenoma | Serocystic disease of Brodie | Pleomorphic adenoma of breast
[2C6Y] Other specified malignant neoplasms of breast
Also known as: Other specified malignant neoplasms of breast | Metaplastic carcinoma of breast | Hereditary breast cancer | Paget disease of breast | areola cancer
[CA0F.Y] Other specified chronic diseases of tonsils or adenoids
Also known as: Other specified chronic diseases of tonsils or adenoids | Chronic tonsillitis | chronic infection of tonsil | Chronic infected tonsil remnant | infected tonsillar remnant
[CA0F.1] Hypertrophy of adenoids
Also known as: Hypertrophy of adenoids | Enlargement of adenoids | adenoid hypertrophy | adenoidal enlargement | adenoidal hypertrophy
Includes: Enlargement of adenoids
[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)
=== GRAPH WALKS ===
--- Walk 1 ---
[2F30.Y] Other specified benign neoplasm of breast
--PARENT--> [2F30] Benign neoplasm of breast
Def: A non-metastasizing neoplasm arising from the breast parenchyma....
--EXCLUDES--> [?] Benign cutaneous neoplasms
Def: Abnormal growth of the cells that comprise the tissues of the skin, without any evidence of malignancy....
--- Walk 2 ---
[2F30.Y] Other specified benign neoplasm of breast
--PARENT--> [2F30] Benign neoplasm of breast
Def: A non-metastasizing neoplasm arising from the breast parenchyma....
--EXCLUDES--> [?] Benign cutaneous neoplasms
Def: Abnormal growth of the cells that comprise the tissues of the skin, without any evidence of malignancy....
--- Walk 3 ---
[2C6Y] Other specified malignant neoplasms of breast
--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....
--CHILD--> [2C61] Invasive carcinoma of breast
--- Walk 4 ---
[2C6Y] Other specified malignant neoplasms of breast
--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 ---
[CA0F.Y] Other specified chronic diseases of tonsils or adenoids
--PARENT--> [CA0F] Chronic diseases of tonsils or adenoids
Def: Any persistent or recurrent disease affecting the round-to-oval mass of lymphoid tissue embedded in the lateral wall of the pharynx (tonsils) or the collection of lymphoid nodules on the posterior wal...
--CHILD--> [CA0F.0] Hypertrophy of tonsils
--- Walk 6 ---
[CA0F.Y] Other specified chronic diseases of tonsils or adenoids
--PARENT--> [CA0F] Chronic diseases of tonsils or adenoids
Def: Any persistent or recurrent disease affecting the round-to-oval mass of lymphoid tissue embedded in the lateral wall of the pharynx (tonsils) or the collection of lymphoid nodules on the posterior wal...
--EXCLUDES--> [?] Recurrent acute tonsillitis
|
[
"[2F30.Y] Other specified benign neoplasm of breast\n --PARENT--> [2F30] Benign neoplasm of breast\n Def: A non-metastasizing neoplasm arising from the breast parenchyma....\n --EXCLUDES--> [?] Benign cutaneous neoplasms\n Def: Abnormal growth of the cells that comprise the tissues of the skin, without any evidence of malignancy....",
"[2F30.Y] Other specified benign neoplasm of breast\n --PARENT--> [2F30] Benign neoplasm of breast\n Def: A non-metastasizing neoplasm arising from the breast parenchyma....\n --EXCLUDES--> [?] Benign cutaneous neoplasms\n Def: Abnormal growth of the cells that comprise the tissues of the skin, without any evidence of malignancy....",
"[2C6Y] Other specified malignant neoplasms of breast\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 --CHILD--> [2C61] Invasive carcinoma of breast",
"[2C6Y] Other specified malignant neoplasms of breast\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...",
"[CA0F.Y] Other specified chronic diseases of tonsils or adenoids\n --PARENT--> [CA0F] Chronic diseases of tonsils or adenoids\n Def: Any persistent or recurrent disease affecting the round-to-oval mass of lymphoid tissue embedded in the lateral wall of the pharynx (tonsils) or the collection of lymphoid nodules on the posterior wal...\n --CHILD--> [CA0F.0] Hypertrophy of tonsils",
"[CA0F.Y] Other specified chronic diseases of tonsils or adenoids\n --PARENT--> [CA0F] Chronic diseases of tonsils or adenoids\n Def: Any persistent or recurrent disease affecting the round-to-oval mass of lymphoid tissue embedded in the lateral wall of the pharynx (tonsils) or the collection of lymphoid nodules on the posterior wal...\n --EXCLUDES--> [?] Recurrent acute tonsillitis"
] |
2F30.Y
|
Other specified benign neoplasm of breast
|
[
{
"from_icd11": "CA0F.1",
"icd10_code": "J352",
"icd10_title": "Hypertrophy of adenoids"
},
{
"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"
}
] |
J352
|
Hypertrophy of adenoids
|
A 51-year-old man with a 16-year history of PD was admitted to our hospital with an indication for STN-DBS. He presented with severe motor fluctuations and off symptoms for more than 2 h a day. His routine medications included levodopa/carbidopa (800 mg, 8 times), pramipexole (1.5 mg), zonisamide (25 mg), and istradefylline (20 mg). He showed no cognitive decline according to the Japanese version of the Montreal Cognitive Assessment (26 points) and Frontal Assessment Battery (17 points) and no psychiatric symptoms (Neuropsychiatric Inventory: 10 points, Beck depression Inventory: 29 points). His Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score was 38 in the off-state (withdrawal of anti-parkinsonian drugs for >12 h) and four in the on-state (1 h following the administration of 1.5 times higher than usual morning levodopa dose; 150 mg/50 mg of levodopa/decarboxylase inhibitor following the drug-off phase). After these evaluations, he consented to undergo STN-DBS with Percept PC (Medtronic, Inc., Minneapolis, MN) . Four days after surgery, we recorded the bipolar LFP activity from contacts 1–3 and 9–11 of the electrodes (contacts 0 and 8 were the most ventral contacts of the left-sided and right-sided electrodes, respectively) in the STN. The contact selected for stimulation was situated between the bipolar contact selected for recording (contact 2 or 10). We could confirm the specific beta oscillation (16.6 Hz, 1.07 μVp) in the off-state before applying the stimulation. Following a manual assessment of rigidity, finger tapping, and pronation-supination movements with DBS off, the current was increased by 1.0-mA increments starting from 0 mA to the point of reducing parkinsonian symptoms, inducing side effects, or reaching the safety limit (5 mA). Contacts that had a wider therapeutic window and improved motor outcome were selected as active contacts, after which, the stimulation was set at 0.8 mA, 60 μs, and 130 Hz, and the current was increased by 0.2–0.4 mA each day. The final cDBS was set at 2 (–) C (+), 130 Hz, 60 μs, and 2.2 mA in both hemispheres, and his levodopa equivalent daily dose was reduced from 950 mg to 550 mg (levodopa/carbidopa 400 mg, four times, pramipexole 1.5 mg). One month post-surgery, we re-evaluated his motor symptoms. The MDS-UPDRS motor score was 27 points during med-off/stim-off, and the LFP intensity values were 1.20 μVp and 1.72 μVp in the left and right STN, respectively . The improvement observed during the off-state following surgery may be attributed to the micro lesioning effect compared to that before surgery. During the med-off /stim-on phase, the MDS-UPDRS score was 22 points while the LFP intensity was 1.24 μVp (left) and 1.00 μVp (right). After a few weeks, the patient was hospitalized with adjustments to the aDBS setting. Prior to the start of the aDBS session, we verified the presence of a significant beta peak (16.6 Hz), and initiated aDBS to establish effective stimulation parameters. We defined the stimulation threshold of aDBS as the stimulation range between the current that elicits the minimum detectable effect (minimum stimulation) on cardinal symptoms and the current that elicits side effects (maximum stimulation). The aDBS stimulation was finally set with the upper stimulation at 3.5 mA on both sides and the lower stimulations at 0.7 mA and 1.2 mA on the left and right sides, respectively. The strength of the beta oscillations that was detected at the minimum and maximum stimulations was set as “upper strength of LFP” and “lower strength of LFP,” respectively. If LFP reached the upper strength of LFP, stimulation was gradually increased toward the maximum stimulation. If LFP reached the lower strength of LFP, stimulation was gradually decreased toward the minimum stimulation. The stimulation frequency and duration were set at 130 Hz and 60 μs, respectively. The patient returned to work the day following discharge. During the aDBS/outside the hospital phase, the MDS-UPDRS dyskinesia score was 0 points and 0 points during the cDBS/outside the hospital phase. The motor fluctuation score was 0 points during the aDBS phase/outside hospital phase and 3 points during the cDBS/outside the hospital phase. During the cDBS mode (outside the hospital), the mean strength of the beta band oscillation and stimulation were 291 least significant bits (LSB) and 2.2 mA, respectively. During the aDBS mode, the mean strength of the beta band oscillation and stimulation amplitude were less evident in the hospital setting (mean strength of beta oscillation: 144.6 LSB; mean amplitude of stimulation: 1.61 mA) than in the non-hospital setting (mean strength of beta oscillation: 280 LSB; mean amplitude of stimulation: 2.93 mA). The percentage exceeding the beta upper threshold was 12%, that below the threshold was 41%, and that between the threshold was 47% inside the hospital setting. Conversely, the percentage exceeding the beta upper threshold was 73%, that below the threshold was 15%, and that between the threshold was 12% in the non-hospital setting, while the stimulation successfully adapted to the fluctuations of LFP during the aDBS phase . The clinical course is summarized in Figure 3 .
| 4.179688
| 0.917969
|
sec[1]/p[0]
|
en
| 0.999997
|
34483867
|
https://doi.org/10.3389/fnhum.2021.702961
|
[
"stimulation",
"points",
"beta",
"that",
"adbs",
"strength",
"phase",
"threshold",
"motor",
"respectively"
] |
[
{
"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"
},
{
"code": "ME84.1",
"title": "Thoracic spine pain"
},
{
"code": "GC03",
"title": "Urethral stricture"
},
{
"code": "GA15.4",
"title": "Stricture or stenosis of cervix uteri"
},
{
"code": "8C73.Z",
"title": "Mitochondrial myopathies, unspecified"
},
{
"code": "9C84.4",
"title": "Gaze-evoked nystagmus"
}
] |
=== ICD-11 CODES FOUND ===
[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
[ME84.1] Thoracic spine pain
Definition: This is a group of conditions characterised by pain perceived anywhere in the region bounded superiorly by a transverse line through the tip of the spinous process of T1, inferiorly by a transverse line through the tip of the spinous process of T12, and laterally by vertical lines tangential to the most lateral margins of the erector spinae muscles.
Also known as: Thoracic spine pain | Thoracic pain | Thoracic pain myofascial | thoracic trigger points | myofascial pain and dysfunction syndrome, thorax
Excludes: Chronic primary thoracic pain | Chronic secondary musculoskeletal pain | Chronic neuropathic pain
[GC03] Urethral stricture
Definition: Stenosis of the urethra accompanied by fibrosis and scarring of the spongiosal body
Also known as: Urethral stricture | ankylurethria | urethral stenosis | urethral contracture | urethral obstruction
[GA15.4] Stricture or stenosis of cervix uteri
Definition: A condition of the cervix uteri, caused by inflammation, trauma, scarring, or atrophy. This condition is characterised by narrowing of the cervical ostium.
Also known as: Stricture or stenosis of cervix uteri | stenosis of cervix | cervical occlusion | cervical stenosis | cervical stricture
Excludes: Obstructed labour due to abnormality of maternal pelvic organs
[8C73.Z] Mitochondrial myopathies, unspecified
Also known as: Mitochondrial myopathies, unspecified | Mitochondrial myopathies | Myopathies in mitochondrial disorders
[9C84.4] Gaze-evoked nystagmus
Also known as: Gaze-evoked nystagmus | Gaze-paretic nystagmus | End-point nystagmus | Rebound nystagmus | Centripetal nystagmus
=== GRAPH WALKS ===
--- Walk 1 ---
[MB72] Results of function studies of the nervous system
--PARENT--> [?] Clinical findings in the nervous system
--CHILD--> [MB72] Results of function studies of the nervous system
--- Walk 2 ---
[MB72] Results of function studies of the nervous system
--PARENT--> [?] Clinical findings in the nervous system
--CHILD--> [MB72] Results of function studies of the nervous system
--- Walk 3 ---
[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects
--PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects
Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...
--CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells
--- Walk 4 ---
[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects
--PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects
Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...
--CHILD--> [4A01.00] Hereditary agammaglobulinaemia with profoundly reduced or absent B cells
Def: This refers to a hereditary type of primary immune deficiency disease characterised by a reduction in all types of gamma globulins, and rare X-linked genetic disorder that affects the body's ability t...
--- Walk 5 ---
[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
--PARENT--> [?] Harmful effects of substances
--CHILD--> [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
--- Walk 6 ---
[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified
--EXCLUDES--> [?] Allergic or hypersensitivity conditions
Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.
Hypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...
--PARENT--> [?] Diseases of the immune system
|
[
"[MB72] Results of function studies of the nervous system\n --PARENT--> [?] Clinical findings in the nervous system\n --CHILD--> [MB72] Results of function studies of the nervous system",
"[MB72] Results of function studies of the nervous system\n --PARENT--> [?] Clinical findings in the nervous system\n --CHILD--> [MB72] Results of function studies of the nervous system",
"[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells",
"[4A01.0Y] Other specified immunodeficiencies with predominantly antibody defects\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.00] Hereditary agammaglobulinaemia with profoundly reduced or absent B cells\n Def: This refers to a hereditary type of primary immune deficiency disease characterised by a reduction in all types of gamma globulins, and rare X-linked genetic disorder that affects the body's ability t...",
"[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --PARENT--> [?] Harmful effects of substances\n --CHILD--> [NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified",
"[NE60] Harmful effects of drugs, medicaments or biological substances, not elsewhere classified\n --EXCLUDES--> [?] Allergic or hypersensitivity conditions\n Def: Allergy is a hypersensitivity reaction initiated by proven immunologic mechanisms.\n\nHypersensitivity is defined as conditions clinically resembling allergy that cause objectively reproducible symptoms...\n --PARENT--> [?] Diseases of the immune system"
] |
MB72
|
Results of function studies of the nervous system
|
[
{
"from_icd11": "MB72",
"icd10_code": "R29818",
"icd10_title": "Other symptoms and signs involving the nervous system"
},
{
"from_icd11": "MB72",
"icd10_code": "R29810",
"icd10_title": "Facial weakness"
},
{
"from_icd11": "MB72",
"icd10_code": "R29898",
"icd10_title": "Other symptoms and signs involving the musculoskeletal system"
},
{
"from_icd11": "MB72",
"icd10_code": "R9402",
"icd10_title": "Abnormal brain scan"
},
{
"from_icd11": "MB72",
"icd10_code": "R9401",
"icd10_title": "Abnormal electroencephalogram [EEG]"
},
{
"from_icd11": "MB72",
"icd10_code": "R29890",
"icd10_title": "Loss of height"
},
{
"from_icd11": "MB72",
"icd10_code": "R9409",
"icd10_title": "Abnormal results of other function studies of central nervous system"
},
{
"from_icd11": "MB72",
"icd10_code": "R298",
"icd10_title": "Other symptoms and signs involving the nervous and musculoskeletal systems"
},
{
"from_icd11": "MB72",
"icd10_code": "R940",
"icd10_title": "Abnormal results of function studies of central nervous system"
},
{
"from_icd11": "MB72",
"icd10_code": "R941",
"icd10_title": "Abnormal results of function studies of peripheral nervous system and special senses"
},
{
"from_icd11": "NE60",
"icd10_code": "T50A95A",
"icd10_title": "Adverse effect of other bacterial vaccines, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50Z15A",
"icd10_title": "Adverse effect of immunoglobulin, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50Z95A",
"icd10_title": "Adverse effect of other vaccines and biological substances, initial encounter"
},
{
"from_icd11": "NE60",
"icd10_code": "T50A95S",
"icd10_title": "Adverse effect of other bacterial vaccines, sequela"
},
{
"from_icd11": "NE60",
"icd10_code": "T50B95A",
"icd10_title": "Adverse effect of other viral vaccines, initial encounter"
}
] |
R29818
|
Other symptoms and signs involving the nervous system
|
The patient was a 42-year-old male with no previous exposure to industrial toxins or radioactive substances. In November 2018, he was hospitalized for ecchymosis of the left lower limb for more than 1 month, gingival bleeding, and fatigue for 10 days, with aggravation for 2 days. On physical examination, the patient appeared anemic with scattered spots of bleeding of the mucosa and the skin over the whole body, no abnormality in heart rhythm or lung auscultation, a soft abdomen, no palpation of the liver or spleen under the ribs, and no edema of either lower limb. The findings of initial blood chemistry analysis were as follows: white blood cell count, 8.1 × 109/L; hemoglobin concentration, 69 g/L; platelet count, 16 × 109/L; prothrombin time, 14.6 s, activated partial thromboplastin time, 21.4 s; thrombin time, 21.5 s; K+, 3.71 mmol/L; Na+, 141 mmol/L; Ca2+, 1.89 mmol/L; γ-glutamine acylase, 144 U/L; total protein, 57.2 g/L; and albumin, 33.2 g/L. Bone marrow (BM) analysis revealed abnormal promyelocytes (89.2%) of different sizes with quasi-round shapes and tumor-like processes on the edge of the cytoplasm, medium amounts of cytoplasm, blue staining, purplish red granules in the cytoplasm, round nuclei, visible depressions, loose and fine chromatin, and visible nucleoli. In addition, erythroid differentiation was inhibited, megakaryocytes were absent, and platelets were rare . Fluorescence in situ hybridization of the BM showed that 68% of the 400 cells analyzed within the detection range revealed the presence of the PML/RARa fusion gene . Further genetic screening revealed mutations to NRAS and TET . Flow cytometry analysis of the BM revealed the presence of abnormal cells that were positive for CD117, CD13, CD33, CD38, CD64, CD123, CD58, and cMPO, with partial expression of CD71, but negative for CD19, CD3, and CD34. Based on these findings, the patient was diagnosed with APL (medium-risk group). After ATRA + ATO double induction therapy, the patient received 2 cycles of ATRA + mitoxantrone and cytarabine, and one cycle of ATRA + idarubicin and cytarabine. Afterward, the patient was negative for the PML-RARα fusion gene. Following remission, intrathecal chemotherapy was administered to prevent the onset of central nervous system leukemia. On April 2, 2019, the patient started an alternating maintenance treatment regimen of ATO + ATRA + methotrexate. Before the fourth cycle of maintenance therapy on January 27, 2020, a BM examination and fusion gene analysis revealed complete remission of APL. On April 14, 2020, during the methotrexate regimen, the results of a routine blood test were as follows: white blood cell count, 4.01 × 109/L; percentage of monocytes, 15%; hemoglobin concentration, 56 g/L; platelet count 76 × 109/L; prothrombin time, 11.0 s; activated partial thromboplastin time, 31.5 s; thrombin time, 16.1 s; K+, 4.35 mmol/L; Ca2+, 2.31 mmol/L; alanine aminotransferase, 12 U/L; aspartate transaminase, 14 U/L; creatinine, 66 μmol/L, total protein, 57.2 g/L; and albumin, 45.3 g/L. A physical examination revealed no anemia, no sites of bleeding on the skin or mucosa, no abnormality in heart rhythm or lung auscultation, a soft abdomen, liver and spleen not palpable under the ribs, and no edema of either lower limb. The patient had no symptoms of altered consciousness at that time, so a bone puncture was performed immediately. BM morphological analysis revealed that 31.0% of the monocytes were primitive and immature with varied cell sizes, medium to rich cytoplasm, large nuclei, fine chromatin that was twisted and folded, visible nucleoli, granulocyte content of 6.5%, some vacuoles throughout the cytoplasm, active red proliferation, visible plasma, reticular cells with normal morphologies, 237 megakaryocytes inone smear, and visible platelets . Flow cytometry revealed that 44.75% of the primitive immature cells were nucleated and positive for CD34, CD38, CD13, CD15, CD117, CD33, CD7, and HLA-DR, but negative for CD3 and CD19. Myeloid expression was abnormal, which conformed to the AML phenotype. The PML-RARα gene was negative by fluorescence in situ hybridization analysis. Qualitative detection of 38 fusion genes specific to leukemia was also negative. Gene mutation analysis by next generation sequencing identified an insertion mutation to the CEBPA gene (c.912_913insTTG (p.Lys304_Gln305insLeu; heterozygous mutation frequency, 28.5%) and a code shift mutation (c.326del (p.Pro109ArgfsTer51; heterozygous). BM cytogenetic studies revealed a normal karyotype of 46, xy (20). The combined results of the physical examination and laboratory results suggested a diagnosis of AML and acute myelomonocytic leukemia with a CEBPA double mutation (low risk group). Therefore, induction chemotherapy was started with a regimen of idarubicin and cytarabine (idarubicin at 10 mg/m2 on days 1–3; and cytarabine at 100 mg every 12 hour on days 1–7). Reexamination of the BM at 14 days after chemotherapy showed that the patient had achieved complete remission. Thereafter, the patient received 3 cycles of idarubicin and cytarabine, and 3 cycles of high-dose cytarabine as consolidation therapy. At present, the patient is in continuous remission with minimal residual disease for both APL and AML.
| 4.152344
| 0.966797
|
sec[1]/p[0]
|
en
| 0.999997
|
33592885
|
https://doi.org/10.1097/MD.0000000000024385
|
[
"time",
"that",
"gene",
"cytarabine",
"mmol",
"cytoplasm",
"visible",
"mutation",
"blood",
"count"
] |
[
{
"code": "PL13.52",
"title": "Incorrect timing of drug or medicament, as mode of injury"
},
{
"code": "QF2A",
"title": "Difficulty or need for assistance with community participation"
},
{
"code": "MF50.1",
"title": "Pollakiuria"
},
{
"code": "JA25.3",
"title": "Eclampsia, time period unspecified"
},
{
"code": "KD3B.Z",
"title": "Unspecified time of fetal death, cause not specified"
},
{
"code": "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 ===
[PL13.52] Incorrect timing of drug or medicament, as mode of injury
Also known as: Incorrect timing of drug or medicament, as mode of injury | wrong timing of drug | timing error in giving drug | timing mistake in administration of drug | administration error involving timing of drug
Excludes: Problem with delayed treatment | Overdose of substance, as mode of injury or harm
[QF2A] Difficulty or need for assistance with community participation
Also known as: Difficulty or need for assistance with community participation | difficulty with community participation | need for assistance with community participation | need for assistance with community, social and civic life | difficulty with community, social and civic life
Includes: Lack of relaxation or leisure
[MF50.1] Pollakiuria
Also known as: Pollakiuria | pollakisuria | Daytime frequency of micturition
[JA25.3] Eclampsia, time period unspecified
Definition: Onset of convulsions in a woman with pre-eclampsia not attributable to other causes without a specific onset time.
Also known as: Eclampsia, time period unspecified | Eclampsia NOS | eclamptic coma | eclamptic toxaemia | toxaemia with convulsions
[KD3B.Z] Unspecified time of fetal death, cause not specified
Also known as: Unspecified time of fetal death, cause not specified | Fetal death, cause not specified | stillbirth NOS | stillborn NOS | intrauterine fetal demise
[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 ---
[PL13.52] Incorrect timing of drug or medicament, as mode of injury
--EXCLUDES--> [?] Delayed treatment
--EXCLUDES--> [?] Non provision of necessary procedure
--- Walk 2 ---
[PL13.52] Incorrect timing of drug or medicament, as mode of injury
--EXCLUDES--> [?] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--EXCLUDES--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances
--- Walk 3 ---
[QF2A] Difficulty or need for assistance with community participation
--PARENT--> [?] Difficulty or need for assistance with activities
Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....
--CHILD--> [QF22] Difficulty or need for assistance with communication
--- Walk 4 ---
[QF2A] Difficulty or need for assistance with community participation
--PARENT--> [?] Difficulty or need for assistance with activities
Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....
--CHILD--> [QF22] Difficulty or need for assistance with communication
--- Walk 5 ---
[MF50.1] Pollakiuria
--PARENT--> [MF50] Abnormal micturition
--CHILD--> [MF50.1] Pollakiuria
--- Walk 6 ---
[MF50.1] Pollakiuria
--PARENT--> [MF50] Abnormal micturition
--PARENT--> [?] Symptoms, signs or clinical findings involving the urinary system
|
[
"[PL13.52] Incorrect timing of drug or medicament, as mode of injury\n --EXCLUDES--> [?] Delayed treatment\n --EXCLUDES--> [?] Non provision of necessary procedure",
"[PL13.52] Incorrect timing of drug or medicament, as mode of injury\n --EXCLUDES--> [?] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...\n --EXCLUDES--> [?] Unintentional exposure to or harmful effects of drugs, medicaments or biological substances",
"[QF2A] Difficulty or need for assistance with community participation\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF22] Difficulty or need for assistance with communication",
"[QF2A] Difficulty or need for assistance with community participation\n --PARENT--> [?] Difficulty or need for assistance with activities\n Def: Identifies activities for which the person needs assistance or has such difficulty with, that it affects their need for health services or their treatment....\n --CHILD--> [QF22] Difficulty or need for assistance with communication",
"[MF50.1] Pollakiuria\n --PARENT--> [MF50] Abnormal micturition\n --CHILD--> [MF50.1] Pollakiuria",
"[MF50.1] Pollakiuria\n --PARENT--> [MF50] Abnormal micturition\n --PARENT--> [?] Symptoms, signs or clinical findings involving the urinary system"
] |
PL13.52
|
Incorrect timing of drug or medicament, as mode of injury
|
[
{
"from_icd11": "QF2A",
"icd10_code": "Z7389",
"icd10_title": "Other problems related to life management difficulty"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z7382",
"icd10_title": "Dual sensory impairment"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z73",
"icd10_title": "Problems related to life management difficulty"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z732",
"icd10_title": "Lack of relaxation and leisure"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z738",
"icd10_title": "Other problems related to life management difficulty"
},
{
"from_icd11": "QF2A",
"icd10_code": "Z739",
"icd10_title": "Problem related to life management difficulty, unspecified"
},
{
"from_icd11": "MF50.1",
"icd10_code": "R351",
"icd10_title": "Nocturia"
},
{
"from_icd11": "MF50.1",
"icd10_code": "R358",
"icd10_title": "Other polyuria"
},
{
"from_icd11": "MF50.1",
"icd10_code": "R35",
"icd10_title": "Polyuria"
},
{
"from_icd11": "JA25.3",
"icd10_code": "O159",
"icd10_title": "Eclampsia, unspecified as to time period"
},
{
"from_icd11": "KD3B.Z",
"icd10_code": "P95",
"icd10_title": "Stillbirth"
},
{
"from_icd11": "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"
}
] |
Z7389
|
Other problems related to life management difficulty
|
The patient was a 56-year old female, who sustained several injuries during a fall from 6 m (third floor). Glasgow Coma Scale (GCS) on admission was 6–7/15. Injury Severity Scale (ISS) score was 34 [Table 1 ]. She was intubated, stabilized and admitted. The initial diagnostic evaluation was performed according to Advanced Trauma Life Support (ATLS) guidelines and included Focused Assessment with Sonography in Trauma (FAST), chest x-ray and pelvic antero-posterior (AP) x-rays, CT-trauma scan and femoral x-rays. Trauma workup revealed diffuse intracerebral contusion, a small parieto-occipital subarachnoid hemorrhage on the right, bilateral mediastinum and lung contusion, maxillary-orbital and temporal bone fractures, the radiological examination revealed a femoral shaft fracture on the left. No other femoral fractures were detected upon X-ray examination [Fig. 1 ]. CT coronal and axial views of the pelvis (3 mm thickness) and of the proximal femur did not show clear evidence of fracture [Fig. 2 ]. Initial treatment, on the day of admission, consisted of closed reduction and external fixation of the femoral shaft. During surgical treatment of the maxillary fractures on post-injury day 1, it was noted that the left lower extremity was shortened and externally rotated. Plain films of the left hip, femur, and knee demonstrated a displaced femoral neck facture and an ipsilateral patellar fracture [Fig. 3 ]. On post-injury day 3, the left femoral shaft and neck fracture was treated with a cephalomedullary nail on a standard traction table by closed reduction. Anatomic reduction and stable fixation of the femur fractures were ascertained intra-operatively by fluoroscopic control, revealing a tip-apex-distance of 10 mm and a central position of the lag screw. The patella fracture was treated with a standard figure-of-8 tension band wire [Fig. 4 ]. Post-operative radiographic control confirmed the satisfactory reduction and stabilization of the left femoral neck and shaft fracture as well as of the ipsilateral patella fracture [Fig. 5 ]. The post-operative course was uneventful. The patient was transferred to a rehabilitation center four weeks after admission and had a physiotherapy exercise protocol with weight bearing on the left lower extremity up to max 10–15 kg (kg) for 6 weeks post-operatively. Full weight-bearing was allowed after 12 weeks. Sport activities were restricted for 6 months. At post-operative weeks 9 and 16, the patient complained of pain in the left groin and shaft, and radiographs demonstrated callous formation in the left femoral shaft. X-rays at post-operative week 28 demonstrated lag-screw cut-out with displacement of the femoral neck fracture [Fig. 6 ]. The patient was offered surgical revision but she refused at this time. One year after injury, the patient agreed to revision surgery and on week 52 (1 year) post-injury she underwent removal of the cephalomedullary implant and placement of a bipolar hemiarthroplasty after being offered a total hip replacement, which she refused. Post-operative clinical and radiological controls were unremarkable [Fig. 7 ]. Post-operative course was uneventful and the patient was transferred to a rehabilitation center two weeks after the surgery. Table 1 List of patient’s injuries and ISS Region Injury description AIS score top three 2 Head or neck diffuse intracerebral contusion 3 traumatic right parieto-occipital subrachnoid hemorrhage 4 16 Face left zygomatic bone fracture 3 right temporal fracture 3 right orbital rim fracture 3 right orbital floor fracture 3 Chest mediastinal contusion 2 bilateral lung contusion 3 9 Abdomen or pelvis contents no injury 0 Extremities or pelvic girdle left femoral shaft fracture 3 9 left patella fracture 2 External alcohol intoxication 2 traumatic rhabdomyolysis 3 acute hemorrhagic anemia 3 hypokalemia 3 ISS (Σ 3most AIS score) 2 34 Only the highest AIS score in each body region is used (highlighted in Bold). The 3 most severely injured body regions have their score squared and added together to produce the ISS score Fig. 1 Pre-operative anteroposterior radiograph of pelvis demonstrating lack of evidence of left femoral neck fracture Fig. 2 Pre-operative CT coronal and axial views of pelvis and of the proximal femur did not show clear evidence of fracture Fig. 3 Follow-up radiograph of pelvis at day 1 post-op, demonstrating displacement of the missed left femoral neck fracture and an ipsilateral patella fracture Fig. 4 Intra-operative fluoroscopic control of a ) the cephalomedullary nail, demonstrating a tip-apex-distance of 10 mm and a central position of the lag screw; b ) the reduction and osteosynthesis of the patella fracture with a standard figure-of-8 tension band wire Fig. 5 Follow-up radiographs of left hip at day 3 post-op, showing satisfactory reduction and fixation of the left femoral neck and shaft fractures by intramedullary nail and the patella fracture, respectively Fig. 6 Follow-up radiographs (5 months post-op) and CT scan (7 months post-op) of pelvis and left hip, demonstrating lag-screw cut-out with displacement of the femoral neck fracture Fig. 7 Post-operative (12 months) AP pelvic x-ray showing the bipolar hemiarthroplasty following removal of the cephalomedullary nail
| 3.837891
| 0.980957
|
sec[1]/p[0]
|
en
| 0.999997
|
28702088
|
https://doi.org/10.1186/s13037-017-0134-0
|
[
"fracture",
"femoral",
"neck",
"shaft",
"injury",
"score",
"pelvis",
"reduction",
"patella",
"contusion"
] |
[
{
"code": "ND56.2",
"title": "Fracture of unspecified body region"
},
{
"code": "ND32",
"title": "Fractures involving multiple body regions"
},
{
"code": "NB52.Z",
"title": "Fracture of lumbar spine or pelvis, unspecified"
},
{
"code": "FB80.B",
"title": "Pathological fracture"
},
{
"code": "FB80.Y",
"title": "Other specified disorders of bone density or structure"
},
{
"code": "LB9A.8",
"title": "Femoral agenesis or hypoplasia"
},
{
"code": "FA31.8",
"title": "Acquired unequal limb length"
},
{
"code": "FA31.Y",
"title": "Other specified acquired deformities of limbs"
},
{
"code": "8C11.2",
"title": "Lesion of femoral nerve"
},
{
"code": "FB86.11",
"title": "Hypertrophy of bone"
}
] |
=== ICD-11 CODES FOUND ===
[ND56.2] Fracture of unspecified body region
Also known as: Fracture of unspecified body region | avulsion fracture of unspecified body site | comminuted fracture of unspecified body site | compression fracture of unspecified body site | fracture dislocation of unspecified body site
Excludes: multiple fractures NOS
[ND32] Fractures involving multiple body regions
Also known as: Fractures involving multiple body regions | multiple skeletal fractures | multiple fractures | multiple compression fractures | fracture of multiple bone sites
[NB52.Z] Fracture of lumbar spine or pelvis, unspecified
Also known as: Fracture of lumbar spine or pelvis, unspecified | Fracture of lumbar spine or pelvis | Fracture of pelvis, not elsewhere classified | fracture pelvis NOS | pelvic fracture
[FB80.B] Pathological fracture
Also known as: Pathological fracture | pathological bone fracture | Pathological fracture NOS | spontaneous fracture | spontaneous fracture with dislocation
Excludes: Collapsed vertebra, not elsewhere classified
[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
[LB9A.8] Femoral agenesis or hypoplasia
Definition: Femoral agenesis/hypoplasia is a rare malformation of variable severity ranging from mild hypoplasia to complete absence of the femur.
Also known as: Femoral agenesis or hypoplasia | absence of femur | absent femur | agenesis of femur | congenital absence of femur
[FA31.8] Acquired unequal limb length
Also known as: Acquired unequal limb length | unequal length of limbs | unequal limb length | Acquired unequal limb length, multiple sites | Acquired unequal limb length, shoulder region
[FA31.Y] Other specified acquired deformities of limbs
Also known as: Other specified acquired deformities of limbs | Acquired deformity of forearm | Deflection of radius | Bowing of the radius | Bowing of forearm
[8C11.2] Lesion of femoral nerve
Also known as: Lesion of femoral nerve | Femoral neuropathy | Lesion of saphenous nerve
Excludes: Injury of femoral nerve at hip or thigh level
[FB86.11] Hypertrophy of bone
Also known as: Hypertrophy of bone | bone thickening | periosteum thickening | Infantile cortical hyperostoses | Post traumatic subperiosteal ossification
=== GRAPH WALKS ===
--- Walk 1 ---
[ND56.2] Fracture of unspecified body region
--EXCLUDES--> [?] Fractures involving multiple body regions
--CHILD--> [?] Fractures involving head with neck
--- Walk 2 ---
[ND56.2] Fracture of unspecified body region
--EXCLUDES--> [?] Fractures involving multiple body regions
--PARENT--> [?] Injuries involving multiple body regions
--- Walk 3 ---
[ND32] Fractures involving multiple body regions
--RELATED_TO--> [?] Fractures involving multiple body regions due to birth injury
Def: A condition characterised by the presence of skeletal fractures in more than one body region due to physical pressure or injury during delivery....
--PARENT--> [?] Fractures involving multiple body regions
--- Walk 4 ---
[ND32] Fractures involving multiple body regions
--RELATED_TO--> [?] Fractures involving multiple body regions due to birth injury
Def: A condition characterised by the presence of skeletal fractures in more than one body region due to physical pressure or injury during delivery....
--PARENT--> [?] Fractures involving multiple body regions
--- Walk 5 ---
[NB52.Z] Fracture of lumbar spine or pelvis, unspecified
--PARENT--> [NB52] Fracture of lumbar spine or pelvis
Def: Broken bone in the lumbar spine or pelvis....
--CHILD--> [NB52.2] Fracture of the pelvic ring with incomplete disruption of posterior arch
--- Walk 6 ---
[NB52.Z] Fracture of lumbar spine or pelvis, unspecified
--PARENT--> [NB52] Fracture of lumbar spine or pelvis
Def: Broken bone in the lumbar spine or pelvis....
--EXCLUDES--> [?] Fracture of neck of femur
|
[
"[ND56.2] Fracture of unspecified body region\n --EXCLUDES--> [?] Fractures involving multiple body regions\n --CHILD--> [?] Fractures involving head with neck",
"[ND56.2] Fracture of unspecified body region\n --EXCLUDES--> [?] Fractures involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions",
"[ND32] Fractures involving multiple body regions\n --RELATED_TO--> [?] Fractures involving multiple body regions due to birth injury\n Def: A condition characterised by the presence of skeletal fractures in more than one body region due to physical pressure or injury during delivery....\n --PARENT--> [?] Fractures involving multiple body regions",
"[ND32] Fractures involving multiple body regions\n --RELATED_TO--> [?] Fractures involving multiple body regions due to birth injury\n Def: A condition characterised by the presence of skeletal fractures in more than one body region due to physical pressure or injury during delivery....\n --PARENT--> [?] Fractures involving multiple body regions",
"[NB52.Z] Fracture of lumbar spine or pelvis, unspecified\n --PARENT--> [NB52] Fracture of lumbar spine or pelvis\n Def: Broken bone in the lumbar spine or pelvis....\n --CHILD--> [NB52.2] Fracture of the pelvic ring with incomplete disruption of posterior arch",
"[NB52.Z] Fracture of lumbar spine or pelvis, unspecified\n --PARENT--> [NB52] Fracture of lumbar spine or pelvis\n Def: Broken bone in the lumbar spine or pelvis....\n --EXCLUDES--> [?] Fracture of neck of femur"
] |
ND56.2
|
Fracture of unspecified body region
|
[
{
"from_icd11": "ND56.2",
"icd10_code": "T142",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T02",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T020",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T021",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T022",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T023",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T024",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T025",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T026",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T027",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T028",
"icd10_title": ""
},
{
"from_icd11": "ND32",
"icd10_code": "T029",
"icd10_title": ""
},
{
"from_icd11": "NB52.Z",
"icd10_code": "S329XXD",
"icd10_title": "Fracture of unspecified parts of lumbosacral spine and pelvis, subsequent encounter for fracture with routine healing"
},
{
"from_icd11": "NB52.Z",
"icd10_code": "S32601A",
"icd10_title": "Unspecified fracture of right ischium, initial encounter for closed fracture"
},
{
"from_icd11": "NB52.Z",
"icd10_code": "S329XXG",
"icd10_title": "Fracture of unspecified parts of lumbosacral spine and pelvis, subsequent encounter for fracture with delayed healing"
}
] |
T142
| |
A 44-year-old gentleman with hypertension and bronchial asthma presented to the emergency department, with weakness of the right upper extremity discovered after awaking. Facial deviation, sensory symptoms, or dysarthria were absent. He was found to have weakness of the right arm (4/5) and was suspected of having a stroke. Computed tomography (CT) of the head and CT angiogram of cervical and cranial circulation were unremarkable. He was admitted for further investigation. Aspirin and atorvastatin were commenced. The next day, neurology service was consulted. Neurological examination revealed normal sensorium, speech, language function, and cranial nerves. The tone was normal all over, and the strength was normal in both lower limbs and the left upper limb. The right upper-limb strength at the shoulder and elbow was 4/5. The wrist and hand grip were 3/5. The right triceps and both ankle reflexes were absent. All other reflexes were 3+ without clonus. Plantar responses were equivocal. Coordination and sensory examinations were normal. Magnetic resonance imaging (MRI) of the head, including diffusion-weighted imaging, was also unremarkable. We could not localize this presentation to a single lesion. The brisker reflexes in all extremities sparing the jaw jerk with normal cranial nerve examination suggested a cervical cord lesion. The right-arm weakness up to the deltoid muscle localized the proximal extent of the cord lesion to the C5-6 segment or above. The right triceps areflexia could be explained by an accompanying right C6-7 root compression; however, this could still not explain ankle areflexia unless there was an underlying peripheral neuropathy. Cervical myeloradiculopathy can be attributed to compressive or non-compressive etiology. 10 – 14 There were a few shortcomings in making a case of cervical myelopathy. First, the onset of right-arm weakness was acute, but the presence of brisker reflexes pointed to a chronic process involving the cervical spinal cord. Also, one could argue that in the absence of clonus, the 3+ reflexes were not pathological. Second, sphincter dysfunction and a sensory level were absent. These findings did not point to the diagnosis of acute cervical myelopathy. The MRI of the cervical spine revealed os odontoideum (OO), with the posterior aspect of the cranial part of the C2 vertebra indenting the spinal canal. The cervical spinal cord at that level showed focal thinning and noncontrast-enhancing focal T2-hyperintense and T1-hypointense signals, suggesting myelomalacia . The initial work-up for peripheral neuropathy, including serum TSH, HbA1c, and vitamin B12, did not reveal any abnormality. The next morning, while trying to get out of bed, the patient sustained a fall. The same evening, he reported weakness in all limbs without involvement of sphincters. The examination revealed quadriparesis with predominant weakness of distal muscles, with an overall strength of 3–/5 proximally and 1/5 distally in the upper extremities and 3+/5 proximally and 2/5 distally in the lower limbs. The remaining examination was unchanged. The quick progression of the weakness after the fall prompted the consideration of an acute cervical cord injury-spinal contusion in relation to the OO. Other possibilities were spinal cord infarction or hemorrhage and less likely transverse myelitis. A CT scan of the cervical spine was obtained that evening and did not reveal any additional abnormalities except OO . We planned a spinal tap that the patient did not consent to, until the next day. To address the possibility of transverse myelitis, one dose of 1 g of IV methylprednisolone was administered. Atorvastatin and aspirin were stopped. MRI, full spine with contrast and diffusion-weighted images, was requested, which did not reveal any of the suspected conditions. Neurosurgeon was consulted who did not deem the cord lesion to be responsible for the presentation or progression. The clinical scenario highly indicated GBS. The patient was commenced on IVIg that evening, and methylprednisolone was discontinued. Cerebrospinal fluid analysis was normal. Serum protein electrophoresis did not show monoclonal bands. On day 4, he developed urinary retention and required the placement of a Foley catheter. Urinary retention was attributed to dysautonomia of GBS. Electromyography was performed, which revealed AMAN. The next day, neurological examination revealed the progression of the weakness of the left lower limb from 2/5 to 1/5 distally, and the knee reflexes were observed to be diminished (1+). He received 2 g/kg of IVIg over a period of 5 days. His strength improved to 3–/5 on the right leg and 2/5 on the left distally. On further inquiry, he reported a diarrheal illness a week ago, as well as vaccination against influenza 2 weeks prior to the onset of symptoms. After 3 days, he regained normal micturition function. He was transferred to the rehabilitation center where he stayed for 3 months. Since then, he has been receiving outpatient physiotherapy to date. At a 10-month post-discharge follow-up by teleconsultation, he reported mostly being wheelchair bound, being able to take a few steps with the help of a walker and eating independently using occupational self-feeding tools.
| 4.152344
| 0.969727
|
sec[1]/p[0]
|
en
| 0.999997
|
PMC10411357
|
https://doi.org/10.5339/qmj.2023.16
|
[
"cervical",
"weakness",
"cord",
"reflexes",
"spinal",
"that",
"next",
"strength",
"lesion",
"distally"
] |
[
{
"code": "GA04",
"title": "Cervicitis"
},
{
"code": "GA1Z&XA5WW1",
"title": "Noninflammatory disorders of cervix uteri"
},
{
"code": "FB1Y",
"title": "Other specified conditions associated with the spine"
},
{
"code": "GA04&XT5R",
"title": "Acute cervicitis"
},
{
"code": "GA04&XT8W",
"title": "Chronic cervicitis"
},
{
"code": "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 ===
[GA04] Cervicitis
Also known as: Cervicitis | inflammation of cervix | inflammation of cervix uteri | Ulcer of cervix with cervicitis | Acute cervicitis
[FB1Y] Other specified conditions associated with the spine
Also known as: Other specified conditions associated with the spine | Other recurrent vertebral subluxation | Interspinous ligament syndrome | Spondylitis muscularis | Posterior longitudinal ligament calcification
[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 ---
[GA04] Cervicitis
--RELATED_TO--> [?] Tuberculosis of cervix uteri
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....
--PARENT--> [?] Cervicitis
--- Walk 2 ---
[GA04] Cervicitis
--RELATED_TO--> [?] Tuberculosis of cervix uteri
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....
--PARENT--> [?] Tuberculosis of female reproductive organs
Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the female reproductive organs....
--- Walk 3 ---
[FB1Y] Other specified conditions associated with the spine
--PARENT--> [?] Conditions associated with the spine
Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....
--PARENT--> [15] Diseases of the musculoskeletal system or connective tissue
Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....
--- Walk 4 ---
[FB1Y] Other specified conditions associated with the spine
--PARENT--> [?] Conditions associated with the spine
Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....
--CHILD--> [?] Degenerative condition of spine
Def: This is a disease characterised by degenerative changes in the intervertebral disc, vertebral end-plates and spinal joints due to aging or structural change....
|
[
"[GA04] Cervicitis\n --RELATED_TO--> [?] Tuberculosis of cervix uteri\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....\n --PARENT--> [?] Cervicitis",
"[GA04] Cervicitis\n --RELATED_TO--> [?] Tuberculosis of cervix uteri\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the cervix uteri....\n --PARENT--> [?] Tuberculosis of female reproductive organs\n Def: This is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. This diagnosis is of the female reproductive organs....",
"[FB1Y] Other specified conditions associated with the spine\n --PARENT--> [?] Conditions associated with the spine\n Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....\n --PARENT--> [15] Diseases of the musculoskeletal system or connective tissue\n Def: This chapter contains diseases of musculoskeletal system and diseases of connective tissue....",
"[FB1Y] Other specified conditions associated with the spine\n --PARENT--> [?] Conditions associated with the spine\n Def: This is a group of conditions in which there is a deviation from or interruption of the normal structure or function of the spine....\n --CHILD--> [?] Degenerative condition of spine\n Def: This is a disease characterised by degenerative changes in the intervertebral disc, vertebral end-plates and spinal joints due to aging or structural change...."
] |
GA04
|
Cervicitis
|
[
{
"from_icd11": "FB1Y",
"icd10_code": "M5126",
"icd10_title": "Other intervertebral disc displacement, lumbar region"
},
{
"from_icd11": "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"
},
{
"from_icd11": "MG22",
"icd10_code": "R53",
"icd10_title": "Malaise and fatigue"
},
{
"from_icd11": "FB32.Y",
"icd10_code": "M6281",
"icd10_title": "Muscle weakness (generalized)"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8384",
"icd10_title": "Todd's paralysis (postepileptic)"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8331",
"icd10_title": "Monoplegia, unspecified affecting right dominant side"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8389",
"icd10_title": "Other specified paralytic syndromes"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8383",
"icd10_title": "Posterior cord syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8381",
"icd10_title": "Brown-Sequard syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8382",
"icd10_title": "Anterior cord syndrome"
},
{
"from_icd11": "MB5Z",
"icd10_code": "G8332",
"icd10_title": "Monoplegia, unspecified affecting left dominant side"
}
] |
M5126
|
Other intervertebral disc displacement, lumbar region
|
In ectopic or extrauterine pregnancy, the blastocyst implants anywhere other than the endometrial lining of the uterine cavity. The presentation of extrauterine pregnancy varies, from an asymptomatic state to postmenopausal uterine bleeding, lower abdominal pain that is worse on 1 side, or tubal rupture with hemorrhagic shock. As the patient always considered vaginal bleeding as menstruation, suspicion of pregnancy did not arise. This may be the major reason for the delayed diagnosis. Extrauterine pregnancy is always diagnosed in the first trimester of gestation, as most patients present with nonspecific complaints. Improved diagnostic and therapeutic methods have resulted in extrauterine pregnancy mostly paused to the 6th through 9th week. Abdominal computed tomography combined with transabdominal ultrasound was performed in this case for preoperative diagnosis. The hemoperitoneum and fetus in the abdominal cavity were visualized where the attached placenta was not accurately reported, and the diagnosis of abdominal pregnancy was suspected. Although diagnostic accuracy has increased over time and in modern practice, the majority of ectopic pregnancies are visualized on ultrasound scans before surgery and are often misdiagnosed and treated as abdominal pregnancies, which are proven to be advanced tubal pregnancies after laparotomy. Ultrasonographic criteria have been suggested for the diagnosis of an abdominal pregnancy, which includes the following: a fetus and gestational sac observed outside the uterine cavity, or the visualization of an abdominal or pelvic mass identifiable as a uterus but separated from the fetus, absence of the uterine wall between the bladder and the fetus, adherence of the fetus to an abdominal organ, and an abnormal location of the placenta outside the uterine cavity. The fetus in the second trimester slips out of the ruptured fallopian tube and leads to a large rupture and massive abdominal bleeding in a short period. Current evidence shows that specific diagnostic and therapeutic criteria for second-trimester tubal pregnancy are lacking owing to its rarity. Before proceeding with the operation, the surgical team meticulously evaluated the differential diagnoses, giving due consideration to primary abdominal pregnancy—a strikingly uncommon scenario where a fertilized ovum implants directly onto the peritoneal surfaces, mesentery, omentum, or other intra-abdominal structures, bypassing the typical route through the fallopian tubes. The rarity of this condition introduces distinctive complexities in both its clinical diagnosis and management, demanding heightened vigilance and expertise from the medical practitioners involved. Abdominal pregnancies are associated with a high risk of maternal morbidity and mortality. The management of early-stage abdominal pregnancy is primarily surgical, with laparotomy being the most common approach, especially in hemorrhagic cases. Laparotomy is typically favored over laparoscopic surgery in the management of suspected abdominal ectopic pregnancies due to the heightened risk of uncontrolled perioperative bleeding from the implantation site. The patient with a high suspicion of hemorrhage was emergently taken to the operating room. Consistent with this case, intraoperative reinfusion of autologous blood was possible through the blood collected during the operation. Caution should be exercised when considering autologous blood reinfusion in intraperitoneal pregnancy as the blood may be contaminated by substances from the ruptured digestive tract. Midline laparotomy is considered the preferred surgical approach in patients with life-threatening intra-abdominal bleeding and an unknown source of the large fetus. Tubal preservation was not suitable for use in the patient we reported as the fallopian tube accommodating the placental attachment had invaded and destroyed. In general, patients with ruptured ectopic pregnancies presenting with hypovolemic shock must be managed with urgent surgery, salpingectomy is a better choice for women with severely damaged fallopian tubes and large tubal pregnancies (>5 cm). Meanwhile, management options include drainage of the hemoperitoneum and replacement of blood and products. However, for treatment of abdominal pregnancy, the fetus should be delivered as soon as possible. There are 2 options for the management of the placenta: removal of the placenta or leaving the placenta in situ. Affecting the function of the viscera or forcing the placenta to divest may not result in serious bleeding, such as those located on the surface of the greater omentum, and partial viscera resection while removing the fetus. When the placenta is attached to important organs, such as the liver or large blood vessels, it can be placed in the abdominal cavity to avoid excessive bleeding. In most cases, the placenta is gradually absorbed with the possibility of abnormal coagulation during absorption. The issue of removing the placenta during surgery remains controversial. Recently, the treatment of retained placenta with methotrexate has been abandoned. Instead, a conservative approach involving the injection of potassium chloride (KCl) into the fetal heart under sonographic guidance has been suggested.
| 4.367188
| 0.734375
|
sec[2]/p[0]
|
en
| 0.999996
|
39312322
|
https://doi.org/10.1097/MD.0000000000039713
|
[
"abdominal",
"pregnancy",
"placenta",
"fetus",
"bleeding",
"pregnancies",
"blood",
"uterine",
"cavity",
"tubal"
] |
[
{
"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": "JA80.Z",
"title": "Maternal care related to unspecified multiple gestation"
},
{
"code": "JA01.1",
"title": "Tubal pregnancy"
},
{
"code": "QA40",
"title": "Pregnancy examination or test"
},
{
"code": "JA61.Y",
"title": "Other specified venous complications in pregnancy"
},
{
"code": "JA01.Y",
"title": "Other specified ectopic pregnancy"
}
] |
=== ICD-11 CODES FOUND ===
[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
[JA80.Z] Maternal care related to unspecified multiple gestation
Also known as: Maternal care related to unspecified multiple gestation | Maternal care related to multiple gestation | multiple gestation, unspecified, unspecified trimester | multiple pregnancy | Multiple pregnancy NOS
[JA01.1] Tubal pregnancy
Definition: A condition characterised by implantation of the embryo within the fallopian tube (ampullary, isthmus, interstitium) during pregnancy.
Also known as: Tubal pregnancy | Fallopian pregnancy | fallopian tube pregnancy | Tubal abortion | Rupture of fallopian tube due to pregnancy
Includes: Fallopian pregnancy | Tubal abortion
[QA40] Pregnancy examination or test
Also known as: Pregnancy examination or test | pregnancy examination | pregnancy test | Pregnancy examination or test, pregnancy not confirmed | pregnancy not yet confirmed
[JA61.Y] Other specified venous complications in pregnancy
Also known as: Other specified venous complications in pregnancy | Venous thrombosis in pregnancy | antepartum thrombosis NOS | Gestational thrombosis NOS | thrombosis in pregnancy NOS
[JA01.Y] Other specified ectopic pregnancy
Also known as: Other specified ectopic pregnancy | Cornual gestation or pregnancy | cornual gestation | cornual pregnancy | Cervical pregnancy
=== GRAPH WALKS ===
--- Walk 1 ---
[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--> [?] 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 ---
[JA01.0] Abdominal pregnancy
Def: A condition characterised by implantation of the embryo within the peritoneal cavity 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 4 ---
[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 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...
--PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen
|
[
"[MD81.3] Acute abdomen\n Def: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases...\n --PARENT--> [MD81] Abdominal or pelvic pain\n Def: Pain, an unpleasant distress sensation occurring in varying degrees of severity, received by nerve ending in the abdominal and pelvic region....\n --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--> [?] 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....",
"[JA01.0] Abdominal pregnancy\n Def: A condition characterised by implantation of the embryo within the peritoneal cavity 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....",
"[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",
"[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 --PARENT--> [?] Symptoms related to the lower gastrointestinal tract or abdomen"
] |
MD81.3
|
Acute abdomen
|
[
{
"from_icd11": "MD81.3",
"icd10_code": "R100",
"icd10_title": "Acute abdomen"
},
{
"from_icd11": "JA01.0",
"icd10_code": "O0000",
"icd10_title": "Abdominal pregnancy without intrauterine pregnancy"
},
{
"from_icd11": "JA01.0",
"icd10_code": "O000",
"icd10_title": "Abdominal pregnancy"
},
{
"from_icd11": "ME04.Z",
"icd10_code": "R180",
"icd10_title": "Malignant ascites"
},
{
"from_icd11": "ME04.Z",
"icd10_code": "R18",
"icd10_title": "Ascites"
},
{
"from_icd11": "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"
}
] |
R100
|
Acute abdomen
|
A 49-year-old man presented to our neurology department with complaints of involuntary shaking in both upper limbs for the past 3 years, along with slowness of movement for the past 2 years. He exhibited rest and action tremors in both upper limbs, along with simultaneous occurrence of bradykinesia and rigidity. Subsequently, he experienced unresponsiveness, memory decline, and choking while drinking, and his speaking rate began to slow down. Additionally, his facial expressions started to diminish, as noticed by his wife. In April 2021, the patient received a diagnosis of Parkinsonian syndrome at a local hospital. Initial treatment with levodopa at a daily dosage of 100 mg, gradually increased to 200 mg, resulted in partial improvement in involuntary shaking, but showed no significant overall improvement. Over the next year, his symptoms rapidly worsened, with progressive aggravation of stiffness and the appearance of mental irritability. Neurological examinations revealed decreased spontaneous facial expressions, poor eye movement in all directions, horizontal nystagmus, mildly increased muscle tone in the neck and limbs, and deep tendon reflexes in the biceps and triceps (1+). A positive Babinski sign was observed bilaterally. Symmetric muscle atrophy of the calves was also noted, which he reported experiencing for as long as he could remember . Additionally, it was noted that he had planovalgus deformities of both feet since the age of 5 years , a condition similar to that of his uncle’s feet. The strength of his upper and lower extremities, as well as proximal and distal muscles, was assessed as 5 on the Medical Research Council Muscle Scale. Brain magnetic resonance imaging revealed only mild atrophy, and his cognitive functions were deemed normal, scoring 28 on the standardized Mini-Mental State Examination and 23 points on the Montreal Cognitive Assessment. Further cervical and thoracic spine MRI showed degenerative changes, and electromyography revealed chronic denervation in both upper and lower extremities. Motor nerve conduction studies demonstrated reduced conduction velocity, amplitude, and distal latency in the left median nerve, as well as in the bilateral tibial and peroneal nerves. Sensory nerve conduction testing revealed normal sensory nerve action potential but showed delayed F-wave latencies in the left median and tibial nerves. However, anal sphincter electromyography was normal. The somatosensory-evoked potential showed abnormalities in the bilateral lower limbs, indicating a conduction block in the somatosensory pathway from the spinal cord to the cortex. Moreover, the bilateral visually evoked potential and bilateral auditory brainstem response were also found to be abnormal. The visually evoked potential showed prolonged P100 latency in both eyes. The auditory brainstem response suggested that bilateral ears were stimulated, but the waveform on both sides was relatively poor. The ambulatory electroencephalogram monitoring was normal. The routine cerebrospinal fluid (CSF) analysis showed normal pressure, cell counts, and levels of protein and glucose. Finally, whole-exome sequencing was performed using MyGenostics. In this study, four steps were employed to select potential pathogenic mutations for downstream analysis: (i) mutations with read counts less than 5 and mutation ratios below 30% were excluded; (ii) mutations with a frequency greater than 5% in 1,000 g, ESP6500, and Inhouse databases were removed; (iii) mutations present in the InNormal database (MyGenostics) were also discarded; (iv) synonymous mutations not listed in the HGMD database were excluded. The remaining mutations were considered potential pathogenic mutations for further analysis . Genomic DNA was extracted from the patient’s whole blood, and subsequent sequencing analysis identified a novel splice site mutation in intron 3 of SIGMAR1 gene (c.446-2A>T), which was further confirmed by Sanger sequencing . A review of the patient’s medical history revealed a longstanding presence of planovalgus deformities in both feet for over 40 years. Physical examination revealed muscle atrophy of both lower limbs at 10 years old, and he complained of mild discomfort while walking. However, his general condition was normal. The patient did not pursue further examination or treatment at that time. During the current clinical examination, upper and lower motor neuron damage was observed, and all the above findings were consistent with the diagnosis of ALS. At that time, the Unified Parkinson’s Disease Rating Scale-Part III motor score (in the morning without antiparkinsonian therapy) was 40. Next, we conducted a levodopa load test, and he showed a good response to levodopa. Based on the findings, the patient was eventually diagnosed with ALS–PD complex. Further exploration of the patient’s family history revealed that his parents were close relatives as they were second cousins. Unfortunately, his father was dead. Genetic testing was conducted on the mother, and it revealed that she has the same SIGMAR1 variant as detected in the proband . Subsequently, a pedigree analysis was performed . At the 3-month follow-up examination, the symptoms were observed to have remained relatively stable.
| 4.21875
| 0.964844
|
sec[1]/p[0]
|
en
| 0.999999
|
PMC10533989
|
https://doi.org/10.3389/fneur.2023.1242472
|
[
"both",
"that",
"mutations",
"potential",
"limbs",
"muscle",
"nerve",
"conduction",
"levodopa",
"atrophy"
] |
[
{
"code": "LB99.6",
"title": "Acheiria"
},
{
"code": "MB51.Z",
"title": "Diplegia of upper extremities, unspecified"
},
{
"code": "LB9A.4",
"title": "Apodia"
},
{
"code": "LB51",
"title": "Anorchia or microorchidia"
},
{
"code": "9D90.2",
"title": "Moderate vision impairment"
},
{
"code": "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 ===
[LB99.6] Acheiria
Definition: A condition caused by failure of one or both hands to develop during the antenatal period.
Also known as: Acheiria | Congenital absence of hand | agenesis of hand | congenital absence of hand and finger | congenital absence of hand and wrist
[MB51.Z] Diplegia of upper extremities, unspecified
Also known as: Diplegia of upper extremities, unspecified | Diplegia of upper extremities | paralysis of both upper limbs | both upper extremity paralysis | diplegia of upper limbs
[LB9A.4] Apodia
Definition: A condition caused by failure of the foot to develop during the antenatal period.
Also known as: Apodia | Congenital absence of foot | agenesis of foot | congenital absence of foot or toe | congenital absence of foot or toe, unspecified side
[LB51] Anorchia or microorchidia
Definition: A disorder affecting males, caused by an abnormality occurring in sex development during the antenatal period. This disorder is characterised by individuals who are born with absence of the testes, or with testes that are deficient in size and function. Confirmation is by physical examination, identification of low testosterone levels but elevated follicle stimulating hormone and luteinizing hormone levels in a blood sample, or imaging.
Also known as: Anorchia or microorchidia | Absence or aplasia of testis, unilateral | congenital absence of testis, unilateral | congenital absent testicle | congenital absence of testis
[9D90.2] Moderate vision impairment
Also known as: Moderate vision impairment | low vision, both eyes | visual impairment category 2, in both eyes | Low vision | LW - [low vision]
Includes: visual impairment category 2, in both eyes
[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 ---
[LB99.6] Acheiria
Def: A condition caused by failure of one or both hands to develop during the antenatal period....
--PARENT--> [LB99] Reduction defects of upper limb
Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB99.2] Radial hemimelia
Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....
--- Walk 2 ---
[LB99.6] Acheiria
Def: A condition caused by failure of one or both hands to develop during the antenatal period....
--PARENT--> [LB99] Reduction defects of upper limb
Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB99.2] Radial hemimelia
Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....
--- Walk 3 ---
[MB51.Z] Diplegia of upper extremities, unspecified
--PARENT--> [MB51] Diplegia of upper extremities
Def: This is a loss of motor control in both arms....
--CHILD--> [MB51.Z] Diplegia of upper extremities, unspecified
--- Walk 4 ---
[MB51.Z] Diplegia of upper extremities, unspecified
--PARENT--> [MB51] Diplegia of upper extremities
Def: This is a loss of motor control in both arms....
--CHILD--> [MB51.0] Flaccid diplegia of upper extremities
--- Walk 5 ---
[LB9A.4] Apodia
Def: A condition caused by failure of the foot to develop during the antenatal period....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.1] Tibial hemimelia
Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....
--- Walk 6 ---
[LB9A.4] Apodia
Def: A condition caused by failure of the foot to develop during the antenatal period....
--PARENT--> [LB9A] Reduction defects of lower limb
Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....
--CHILD--> [LB9A.0] Amelia of lower limb
|
[
"[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.2] Radial hemimelia\n Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....",
"[LB99.6] Acheiria\n Def: A condition caused by failure of one or both hands to develop during the antenatal period....\n --PARENT--> [LB99] Reduction defects of upper limb\n Def: Any condition caused by the failure of an upper limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB99.2] Radial hemimelia\n Def: Radial hemimelia is a congenital longitudinal deficiency of the radius bone of the forearm characterised by partial or total absence of the radius....",
"[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --CHILD--> [MB51.Z] Diplegia of upper extremities, unspecified",
"[MB51.Z] Diplegia of upper extremities, unspecified\n --PARENT--> [MB51] Diplegia of upper extremities\n Def: This is a loss of motor control in both arms....\n --CHILD--> [MB51.0] Flaccid diplegia of upper extremities",
"[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.1] Tibial hemimelia\n Def: Tibial hemimelia is a rare congenital anomaly characterised by deficiency of the tibia with a relatively intact fibula....",
"[LB9A.4] Apodia\n Def: A condition caused by failure of the foot to develop during the antenatal period....\n --PARENT--> [LB9A] Reduction defects of lower limb\n Def: Any condition caused by the failure of a lower limb to correctly develop during the antenatal period. These conditions are characterised by reduction in size or absence of the limb....\n --CHILD--> [LB9A.0] Amelia of lower limb"
] |
LB99.6
|
Acheiria
|
[
{
"from_icd11": "LB99.6",
"icd10_code": "Q7131",
"icd10_title": "Congenital absence of right hand and finger"
},
{
"from_icd11": "LB99.6",
"icd10_code": "Q7133",
"icd10_title": "Congenital absence of hand and finger, bilateral"
},
{
"from_icd11": "LB99.6",
"icd10_code": "Q7130",
"icd10_title": "Congenital absence of unspecified hand and finger"
},
{
"from_icd11": "LB99.6",
"icd10_code": "Q713",
"icd10_title": "Congenital absence of hand and finger"
},
{
"from_icd11": "MB51.Z",
"icd10_code": "G830",
"icd10_title": "Diplegia of upper limbs"
},
{
"from_icd11": "LB9A.4",
"icd10_code": "Q7231",
"icd10_title": "Congenital absence of right foot and toe(s)"
},
{
"from_icd11": "LB9A.4",
"icd10_code": "Q7230",
"icd10_title": "Congenital absence of unspecified foot and toe(s)"
},
{
"from_icd11": "LB9A.4",
"icd10_code": "Q723",
"icd10_title": "Congenital absence of foot and toe(s)"
},
{
"from_icd11": "LB51",
"icd10_code": "Q550",
"icd10_title": "Absence and aplasia of testis"
},
{
"from_icd11": "LB51",
"icd10_code": "Q55",
"icd10_title": "Other congenital malformations of male genital organs"
},
{
"from_icd11": "9D90.2",
"icd10_code": "H542",
"icd10_title": "Low vision, both eyes"
},
{
"from_icd11": "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"
}
] |
Q7131
|
Congenital absence of right hand and finger
|
For the patient presented, her recurrent hip pain significantly worsened during her second pregnancy and included the low back and pelvic girdle. Pain localized to the pelvic girdle can have a wide spectrum of underlying pathologies, with hormonal and musculoskeletal changes of pregnancy altering the normal anatomy and physiology of a patient . Low back and PGP can often go hand-in-hand, but the general consensus is that PGP is a subset of low back pain . Our patient presented with multiple symptoms involving bilateral hips, low back, and pelvic pain. All of these terms have been used interchangeably, discovered through a literature review, to refer to PGP. The general instability of pregnancy, with hormonal changes involving ligament laxity and joint mobility, likely contributed to the patient’s presentation . Theoretically, pregnancy causes the ligaments of the SIJ to slacken due to the hormone relaxin, which could further add to her chronic baseline pain . However, current research does not have a consensus about specific hormones or serum levels that would cause or prevent PGP. It is thought that pregnant and postpartum females have joint and ligament hypermobility, which can add to their pain. Other risk factors for the development of PGP include parity, with each subsequent pregnancy increasing risk, metabolic factors such as diabetes mellitus, and genetic factors such as family members developing this condition appear to predispose patients for acquiring PGP . After a careful review of the patient’s chart, physical examination, and history, her initial presentation and constellation of symptoms led to her original diagnosis of PGP, most closely resembling type 2, which involved bilateral SIJs and posterior PGP. Treatment for this would be focused on pelvic floor dysfunction, which she responded to appropriately with significant improvement in her urinary incontinence. However, she continued to have pain localizing now to her left SIJ and left iliopsoas tendon along the inguinal area. At this point, with her poor response to appropriately targeted treatment for PGP type 2, her treatment regimen and the diagnosis were changed in order to focus on PGP type 4 and likely SIJ dysfunction. Her pain now met the criteria for anterior pelvic girdle and pubic symphysis localization, i.e., type 4 PGP, and physical therapy treatments now focused on this area for manipulation and treatment. All exercises and manipulations were customized to the patient, with both her short timeline and improvement in function taken into account. Ultimately, her treatment was further adjusted with a focus on potential SIJ dysfunction after multiple physical examination maneuvers, including the thigh thrust test, localized her pain. With further customization of her treatment regimen, she was ultimately able to make a full recovery. This patient presented with a diagnostic dilemma, as her diagnosis and treatment plan changed many times. Initially, she was thought to have PGP type 2, was reclassified as type 4, and ultimately her treatment course was focused on SIJ dysfunction and iliopsoas tendinopathy. These diagnoses have significant overlap, as they all involve similar areas within the pelvic girdle, with many of the same signs and symptoms. She presented with a challenge, as she was able to respond to pelvic floor exercises that should have allowed relief from a diagnosis of PGP type 2. When she showed a plateau in her response, measured as continued pain, and her treatment was focused on a type 4 diagnosis, she had some improvement in pain, but still not complete resolution. The final diagnosis was SIJ dysfunction with iliopsoas tendinopathy, especially after pain was elicited during the thigh thrust test, and her focused treatment plan targeted the SIJ and iliopsoas tendon. SIJ pain has been described as referred pain from myofascial trigger points, especially when targeting areas around the gluteus, quadratus lumborum, rectus abdominis, piriformis, and iliopsoas muscles . Our patient felt pain when performing iliopsoas-activating maneuvers and improvement following stretching exercises targeting this muscle. SIJ dysfunction has been shown to be associated with inflammatory and rheumatologic diseases, such as ankylosing spondylitis, psoriatic arthritis, or inflammatory bowel-associated seronegative spondyloarthropathies, but as in the case presented, micro-trauma can also be a link to chronic SIJ pain . Micro-trauma has been described as caused by pregnancy and during the postpartum period, where the SIJ pain is attributed to the pubic symphysis being more unstable due to hormonal and physical body changes . Micro-trauma can also be seen in athletic activity-related injuries and trauma . This can be applied to the patient presented, as she had a history of a stress fracture in the general location of her pain several years prior to the current presentation. The build-up of the image-documented trauma in combination with her pregnancies and hormone-related changes to her SIJ, likely caused the instability and pain she reported. The referred pain to her iliopsoas muscle that improved following her exercise regimen supports the idea that she likely had SIJ dysfunction and tendon pathology.
| 4.222656
| 0.952637
|
sec[2]/p[1]
|
en
| 0.999996
|
34290919
|
https://doi.org/10.7759/cureus.15719
|
[
"pain",
"type",
"pelvic",
"this",
"dysfunction",
"iliopsoas",
"pregnancy",
"that",
"focused",
"trauma"
] |
[
{
"code": "MG3Z",
"title": "Pain, unspecified"
},
{
"code": "8E43.Z",
"title": "Pain disorders, unspecified"
},
{
"code": "MG31.Z",
"title": "Acute pain, unspecified"
},
{
"code": "MG30.Z",
"title": "Chronic pain, unspecified"
},
{
"code": "FB56.2",
"title": "Myalgia"
},
{
"code": "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 ===
[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
[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 ---
[MG3Z] Pain, unspecified
--PARENT--> [?] Pain
--EXCLUDES--> [?] 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....
--- Walk 2 ---
[MG3Z] Pain, unspecified
--PARENT--> [?] Pain
--EXCLUDES--> [?] Mastodynia
Def: The symptom of breast pain. This symptom may be classified as cyclic or non-cyclical depending on the clinical patterns....
--- Walk 3 ---
[8E43.Z] Pain disorders, unspecified
--PARENT--> [8E43] Pain disorders
--CHILD--> [8E43.Z] Pain disorders, unspecified
--- Walk 4 ---
[8E43.Z] Pain disorders, unspecified
--PARENT--> [8E43] Pain disorders
--CHILD--> [8E43.Y] Other specified pain disorders
--- Walk 5 ---
[MG31.Z] Acute pain, unspecified
--PARENT--> [MG31] Acute pain
Def: Pain with a duration of less than 3 months.
This code should be used only when there is no further specification of site....
--CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified
--- Walk 6 ---
[MG31.Z] Acute pain, unspecified
--PARENT--> [MG31] Acute pain
Def: Pain with a duration of less than 3 months.
This code should be used only when there is no further specification of site....
--CHILD--> [MG31.2] Acute postoperative pain, not elsewhere classified
Def: Pain at the intervention site or caused by an intervention....
|
[
"[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --EXCLUDES--> [?] 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....",
"[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --EXCLUDES--> [?] Mastodynia\n Def: The symptom of breast pain. This symptom may be classified as cyclic or non-cyclical depending on the clinical patterns....",
"[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.Z] Pain disorders, unspecified",
"[8E43.Z] Pain disorders, unspecified\n --PARENT--> [8E43] Pain disorders\n --CHILD--> [8E43.Y] Other specified pain disorders",
"[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.0] Acute pain in the face, not elsewhere classified",
"[MG31.Z] Acute pain, unspecified\n --PARENT--> [MG31] Acute pain\n Def: Pain with a duration of less than 3 months.\n\nThis code should be used only when there is no further specification of site....\n --CHILD--> [MG31.2] Acute postoperative pain, not elsewhere classified\n Def: Pain at the intervention site or caused by an intervention...."
] |
MG3Z
|
Pain, unspecified
|
[
{
"from_icd11": "MG3Z",
"icd10_code": "R52",
"icd10_title": "Pain, unspecified"
},
{
"from_icd11": "MG3Z",
"icd10_code": "R529",
"icd10_title": ""
},
{
"from_icd11": "MG31.Z",
"icd10_code": "R520",
"icd10_title": ""
},
{
"from_icd11": "MG30.Z",
"icd10_code": "R521",
"icd10_title": ""
},
{
"from_icd11": "MG30.Z",
"icd10_code": "R522",
"icd10_title": ""
},
{
"from_icd11": "FB56.2",
"icd10_code": "M7918",
"icd10_title": "Myalgia, other site"
},
{
"from_icd11": "FB56.2",
"icd10_code": "M7910",
"icd10_title": "Myalgia, unspecified site"
},
{
"from_icd11": "FB56.2",
"icd10_code": "M7912",
"icd10_title": "Myalgia of auxiliary muscles, head and neck"
},
{
"from_icd11": "FB56.2",
"icd10_code": "M791",
"icd10_title": "Myalgia"
},
{
"from_icd11": "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"
}
] |
R52
|
Pain, unspecified
|
We present a 9-year-old male, single child from nonconsanguineous parents from Northern Tanzania. The father was not living with the mother, but was reportedly well. The mother's gait was normal but further neurological examination has not been performed due to loss to follow-up. There was no previous medical history. The child had normal milestones and had been performing well until recently, but has always been shorter than his age mates. He reported to our clinic at the Kilimanjaro Christian Medical Centre, a tertiary referral hospital in Moshi, Northern Tanzania with a 3-4 month history of progressive confusion and difficulty walking. There were episodes of aggression and hyperactivity which fluctuated over days and were worse at night. He had been asked to leave the school. In the same period he developed difficulty walking and had become incontinent for urine and faeces. There was no acute onset, nor was there a febrile illness preceding the complaint. Upon physical examination, we saw a proportionally small child, height 110 centimetres (below third percentile, ) and weight 24 kilograms (fifth percentile ). His nutritional condition was moderate. General physical examination, and notably the skin, was normal and there were no dysmorphic features. Head circumference was normal. Upon neurological screening, the boy appeared to be only partially aware of his environment, talking to no one in particular and acting defensively and aggressively at times. Cranial nerve exam was unremarkable. Fundoscopy of the optic nerve and retina was normal. Visual acuity testing was complicated by a short attention span. He could, however discern and localise bright and moving objects. Motor exam revealed moderate spasticity with exaggerated reflexes for as far as the child permitted examination, plantars were upgoing bilaterally and he was visibly incontinent. Proximal leg musculature was grade 5-/5, muscle bulk was slightly decreased in keeping with a short stature and moderate nutritional condition. He could walk with assistance with a broad based, high stepping gait. In the course of months upon follow-up, he developed fatigue, generalised lassitude, and a slate-grey discolouration most prominently around the nose and mouth, tongue, hand palms, and around skin scars . He was always feeling cold and was too tired to eat. Laboratory investigations were normal except a hyponatremia of 116 mmol/l and hyperkalaemia which was initially treated with hypertonic saline and a salt-enriched diet, but did not improve much. HIV test was negative and chest X-ray normal. Lumbar puncture showed a normal number of cells, protein, and glucose levels. Immune electrophoresis is not available in our centre and was not affordable through a commercial laboratory. Computed Tomography (CT, Supplementary Material ) and Magnetic Resonance Imaging (MRI, Supplementary Material ) of the brain showed a striking posteriorly distributed hypodense white matter, with volume loss and enhancement with contrast on MRI. The characteristic radiological pattern with anterior sparing of extensive white matter abnormalities in combination with neurodegeneration and adrenocortical failure suggested ALD. The working diagnosis was a rapidly progressive multifocal central nervous system disorder, with in second instance an endocrine complication, query hypothyroidism or adrenocortical insufficiency. Because of the short history, initially a low- grade encephalopathy or encephalitis was suspected, with HIV as a main infection to be ruled out. Alternatively, an inflammatory demyelinating encephalopathy was queried. Acute Demyelinating Encephalomyelitis (ADEM) or auto-immune encephalitis was amongst the possibilities, for which a lumbar puncture was performed. Less likely in this SSA setting but not impossibly would this be the onset of a metabolic or neurodegenerative disorder. Adrenocortical failure was subsequently suspected based on clinical grounds, and oral hydrocortisone supplementation therapy was started. Very long chain fatty acid level, cortisol, and ACTH testing was not available in Northern Tanzania. Within days, his general condition markedly improved, but not his neurological performance. Later on, for local unavailability of oral hydrocortisone therapy, the patient had to be switched to prednisolone. This allowed for some improvement albeit not as much as before. Written informed consent for genetic testing of the ABCD1 gene was obtained from the mother for genetic research and photographs, in Swahili and English. Venous blood was sampled from the patient, and was sent to the Laboratory Genetic Metabolic Diseases, Amsterdam UMC, Amsterdam, The Netherlands. Sanger sequencing was performed of all coding exons plus flanking intron sequences of the ABCD1 gene. DNA sequence analysis of the ABCD1 gene revealed the hemizygous variant c.1534G>A (p.(Gly512Ser)) which is a recurrent, pathogenicity class 5 variant . No additional pathogenic mutations were identified in the ABCD1 gene; this confirms the diagnosis of ALD. The mother and grandmother of the patient were counseled about the findings but since, has not yet been available for further testing. The patient unfortunately passed away a year after the diagnosis.
| 3.90625
| 0.983398
|
sec[1]/p[0]
|
en
| 0.999995
|
32089906
|
https://doi.org/10.1155/2019/6148425
|
[
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"which",
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"this",
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"northern",
"tanzania",
"neurological",
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] |
[
{
"code": "QA48.1",
"title": "Care or examination of lactating mother"
},
{
"code": "KB60.1",
"title": "Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent"
},
{
"code": "1C1D.0",
"title": "Primary yaws"
},
{
"code": "KD35",
"title": "Neonatal withdrawal syndrome from maternal use of drugs of addiction"
},
{
"code": "KB60.0",
"title": "Syndrome of infant of mother with gestational diabetes"
},
{
"code": "BD50.41",
"title": "Abdominal aortic aneurysm with rupture"
},
{
"code": "EK91",
"title": "Dermatoses which may presage cutaneous lymphoma"
},
{
"code": "MH12.1",
"title": "Death occurring less than 24 hours from onset of symptoms, not otherwise explained"
},
{
"code": "8A44.3",
"title": "Certain specified leukodystrophies"
},
{
"code": "QA40",
"title": "Pregnancy examination or test"
}
] |
=== ICD-11 CODES FOUND ===
[QA48.1] Care or examination of lactating mother
Also known as: Care or examination of lactating mother | care of lactating mother | examination of lactating mother | supervision of lactation | supervision of breastfeeding
Excludes: Certain specified disorders of breast or lactation associated with childbirth
[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent
Definition: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birth injuries, congenital anomalies, hypoglycaemia, respiratory distress, caudal regression syndrome and hypertrophic cardiomyopathy.
Also known as: Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent | infant of a diabetic mother syndrome | maternal diabetes syndrome | syndrome of infant of diabetic mother | infant of diabetic mother
[1C1D.0] Primary yaws
Definition: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developing into a large non-tender ulcerating nodule, often resembling a raspberry (hence the name ‘framboesia’). The primary lesion is most commonly located on the legs and ankles may also be found on the buttocks, arms, hands, and face. It usually heals after 3–6 months and is still present at the onset o
Also known as: Primary yaws | Chancre of yaws | Primary framboesia | initial lesions of yaws | mother yaw
Includes: Chancre of yaws | Primary framboesia
[KD35] Neonatal withdrawal syndrome from maternal use of drugs of addiction
Definition: Intrauterine exposure to addictive drugs can lead to neonatal withdrawal symptoms. Withdrawal symptoms are usually neurological, preventing normal autonomic function. The clinical presentation of drug withdrawal is variable and dependent on several factors, such as, the type and dose of drug used and rate of metabolism and excretion of the mother and infant.
Also known as: Neonatal withdrawal syndrome from maternal use of drugs of addiction | Drug withdrawal syndrome in infant of dependent mother | Neonatal abstinence syndrome | drug withdrawal syndrome in newborn | neonatal drug withdrawal syndrome
Includes: Drug withdrawal syndrome in infant of dependent mother | Neonatal abstinence syndrome
Excludes: Fetus or newborn affected by maternal anaesthesia or analgesia in pregnancy, labour or delivery
[KB60.0] Syndrome of infant of mother with gestational diabetes
Definition: Describes the range of effects on the infant born to a woman with gestational diabetes (onset or first recognition of carbohydrate intolerance of variable severity in pregnancy). Common neonatal effects include macrosomia, intrauterine growth restriction, birth injuries, congenital anomalies, hypoglycaemia, respiratory distress, and hypertrophic cardiomyopathy.
Also known as: Syndrome of infant of mother with gestational diabetes | infant of mother with gestational diabetes | IGDM - [infant of gestational diabetic mother] | Fetus or newborn with hypoglycaemia affected by maternal gestational diabetes | Fetus or newborn affected by maternal gestational diabetes
[BD50.41] Abdominal aortic aneurysm with rupture
Also known as: Abdominal aortic aneurysm with rupture | abdominal aorta aneurysm rupture | abdominal aorta aneurysm ruptured | abdominal aortic aneurysm which has ruptured | ruptured AAA
[EK91] Dermatoses which may presage cutaneous lymphoma
Definition: Dermatoses which may represent the earliest stages of cutaneous lymphoma but where it is not possible to confirm their neoplastic nature.
Also known as: Dermatoses which may presage cutaneous lymphoma
[MH12.1] Death occurring less than 24 hours from onset of symptoms, not otherwise explained
Also known as: Death occurring less than 24 hours from onset of symptoms, not otherwise explained | died without sign of disease | Death known not to be violent or instantaneous for which no cause can be discovered | death known not to be violent or instantaneous, cause unknown | Death without sign of disease
Includes: Death known not to be violent or instantaneous for which no cause can be discovered | Death without sign of disease
[8A44.3] Certain specified leukodystrophies
Also known as: Certain specified leukodystrophies | CACH syndrome | Vanishing white matter disease | Childhood ataxia with central nervous system hypomyelination | Congenital or early infantile CACH syndrome
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[QA48.1] Care or examination of lactating mother
--EXCLUDES--> [?] Certain specified disorders of breast or lactation associated with childbirth
--CHILD--> [?] Other or unspecified disorders of breast associated with childbirth
--- Walk 2 ---
[QA48.1] Care or examination of lactating mother
--EXCLUDES--> [?] Certain specified disorders of breast or lactation associated with childbirth
--CHILD--> [?] Retracted nipple associated with childbirth
Def: A condition characterised as the abnormal inversion of a nipple that does not return to normal position even when stimulated that has occurred in association with childbirth....
--- Walk 3 ---
[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent
Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...
--PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn
Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ...
--CHILD--> [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent
Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...
--- Walk 4 ---
[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent
Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...
--PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn
Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ...
--CHILD--> [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent
Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...
--- Walk 5 ---
[1C1D.0] Primary yaws
Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developi...
--PARENT--> [1C1D] Yaws
Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con...
--PARENT--> [?] Other bacterial diseases
--- Walk 6 ---
[1C1D.0] Primary yaws
Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developi...
--PARENT--> [1C1D] Yaws
Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con...
--CHILD--> [1C1D.2] Tertiary yaws
Def: Tertiary yaws develops in <10% of untreated infected individuals after and interval of 5 years or more. The late stage skin lesions are characterised by gummatous nodules with necrotic tissue destruct...
|
[
"[QA48.1] Care or examination of lactating mother\n --EXCLUDES--> [?] Certain specified disorders of breast or lactation associated with childbirth\n --CHILD--> [?] Other or unspecified disorders of breast associated with childbirth",
"[QA48.1] Care or examination of lactating mother\n --EXCLUDES--> [?] Certain specified disorders of breast or lactation associated with childbirth\n --CHILD--> [?] Retracted nipple associated with childbirth\n Def: A condition characterised as the abnormal inversion of a nipple that does not return to normal position even when stimulated that has occurred in association with childbirth....",
"[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...\n --PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn\n Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ...\n --CHILD--> [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...",
"[KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...\n --PARENT--> [KB60] Transitory disorders of carbohydrate metabolism specific to fetus or newborn\n Def: A group of paediatric conditions in which there is a temporary disorder in a newborn or infant associated with abnormal chemical reactions in the body disrupting the process of getting or making energ...\n --CHILD--> [KB60.1] Syndrome of infant of a diabetic mother, type 1 or 2, nongestational, insulin dependent\n Def: Describes the range of effects on the infant born to a woman with pregestational diabetes mellitus (type 1 or type 2). Common neonatal effects include macrosomia, intrauterine growth restriction, birt...",
"[1C1D.0] Primary yaws\n Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developi...\n --PARENT--> [1C1D] Yaws\n Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con...\n --PARENT--> [?] Other bacterial diseases",
"[1C1D.0] Primary yaws\n Def: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developi...\n --PARENT--> [1C1D] Yaws\n Def: An infectious disease caused by Treponema pallidum subsp. pertenue which mainly affects children in rural communities in the humid tropics. It affects the skin and bones, is spread by skin to skin con...\n --CHILD--> [1C1D.2] Tertiary yaws\n Def: Tertiary yaws develops in <10% of untreated infected individuals after and interval of 5 years or more. The late stage skin lesions are characterised by gummatous nodules with necrotic tissue destruct..."
] |
QA48.1
|
Care or examination of lactating mother
|
[
{
"from_icd11": "QA48.1",
"icd10_code": "Z391",
"icd10_title": "Encounter for care and examination of lactating mother"
},
{
"from_icd11": "KB60.1",
"icd10_code": "P701",
"icd10_title": "Syndrome of infant of a diabetic mother"
},
{
"from_icd11": "1C1D.0",
"icd10_code": "A660",
"icd10_title": "Initial lesions of yaws"
},
{
"from_icd11": "KD35",
"icd10_code": "P961",
"icd10_title": "Neonatal withdrawal symptoms from maternal use of drugs of addiction"
},
{
"from_icd11": "KB60.0",
"icd10_code": "P700",
"icd10_title": "Syndrome of infant of mother with gestational diabetes"
},
{
"from_icd11": "BD50.41",
"icd10_code": "I713",
"icd10_title": "Abdominal aortic aneurysm, ruptured"
},
{
"from_icd11": "EK91",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "MH12.1",
"icd10_code": "R961",
"icd10_title": ""
},
{
"from_icd11": "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": ""
}
] |
Z391
|
Encounter for care and examination of lactating mother
|
The proband is the third child of non-consanguineous parents. Prior to his birth, the mother had one spontaneous abortion. Caesarean section was performed at 36.5 weeks of gestation because of preeclampsia. At birth, the patient showed low weight (<3rd centile) and length in the 10th–25th centile. The Apgar score was 7/10. Developmental delay, feeding difficulties, and recurrent upper airways infections compromised his early infancy. He underwent several surgical procedures because of bilateral hip dislocation, clubfeet varus, and hypospadias. At 5 years and 3 months of age, he had one febrile seizure, and 2 months later, he underwent surgery for bilateral inguinal hernia and left orchidopexy. Clinical evaluation was performed at 6 years and 7 months, and the weight was 16.1 kg (<3rd centile), the height was 112 cm (10–25 centile), and the occipital-frontal circumference was 46.5 cm (<3rd centile). The clinical findings are described in Figure 1 a–d and Table 1 . Hormonal studies, including analyses of FSH, LH, testosterone, oestradiol, progesterone, TSH, T3, T4, ACTH, cortisol, and growth hormone (basal and post-stimulation with glucose) all yielded normal results. Pelvic USG, EEG, audiometry and ECG yielded normal results. Figure 1 Proband phenotype and cytogenetic analysis. Proband at the age of 6 years and 7 months, showing (a) slender habitus with little subcutaneous fat and scars from the surgery for inguinal hernias; (b) cutis aplasia in midline scalp; (c) sparse hair, long face, high frontal hair line, sparse eyebrows and eyelashes, hypoplastic alae nasi, and low-set ears; and (d) shawl scrotum. (e) Partial GTG-banding karyotype of the patient showing normal and derivative chromosomes 2 and 19. (f) Normal and derivative chromosomes 2 and 19 showing FISH signals. Note the signal of 19q (orange) at the top of der(2), followed by the 2p (green) signal and the 2q (orange) signal at the end of the chromosome. der(19) shows only the 19p (green) signal. (g) Diagram illustrating the insertion of the segment from 19q13.12 to 19q13.43 in 2p25.3, with concomitant deletion of 19q13.11-q13.12. Table 1 Clinical features of patients with 19q13.11 deletion syndrome Patient 1 2 3 4 5 6 7 8 9 10 11 Proband Total Size of the deletion (Mb) 11 6.16 4.27 3.19 2.4 1.74 2.63 7.87 1.37 8.16 2.30 2.49 Gender F M M M M M F M F F M M 4 F/8 M Age [years. months] 3.0 6.0 9.2 5.0 4.10 14 8.0 ϕ 6.5 5.6 1.6 6.7 Preterm delivery [≤38 weeks] + + + + + + + + + + 10/10 Development characteristics Prenatal growth retardation + + + + + + + + + - + + 11/12 Feeding problems + + + + + + - + + + + 10/11 Postnatal growth retardation + + + + + + + + + + + 11/11 Slender habitus + + + + - + - + + 7/9 Little subcutaneous fat + + + + - + + 6/7 DD/ID + + + + + + + + + + + 11/11 Speech disturbance + + + + + + + + + + + 11/11 Microcephaly + + + + + + + + + + + 11/11 Minor Facial dysmorphic features* + + + + + + + + + + + + 12/12 Long face + + + + + + - a + + + + 10/11 High frontal hairline + + + + b + + + + + + 10/10 High forehead + + + + + + + + + 9/9 Eye abnormalities + c - + d + e - + f + c 5/7 V-shaped nasal tip + + + + + + + + 8/8 Hypoplastic nasal alae + + + + + + + + 8/8 Low-set columella + + + + + 5/5 Thin lips + + + + + + + + + + 10/10 Retro-micrognathia + + + + + + + + + - + + 11/12 Large ears or low-set ears + + + + + + + + + + + 11/11 Signs of ectodermal dysplasia Aplasia cutis in midline of scalp + + + + + + - + - + + 9/11 Thin/dry skin + + + + + - - + 6/8 Thin-sparse hair + + + + + - + - - + 7/10 Thin-sparse eyebrows/eyelashes + + + + + + + + - - + 9/11 Teeth abnormalities + g + h - + i + j - + j 5/7 Dysplasic nails + + - + - - + - - + 5/10 Genital abnormalities Hypospadias NA + + + + + NA + NA NA + + 8/8 Testicular ectopia NA - + + + - NA NA NA + + 5/7 Bifid scrotum NA + - - + - NA NA NA - + 3/7 Extremity abnormalities Long/tapering fingers + + + + + + + + 8/8 Clinodactyly of the 5th finger + + + + + + - + 7/9 Abnormal positioning of the feet + + + - + 4/5 Overlapping of the toes + + - - - - - + + 4/9 Cutaneous syndactyly F/T - + + + + - - + + + 7/10 Others Recurrent airways infections + + + + - + + 6/7 Heart disease + + - + - + - + - 5/9 Inguinal hernia + + + 3/3 Febrile seizure + + + 3/3 Endocrine abnormalities + + + - 3/4 Patients: (1) Kulhayra et al , (2–4) Malan et al , (5) Schuurs-Hoeijmakers et al , (6–7) Gana et al , (8) Lin et al , (9) Forzano et al , and (10–11) Chowdhury et al . The total number of patients with a specific phenotype differs depending on whether the phenotype was specifically mentioned in the reports; only those reported are counted, and blank spaces correspond to data not documented. *We included the reported facial features and also features that were not reported in cases where evaluation of the published photographs was possible. Abbreviations : F, female; M, male; ϕ, foetus aborted at the 28th week of gestation; DD/ID, developmental delay/intellectual disability; F/T, fingers or toes; +, present; -, absent; NA, not applicable. Clinical findings: (a) round face, (b) frontal upsweep of hair, (c) strabismus, (d) microcornea-cataract, (e) epiblepharon, (f) astigmatism, (g) single median incisor, (h) teeth irregularly placed, (i) hypodontia and (j) multiple caries.
| 4.191406
| 0.88916
|
sec[1]/sec[0]/p[0]
|
en
| 0.999998
|
25516771
|
https://doi.org/10.1186/s13039-014-0061-z
|
[
"centile",
"abnormalities",
"proband",
"frontal",
"sparse",
"hair",
"signal",
"features",
"thin",
"inguinal"
] |
[
{
"code": "MB23.Z",
"title": "Symptoms and signs involving appearance and behaviour, unspecified"
},
{
"code": "GA20.3",
"title": "Abnormal regularity of uterine bleeding"
},
{
"code": "5D2Z",
"title": "Metabolic disorders, unspecified"
},
{
"code": "LD9Z",
"title": "Developmental anomalies, unspecified"
},
{
"code": "MC1Y",
"title": "Other specified symptoms or signs involving the visual system"
},
{
"code": "9C82.4",
"title": "Oculomotor apraxia"
},
{
"code": "CA0A.Y&XA91G8",
"title": "Frontal sinus fistula"
},
{
"code": "CA0J.Y&XA91G8",
"title": "Polyp of frontal sinus"
},
{
"code": "NA02.14",
"title": "Fracture of frontal sinus of skull"
},
{
"code": "CA0C&XA91G8",
"title": "Cyst of frontal sinus"
}
] |
=== ICD-11 CODES FOUND ===
[MB23.Z] Symptoms and signs involving appearance and behaviour, unspecified
Also known as: Symptoms and signs involving appearance and behaviour, unspecified | Symptoms or signs involving appearance or behaviour | self neglect NOS | abnormal behaviour NOS
[GA20.3] Abnormal regularity of uterine bleeding
Definition: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days.
Also known as: Abnormal regularity of uterine bleeding | Irregular menstrual bleeding | irregular cycle menstruation | irregular menses | irregular menstrual cycle
[5D2Z] Metabolic disorders, unspecified
Also known as: Metabolic disorders, unspecified | metabolic abnormality | metabolic debility | metabolic defect | metabolic disruption
[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
[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
[9C82.4] Oculomotor apraxia
Also known as: Oculomotor apraxia | Congenital ocular motor apraxia | Cogan’s congenital ocular motor apraxia | Saccadic palsy | Head thrust movement
[NA02.14] Fracture of frontal sinus of skull
Also known as: Fracture of frontal sinus of skull | fracture of frontal sinus | frontal sinus bone fracture
=== GRAPH WALKS ===
--- Walk 1 ---
[MB23.Z] Symptoms and signs involving appearance and behaviour, unspecified
--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 2 ---
[MB23.Z] Symptoms and signs involving appearance and behaviour, unspecified
--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 3 ---
[GA20.3] Abnormal regularity of uterine bleeding
Def: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days....
--PARENT--> [GA20] Menstrual cycle bleeding disorders
--CHILD--> [GA20.1] Abnormal frequency of uterine bleeding
Def: Any condition of the genital system affecting females, caused by hormonal disturbances. These conditions are characterised by menstrual bleeding episodes that occur with increased frequency or are del...
--- Walk 4 ---
[GA20.3] Abnormal regularity of uterine bleeding
Def: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days....
--PARENT--> [GA20] Menstrual cycle bleeding disorders
--CHILD--> [GA20.1] Abnormal frequency of uterine bleeding
Def: Any condition of the genital system affecting females, caused by hormonal disturbances. These conditions are characterised by menstrual bleeding episodes that occur with increased frequency or are del...
--- Walk 5 ---
[5D2Z] Metabolic disorders, unspecified
--PARENT--> [?] Metabolic disorders
--CHILD--> [?] 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 6 ---
[5D2Z] Metabolic disorders, unspecified
--PARENT--> [?] Metabolic disorders
--EXCLUDES--> [?] Congenital adrenal hyperplasia
Def: Congenital adrenal hyperplasia (CAH) refers to a group of conditions associated with either complete (classical form) or partial (non-classical) anomalies in the biosynthesis of adrenal hormones. The ...
|
[
"[MB23.Z] Symptoms and signs involving appearance and behaviour, unspecified\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.Z] Symptoms and signs involving appearance and behaviour, unspecified\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....",
"[GA20.3] Abnormal regularity of uterine bleeding\n Def: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days....\n --PARENT--> [GA20] Menstrual cycle bleeding disorders\n --CHILD--> [GA20.1] Abnormal frequency of uterine bleeding\n Def: Any condition of the genital system affecting females, caused by hormonal disturbances. These conditions are characterised by menstrual bleeding episodes that occur with increased frequency or are del...",
"[GA20.3] Abnormal regularity of uterine bleeding\n Def: A condition of the genital system affecting females, caused by hormonal disturbances. This condition is characterised by abnormal menstruation, with a between cycle variation of 2-20 days....\n --PARENT--> [GA20] Menstrual cycle bleeding disorders\n --CHILD--> [GA20.1] Abnormal frequency of uterine bleeding\n Def: Any condition of the genital system affecting females, caused by hormonal disturbances. These conditions are characterised by menstrual bleeding episodes that occur with increased frequency or are del...",
"[5D2Z] Metabolic disorders, unspecified\n --PARENT--> [?] Metabolic disorders\n --CHILD--> [?] 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...",
"[5D2Z] Metabolic disorders, unspecified\n --PARENT--> [?] Metabolic disorders\n --EXCLUDES--> [?] Congenital adrenal hyperplasia\n Def: Congenital adrenal hyperplasia (CAH) refers to a group of conditions associated with either complete (classical form) or partial (non-classical) anomalies in the biosynthesis of adrenal hormones. The ..."
] |
MB23.Z
|
Symptoms and signs involving appearance and behaviour, unspecified
|
[
{
"from_icd11": "MB23.Z",
"icd10_code": "R4689",
"icd10_title": "Other symptoms and signs involving appearance and behavior"
},
{
"from_icd11": "MB23.Z",
"icd10_code": "R4681",
"icd10_title": "Obsessive-compulsive behavior"
},
{
"from_icd11": "MB23.Z",
"icd10_code": "R46",
"icd10_title": "Symptoms and signs involving appearance and behavior"
},
{
"from_icd11": "MB23.Z",
"icd10_code": "R466",
"icd10_title": "Undue concern and preoccupation with stressful events"
},
{
"from_icd11": "MB23.Z",
"icd10_code": "R468",
"icd10_title": "Other symptoms and signs involving appearance and behavior"
},
{
"from_icd11": "GA20.3",
"icd10_code": "N926",
"icd10_title": "Irregular menstruation, unspecified"
},
{
"from_icd11": "GA20.3",
"icd10_code": "N925",
"icd10_title": "Other specified irregular menstruation"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8840",
"icd10_title": "Mitochondrial metabolism disorder, unspecified"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8849",
"icd10_title": "Other mitochondrial metabolism disorders"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8841",
"icd10_title": "MELAS syndrome"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8842",
"icd10_title": "MERRF syndrome"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8809",
"icd10_title": "Other disorders of plasma-protein metabolism, not elsewhere classified"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8881",
"icd10_title": "Metabolic syndrome"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8889",
"icd10_title": "Other specified metabolic disorders"
},
{
"from_icd11": "5D2Z",
"icd10_code": "E8801",
"icd10_title": "Alpha-1-antitrypsin deficiency"
}
] |
R4689
|
Other symptoms and signs involving appearance and behavior
|
On macroscopic examination, the right ovary was replaced by a cystic mass with a glistening surface, measuring 17 cm in diameter . On incision, the cyst was partly filled with fatty material and hair. The wall of the cyst was thickened with solid, grayish nodules. The spleen was diffusely infiltrated with grayish nodes as well, measuring up to 4.5 cm in diameter . There was a lobulated, well circumscribed solid, grayish nodule identified on lumpectomy of the breast. On histological examination, the cavity of the cyst was lined by skin with dermal appendages as well as respiratory type of epithelium, smooth muscle, mature adipose and bone tissue. This morphology was in agreement with a diagnosis of mature cystic teratoma of the ovary. Solid nodules within cyst walls were tumor tissue, with a diffuse growth pattern, composed of large polymorphic cells with vesicular nuclei, a high nuclear-cytoplasmic ratio, and one or more prominent nucleoli. Some cells had eccentrically positioned nuclei with a cytoplasmic halo resembling plasmablasts. The tumor tissue from the right breast and spleen had the same histological appearance. An extensive immunohistochemical evaluation was performed. Tumor cells were negative for panCK, AFP, PLAP, CD117, D2-40, CD30, MyoD1, HMB45, desmin and CD99, but positive for LCA, EMA and vimentin. Therefore, a diagnosis of NHL was made. Subsequent immunohistochemistry showed tumor cells to be CD79a, PAX5, MUM-1, CD38, CD138 positive and CD20, CD10, Bcl-6, ALK, cyclin D1, CD56 negative. Ki-67 was high, around 80% and EBER in situ hybridization was negative . According to the morphological and immunohistochemical findings a diagnosis of PBL was made. Based on the clinical findings, the patient was staged, Ann-Arbour IV PBL. Laboratory data showed anemia, normal platelet and leucocyte counts with elevated lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and C-reactive protein (CRP). Serum alpha-1-fetoprotein and human chorionic gonadotropin were normal while carbohydrate antigen 125 was increased. Urine analysis and renal function were within normal limits. Serum immunoglobulin levels were within normal limits, without evidence of monoclonal gammopathy and serology was negative for HIV, HBV and HCV. The patient was transferred to the Hematology ward and treated with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH) as well as intra-thecal EPOCH with each cycle . After 4 cycles of chemotherapy, the patient subjectively felt better however evaluation with positron emission tomography and computed tomography scans (PET-CT) showed high activity of disease. An autologous peripheral blood stem cell transplantation was planned and 1 cycle of salvage chemotherapy was given according to DHAP protocol (cisplatin, cytarabine and dexamethasone). Unfortunately, her underlying disease continued to progress and 4 cycles of alternating modified CODOX-M and IVAC chemotherapy (cyclophosphamide, vincristine, doxorubicin, high-dosemethotrexate/ifosfamide, etoposide, and high-dosecytarabine) were given. Autologous stem cell transplantation could no longer be performed due to patient’s clinical deterioration. After the fourth cycle of chemotherapy, PET-CT scan was performed again, and revealed profound disease progression. The patient also had developed treatment complications, such as secondary anemia, thrombocytopenia, sepsis, enterocolitis, ileus, pleural effusions and ascites. Due to the worsening of the patient’s physical condition, her goals of care were changed and only supportive therapy was given. The patient died of multiple organ failure approximately 11 months after initial diagnosis (Additional file 1 ). Fig. 1 Macroscopic image of multiloculated ovarian cyst and spleen. a The right ovary was replaced by a cystic tumor (mature teratoma) with multiple solid nodules of PBL within the cyst’s walls (arrows). b Spleen with multiple PBL nodules Fig. 2 Histology and immunohistochemisty of plasmablastic lymphoma. a Haematoxylin and eosin section shows monotonous, lymphoid cells with “starry sky” pattern (magnification ×100). b Giemsa staining highlights the plasmablastic appearance with eccentrically positioned nuclei, prominent nucleoli and abundant basophilic cytoplasm (magnification ×400). c - f Atypical lymphoid cells were negative for CD20 ( c ) and CD30 ( e ), while they were positive for CD79a ( d ) and CD138 ( f ) (immunoperoxidase stain; c , d and e magnification × 400; f magnification ×200). g Nuclear proliferation rate, assessed by Ki-67 was approximately 80% (immunoperoxidase stain; magnification × 200). h EBV encoded RNA (EBER) was negative in the nuclei of the atypical cells (magnification ×400) Fig. 3 MYC immunohistochemistry and fluorescent in situ hybridization (FISH). a Large atypical plasmablasts were c-MYC positive in >40% of cells. b FISH analysis using Vysis MYC Break Apart FISH Probe Kit revealed 8q24 rearrangement within tumour cells . c FISH analysis using Vysis LSI IGH/MYC , CEP 8 Tri-color Dual Fusion Translocation Probe is negative for t(8,14), without yellow signals specific for IGH/MYC translocation (normal 2 green ( IgH ) and 2 red ( MYC , 8q24) signals); magnification × 1000
| 4.183594
| 0.959961
|
sec[1]/p[1]
|
en
| 0.999997
|
29187222
|
https://doi.org/10.1186/s13000-017-0672-x
|
[
"cells",
"magnification",
"cyst",
"within",
"tumor",
"solid",
"nodules",
"spleen",
"well",
"nuclei"
] |
[
{
"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": "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"
}
] |
=== 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
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--CHILD--> [MF92] Chyluria
Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white....
--- Walk 2 ---
[MF9Y] Other specified clinical findings on examination of urine, without diagnosis
--PARENT--> [?] Clinical findings on examination of urine, without diagnosis
--EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism
--- 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....
--PARENT--> [5C56] Lysosomal diseases
--- 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--> [3A51.2] Sickle cell disease with crisis
Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch...
|
[
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --CHILD--> [MF92] Chyluria\n Def: Chyluria, also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white....",
"[MF9Y] Other specified clinical findings on examination of urine, without diagnosis\n --PARENT--> [?] Clinical findings on examination of urine, without diagnosis\n --EXCLUDES--> [?] Inborn errors of amino acid or other organic acid metabolism",
"[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 --PARENT--> [5C56] Lysosomal diseases",
"[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--> [3A51.2] Sickle cell disease with crisis\n Def: Sickle cell crisis occurs when the sickle cells block blood flow, thus decreasing oxygen delivery to the tissues. This results in intense to severe pain in the extremities, lower back, abdomen, and ch..."
] |
MF9Y
|
Other specified clinical findings on examination of urine, without diagnosis
|
[
{
"from_icd11": "3A51.1",
"icd10_code": "D571",
"icd10_title": "Sickle-cell disease without crisis"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D609",
"icd10_title": "Acquired pure red cell aplasia, unspecified"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D608",
"icd10_title": "Other acquired pure red cell aplasias"
},
{
"from_icd11": "3A61.Z",
"icd10_code": "D60",
"icd10_title": "Acquired pure red cell aplasia [erythroblastopenia]"
},
{
"from_icd11": "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"
}
] |
D571
|
Sickle-cell disease without crisis
|
A 66-year-old woman consulted a hospital due both to a large tumor in her left breast and presumed spinal metastasis-induced lower limb paresthesia. Core needle biopsy to the breast tumor showed atypical cells growing in a papillary fashion in the mucous lake, leading to the diagnosis of breast mucinous carcinoma. The tumor showed high estrogen receptor positivity, i.e., Allred score of 8, low growing potential, i.e., Ki-labeling index of 10%, and human epidermal growth factor receptor type 2 negativity. Onset of the paresthesia and the bleeding from the left breast cancer forced the attending physicians to treat the patient with tumorectomy of the intradural extramedullary tumor, 50 Gy radiotherapy to the left breast cancer, and systemic therapy using letrozole and palbociclib. Based on the request of the patient’s family, the patient was further referred to our hospital for the treatment of her metastatic breast cancer. At her first visit to our hospital, we found no paresthesia, no bleeding from the breast cancer, and total necrosis of the left breast with bacterial culture-proven Pseudomonas aeruginosa infection . Removal of the necrotic breast tissue resulted in direct exposure of the left ribs and intercostal muscles , markedly deteriorating quality of life of the patient due to the onset of severe chest pain. Computed tomography (CT) showed bilateral multiple lung metastases . The largest pulmonary nodule seemed to infiltrate the right pulmonary hilum. We, therefore, judged the lung metastases to be life-threatening and converted the systemic therapy from letrozole plus palbociclib to bevacizumab plus paclitaxel, fortunately leading to marked regression of the lung metastases . Pseudomonas aeruginosa infection continued even after the upfront therapies, i.e., removal of the necrotic left breast followed by bevacizumab-containing chemotherapy, in our hospital. After confirming marked regression of the multiple lung metastases, to improve quality of life of the patient, we decided to cover the exposed ribs and intercostal muscles with LD-MC flap for chest pain control and wound management. Although we did not perform a bacterial culture test just before surgery, we judged that Pseudomonas aeruginosa infection continued to some extent on the rib periosteum and intercostal muscle surface based on local macroscopic findings. Before operation we obtained full informed consent about possible total flap loss because no reports had been made at that time concerning the MC flap grafting to the overtly infected recipient site. To cover the skin defect, spindly shaped skin island, 22 × 6 cm in size, on the back was harvested with the LD muscle and was moved onto the skin defect area after resecting the exposed left 4th rib and removing the two swollen axillary lymph nodes . LD-MC flap grafting to the skin defect brought about immediate, i.e., when the patient became fully conscious after awaking from anesthesia, pain relief to the patient. The patient had required oral morphine and loxoprofen for pain control before surgery, but no longer needed pain relievers after surgery. Pathological evaluation of the sampled axillary lymph nodes showed no viable cancer cells in the mucous lakes widely prevailing in the nodes. Skin island showed no problems for 4 days just after the operation but thereafter gradually turned out to be edematous to ill-colored in the distal part, i.e., approximately 1/5 area, of the flap skin . The patient eventually developed partial skin necrosis of the LD-MC flap and required 11 months for complete wound healing under conservative wound management . The patient has been well on fulvestrant and palbociclib therapy for 14 months after palliative chest wall covering surgery with no progression of the lung metastases. Fig. 1 Local findings. A The left breast was completely necrotic with Pseudomonas aeruginosa infection (asterisk), and marked skin redness (arrows) was observed around the necrotic tissue. B Necrotomy caused total loss of the left breast and at least major part of the pectoral muscles. Necrotic tissue and massive purulent discharge were still observed just after the necrotomy. C Neither tumor nor mammary gland was observed on the left chest wall after the completion of bevacizumab and paclitaxel therapy for four months. Slightly elevated 4th rib (arrow) was seen in the center of the exposed chest wall Fig. 2 Computed tomography (CT) of the chest. A CT just before her first visit to our hospital showed multiple lung nodules. The largest lesion (asterisk) involved the right pulmonary hilum, causing stenosis of the bronchus intermedius (arrow). B Bevacizumab and paclitaxel therapy brought about marked regression of the lung metastatic foci and improvement of the bronchial stenosis (arrow) Fig. 3 Post-operative local findings. A Skin defect was well covered with the latissimus dorsi musculocutaneous (LD-MC) flap. B Partial flap necrosis was observed in the distal part of the LD-MC flap. C Three months after operation, despite the large skin defect, no ribs and intercostal muscles were observed. D Eight months after operation, the skin defect became much smaller. E Eleven months after operation, complete skin healing was finally observed
| 3.919922
| 0.979492
|
sec[1]/p[0]
|
en
| 0.999996
|
37428338
|
https://doi.org/10.1186/s40792-023-01711-x
|
[
"breast",
"skin",
"flap",
"lung",
"chest",
"defect",
"tumor",
"cancer",
"necrotic",
"pain"
] |
[
{
"code": "GB23",
"title": "Certain specified disorders of breast"
},
{
"code": "GB21.Z",
"title": "Inflammatory disorders of breast, unspecified"
},
{
"code": "GB21.Y",
"title": "Other specified inflammatory disorders of breast"
},
{
"code": "QF01.0",
"title": "Acquired absence of breast"
},
{
"code": "GB23.3",
"title": "Atrophy of breast"
},
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "ME66.Y",
"title": "Other specified skin changes"
},
{
"code": "EM0Y",
"title": "Other specified diseases of the skin"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "ME66.1",
"title": "Changes in skin texture"
}
] |
=== ICD-11 CODES FOUND ===
[GB23] Certain specified disorders of breast
Definition: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere.
Also known as: Certain specified disorders of breast | disease of breast | mastopathy
[GB21.Z] Inflammatory disorders of breast, unspecified
Also known as: Inflammatory disorders of breast, unspecified | Inflammatory disorders of breast | breast inflammation | inflammatory breast disease | mastitis NOS
[GB21.Y] Other specified inflammatory disorders of breast
Also known as: Other specified inflammatory disorders of breast | Breast antibioma | Infective mastitis | acute infective mastitis | nonpuerperal infective mastitis
[QF01.0] Acquired absence of breast
Also known as: Acquired absence of breast | absence of breast | mastectomy status | Acquired absence of breast, partial | Acquired absence of breast, total
[GB23.3] Atrophy of breast
Definition: A condition of the breast, caused by apoptosis of the cells commonly due to prolonged estrogen reduction, diminished cellular proliferation, decreased cellular volume, decreased function, ischaemia, malnutrition, disease, or mutation. This condition is characterised by a partial or complete decrease in size and function of the breast tissue.
Also known as: Atrophy of breast | Hypoplasia of breast | hypoplastic breast | mammary hypoplasia
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[ME66.Y] Other specified skin changes
Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta
[EM0Y] Other specified diseases of the skin
Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures
[ME60.Z] Skin lesion of unspecified nature
Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature
[ME66.1] Changes in skin texture
Definition: Alterations in skin texture of unspecified cause.
Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis
=== GRAPH WALKS ===
--- Walk 1 ---
[GB23] Certain specified disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....
--PARENT--> [?] Disorders of breast
Def: Any disorder characterised by pathological changes to the breast or breast tissue....
--CHILD--> [GB21] Inflammatory disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....
--- Walk 2 ---
[GB23] Certain specified disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....
--RELATED_TO--> [?] Other signs or symptoms in breast
Def: Any sign or symptom of the breast, not classified elsewhere....
--CHILD--> [?] Nipple discharge
--- Walk 3 ---
[GB21.Z] Inflammatory disorders of breast, unspecified
--PARENT--> [GB21] Inflammatory disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....
--CHILD--> [GB21.0] Breast abscess
Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...
--- Walk 4 ---
[GB21.Z] Inflammatory disorders of breast, unspecified
--PARENT--> [GB21] Inflammatory disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....
--RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth
--- Walk 5 ---
[GB21.Y] Other specified inflammatory disorders of breast
--PARENT--> [GB21] Inflammatory disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....
--CHILD--> [GB21.0] Breast abscess
Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...
--- Walk 6 ---
[GB21.Y] Other specified inflammatory disorders of breast
--PARENT--> [GB21] Inflammatory disorders of breast
Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....
--CHILD--> [GB21.Y] Other specified inflammatory disorders of breast
|
[
"[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --PARENT--> [?] Disorders of breast\n Def: Any disorder characterised by pathological changes to the breast or breast tissue....\n --CHILD--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....",
"[GB23] Certain specified disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by pathological changes, not classified elsewhere....\n --RELATED_TO--> [?] Other signs or symptoms in breast\n Def: Any sign or symptom of the breast, not classified elsewhere....\n --CHILD--> [?] Nipple discharge",
"[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.0] Breast abscess\n Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...",
"[GB21.Z] Inflammatory disorders of breast, unspecified\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --RELATED_TO--> [?] Nonpurulent mastitis associated with childbirth",
"[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.0] Breast abscess\n Def: A condition of the breast, caused by inflammation due to infection with a bacterial or parasitic host, or contact with other foreign materials. This condition is characterised by a focal accumulation ...",
"[GB21.Y] Other specified inflammatory disorders of breast\n --PARENT--> [GB21] Inflammatory disorders of breast\n Def: Any disorder of the breast or breast tissue, characterised by inflammatory effects, pain, heat, redness, swelling, and loss of function....\n --CHILD--> [GB21.Y] Other specified inflammatory disorders of breast"
] |
GB23
|
Certain specified disorders of breast
|
[
{
"from_icd11": "GB23",
"icd10_code": "N6459",
"icd10_title": "Other signs and symptoms in breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N6489",
"icd10_title": "Other specified disorders of breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N6481",
"icd10_title": "Ptosis of breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N6482",
"icd10_title": "Hypoplasia of breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N6452",
"icd10_title": "Nipple discharge"
},
{
"from_icd11": "GB23",
"icd10_code": "N6451",
"icd10_title": "Induration of breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N6453",
"icd10_title": "Retraction of nipple"
},
{
"from_icd11": "GB23",
"icd10_code": "N64",
"icd10_title": "Other disorders of breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N648",
"icd10_title": "Other specified disorders of breast"
},
{
"from_icd11": "GB23",
"icd10_code": "N645",
"icd10_title": "Other signs and symptoms in breast"
},
{
"from_icd11": "GB21.Z",
"icd10_code": "N610",
"icd10_title": "Mastitis without abscess"
},
{
"from_icd11": "GB21.Z",
"icd10_code": "N611",
"icd10_title": "Abscess of the breast and nipple"
},
{
"from_icd11": "GB21.Z",
"icd10_code": "N61",
"icd10_title": "Inflammatory disorders of breast"
},
{
"from_icd11": "QF01.0",
"icd10_code": "Z9012",
"icd10_title": "Acquired absence of left breast and nipple"
},
{
"from_icd11": "QF01.0",
"icd10_code": "Z9011",
"icd10_title": "Acquired absence of right breast and nipple"
}
] |
N6459
|
Other signs and symptoms in breast
|
We herein describe a 17-year old female hospitalized for a history of fever, asthenia, cough, anorexia, abdominal pain, and vomiting. The patient has a positive familial history for autoimmune disorders (inflammatory bowel diseases, connective tissue diseases, and multiple sclerosis). She had paucisymptomatic SARS-CoV-2 infection approximately 1 year before this episode, and was vaccinated with two doses of anti-SARS-CoV-2 mRNA vaccine (Comirnaty), performed 5 and 4 months before hospitalization, respectively, and resulting in a detectable immune response (anti-spike protein antibodies 2,139.6 U/mL, reference value <50 U/mL). She had a high-risk contact (more than 6 h, without protective face mask) with a SARS-CoV-2 positive patients 10 days before hospitalization. At admission, mild splenomegaly was evidenced and laboratory exams showed neutrophilic leukocytosis, elevation of inflammatory markers (erythrocyte sedimentation rate 85 mm/h, reference value <25, C-reactive protein 8.35 mg/dL, and reference value <0.5), transaminases, total and direct bilirubin, and a nasal swab for SARS-CoV-2 identification resulted negative. Chest X -ray and abdomen ultrasound resulted normal. During the following days, the fever persisted and she developed bilateral, non-exudative conjunctivitis, cutaneous erythematosus rash at lower limbs and mild hepatomegaly associated with the worsening of abdominal pain, mostly localized in right hypochondrium. Laboratory examinations showed progressive leukopenia ( Table 1 ), worsening of hypertransaminasemia and hyperbilirubinemia, progressive reduction of serum albumin levels, and elevation of D-dimer. Markers of hemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS) were also measured, including ferritin, lactate dehydrogenase, triglycerides, resulting not suitable with this condition. Particularly, the highest ferritin value was 419 μg/L (reference value 30–400), and triglycerides, fibrinogen, and LDH values were within the normal range [triglycerides 180 mg/dL (reference value <200), fibrinogen 308 mg/dL (reference value 200–400), and LDH 151 U/L (reference value <214)]. Microbiological work-up included blood, urine and stool bacterial cultures, and viral serologies and PCR for pathogens associated with infectious hepatitis (Epstein-Barr virus, Cytomegalovirus, Hepatitis A, B, and C virus). Serologic testing for autoimmune hepatitis, cholangitis, and systemic connective tissue diseases were also performed and resulted negative, with the exception of a positivity for antinucleous antibodies (1:160). A peripheral blood smear resulted negative for the presence of schistocytes or atypical cells, and a first-level immunological assessment (serum immunoglobulin and subclasses, lymphocyte subpopulation) did not evidence findings suggestive for an immunodeficiency. To investigate the worsening abdominal pain, a computed tomography (CT) was performed, evidencing hepatomegaly and mild edema in the gallbladder wall, in absence of biliary obstruction. A chest CT showed multiple nodular areas involving both the lungs, and mostly represented in the basal segments . Also, mild pericardial effusion was evidenced. Echocardiography did not evidence anatomical or functional abnormalities, and serum troponin and BNP resulted normal. Meanwhile, the general conditions of the patient continued worsening, and she also presented a hand acral vasculitis that spontaneously resolved after 24 h. On the basis of the clinical picture of multisystemic involvement (fever, hepato-splenomegaly, hypoalbuminemia, pulmonary nodular involvement, conjunctivitis, erythematous rash, acral vasculitis, and raised inflammatory markers) and the history of recent exposure to SARS-CoV-2, the diagnosis of MIS-C was posed, according to the World Health Organization (WHO) and center for disease control and prevention (CDC) diagnostic criteria ( 5 ). Consequently, the patient was treated with intravenous immunoglobulin (IVIG) at a cumulative dose of 2 g/Kg divided into five administrations and accompanied by oral prednisone 1 mg/Kg daily and subcutaneous heparin 100 U/Kg daily. The introduction of treatment was rapidly followed by the resolution of fever, improvement of the general condition, and normalization of the inflammatory markers, while transaminases continued to increase. A week after the introduction of treatment, she presented a relapse of the abdominal pain, associated with elevation of amylase and lipase, and the patient underwent a chest and abdomen CT, that showed a marked improvement of the pulmonary radiologic findings and features consistent with hepatitis and pancreatitis. In the following days, she continued the corticosteroid therapy and received parenteral nutrition for 2 days, resulting in a progressive resolution of the clinical and laboratory picture. The diagnostic work-up was completed by abdomen magnetic resonance which excluded the presence of cholelithiasis and showed a moderate peri-portal inflammatory infiltrate without signs of bile ducts damage. After 30 days of hospitalization, the patient was discharged in good general conditions, without clinical and laboratory evidence of organ involvement, and negative inflammatory markers.
| 4.191406
| 0.961426
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC9149168
|
https://doi.org/10.3389/fped.2022.896903
|
[
"reference",
"inflammatory",
"sars",
"markers",
"resulted",
"fever",
"abdominal",
"pain",
"laboratory",
"hepatitis"
] |
[
{
"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": "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 ===
[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
[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 ---
[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--> [6B22.1] Olfactory reference disorder with poor to absent insight
Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...
--- Walk 3 ---
[MB26.03] Delusion of reference
Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....
--PARENT--> [MB26.0] Delusion
Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...
--CHILD--> [MB26.01] Delusion of being controlled
Def: A delusion that involves an external force or person controlling one's feelings, impulses, thoughts, or behaviour....
--- Walk 4 ---
[MB26.03] Delusion of reference
Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....
--PARENT--> [MB26.0] Delusion
Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...
--PARENT--> [MB26] Symptoms or signs involving content of thought
Def: Symptoms and signs involving content of thought include delusions, experiences of influence, passivity, and control, grandiosity, homicidal ideation, identity disturbance, obsessions, overvalued ideas...
--- Walk 5 ---
[6B22.1] Olfactory reference disorder with poor to absent insight
Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.1] Olfactory reference disorder with poor to absent insight
Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...
--- Walk 6 ---
[6B22.1] Olfactory reference disorder with poor to absent insight
Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...
--PARENT--> [6B22] Olfactory reference disorder
Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...
--CHILD--> [6B22.0] 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--> [6B22.1] Olfactory reference disorder with poor to absent insight\n Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...",
"[MB26.03] Delusion of reference\n Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....\n --PARENT--> [MB26.0] Delusion\n Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...\n --CHILD--> [MB26.01] Delusion of being controlled\n Def: A delusion that involves an external force or person controlling one's feelings, impulses, thoughts, or behaviour....",
"[MB26.03] Delusion of reference\n Def: A delusion that events, objects, or other people in the person's immediate environment have a particular and unusual personal significance, usually of a negative or pejorative nature....\n --PARENT--> [MB26.0] Delusion\n Def: A belief that is demonstrably untrue or not shared by others, usually based on incorrect inference about external reality. The belief is firmly held with conviction and is not, or is only briefly, sus...\n --PARENT--> [MB26] Symptoms or signs involving content of thought\n Def: Symptoms and signs involving content of thought include delusions, experiences of influence, passivity, and control, grandiosity, homicidal ideation, identity disturbance, obsessions, overvalued ideas...",
"[6B22.1] Olfactory reference disorder with poor to absent insight\n Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.1] Olfactory reference disorder with poor to absent insight\n Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...",
"[6B22.1] Olfactory reference disorder with poor to absent insight\n Def: All definitional requirements of olfactory reference disorder are met. Most or all of the time, the individual is convinced that the disorder-specific beliefs are true and cannot accept an alternative...\n --PARENT--> [6B22] Olfactory reference disorder\n Def: Olfactory Reference Disorder is characterised by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only sl...\n --CHILD--> [6B22.0] 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": "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"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M13869",
"icd10_title": "Other specified arthritis, unspecified knee"
},
{
"from_icd11": "FA2Z",
"icd10_code": "M1388",
"icd10_title": "Other specified arthritis, other site"
}
] |
F428
|
Other obsessive-compulsive disorder
|
We present four cases of children and adolescents with complicated psychiatric and neurologic symptomatology, evaluated at a large tertiary medical center, in whom autoimmune encephalitis was suspected and treatment was initiated. These cases were diagnostically challenging, with negative autoantibody panels, normal or inconclusive MRI results, non-specific CSF changes, and no tissue testing (either via immunochemistry in brain tissue or a neuronal cell culture). All received immunosuppressive and/or immunomodulatory treatments for autoimmune encephalitis based solely on clinical symptomatology. Table 1 summarizes each case, specific testing and outcome. Figure 1 describes the laboratory-specific autoantibody testing performed in serum and spinal fluid at our institution. Additional file 1 provides a method description of Mayo Clinic laboratory testing for autoimmune encephalopathy- evaluation, for cerebrospinal fluid and serum samples. The cases demonstrate both a need for better understanding of pediatric autoantibody-negative encephalitis, and also the importance of applying clinical guidelines to diagnosis and treatment, especially in cases where the diagnosis is not clear. Table 1 Summary of physical, laboratory, imaging findings, treatment and outcomes for 4 cases of suspected autoimmune encephalitis. Clinical features suggestive of autoimmune encephalitis are bolded Case 1 2 3 4 Age in years/sex 13/M 17/F 9/F 17/M Symptom duration 8 months 3 months 1 year 6 months Physical symptoms Anorexia Motor slowing Slow, ataxic gait Abnormal movements of lip/tongue Mutism Food refusal Dizziness Autonomic instability Headaches Abdominal pain Emesis Urinary retention Vibratory tactile sensation in head Dysphagia Constipation Periods of confusion Disorientation Decreased speech fluency Language regression Nonsensical speech Decreased movements Decreased speech Soft, scripted speech Staring spells Fatigue Psychiatric symptoms Social isolation Catatonia Memory difficulties Decline in academic performance Social isolation Anxiety Panic attacks Agitation Insomnia Paranoia Inappropriate laughter Talking to imaginary friends Disengagement in school Aggression Defiance Social Isolation Visual hallucinations Paranoia Disorganized behavior Decreased attention and concentration Social isolation Not caring for self Auditory and visual hallucinations Talking to self Irritability Difficulties with multistep commands Increased sleep Family History of autoimmune disease None None Father with multiple sclerosis Paternal aunt with Myasthenia Gravis None Serum and urine Mildly elevated GAD65 antibody (0.15 nmol/L), otherwise unremarkable including rest of encephalopathy panel, electrolytes including calcium (with exception of low phosphorus), folate, B12, Lyme serology, herpes simplex, enterovirus, cryptococcus, VDRL, whole exome sequencing Mildly elevated GAD65 antibody (0.15 nmol/L), otherwise unremarkable including CBC, electrolytes, thyroid function, liver function, C-reactive protein, B12, ceruloplasmin, toxicology, heavy metals, blood smear, urinalysis Unremarkable including outside hospital testing CBC, CMP, inflammatory markers, thyroid studies, ammonia, folate, copper, ceruloplasmin, heavy metals, plasma amino acids, urine organic acids, very long chain fatty acids, lysosomal disorders screen, chromosomal microarray, Noonan panel. Repeat inpatient testing unremarkable Unremarkable except for low ferritin (12 mcg/L), including toxicology screen, CBC, electrolytes, inflammatory markers, thyroid function MRI Unremarkable other than evidence of malnutrition Slit third ventricle with narrowed lateral ventricles, no cerebral hypotension and diffuse changes consistent with perinatal insult Unremarkable Unremarkable CSF Mildly elevated protein (45 mg/dL), otherwise unremarkable; no presence of bands Total protein elevated (144 mg/dL; 110 mg/dL 6 months later); no presence of bands Unremarkable; no presence of bands Positive GFAP antibodies from outside hospital, repeat negative; no presence of bands EEG Unremarkable Unremarkable Intermittent diffuse nonspecific bifrontal slowing, bifrontal spikes and sharp waves without clinical correlate, intermittent independent left/right temporal slowing Mild nonspecific background slowing Treatment with IVIG or corticosteroids 5 days IV methylprednisolone; 5 days IVIG then monthly infusions for 3 months 5 days IVIG then intermittent doses; 5 days methylprednisolone upon readmission 3 days high dose IV methylprednisolone then oral prednisone; single dose IVIG then twice-weekly IVIG, then monthly IVIG; rituximab 5 days IV methylprednisolone Response Improved over time Initial significant improvement, not sustained with both treatment course. Return to baseline after neurosurgical intervention Some initial improvement in mood, speech, social interactions; not sustained Initial improvement, not sustained Fig. 1 Summary of autoantibody testing in serum and spinal fluid in Mayo Clinic’s autoimmune encephalopathy panels with reference values in brackets. Test details and references obtained from Mayo Clinic Laboratory Test Catalog, https://www.mayocliniclabs.com/testcatalog/Overview/92116 . (*Denotes testing completed in serum but not in spinal fluid)
| 4.230469
| 0.731445
|
sec[0]/p[4]
|
en
| 0.999997
|
32013931
|
https://doi.org/10.1186/s12883-020-1605-y
|
[
"unremarkable",
"testing",
"autoimmune",
"ivig",
"cases",
"encephalitis",
"serum",
"speech",
"social",
"including"
] |
[
{
"code": "QA40",
"title": "Pregnancy examination or test"
},
{
"code": "QA00.6Z",
"title": "Examination of eyes or vision, unspecified"
},
{
"code": "QA00.7",
"title": "Examination of ears and hearing"
},
{
"code": "QA00.A",
"title": "Skin or other sensitisation tests"
},
{
"code": "QA3Y",
"title": "Contact with health services for other specified procreative management"
},
{
"code": "4A4Z",
"title": "Nonorgan specific systemic autoimmune disorders, unspecified"
},
{
"code": "4A01.21",
"title": "Immune dysregulation syndromes presenting primarily with autoimmunity"
},
{
"code": "8E4A.0",
"title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord"
},
{
"code": "9A75",
"title": "Autoimmune keratitis"
},
{
"code": "DA96.0Y",
"title": "Other specified intestinal malabsorption"
}
] |
=== ICD-11 CODES FOUND ===
[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
[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
[QA00.7] Examination of ears and hearing
Also known as: Examination of ears and hearing | examination of ear | hearing examination | hearing test
[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
[QA3Y] Contact with health services for other specified procreative management
Also known as: Contact with health services for other specified procreative management | Procreative investigation or testing | procreative test | Fallopian tube insufflation | Sperm count for procreative test
[4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified
Also known as: Nonorgan specific systemic autoimmune disorders, unspecified | systemic autoimmune disease | systemic collagen vascular disease | systemic vascular disease | autoimmune disease NOS
[4A01.21] Immune dysregulation syndromes presenting primarily with autoimmunity
Also known as: Immune dysregulation syndromes presenting primarily with autoimmunity | Syndrome with autoimmunity | Immunodeficiency syndromes presenting primarily with autoimmunity | FADD-related immunodeficiency | X-linked immune dysregulation – polyendocrinopathy – enteropathy
[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord
Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem
Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis
[9A75] Autoimmune keratitis
Also known as: Autoimmune keratitis | Autoimmune interstitial keratitis | Peripheral ulcerative keratitis
[DA96.0Y] Other specified intestinal malabsorption
Also known as: Other specified intestinal malabsorption | Certain intestinal malabsorption | Autoimmune enteropathy | Structural enterocyte defects due to other diseases | Collagenous sprue
=== GRAPH WALKS ===
--- Walk 1 ---
[QA40] Pregnancy examination or test
--PARENT--> [?] Contact with health services for reasons associated with reproduction
--RELATED_TO--> [?] Contact with health services for preimplantation genetic screening
Def: A reason for encounter to genetically profile oocytes, zygotes, or embryos through in vitro fertilization prior to implantation for screening of chromosomes for aneuploidy, mutation, or DNA rearrangem...
--- Walk 2 ---
[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....
--- Walk 3 ---
[QA00.6Z] Examination of eyes or vision, unspecified
--PARENT--> [QA00.6] Examination of eyes or vision
--EXCLUDES--> [?] Examination for driving license
--- Walk 4 ---
[QA00.6Z] Examination of eyes or vision, unspecified
--PARENT--> [QA00.6] Examination of eyes or vision
--EXCLUDES--> [?] Examination for driving license
--- Walk 5 ---
[QA00.7] Examination of ears and hearing
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--EXCLUDES--> [?] Special screening examination for neoplasms
--- Walk 6 ---
[QA00.7] Examination of ears and hearing
--PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis
--CHILD--> [QA00.0] General adult medical examination
Def: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult....
|
[
"[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 screening\n Def: A reason for encounter to genetically profile oocytes, zygotes, or embryos through in vitro fertilization prior to implantation for screening of chromosomes for aneuploidy, mutation, or DNA rearrangem...",
"[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....",
"[QA00.6Z] Examination of eyes or vision, unspecified\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license",
"[QA00.6Z] Examination of eyes or vision, unspecified\n --PARENT--> [QA00.6] Examination of eyes or vision\n --EXCLUDES--> [?] Examination for driving license",
"[QA00.7] Examination of ears and hearing\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --EXCLUDES--> [?] Special screening examination for neoplasms",
"[QA00.7] Examination of ears and hearing\n --PARENT--> [QA00] General examination or investigation of persons without complaint or reported diagnosis\n --CHILD--> [QA00.0] General adult medical examination\n Def: Encounter for periodic examination (annual) (physical) and any associated laboratory and radiologic examinations on adult...."
] |
QA40
|
Pregnancy examination or test
|
[
{
"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": "QA00.6Z",
"icd10_code": "Z010",
"icd10_title": "Encounter for examination of eyes and vision"
},
{
"from_icd11": "QA00.7",
"icd10_code": "Z011",
"icd10_title": "Encounter for examination of ears and hearing"
},
{
"from_icd11": "QA00.A",
"icd10_code": "Z015",
"icd10_title": ""
},
{
"from_icd11": "4A4Z",
"icd10_code": "M358",
"icd10_title": "Other specified systemic involvement of connective tissue"
},
{
"from_icd11": "4A4Z",
"icd10_code": "M359",
"icd10_title": "Systemic involvement of connective tissue, unspecified"
},
{
"from_icd11": "4A4Z",
"icd10_code": "M368",
"icd10_title": "Systemic disorders of connective tissue in other diseases classified elsewhere"
},
{
"from_icd11": "4A4Z",
"icd10_code": "M30-M36",
"icd10_title": ""
},
{
"from_icd11": "4A4Z",
"icd10_code": "M35",
"icd10_title": "Other systemic involvement of connective tissue"
},
{
"from_icd11": "4A4Z",
"icd10_code": "M36",
"icd10_title": "Systemic disorders of connective tissue in diseases classified elsewhere"
}
] |
Z3201
|
Encounter for pregnancy test, result positive
|
Nine months after the accident the athlete shows a persisting atrophy of the brachialis muscle and a decreased sensibility in the region of the clavicle part of the deltoid muscle, whereas before the operation he also felt a decreased sensibility in the radial part of the forearm. This suggests a lesion of the brachial plexus caused by the two clavicle fragments, indicated with the arrows involving both, the motor and sensory branches of the musculocutaneous nerve. In most cases, palsies of the brachial plexus are the result of a high-energy trauma leading to traction-injuries associated with an acute onset of the symptoms and poor prognosis, whereas the presence of a clavicle fracture in such cases is much less important. In 1991, Della Santa described, that only 1% of brachial plexus injuries are caused by bone fragments after a clavicle fracture. We assume that in this case both - the sensible as well as the motoric - parts of the musculocutaneus nerve as well as the sensible part of the axillaris nerve were hurt by the clavicle fragments, whereas the sensible part of the musculocutaneus nerve convalesced in the meantime. Therefore, this case report shows an incident with a very rare outcome. The underlying mechanism for this kind of injury was described by Auzou et al. in 2000 and also Rumball et al. described the onset of brachial plexus palsy after a few days after a displaced clavicle fracture. Other possibilities for the appearance of the symptoms and especially for the delayed onset could be compression from hypertrophic callus or nonunion. Additionally, also cases of secondary brachial plexus palsies after direct compression by a bone fragment have been reported by Reichenbacher and Siebler. The persistent deficiency of the motoric part of the musculocutaneous nerve explains the atrophy of the brachialis muscle the athlete observed. A hyposensitivity in the region of the deltoid muscle is the result of a lesion in the sensible part of the axillar nerve. Anatomically, the musculocutaneous nerve originates from the lateral cord of the brachial plexus and the axillar nerve from the posterior cord, respectively. Miller et al. as well as Della Santa et al. showed that most frequently the medial and the posterior cord of the plexus brachialis are involved in such injuries. This agrees with the involvement of the axillar nerve, but not with the involvement of the musculocutaneous nerve, leading to the conclusion, that the athlete described in this case reports suffers from an even more rarely manifestation of coincidence of clavicle fracture and plexus brachialis injury. Based on the success of the healing process the athlete has displayed so far, and also on the neurologist's expert opinion, we assume that he has a good chance of a further recovery of his neurological function. The athlete first tried his old figure-of-eight dressing as a self-treatment and later he decided on an intramedullary nailing after he was advised to have the displaced fracture being fixed. A study of the Canadian Orthopedic Trauma Society in 2007 showed that an operative treatment of clavicle fractures using plate fixation is better than a non-operative treatment regarding to non-union, mal-union and cosmetic aspects. Similar results have been found by Jubel et al. in 2005 for intramedullary nailing and Zlowodzki et al. showed in 2005 that conservative treatment of a displaced clavicle fracture leads to a higher number of pseudarthrosis than an operative treatment, whereas the results were independent of the surgical method. Even if Pieske et al. could show in their survey-based study in 2008 that the outcome of an operative-treated displaced clavicle fracture is always better than that of a conservatively-treated one, and that intramedullary nailing should be the surgical method of choice. Debates still exist regarding which is the superior fixation method for clavicular fractures and thus each individual should be evaluated independently based on its requirements and wishes. The patient should be the center of the decision-making process, and the attending doctor has to base his decision on the demands of the patient. In this case one of the athlete's most important aims was to be able to continue his training and to participate in competitions again, as soon as possible. Considering the athlete's wishes as well as his general condition and compliance, a treatment with medullary nailing was certainly indicated and was the method of choice. Along with the result that intramedullary nailing is the best available treatment for displaced clavicle fractures, Pieske et al. could also show that despite of the frequency and, additionally, the large variation of clavicle fractures there is still no standardized classification on hand. According to the classification system suggested by Pieske et al. the athlete suffered a type A-3 fracture, which means it was a single, midshaft clavicle fracture without any existing contact between the fracture fragments (see Additional File 1 ). Ultimately an X-Ray in two planes is the gold standard for rating the type as well as degree of dislocation of a midshaft clavicle fracture, and thus should always be carried out to evaluate any further steps.
| 4.375
| 0.643555
|
sec[2]/p[0]
|
en
| 0.999998
|
21961883
|
https://doi.org/10.1186/1749-7221-6-7
|
[
"clavicle",
"that",
"fracture",
"nerve",
"athlete",
"plexus",
"this",
"part",
"brachial",
"well"
] |
[
{
"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"
},
{
"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 ===
[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
[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 ---
[LB72.Y] Other specified structural developmental anomalies of shoulder girdle
--PARENT--> [LB72] Structural developmental anomalies of shoulder girdle
Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....
--CHILD--> [LB72.2] Deformation of scapula
--- Walk 2 ---
[LB72.Y] Other specified structural developmental anomalies of shoulder girdle
--PARENT--> [LB72] Structural developmental anomalies of shoulder girdle
Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....
--CHILD--> [LB72.2] Deformation of scapula
--- Walk 3 ---
[FB86.11] Hypertrophy of bone
--PARENT--> [FB86.1] Bone hyperplasias
--PARENT--> [FB86] Disorders associated with bone growth
--- Walk 4 ---
[FB86.11] Hypertrophy of bone
--PARENT--> [FB86.1] Bone hyperplasias
--RELATED_TO--> [?] Ankylosing hyperostosis
--- Walk 5 ---
[ME85] Stiffness of joint
Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....
--PARENT--> [?] Symptoms or signs of the musculoskeletal system
--PARENT--> [?] Symptoms, signs or clinical findings of the musculoskeletal system
--- Walk 6 ---
[ME85] Stiffness of joint
Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....
--PARENT--> [?] Symptoms or signs of the musculoskeletal system
--RELATED_TO--> [?] Abnormality of tonus or reflex
|
[
"[LB72.Y] Other specified structural developmental anomalies of shoulder girdle\n --PARENT--> [LB72] Structural developmental anomalies of shoulder girdle\n Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....\n --CHILD--> [LB72.2] Deformation of scapula",
"[LB72.Y] Other specified structural developmental anomalies of shoulder girdle\n --PARENT--> [LB72] Structural developmental anomalies of shoulder girdle\n Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....\n --CHILD--> [LB72.2] Deformation of scapula",
"[FB86.11] Hypertrophy of bone\n --PARENT--> [FB86.1] Bone hyperplasias\n --PARENT--> [FB86] Disorders associated with bone growth",
"[FB86.11] Hypertrophy of bone\n --PARENT--> [FB86.1] Bone hyperplasias\n --RELATED_TO--> [?] Ankylosing hyperostosis",
"[ME85] Stiffness of joint\n Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....\n --PARENT--> [?] Symptoms or signs of the musculoskeletal system\n --PARENT--> [?] Symptoms, signs or clinical findings of the musculoskeletal system",
"[ME85] Stiffness of joint\n Def: Lack of range of motion of a joint secondary to pain, disease process or congenital malformation not detailed in or used in conjunction with other codes....\n --PARENT--> [?] Symptoms or signs of the musculoskeletal system\n --RELATED_TO--> [?] Abnormality of tonus or reflex"
] |
LB72.Y
|
Other specified structural developmental anomalies of shoulder girdle
|
[
{
"from_icd11": "FB86.11",
"icd10_code": "M89351",
"icd10_title": "Hypertrophy of bone, right femur"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89361",
"icd10_title": "Hypertrophy of bone, right tibia"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M8938",
"icd10_title": "Hypertrophy of bone, other site"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89371",
"icd10_title": "Hypertrophy of bone, right ankle and foot"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89363",
"icd10_title": "Hypertrophy of bone, right fibula"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89333",
"icd10_title": "Hypertrophy of bone, right radius"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M89362",
"icd10_title": "Hypertrophy of bone, left tibia"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M8930",
"icd10_title": "Hypertrophy of bone, unspecified site"
},
{
"from_icd11": "FB86.11",
"icd10_code": "M893",
"icd10_title": "Hypertrophy of bone"
},
{
"from_icd11": "ME85",
"icd10_code": "M25661",
"icd10_title": "Stiffness of right knee, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M2560",
"icd10_title": "Stiffness of unspecified joint, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25662",
"icd10_title": "Stiffness of left knee, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25642",
"icd10_title": "Stiffness of left hand, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25621",
"icd10_title": "Stiffness of right elbow, not elsewhere classified"
},
{
"from_icd11": "ME85",
"icd10_code": "M25612",
"icd10_title": "Stiffness of left shoulder, not elsewhere classified"
}
] |
M89351
|
Hypertrophy of bone, right femur
|
Our patient is a 32-year old white female patient who underwent surgery for multinodular goiter in 2006. During surgery, a papillary thyroid carcinoma had been detected (final histology: pT2, pN0, R0). Therefore, extensive neck dissection with total thyroidectomy was necessary leading to removal of all four parathyroid glands. Severe chronic postsurgical hypoparathyroidism developed rapidly. Despite optimal medical treatment with high doses of oral calcium (3 g/day), cholecalciferol and calcitriol (2.0–3.75 μg/day) her calcium level remained low (6.25 mg/dl; normal 8.6–10.6 mg/dl) causing intolerable clinical hypocalcemic symptoms including tetany and paresthesias. Moreover, the patient frequently required hospitalization for i.v. calcium administration. Five years after thyroid surgery additional hormonal replacement therapy with parathyroid hormone PTH (1–84) was started (subcutaneous injection: 100 μg/day). However, the patient’s symptoms improved transiently for only three months. Altogether the quality of life was considered very low. Thus, allotransplantation of parathyroid glands for (definitive) treatment of persistent symptomatic and refractory hypocalcemia seemed an attractive therapeutic option. Despite of the potential risks associated with lifelong immunosuppressive therapy it was the distinct will of the patient to undergo the allotransplantation procedure. The patient’s 31-year old healthy brother expressed interest to be evaluated as a potential donor. He was ABO compatible to the recipient with no history of any relevant diseases and considered a suitable donor. Importantly, preoperative calcium and PTH-levels were within the normal range (Table 1 ). By using contrast-enhanced ultrasonography (CEUS) , three parathyroid glands (one left superior, one left inferior, one right inferior) could exactly be localized preoperatively . Importantly, the Hospital Living-Donation Committee as well as the Hospital Ethics Committee approved the planned operative procedure. After removing the two left parathyroid glands from the donor through an unilateral horizontal anterior neck incision and histological confirmation by frozen section the parathyroid tissue was fragmented into approximately 20 small particles and implanted in the recipient’s left forearm brachioradialis muscle. Based on the the immunosuppressive therapy regimen for kidney transplantation, immunosuppression was initiated during surgery before implantation of parathyroid tissue by prednisolone i.v. (500 mg) and a perioperative single dose of basiliximab (20 mg). Additionally, oral application of tacrolimus was started six hours after surgery. Tacrolimus trough levels were maintained in the 10–12 ng/ml range. On day five after surgery, the patient received a second dose of basiliximab i.v. (20 mg). Prednisolone was reduced in a stepwise fashion to a maintenance dose of 2.5 mg per day after six months. Hormonal replacement therapy with PTH (1–84) was stopped after transplantation. Neither the donor nor the recipient experienced any surgical complications. The donor was discharged from our hospital on the second postoperative day and routine checks of calcium and PTH-levels showed normal values after surgery (Table 1 ). In the postoperative course of the recipient increasing PTH levels were detectable and thereafter remained within the normal range with a serum total PTH of 21 pg/ml (normal range: 15–65 pg/ml) nearly three years after transplantation (Table 2 ). Postoperative Casanova-Tests (venous blood samples for PTH measurement after inflation of an armlet on the graft-bearing arm) clearly verified the graft-bearing forearm as the source of increasing endogenous PTH levels after transplantation. Moreover, CEUS ten days posttransplant revealed vascularization of the allograft . The calcium levels of the recipient also returned into the normal range after parathyroid allotransplantation (Table 2 ). Consequently the former replacement therapy (calcium and vitamin D) could be discontinued stepwise completely and was stopped on day 16 after the transplantation. Six months posttransplant another Casanova-Test verified the functioning graft (PTH-level before and after compression of the graft-bearing forearm: 41 pg/ml and 5.9 pg/ml respectively). The patient remained free of hypocalcemic symptoms to the present day after a follow-up of 35 months so far. Table 1 Serum calcium levels of the donor Months after transplant Preoperative Postoperative 3 6 12 Calcium [mg/dl] 9.2 8.8 9.2 8.4 8.8 No calcium or vitamin D supplementation; PTH within the normal range Fig. 1 Living-donor allotransplantation of parathyroid glands. a Donor: preoperative localization of the parathyroid glands by CEUS b Donor: retrieval of the parathyroid allograft c Parathyroid glands were cut into approximately 20 tissue particles of 1–2 mm size d Recipient: postsurgical examination of the vascularization of transplanted parathyroid tissue by CEUS 10 days posttransplant Table 2 PTH values and serum calcium levels posttransplant (recipient) Months after transplant 2 3 8 10 19 27 30 35 PTH [pg/ml] 22 21 24 35 17 18 17.5 21 Calcium [mg/dl] 9.6 9.6 9.2 9.6 8.4 9.2 9.6 9.2 Normal range: PTH: 15–65 pg/ml; serum calcium: 8.6–10.6 mg/dl
| 4.09375
| 0.969238
|
sec[1]/p[0]
|
en
| 0.999998
|
27488573
|
https://doi.org/10.1186/s12893-016-0165-y
|
[
"parathyroid",
"calcium",
"donor",
"glands",
"recipient",
"range",
"transplantation",
"allotransplantation",
"ceus",
"tissue"
] |
[
{
"code": "5A5Z",
"title": "Disorders of the parathyroids or parathyroid hormone system, unspecified"
},
{
"code": "5A51.0",
"title": "Primary hyperparathyroidism"
},
{
"code": "5A50.Z",
"title": "Hypoparathyroidism, unspecified"
},
{
"code": "5D42",
"title": "Postprocedural hypoparathyroidism"
},
{
"code": "NA21.0&XA1342",
"title": "Laceration of parathyroid gland"
},
{
"code": "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 ===
[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified
Also known as: Disorders of the parathyroids or parathyroid hormone system, unspecified | parathyroidal disturbance | disorder of parathyroid gland | parathyroid gland disease | parathyroid disease
[5A51.0] Primary hyperparathyroidism
Definition: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperparathyroidism usually causes hypercalcaemia by enhanced PTH actions.
Also known as: Primary hyperparathyroidism | parathyroid enlargement | Familial primary hyperparathyroidism | Hereditary primary hyperparathyroidism | Familial isolated hyperparathyroidism
[5A50.Z] Hypoparathyroidism, unspecified
Also known as: Hypoparathyroidism, unspecified | Hypoparathyroidism | deficiency of parathyroid hormone | parathyroid gland insufficiency | parathyroid insufficiency
[5D42] Postprocedural hypoparathyroidism
Definition: This refers to a postprocedural decreased function of the parathyroid glands with underproduction of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping and twitching of muscles or tetany (involuntary muscle contraction), and several other symptoms.
Also known as: Postprocedural hypoparathyroidism | absence of parathyroid gland | postoperative tetany | Parathyroprival tetany
Includes: Parathyroprival tetany
[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 ---
[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified
--PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system
Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...
--EXCLUDES--> [?] Hypocalcaemic vitamin D dependent rickets
Def: Hypocalcaemic vitamin D-dependent rickets (VDDR-I) is an early-onset hereditary vitamin D metabolism disorder characterised by severe hypocalcaemia leading to osteomalacia and rachitic bone deformatio...
--- Walk 2 ---
[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified
--PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system
Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...
--CHILD--> [5A51] Hyperparathyroidism
Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...
--- Walk 3 ---
[5A51.0] Primary hyperparathyroidism
Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...
--PARENT--> [5A51] Hyperparathyroidism
Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...
--EXCLUDES--> [?] Adult osteomalacia
Def: A disease characterised by defects in bone mineralization and bone softening secondary to vitamin D deficiency....
--- Walk 4 ---
[5A51.0] Primary hyperparathyroidism
Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...
--PARENT--> [5A51] Hyperparathyroidism
Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...
--EXCLUDES--> [?] Vitamin D deficiency rickets
Def: Rickets is a disease of growing bone that is due to unmineralized matrix at the growth plates and occurs in children only before fusion of the epiphyses. There are many causes of rickets, including vi...
--- Walk 5 ---
[5A50.Z] Hypoparathyroidism, unspecified
--PARENT--> [5A50] Hypoparathyroidism
Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...
--EXCLUDES--> [?] Postprocedural hypoparathyroidism
Def: This refers to a postprocedural decreased function of the parathyroid glands with underproduction of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping an...
--- Walk 6 ---
[5A50.Z] Hypoparathyroidism, unspecified
--PARENT--> [5A50] Hypoparathyroidism
Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...
--EXCLUDES--> [?] Postprocedural hypoparathyroidism
Def: This refers to a postprocedural decreased function of the parathyroid glands with underproduction of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping an...
|
[
"[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified\n --PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system\n Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...\n --EXCLUDES--> [?] Hypocalcaemic vitamin D dependent rickets\n Def: Hypocalcaemic vitamin D-dependent rickets (VDDR-I) is an early-onset hereditary vitamin D metabolism disorder characterised by severe hypocalcaemia leading to osteomalacia and rachitic bone deformatio...",
"[5A5Z] Disorders of the parathyroids or parathyroid hormone system, unspecified\n --PARENT--> [?] Disorders of the parathyroids or parathyroid hormone system\n Def: Disorders of the parathyroids and parathyroid hormone system generally refer to conditions with inappropriate secretion and/or actions of parathyroid hormone that cause dysregulation of calcium metabo...\n --CHILD--> [5A51] Hyperparathyroidism\n Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...",
"[5A51.0] Primary hyperparathyroidism\n Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...\n --PARENT--> [5A51] Hyperparathyroidism\n Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...\n --EXCLUDES--> [?] Adult osteomalacia\n Def: A disease characterised by defects in bone mineralization and bone softening secondary to vitamin D deficiency....",
"[5A51.0] Primary hyperparathyroidism\n Def: Primary hyperparathyroidism is a condition with enhanced PTH secretion and high circulatory PTH level caused by abnormal parathyroid pathology such as adenoma, hyperplasia and cancer. Primary hyperpar...\n --PARENT--> [5A51] Hyperparathyroidism\n Def: Hyperparathyroidism refers to overproduction of parathormone and is most frequently due to a tumour in one of the parathyroid glands. It may also occur in response to low calcium levels, as encountere...\n --EXCLUDES--> [?] Vitamin D deficiency rickets\n Def: Rickets is a disease of growing bone that is due to unmineralized matrix at the growth plates and occurs in children only before fusion of the epiphyses. There are many causes of rickets, including vi...",
"[5A50.Z] Hypoparathyroidism, unspecified\n --PARENT--> [5A50] Hypoparathyroidism\n Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...\n --EXCLUDES--> [?] Postprocedural hypoparathyroidism\n Def: This refers to a postprocedural decreased function of the parathyroid glands with underproduction of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping an...",
"[5A50.Z] Hypoparathyroidism, unspecified\n --PARENT--> [5A50] Hypoparathyroidism\n Def: Hypoparathyroidism is a condition with insufficient biological actions of parathyroid hormone due to impaired secretion of parathyroid hormone or refractoriness of target tissues to parathyroid hormon...\n --EXCLUDES--> [?] Postprocedural hypoparathyroidism\n Def: This refers to a postprocedural decreased function of the parathyroid glands with underproduction of parathyroid hormone. This can lead to low levels of calcium in the blood, often causing cramping an..."
] |
5A5Z
|
Disorders of the parathyroids or parathyroid hormone system, unspecified
|
[
{
"from_icd11": "5A5Z",
"icd10_code": "E213",
"icd10_title": "Hyperparathyroidism, unspecified"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E212",
"icd10_title": "Other hyperparathyroidism"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E214",
"icd10_title": "Other specified disorders of parathyroid gland"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E215",
"icd10_title": "Disorder of parathyroid gland, unspecified"
},
{
"from_icd11": "5A5Z",
"icd10_code": "E21",
"icd10_title": "Hyperparathyroidism and other disorders of parathyroid gland"
},
{
"from_icd11": "5A51.0",
"icd10_code": "E210",
"icd10_title": "Primary hyperparathyroidism"
},
{
"from_icd11": "5A50.Z",
"icd10_code": "E209",
"icd10_title": "Hypoparathyroidism, unspecified"
},
{
"from_icd11": "5A50.Z",
"icd10_code": "E208",
"icd10_title": "Other hypoparathyroidism"
},
{
"from_icd11": "5A50.Z",
"icd10_code": "E20",
"icd10_title": "Hypoparathyroidism"
},
{
"from_icd11": "5D42",
"icd10_code": "E892",
"icd10_title": "Postprocedural hypoparathyroidism"
},
{
"from_icd11": "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"
}
] |
E213
|
Hyperparathyroidism, unspecified
|
We present a case of a Caucasian patient with chorea syndrome and cerebellar ataxia. The genetic diagnostics was performed which excluded spinocerebellar ataxia type 1, 2, 3, 6, and 17, Huntington’s disease, and FMR1 premutation. Exome sequencing using the NGS method revealed two variants, c.2395C > T and c.1349G > A, in the ERCC4 gene. NER is a mechanism responsible for DNA damage repair and occurs as a result of endogenous or exogenous factors . NER impairment is associated with the occurrence of diseases such as XP and CS, and due to the possible occurrence of many variants of these genes, different phenotypes are described. Recently, attention has been paid to the development of adult-onset neurodegeneration in connection with damage to NER mechanisms, including the occurrence of ERCC4 variants . All of them presented progressive symptoms of neurodegeneration beginning in adulthood: ataxia, chorea, and global brain atrophy. The concept of nucleotide excision repair disorders (NERDs) has recently been introduced to cover the spectrum of patients with adult-onset neurodegeneration with diagnosed NER impairment. Cordts et al., 2022 described 13 patients with NER gene variants who presented progressive neurological disorders, of which eight patients showed variants in the ERCC4 gene. In this study, it was estimated that among patients with ataxia, NER disorders occurred in 1% of patients and among patients with ataxia and cognitive disorders, NER disorders occurred in 8.6% (). ERCC4 variants have been described to be associated with autosomal recessive inheritance diseases: XP , FANCQ , CS , and XFEPS . XP is a disease characterized by hypersensitivity to the sun, the presence of sun-induced skin lesions, and a high risk of skin cancer development, usually in the first decade of life . Niraj et al. reported cases of two patients with XPF who showed signs of cerebellar ataxia, chorea syndrome, hearing loss, and global atrophy on brain MRI. One of these patients had a history of basal cell carcinoma of the skin. In both patients described in this report, the c.2395C > T variant in the ERCC4 gene was identified . Eight patients who carried variants in the ERCC4 gene were reported with adult-onset neurological deterioration. Seven patients harbored missense c.2395C > T variant in the heterozygous state . In our case, the second variant c.1349G> A has not been reported previously. Since childhood, our patient has been highly hypersensitive to solar radiation, but the oncological history remains negative. Doi et al. described the coexistence of slowly progressive cerebellar ataxia, chorea syndrome, and mild hypersensitivity to solar radiation, in association with ERCC4 gene mutation. The neurological symptoms of XP occur in 20–30% of cases, mainly in the XPF . This phenotype is often classified as CS. CS is characterized by microcephaly, significant sensitivity to the sun, and progressive neurodegeneration from the first months of life. The mean age at death is 12.5 years. Despite the similar genetic etiology, the differences in the clinical picture, including the age of the first symptoms, do not allow the patient to be diagnosed with CS. In-depth neurological diagnostics of the presented patient, apart from the highly developed chorea syndrome and cerebellar ataxia, showed significant cognitive impairment. In addition, bilateral sensory hearing loss was detected. Imaging diagnostics showed generalized brain atrophy. It is worth noting that the patient suffered from spherocytosis as a child, due to which she underwent splenectomy. Currently, she is diagnosed with macrocytic anemia due to vitamin B12 deficiency. FA is characterized by bone marrow failure, congenital anomalies, and possible sun hypersensitivity, and the patient usually dies in childhood. Apart from the abnormalities mentioned previously, no symptoms of bone marrow failure have been found in our patient so far. It is worth emphasizing that the family history remained negative. Variants in the ERCC4 gene were found in the mother and father of the proband. In addition to increasing knowledge about NERD, the current literature does not provide a description of the coexistence of the two variants, c.2395 > T and c.1349G > A, in the ERCC4 gene. Only a few cases of cerebellar ataxia have been described so far in connection with the variants of the ERCC4 gene. The patient is aware of the genetic cause of her symptoms and has been informed about a very rare phenotype, which makes it impossible to attribute the symptoms to a specific genetic syndrome. However, due to the current cognitive impairment, information about the overall health condition is communicated to her husband. Adult-onset neurodegeneration, such as ataxia, chorea, cognitive impairment, and brain atrophy, should be considered a disrupted nucleotide excision repair mechanism, which has recently been referred to as NERD . In patients with ERCC4 biallelic variants, the adult neurological phenotype can sometimes be the first symptoms and reason for access to genetic testing. The aforementioned case highlights the occurrence of rare genetic causes of progressive neurodegenerative diseases in adults, especially with the spectrum of autosomal NERD.
| 4.363281
| 0.728516
|
sec[2]/p[0]
|
en
| 0.999997
|
PMC9932026
|
https://doi.org/10.3389/fgene.2023.1107460
|
[
"patients",
"variants",
"ataxia",
"gene",
"chorea",
"genetic",
"cerebellar",
"which",
"impairment",
"neurodegeneration"
] |
[
{
"code": "PL14.C",
"title": "Patient received diagnostic test or treatment intended for another patient"
},
{
"code": "QB14",
"title": "Unavailability or inaccessibility of health care facilities"
},
{
"code": "PL14.2",
"title": "Problem associated with physical transfer of patient"
},
{
"code": "QB12.0",
"title": "Organ transplant candidate"
},
{
"code": "QA15.1",
"title": "Counselling related to sexual behaviour and orientation or sexual relationships of the person"
},
{
"code": "4A00.0Y",
"title": "Other specified functional neutrophil defects"
},
{
"code": "8A40.Y",
"title": "Other specified multiple sclerosis"
},
{
"code": "8E4A.0",
"title": "Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord"
},
{
"code": "8E01.2",
"title": "Variant Creutzfeldt-Jakob Disease"
},
{
"code": "5C56.00",
"title": "Gangliosidosis"
}
] |
=== ICD-11 CODES FOUND ===
[PL14.C] Patient received diagnostic test or treatment intended for another patient
Also known as: Patient received diagnostic test or treatment intended for another patient | wrong patient | incorrect patient
Excludes: Procedure undertaken at wrong site or wrong side, as mode of injury or harm
[QB14] Unavailability or inaccessibility of health care facilities
Also known as: Unavailability or inaccessibility of health care facilities | unavailability of medical facilities | Unavailability of outpatient clinic | Unavailability or inaccessibility of residential aged care service
Excludes: bed unavailable
[PL14.2] Problem associated with physical transfer of patient
Also known as: Problem associated with physical transfer of patient
[QB12.0] Organ transplant candidate
Also known as: Organ transplant candidate | patient waiting for organ availability | health services provided because of need for organ transplant | organ transplant candidate awaiting organ availability | person on organ transplant waiting list
[QA15.1] Counselling related to sexual behaviour and orientation or sexual relationships of the person
Also known as: Counselling related to sexual behaviour and orientation or sexual relationships of the person | advice on sexual behaviour or orientation | counselling on sexual behaviour or orientation | promiscuity counselling | patient concerned regarding sexual orientation
[4A00.0Y] Other specified functional neutrophil defects
Also known as: Other specified functional neutrophil defects | Chronic granulomatous disease | Chronic septic granulomatosis | CGD - [chronic granulomatous disease] | chronic granulomatous disorder
[8A40.Y] Other specified multiple sclerosis
Also known as: Other specified multiple sclerosis | Certain specified rare variants of multiple sclerosis | Multiple sclerosis, Marburg variant | Myelinoclastic diffuse sclerosis | Schilder disease
[8E4A.0] Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord
Definition: Paraneoplastic and autoimmune disorders of the central nervous system, brain and spinal cord nervous system result from a targeted immune attack on neurons or glial cells in the central (e.g. encephalopathy, ataxia, myelopathy, myelitis) nervous system. In the paraneoplastic context, this attack is a consequence of a potentially effective tumour immune response initiated by onco-neural antigens derived from a systemic cancer. In the non-paraneoplastic context termed ‘autoimmune’ the etiology rem
Also known as: Paraneoplastic or autoimmune disorders of the central nervous system, brain or spinal cord | Paraneoplastic encephalitis | Paraneoplastic encephalitis, neural autoantibody positive | Paraneoplastic encephalitis, neural autoantibody negative | Autoimmune encephalitis
[8E01.2] Variant Creutzfeldt-Jakob Disease
Definition: A disease of the brain, that is suspected to be caused by a prion associated with Bovine Spongiform Encephalopathy. This disease is characterised by a long incubation period, psychiatric symptoms followed by neurological deficits, and is fatal. Transmission may be by ingestion of food (with a bovine origin) contaminated with infected brain or spinal cord from an infected cow, or blood transfusion. Confirmation is by pathological examination of the brain.
Also known as: Variant Creutzfeldt-Jakob Disease | vCJD - [Variant Creutzfeldt-Jakob Disease]
[5C56.00] Gangliosidosis
Also known as: Gangliosidosis | GM1 gangliosidosis | Landing disease | GM1 gangliosidosis type 1 | Generalised gangliosidosis
=== GRAPH WALKS ===
--- Walk 1 ---
[PL14.C] Patient received diagnostic test or treatment intended for another patient
--EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm
--EXCLUDES--> [?] Patient received diagnostic test or treatment intended for another patient
--- Walk 2 ---
[PL14.C] Patient received diagnostic test or treatment intended for another patient
--EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm
--EXCLUDES--> [?] Patient received diagnostic test or treatment intended for another patient
--- Walk 3 ---
[QB14] Unavailability or inaccessibility of health care facilities
--EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere
--CHILD--> [?] Person awaiting admission to residential aged care service
--- Walk 4 ---
[QB14] Unavailability or inaccessibility of health care facilities
--EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere
--CHILD--> [?] Person awaiting admission to acute hospital
--- Walk 5 ---
[PL14.2] Problem associated with physical transfer of patient
--PARENT--> [PL14] Mode of injury or harm associated with other health care related causes
--CHILD--> [PL14.0] Non-administration of necessary drug
--- Walk 6 ---
[PL14.2] Problem associated with physical transfer of patient
--PARENT--> [PL14] Mode of injury or harm associated with other health care related causes
--CHILD--> [PL14.0] Non-administration of necessary drug
|
[
"[PL14.C] Patient received diagnostic test or treatment intended for another patient\n --EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm\n --EXCLUDES--> [?] Patient received diagnostic test or treatment intended for another patient",
"[PL14.C] Patient received diagnostic test or treatment intended for another patient\n --EXCLUDES--> [?] Procedure undertaken at wrong site or wrong side, as mode of injury or harm\n --EXCLUDES--> [?] Patient received diagnostic test or treatment intended for another patient",
"[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --CHILD--> [?] Person awaiting admission to residential aged care service",
"[QB14] Unavailability or inaccessibility of health care facilities\n --EXCLUDES--> [?] Person awaiting admission to adequate facility elsewhere\n --CHILD--> [?] Person awaiting admission to acute hospital",
"[PL14.2] Problem associated with physical transfer of patient\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --CHILD--> [PL14.0] Non-administration of necessary drug",
"[PL14.2] Problem associated with physical transfer of patient\n --PARENT--> [PL14] Mode of injury or harm associated with other health care related causes\n --CHILD--> [PL14.0] Non-administration of necessary drug"
] |
PL14.C
|
Patient received diagnostic test or treatment intended for another patient
|
[
{
"from_icd11": "QB14",
"icd10_code": "Z753",
"icd10_title": "Unavailability and inaccessibility of health-care facilities"
},
{
"from_icd11": "QA15.1",
"icd10_code": "F66",
"icd10_title": "Other sexual disorders"
},
{
"from_icd11": "QA15.1",
"icd10_code": "F660",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F661",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F662",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F668",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "F669",
"icd10_title": ""
},
{
"from_icd11": "QA15.1",
"icd10_code": "Z701",
"icd10_title": "Counseling related to patient's sexual behavior and orientation"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3183",
"icd10_title": "Dementia with Lewy bodies"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G2581",
"icd10_title": "Restless legs syndrome"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G3184",
"icd10_title": "Mild cognitive impairment, so stated"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G9349",
"icd10_title": "Other encephalopathy"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G0481",
"icd10_title": "Other encephalitis and encephalomyelitis"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G9589",
"icd10_title": "Other specified diseases of spinal cord"
},
{
"from_icd11": "8E4A.0",
"icd10_code": "G2589",
"icd10_title": "Other specified extrapyramidal and movement disorders"
}
] |
Z753
|
Unavailability and inaccessibility of health-care facilities
|
A total thyroidectomy by the collar incision without a median sternotomy with I-IONM and the energy-based device was decided in order of facing with symptomatic substernal goiter, including the bilateral multiple nodules, that did not extend beyond the left innominate vein proximally, such the vital organs like as the arcus aorta. The informed consent was received for both her treatment and the present article, preoperatively. To this end, it was practiced on the ‘Iowa Head and Neck Protocols for Thyroidectomy and Thyroid, Iowa, the US' for most of the surgical procedures. For these purposes, she was brought to the operating room and placed on the operating table in the supine position. She was then transorally intubated and a skin crease incision was designed and drawn at one fingerbreadth above her clavicles. Thereafter, a shoulder roll was placed behind the scapulae and a mini roll behind the posterior aspect of the neck, then her hyperextended neck was prepared with chlorhexidine and draped in a sterile fashion. A 15-blade scalpel was used to perform the planned and drawn beforehand Kocher's transverse collar incision, which was carried down through the platysma to the level of the strap muscles of the neck, after administrating the agents of lidocaine 1% and epinephrine 1:100,000 into the incision line. The subplatysmal flaps were subsequently elevated through accessing its avascular space and underlying areolar tissue plan. Paying attention to the preservation of the anterior jugular veins, the strap muscles were split in the midline raphae, the linea alba cervicalis, the fascia of sternothyroid muscle was divided, and the capsular blood vessels of the gland were pointed out. After constituting a proper cleavage plan, the sternothyroid and sternothyroid muscles were retracted laterally to the gland, leading to the thyroid were explored without being supposed to dissection of the strap muscles. Firstly, the left middle vein was explored and divided to be able to provide safe and bloodless maneuvers of the left lobe of the gland. In dissecting around the left superior pole of the thyroid, the branches of the left superior thyroid artery and left superior thyroid vein were dissected separately in order not to harm the left superior laryngeal nerve, and the left superior parathyroid gland was revealed and was dissected away from the lobe. The thyroid gland was then retracted anteriorly and medially in order of facilitating the exposure of the left tracheoesophageal groove. The left inferior thyroid artery was exposed and the left recurrent laryngeal nerve (RLN) was identified and preserved by using its present anatomic association, i.e. crossing it posteriorly. The mentioned situation was also confirmed by I-IONM. The gland was then retracted superiorly and laterally in order of releasing the left inferior pole. Charles Proye’s Toboggan Technique was used to facilitate the dissection and retraction out of the left inferior lobe from the surgical bed by slackening its remaining attachments and division of the left inferior thyroid veins. Herewith, the left inferior parathyroid gland was exposed and preserved. The thyroid was carefully examined after the removal process with LigaSure Small Jaw (LSJ) in order of being convinced for not harboring any evidence of parathyroid tissue on it. Afterwards, the right side was dissected and spared in a similar fashion with the relevant exposures of the branches of right superior thyroid artery and right superior thyroid vein, right superior laryngeal nerve, right superior and inferior parathyroid glands, right inferior thyroid artery and vein, and right recurrent laryngeal nerve (RLN) by using LSJ and I-IONM. Both the RLNs, per se, were not lying over the enlarged gland as being possible in case of a substernal goiter. What follows both thyroid lobes with the isthmus and pyramidal lobe were resected with the aid of the I-IONM and energy-based device, the mini roll behind the posterior aspect of the neck was removed in order to attenuate the collar tension, then the wound was profusely and meticulously irrigated with the sterile saline and the relevant haemostasis was provided. The mentioned field of the surgical procedure had preserved till the anesthesiologist recognized the positions of the vocal cords. Meanwhile, the entire gland was examined carefully, particularly whether harboring any parathyroid gland/tissue or not. While no evidence of any parathyroid gland/tissue and lymphadenopathy in the level VI, cervical compartment, was notified, a 15-French Jackson-Pratt drain was inserted and secured to the skin with 3-0 non-absorbable suture. The wound was closed by reapproximating the strap muscles and platysma with deep 3-0 vicryl stitches while the skin by a running 5-0 monocryl subcuticular continuous stitch with the benzoin and steri-strips, placing over the collar incision. Eventually, she had tolerated the procedure well and extubated in the operating room uneventfully. Herein, she transferred to the post-anesthesia care unit, subsequently. No intra-, peri-, and postoperative complications and/or morbidity have developed. Ultimately, she demonstrated improved symptoms and discharged home on the hospital day one.
| 4.039063
| 0.927734
|
sec[1]/p[4]
|
en
| 0.999995
|
34277302
|
https://doi.org/10.7759/cureus.16258
|
[
"thyroid",
"gland",
"order",
"parathyroid",
"incision",
"vein",
"neck",
"muscles",
"collar",
"ionm"
] |
[
{
"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": "BD90.Z",
"title": "Lymphadenitis, unspecified"
},
{
"code": "BD90.Y",
"title": "Other specified lymphadenitis"
},
{
"code": "MA01.Z",
"title": "Enlarged lymph nodes, unspecified"
},
{
"code": "5B3Z",
"title": "Endocrine diseases, unspecified"
},
{
"code": "9A10.Z",
"title": "Disorders of lacrimal gland, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[5A03.Z] Thyroiditis, unspecified
Also known as: Thyroiditis, unspecified | Thyroiditis | inflammation of thyroid | thyroiditis NOS
[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified
Also known as: Disorders of the thyroid gland or thyroid hormones system, unspecified
[5A03.Y] Other specified thyroiditis
Also known as: Other specified thyroiditis | Riedel thyroiditis | Chronic invasive fibrous thyroiditis | Ligneous thyroiditis | Riedel struma
[5A00.2Z] Acquired hypothyroidism, unspecified
Also known as: Acquired hypothyroidism, unspecified | Acquired hypothyroidism | hypothyrea | thyroid insufficiency | hypothyroidea
[5A03.0] Acute thyroiditis
Definition: Acute thyroiditis is a rare form of thyroiditis directly caused by an infection, frequently bacterial.
Also known as: Acute thyroiditis | infectious thyroiditis | Acute thyroiditis due to bacterial infection | Acute thyroiditis due to fungal infection | Abscess of thyroid
[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
[MA01.Z] Enlarged lymph nodes, unspecified
Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy
[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
[9A10.Z] Disorders of lacrimal gland, unspecified
Also known as: Disorders of lacrimal gland, unspecified | Disorders of lacrimal gland
=== GRAPH WALKS ===
--- Walk 1 ---
[5A03.Z] Thyroiditis, unspecified
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--EXCLUDES--> [?] Acquired hypothyroidism
Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....
--- Walk 2 ---
[5A03.Z] Thyroiditis, unspecified
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--EXCLUDES--> [?] Acquired hypothyroidism
Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....
--- Walk 3 ---
[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified
--PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system
Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....
--CHILD--> [5A00] Hypothyroidism
--- Walk 4 ---
[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified
--PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system
Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....
--CHILD--> [5A02] Thyrotoxicosis
Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...
--- Walk 5 ---
[5A03.Y] Other specified thyroiditis
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--RELATED_TO--> [?] Postpartum thyroiditis
Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...
--- Walk 6 ---
[5A03.Y] Other specified thyroiditis
--PARENT--> [5A03] Thyroiditis
Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...
--CHILD--> [5A03.1] Subacute thyroiditis
Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection....
|
[
"[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....",
"[5A03.Z] Thyroiditis, unspecified\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --EXCLUDES--> [?] Acquired hypothyroidism\n Def: Acquired hypothyroidism is a condition where the thyroid gland produces too little or no thyroid hormone, and the condition arises only after birth....",
"[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A00] Hypothyroidism",
"[5A0Z] Disorders of the thyroid gland or thyroid hormones system, unspecified\n --PARENT--> [?] Disorders of the thyroid gland or thyroid hormones system\n Def: Disorders due to dysfunction of thyroid gland and regulation systems of thyroid hormone actions including dysfunction of the pituitary, hypothalamus, or thyroid hormone receptors....\n --CHILD--> [5A02] Thyrotoxicosis\n Def: A hypermetabolic condition associated with elevated levels of free thyroxine and/or free triiodothyronine resulting in excess synthesis and secretion of thyroid hormone...",
"[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --RELATED_TO--> [?] Postpartum thyroiditis\n Def: Postpartum thyroiditis (PPT) is the occurrence, in the postpartum period, of transient hyperthyroidism and/or transient hypothyroidism, with most women returning to the euthyroid state by 1 year postp...",
"[5A03.Y] Other specified thyroiditis\n --PARENT--> [5A03] Thyroiditis\n Def: Thyroiditis is the inflammation of the thyroid gland. It includes acute and chronic forms of thyroiditis. Thyroiditis is usually caused by autoimmune reaction to the thyroid, resulting in inflammation...\n --CHILD--> [5A03.1] Subacute thyroiditis\n Def: A self-limited thyroiditis associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. It is thought to be caused by a viral infection...."
] |
5A03.Z
|
Thyroiditis, unspecified
|
[
{
"from_icd11": "5A03.Z",
"icd10_code": "E069",
"icd10_title": "Thyroiditis, unspecified"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E064",
"icd10_title": "Drug-induced thyroiditis"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E065",
"icd10_title": "Other chronic thyroiditis"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E06",
"icd10_title": "Thyroiditis"
},
{
"from_icd11": "5A03.Z",
"icd10_code": "E062",
"icd10_title": "Chronic thyroiditis with transient thyrotoxicosis"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E0781",
"icd10_title": "Sick-euthyroid syndrome"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E0789",
"icd10_title": "Other specified disorders of thyroid"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E079",
"icd10_title": "Disorder of thyroid, unspecified"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E034",
"icd10_title": "Atrophy of thyroid (acquired)"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E00-E07",
"icd10_title": ""
},
{
"from_icd11": "5A0Z",
"icd10_code": "E07",
"icd10_title": "Other disorders of thyroid"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E078",
"icd10_title": "Other specified disorders of thyroid"
},
{
"from_icd11": "5A0Z",
"icd10_code": "E35",
"icd10_title": "Disorders of endocrine glands in diseases classified elsewhere"
},
{
"from_icd11": "5A00.2Z",
"icd10_code": "E033",
"icd10_title": "Postinfectious hypothyroidism"
},
{
"from_icd11": "5A03.0",
"icd10_code": "E060",
"icd10_title": "Acute thyroiditis"
}
] |
E069
|
Thyroiditis, unspecified
|
An 18-year-old male adolescent was diagnosed with common acute lymphoblastic leukemia in March 2004. In February 2006, under treatment after ALL-BMF 2000 trial protocol, a bone marrow relapse was diagnosed. During the first course of chemotherapy according to the ALL relapse BFM 2002 trial, he developed neutropenic fever. As antibiotic treatment failed, he was treated empirically with L-AmB. During this therapy, he developed dyspnea and cough. A computed tomography revealed nodular pulmonary infiltration in the apical right lung . The patient tested positive for aspergillus galactomannan antigen (index 1.6; normal <0.5). In addition, bronchoalveolar lavage fluid and sputum culture confirmed an Aspergillus fumigatus infection. We began combination therapy with L-AmB (3 mg/kg bw/day) and caspofungin (loading dose of 70 mg and then 50 mg/day) due to the high risk situation with intensive chemotherapy, the imminent allogeneic hematopoietic stem cell transplantation and prolonged neutropenia, and in order to avoid a lengthy therapy recess. The pulmonary situation improved, and therefore, L-AmB was replaced by oral voriconazole (2 × 200 mg/day) in April 2006. In June 2006, the pulmonary aspergillosis in the upper right lobe of the lung showed regression . However, in the basal part of the right lung, additional nodular infiltrations were diagnosed and the patient still tested positive for aspergillus galactomannan antigen (index: 0.9). Due to the aggressive leukemia, the patient received the first HSCT from an HLA-identical unrelated donor in July 2006. From the start of the conditioning regimen until day 31 after transplantation, he was again treated with a combination therapy of caspofungin (50 mg/day) and L-AmB (3 mg/kg bw/day). During this therapy, the pulmonary aspergillosis showed signs of marked improvement and the aspergillus galactomannan antigen decreased and finally became negative, even though the patient had undergone HSCT. We reduced the antifungal therapy to L-AmB (3 mg/kg bw/day) and local prophylaxis with oral amphotericin B. By the end of August 2006, the patient presented with reduced counts of leukocytes and platelets. At that time, molecular chimerism revealed 30% autologous cells, completely autologous T cells and concomitant haemophagocytosis in bone marrow cytology, indicative for graft rejection. We decided to perform a second transplant with a graft from the same HLA-matched unrelated donor. During the second transplantation in September 2006, antifungal therapy was continued with L-AmB (3 mg/kg bw/day) alone. Due to increase of urea to 70 mg/dL on day 15 after the second allogeneic HSCT, the patient was switched to intravenous voriconazole for a total of seven days and ten days before anticipated discharge to oral voriconazole (2 × 200 mg/day). On the day of discharge in October 2006, the patient developed a mild fever of 38.3°C with a CRP of 2.2 mg/dL and first pulmonary symptoms, that is, mild coughing. The aspergillus galactomannan antigen had increased to an index of 0.9 and thoracic computed tomography showed a clear progression of the pulmonary aspergillosis . Therefore, we treated with a combination of caspofungin and oral voriconazole. In December 2006, five weeks after the start of this combination, the computed tomography showed signs of improved IPA and the aspergillus galactomannan antigen index dropped below the detection limit. In January 2007, four months after the second transplantation, a second relapse of the CD19 positive cALL occurred, which was treated with 3 doses of rituximab (375 mg/m² per dose), vincristine, cytarabine, pegylated asparaginase, and thioguanine. During the therapy, the blasts in peripheral blood decreased from 20% to 2%. Finally, we decided to perform a third HSCT in February 2007. This time, the HLA-haploidentical mother served as donor. During the conditioning regimen, comprised of fludarabine, thiotepa and melphalan, and after HSCT, the antifungal therapy was caspofungin and L-AmB (1 mg/kg bw/day). One week after transplantation of the T-cell depleted graft, that is, during aplasia, there was a febrile episode of up to 38.8°C with a CRP of 12.3 mg/dL and partial respiratory insufficiency requiring nasal oxygen insufflation with flow rates up to 4 L/min. The computed tomography at the time showed pneumonia and a progression of pulmonary aspergillosis. The combination therapy was continued with caspofungin and increased L-AmB (3 mg/kg bw/day). Before discharge, the regimen was changed to a combination of caspofungin and oral voriconazole. In June 2007, almost four months after the third allogeneic HSCT and eight months after the start of the second period of combination therapy with caspofungin-based antifungal therapy, the pulmonary aspergillosis had almost completely disappeared without surgical intervention necessary . Therefore, we continued the antifungal therapy as monotherapy with oral voriconazole. Since the small aspergillosis lesion in the left lung segment 3 remained unchanged, it was removed eight months after the third HSCT thoracoscopically. Unfortunately, the patient experienced an incurable ALL relapse shortly thereafter and died in the 12th month after his third allogeneic HSCT.
| 4.035156
| 0.974609
|
sec[1]/p[0]
|
en
| 0.999997
|
23259137
|
https://doi.org/10.1155/2012/672923
|
[
"pulmonary",
"hsct",
"combination",
"caspofungin",
"aspergillus",
"oral",
"voriconazole",
"aspergillosis",
"galactomannan",
"antigen"
] |
[
{
"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": "4A01.1Z",
"title": "Combined immunodeficiencies, unspecified"
},
{
"code": "PB29",
"title": "Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances"
},
{
"code": "8A40.Z",
"title": "Multiple sclerosis, unspecified"
},
{
"code": "6C4F.3",
"title": "Intoxication due to multiple specified psychoactive substances"
},
{
"code": "PH49",
"title": "Exposure to or harmful effects of undetermined intent of multiple drugs, medicaments or biological substances"
}
] |
=== 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
[4A01.1Z] Combined immunodeficiencies, unspecified
Also known as: Combined immunodeficiencies, unspecified | Combined immunodeficiencies | Combined T and B cell immunodeficiency | combined immunity deficiency | combined immunodeficiency syndrome
[PB29] Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances
Also known as: Unintentional exposure to or harmful effects of multiple drugs, medicaments or biological substances | accidental overdose of multiple drugs, medicaments or biological substances | accidental poisoning by multiple drugs, medicaments or biological substances | multiple drugs, medicaments or biological substances taken in error | combined drug toxicity NOS
Includes: accidental overdose of multiple drugs, medicaments or biological substances
[8A40.Z] Multiple sclerosis, unspecified
Also known as: Multiple sclerosis, unspecified | Multiple sclerosis | cerebrospinal sclerosis | disseminated sclerosis | generalised multiple sclerosis
[6C4F.3] Intoxication due to multiple specified psychoactive substances
Definition: Intoxication due to multiple specified psychoactive substances is a clinically significant transient condition that develops during or shortly after the consumption of multiple specified substances or medications that is characterised by disturbances in consciousness, cognition, perception, affect, behaviour, or coordination. These disturbances are caused by the known pharmacological effects of the multiple specified psychoactive substances and their intensity is closely related to the amount of
Also known as: Intoxication due to multiple specified psychoactive substances | mixed drug intoxication NOS | combined drug intoxication NOS | acute mixed drug intoxication NOS | acute combined drug intoxication NOS
[PH49] Exposure to or harmful effects of undetermined intent of multiple drugs, medicaments or biological substances
Also known as: Exposure to or harmful effects of undetermined intent of multiple drugs, medicaments or biological substances | mixed substance toxicity NOS | acute combined drug toxicity
=== GRAPH WALKS ===
--- Walk 1 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--RELATED_TO--> [?] Alpha-1-antitrypsin deficiency
Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...
--- Walk 2 ---
[CB40.Y] Other specified diseases of the respiratory system
--PARENT--> [CB40] Certain diseases of the respiratory system
--RELATED_TO--> [?] Pulmonary sporotrichosis
Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled.
Symptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...
--- Walk 3 ---
[LA75.1] Agenesis of lung
Def: This refers to the absence or rudimentary residua of an undeveloped lung....
--PARENT--> [LA75] Structural developmental anomalies of lungs
Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....
--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--> [LA75.0] Accessory lobe of lung
Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...
--- Walk 5 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--EXCLUDES--> [?] Pneumonitis
Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly....
--- Walk 6 ---
[CA40.Z] Pneumonia, organism unspecified
--PARENT--> [CA40] Pneumonia
Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...
--EXCLUDES--> [?] Pneumonitis
Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly....
|
[
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Alpha-1-antitrypsin deficiency\n Def: Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterised by low serum leve...",
"[CB40.Y] Other specified diseases of the respiratory system\n --PARENT--> [CB40] Certain diseases of the respiratory system\n --RELATED_TO--> [?] Pulmonary sporotrichosis\n Def: Pulmonary forms of infection, although uncommon, can occur when Sporothrix schenckii conidia are inhaled. \nSymptoms of pulmonary sporotrichosis mimic those of tuberculosis including constitutional com...",
"[LA75.1] Agenesis of lung\n Def: This refers to the absence or rudimentary residua of an undeveloped lung....\n --PARENT--> [LA75] Structural developmental anomalies of lungs\n Def: Any condition caused by failure of the lungs to correctly develop during the antenatal period....\n --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--> [LA75.0] Accessory lobe of lung\n Def: An extra lobe of lung beyond the 3 on the right and the 2 on the left...",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --EXCLUDES--> [?] Pneumonitis\n Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly....",
"[CA40.Z] Pneumonia, organism unspecified\n --PARENT--> [CA40] Pneumonia\n Def: A disease of the lungs, frequently but not always caused by an infection with bacteria, virus, fungus, or parasite. This disease is characterised by fever, chills, cough with sputum production, chest ...\n --EXCLUDES--> [?] Pneumonitis\n Def: Pneumonitis is a general term that refers to inflammation of lung tissue. Pneumonitis includes the non-infectious lung diseases that cause inflammation of the interstitium of the lung tissue mainly...."
] |
CB40.Y
|
Other specified diseases of the respiratory system
|
[
{
"from_icd11": "LA75.1",
"icd10_code": "Q333",
"icd10_title": "Agenesis of lung"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J189",
"icd10_title": "Pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J181",
"icd10_title": "Lobar pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J188",
"icd10_title": "Other pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J168",
"icd10_title": "Pneumonia due to other specified infectious organisms"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J180",
"icd10_title": "Bronchopneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J17",
"icd10_title": "Pneumonia in diseases classified elsewhere"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J182",
"icd10_title": "Hypostatic pneumonia, unspecified organism"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J16",
"icd10_title": "Pneumonia due to other infectious organisms, not elsewhere classified"
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J171",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J173",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J178",
"icd10_title": ""
},
{
"from_icd11": "CA40.Z",
"icd10_code": "J18",
"icd10_title": "Pneumonia, unspecified organism"
},
{
"from_icd11": "CB41",
"icd10_code": "J9622",
"icd10_title": "Acute and chronic respiratory failure with hypercapnia"
},
{
"from_icd11": "CB41",
"icd10_code": "J9620",
"icd10_title": "Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia"
}
] |
Q333
|
Agenesis of lung
|
A 46-year-old Bangladeshi woman presented with a 36-month history of blurred vision with floaters. This proband was otherwise asymptomatic without weight loss and with no relevant past medical history. She had no familial history of amyloidosis. Visual acuity was 7/10 P2 for her right eye and 9/10 P2 for her left eye. Intraocular pressure was normal in both eyes (15 mmHg). No pars plana vitrectomy was performed. A slit-lamp biomicroscopy showed abnormal conjunctival vessels with keratoconjunctivitis sicca. No change of the pupillary shape and no amyloid deposition on the lens surface or at the pupillary border were noted. Light pupillary reflex was normal. Fundoscopy revealed yellowish-white “glass-wool” vitreous opacity in both eyes consistent with amyloid deposits . The macula and the optic disc appeared normal, and no retinal hemorrhages were detected. Optical coherence tomography (OCT) revealed a normal retinal morphology including in the area of the macula . An extensive evaluation, including extensive cardiac investigation, did not reveal other clinical features. Magnetic resonance imaging of her brain was normal, without any leptomeningeal involvement . She did not have carpal tunnel syndrome, and a neurological examination of her peripheral nerve system did not detect abnormalities in her upper and lower limbs. The results of nerve conduction studies were normal, but a distal leg skin biopsy detected loss of intra-epidermal nerve fiber density with a value of 0.29 fiber/millimeter, supporting the diagnosis of small fiber neuropathy . She progressively experienced postural dizziness and vomiting, and gastric emptying scintigraphy confirmed gastroparesis with abnormal gastric retention: for liquids, 30% at 4 hours (N< 10%); and for solids, 77% (N<10%), demonstrating severe autonomic neuropathy . A histological examination of accessory salivary glands revealed Congo-red-positive deposits with an apple-green birefringence under polarized light in the interstitium and basement membranes of the acini. A biopsy of her stomach revealed perivascular amyloid deposits in the submucosa and the muscular circular layer. Direct sequencing of TTR gene revealed that she was heterozygous for a single nucleotide substitution c.259 G>C in exon 3, resulting in replacement of glycine with arginine at position 87 of the mature protein, that is, p.Gly87Arg . Conservation analysis of ten vertebrate species indicated that Glycine 87 is highly conserved in the TTR protein. Proteomic analysis performed on the formalin-fixed paraffin-embedded salivary gland tissue using laser microdissection followed by tandem mass spectrometry identified TTR as the dominant amyloid protein and identified the mutated TTR peptide (p.Gly87Arg) within the deposits, whereas the corresponding wild-type TTR peptide was not found . TTR was associated with several proteins known to be associated with amyloid deposits such as serum amyloid P-component and apolipoprotein E. In Fig. 3c , the protein sequence coverage shown in bold blue was 45%, and the mutated peptide is shown in bold red. Fig. 1 Vitreous amyloidosis. An ocular examination revealed accumulation of extensive fibrillogranular deposits in the vitreous consistent with amyloid deposits (panels a , b , c and d ), and conjunctivochalasis (panel e ). Optical coherence tomography showed normal retinal appearance with a normal macular and foveal thickness (panel f ). Magnetic resonance imaging of the brain revealed no leptomeningeal involvement associated with vitreous amyloidosis on T2-weighted fluid-attenuated inversion recovery sequences (panels g and h ) and gadolinium-enhanced T1-weighted sequences (panels i and j ). OD right eye, OS left eye Fig. 2 Gastric scintigraphy. The test consisted of an exploration of both the solid (ovalbumin with 99m Tc-labeled colloids) and the liquid ( 111 In diethylene triamine pentaacetic acid diluted in water) phases of gastric emptying ( left panel for liquids and right panel for solids). The parameters used for the result interpretation were the half-time emptying (T1/2) and the residual activity at 4 hours (activity/time curves for liquid and solid). In this case, there was a very slow and gradual reduction of the tracer in the stomach. The residual activity remains very high 4 hours after ingestion: 30% at 4 hours (N< 10%) for liquid, and 77% (N< 10%) for solids Fig. 3 Analysis of amyloidosis deposits. The Congo-red stain on minor salivary gland biopsy (panel a ) showed deposits localized around the acini and in the interstitium with an apple-green birefringence under polarized light ( insert ). Partial sequencing electropherogram showing the c.259 G>C in exon 3 of transthyretin, resulting in replacement of glycine with arginine at position 87 of the mature protein (Panel b ), that is, p.Gly87Arg (Gly67Arg). Proteomic profile of the amyloid deposits using tandem mass spectrometry analysis identified transthyretin as the dominant amyloid protein (panel c ). Transthyretin was associated with several proteins known to be associated with amyloid deposits such as serum amyloid P-component and apolipoprotein E. The protein sequence coverage shown in bold blue was 45%, and the mutated peptide is shown in bold red
| 4.300781
| 0.911621
|
sec[1]/p[0]
|
en
| 0.999996
|
28802308
|
https://doi.org/10.1186/s13256-017-1407-z
|
[
"amyloid",
"deposits",
"protein",
"panel",
"associated",
"amyloidosis",
"vitreous",
"gastric",
"hours",
"that"
] |
[
{
"code": "5D00.Z",
"title": "Amyloidosis, unspecified"
},
{
"code": "5D00.0/FA38.Y",
"title": "Arthropathy in amyloidosis"
},
{
"code": "5D00.0",
"title": "AL amyloidosis"
},
{
"code": "5D00.1",
"title": "AA amyloidosis"
},
{
"code": "5D00.0&XA9607",
"title": "Amyloid gastrointestinal disease"
},
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "9A78.1",
"title": "Corneal pigmentations or deposits"
},
{
"code": "9A61.6",
"title": "Conjunctival or subconjunctival degenerations or deposits"
},
{
"code": "FB40.Y",
"title": "Other specified tenosynovitis"
},
{
"code": "9A77.Y",
"title": "Other specified corneal scars or opacities"
}
] |
=== ICD-11 CODES FOUND ===
[5D00.Z] Amyloidosis, unspecified
Also known as: Amyloidosis, unspecified | Amyloidosis | amyloid | amyloid disease | amyloid degeneration
[5D00.0] AL amyloidosis
Definition: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By light microscopy there is amorphous hyaline material in the mesangium and capillary walls. A light chain producing plasma cell or B-cell dysplasia is responsible. Other organs are also involved in this systemic disease.
Also known as: AL amyloidosis | Primary amyloidosis | Immunoglobulinic amyloidosis | Amyloid AL | Organ-limited amyloidosis
[5D00.1] AA amyloidosis
Definition: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chronic inflammation is responsible. Other organs are also involved in this systemic disease.
Also known as: AA amyloidosis | reactive systemic amyloidosis | Secondary systemic amyloidosis | Amyloid AA | Secondary amyloidosis
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[9A78.1] Corneal pigmentations or deposits
Also known as: Corneal pigmentations or deposits | Haematocornea | corneal blood staining | keratohaemia | Kayser-Fleischer ring
Includes: Haematocornea | Kayser-Fleischer ring | Krukenberg spindle
[9A61.6] Conjunctival or subconjunctival degenerations or deposits
Definition: These are the conjunctival/subconjunctival accumulation of some materials and gradual deterioration with impairment or loss of function, caused by injury, disease, or aging.
Also known as: Conjunctival or subconjunctival degenerations or deposits | Conjunctival concretions | conjunctival concretion | conjunctival calculus | conjunctival calcification
Includes: Conjunctival concretions | Conjunctival cysts or argyrosis | Conjunctival pigmentations
[FB40.Y] Other specified tenosynovitis
Also known as: Other specified tenosynovitis | Other tenosynovitis or tendinitis | synovitis NOS | Bicipital tendinitis | biceps tendinitis
[9A77.Y] Other specified corneal scars or opacities
Also known as: Other specified corneal scars or opacities | Corneal infiltrate or haze | Surgically-induced corneal haze | Argentous corneal deposits | Corneal deposits in metabolic disorders
=== GRAPH WALKS ===
--- Walk 1 ---
[5D00.Z] Amyloidosis, unspecified
--PARENT--> [5D00] Amyloidosis
Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...
--CHILD--> [5D00.1] AA amyloidosis
Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...
--- Walk 2 ---
[5D00.Z] Amyloidosis, unspecified
--PARENT--> [5D00] Amyloidosis
Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...
--CHILD--> [5D00.1] AA amyloidosis
Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...
--- Walk 3 ---
[5D00.0] AL amyloidosis
Def: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By ligh...
--RELATED_TO--> [?] Isolated cerebral amyloid angiopathy
Def: Cerebral amyloid angiopathy is characterised by the progressive accumulation of amyloid protein in the walls of small-to-medium-sized arteries and arterioles predominantly located in the leptomeningea...
--PARENT--> [?] Organ-limited amyloidosis
Def: This is a category of amyloidosis where the distribution can be associated primarily with a single organ. It is contrasted to systemic amyloidosis, and it can be caused by several different types of a...
--- Walk 4 ---
[5D00.0] AL amyloidosis
Def: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By ligh...
--PARENT--> [5D00] Amyloidosis
Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...
--EXCLUDES--> [?] Dementia due to Alzheimer disease
Def: Dementia due to Alzheimer disease is the most common form of dementia. Onset is insidious with memory impairment typically reported as the initial presenting complaint. The characteristic course is a ...
--- Walk 5 ---
[5D00.1] AA amyloidosis
Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...
--PARENT--> [5D00] Amyloidosis
Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...
--EXCLUDES--> [?] Dementia due to Alzheimer disease
Def: Dementia due to Alzheimer disease is the most common form of dementia. Onset is insidious with memory impairment typically reported as the initial presenting complaint. The characteristic course is a ...
--- Walk 6 ---
[5D00.1] AA amyloidosis
Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...
--PARENT--> [5D00] Amyloidosis
Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...
--CHILD--> [5D00.0] AL amyloidosis
Def: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By ligh...
|
[
"[5D00.Z] Amyloidosis, unspecified\n --PARENT--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...\n --CHILD--> [5D00.1] AA amyloidosis\n Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...",
"[5D00.Z] Amyloidosis, unspecified\n --PARENT--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...\n --CHILD--> [5D00.1] AA amyloidosis\n Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...",
"[5D00.0] AL amyloidosis\n Def: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By ligh...\n --RELATED_TO--> [?] Isolated cerebral amyloid angiopathy\n Def: Cerebral amyloid angiopathy is characterised by the progressive accumulation of amyloid protein in the walls of small-to-medium-sized arteries and arterioles predominantly located in the leptomeningea...\n --PARENT--> [?] Organ-limited amyloidosis\n Def: This is a category of amyloidosis where the distribution can be associated primarily with a single organ. It is contrasted to systemic amyloidosis, and it can be caused by several different types of a...",
"[5D00.0] AL amyloidosis\n Def: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By ligh...\n --PARENT--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...\n --EXCLUDES--> [?] Dementia due to Alzheimer disease\n Def: Dementia due to Alzheimer disease is the most common form of dementia. Onset is insidious with memory impairment typically reported as the initial presenting complaint. The characteristic course is a ...",
"[5D00.1] AA amyloidosis\n Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...\n --PARENT--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...\n --EXCLUDES--> [?] Dementia due to Alzheimer disease\n Def: Dementia due to Alzheimer disease is the most common form of dementia. Onset is insidious with memory impairment typically reported as the initial presenting complaint. The characteristic course is a ...",
"[5D00.1] AA amyloidosis\n Def: AA amyloid is due to the deposition of the acute phase reactant serum amyloid A protein (SAA) in glomeruli where they are seen as Congo red binding fibrils which immunostain specifically for SAA. Chro...\n --PARENT--> [5D00] Amyloidosis\n Def: Amyloidosis is a vast group of diseases defined by the presence of insoluble protein deposits in tissues. Its diagnosis is based on histological findings. Amyloidoses are classified according to clini...\n --CHILD--> [5D00.0] AL amyloidosis\n Def: AL amyloid is due to the deposition of immunoglobulin light chains in glomeruli where they are seen as Congo red binding fibrils and immuno-stain specifically for kappa or lambda light chains. By ligh..."
] |
5D00.Z
|
Amyloidosis, unspecified
|
[
{
"from_icd11": "5D00.Z",
"icd10_code": "E8582",
"icd10_title": "Wild-type transthyretin-related (ATTR) amyloidosis"
},
{
"from_icd11": "5D00.Z",
"icd10_code": "E8581",
"icd10_title": "Light chain (AL) amyloidosis"
},
{
"from_icd11": "5D00.Z",
"icd10_code": "E8589",
"icd10_title": "Other amyloidosis"
},
{
"from_icd11": "5D00.Z",
"icd10_code": "E859",
"icd10_title": "Amyloidosis, unspecified"
},
{
"from_icd11": "5D00.Z",
"icd10_code": "E858",
"icd10_title": "Other amyloidosis"
},
{
"from_icd11": "5D00.Z",
"icd10_code": "E85",
"icd10_title": "Amyloidosis"
},
{
"from_icd11": "5D00.Z",
"icd10_code": "L990",
"icd10_title": ""
},
{
"from_icd11": "5D00.0",
"icd10_code": "E854",
"icd10_title": "Organ-limited amyloidosis"
},
{
"from_icd11": "5D00.1",
"icd10_code": "E853",
"icd10_title": "Secondary systemic amyloidosis"
},
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "9A78.1",
"icd10_code": "H18049",
"icd10_title": "Kayser-Fleischer ring, unspecified eye"
},
{
"from_icd11": "9A78.1",
"icd10_code": "H180",
"icd10_title": "Corneal pigmentations and deposits"
},
{
"from_icd11": "9A61.6",
"icd10_code": "H111",
"icd10_title": "Conjunctival degenerations and deposits"
}
] |
E8582
|
Wild-type transthyretin-related (ATTR) amyloidosis
|
This patient underwent a left nephrostomy six months ago, and no tumor was found in the left renal at that time. However, six months later, the morphology of the left renal was completely abnormal. Laboratory tests upon admission indicated the presence of infection. Based on the patient’s medical history and the rapid progression of the disease, CT scan initially suggested the possibility of a renal abscess, and the lymph nodes were considered as inflammatory hyperplasia, leading to a misdiagnosis of this case. The two-dimensional ultrasound examination revealed the absence of normal renal imaging in the left renal region. Instead, a large mixed echoic tumor was observed, with indistinct borders, an irregular shape, and heterogeneous internal echoes. Through the visualization of drainage tubes and stones, as well as the detected renal hilum blood flow signals, it was determined that the tumor originated from the left renal. The overall appearance of the tumor resembled an enlarged renal, with no visible normal renal parenchyma and no tumor protruding beyond the renal contour. On further detailed examination using CEUS, the tumor in this case showed an expansive growth pattern with no clear renal borders. Renal abscesses typically show a ring-like or heterogeneous hyperenhancement in the early enhancement phase, with no enhancement in the abscess cavity ( 11 ). However, given that this patient’s disease course had lasted for nearly six months without the formation of an abscess cavity, which was rare, the possibility of an abscess was excluded. Furthermore, the tumor showed hyperenhancement in the early phase, which rapidly washed out in the late phase, consistent with the “fast-in and fast-out” pattern seen in common malignancies. Characteristic fissure-like non-enhancing areas were observed within the tumor, with regular shapes and arrangements, which were considered dilated renal collecting ducts rather than necrotic abscess cavities. CEUS based on harmonic ultrasound imaging technology significantly improves image contrast and resolution by leveraging the nonlinear effects of ultrasound waves, particularly in visualizing subtle structures and microvascular networks, improving the visualization of blood perfusion and intricate details within the tumor, thereby allowing for a more accurate assessment of its characteristics, including the fissure-like non-enhanced areas that resemble the calyceal structure and are of considerable diagnostic value. Therefore, combining the findings from two-dimensional ultrasound and CEUS, a highly malignant tumor originating from the left renal medulla was considered the most likely diagnosis, negating the CT diagnosis. Surgical resection ultimately confirmed the diagnosis of CDC. In the present case, we did not observe composite subtypes within the tumor. However, notable intratumoral heterogeneity was identified. This heterogeneity was reflected in the variable expression of markers such as PCK, EMA, CK7, 34βE12, and Pax-8 across different regions of the tumor, indicating diverse cellular phenotypes and potential differences in tumor cell biology. The observation of heterogeneity underscores the complex nature of renal cancers and suggests that intratumoral genetic and phenotypic diversity may contribute to the aggressive behavior and treatment resistance observed in these neoplasms. Further studies exploring the molecular underpinnings of this heterogeneity could provide insights into the pathogenesis and progression of renal cell carcinoma, potentially leading to more targeted and effective therapeutic strategies. In addition to differentiating from abscesses, this case required differential diagnosis from other conditions. Firstly, granulomatous nephritis has to be considered because the patient’s history of catheterization could lead to foreign body stimulation and granuloma formation. However, granulomatous nephritis typically shows hypoenhancement on CEUS, which is inconsistent with the appearance of CDC. Secondly, clear cell renal cell carcinoma (ccRCC) needed to be differentiated from CDC, ccRCC is the most common primary renal tumor. ccRCC has variable two-dimensional ultrasound echo patterns, often presenting as solid hypoechoic tumors, and it is frequently located outside the renal contour, with surrounding tissues compressed and displaced. CEUS of ccRCC typically shows heterogeneous hyperenhancement in the early phase, though a minority may demonstrate homogeneous hyperenhancement. ccRCC commonly has a pseudocapsule, and it may have hemorrhage or necrosis. During the washout phase, the enhancement can clear either rapidly or slowly ( 12 ). Furthermore, in early-stage tumors originating from the urothelium, they are typically observed to grow within the renal pelvis and show an infiltrative growth pattern. On CEUS, these tumors often show a rapid wash-in hyperenhancement. However, for larger, late-stage tumors where the surrounding tissue structures are difficult to distinguish, differentiating them from CDC can present challenges. In such cases, additional diagnostic modalities such as CT or MRI scan, as well as a comprehensive clinical assessment, may be necessary to establish an accurate imaging diagnosis.
| 4.292969
| 0.855957
|
sec[2]/p[1]
|
en
| 0.999997
|
39850820
|
https://doi.org/10.3389/fonc.2024.1511009
|
[
"renal",
"tumor",
"this",
"ceus",
"that",
"however",
"abscess",
"ultrasound",
"hyperenhancement",
"phase"
] |
[
{
"code": "GC2Z&XA6KU8",
"title": "Disease of kidney, not elsewhere classified"
},
{
"code": "GB6Z",
"title": "Kidney failure, unspecified"
},
{
"code": "LB30.1",
"title": "Renal dysplasia"
},
{
"code": "NB92.0Y",
"title": "Other specified injury of kidney"
},
{
"code": "LB30.7",
"title": "Ectopic or pelvic kidney"
},
{
"code": "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 ===
[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
[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 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--RELATED_TO--> [?] Renal failure following abortion, ectopic or molar pregnancy
--- Walk 2 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--EXCLUDES--> [?] Hypertensive renal disease
Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....
--- Walk 3 ---
[LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or both kidneys....
--EXCLUDES--> [?] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--PARENT--> [?] Hereditary cystic or dysplastic kidney disease, dominant inheritance
Def: Cystic or dysplastic renal diseases that are inherited in an autosomal dominant fashion. Usually monogenetic, and can be associated with abnormalities in other organs....
--- Walk 4 ---
[LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or both kidneys....
--EXCLUDES--> [?] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--CHILD--> [?] Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis
Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin1 gene on chromosome 16 (PKD1 gene)...
--- Walk 5 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.02] Laceration of kidney, minor
--- Walk 6 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.02] Laceration of kidney, minor
|
[
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --RELATED_TO--> [?] Renal failure following abortion, ectopic or molar pregnancy",
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --EXCLUDES--> [?] Hypertensive renal disease\n Def: Hypertensive renal disease is a medical condition referring to damage to the kidney due to chronic high blood pressure....",
"[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --PARENT--> [?] Hereditary cystic or dysplastic kidney disease, dominant inheritance\n Def: Cystic or dysplastic renal diseases that are inherited in an autosomal dominant fashion. Usually monogenetic, and can be associated with abnormalities in other organs....",
"[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease type 1 without tuberous sclerosis\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin1 gene on chromosome 16 (PKD1 gene)...",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.02] Laceration of kidney, minor",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.02] Laceration of kidney, minor"
] |
GC2Z&XA6KU8
|
Disease of kidney, not elsewhere classified
|
[
{
"from_icd11": "GB6Z",
"icd10_code": "N19",
"icd10_title": "Unspecified kidney failure"
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17-N19",
"icd10_title": ""
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17",
"icd10_title": "Acute kidney failure"
},
{
"from_icd11": "LB30.1",
"icd10_code": "Q614",
"icd10_title": "Renal dysplasia"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q632",
"icd10_title": "Ectopic kidney"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q63",
"icd10_title": "Other congenital malformations of kidney"
},
{
"from_icd11": "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"
}
] |
N19
|
Unspecified kidney failure
|
A 75-year-old woman was referred to our hospital with a gastroesophageal lesion. Upper gastrointestinal endoscopy revealed a raised lesion with ulceration on the posterior wall of the greater curvature of the cardia. The endoscopy also indicated tenderness in the lower esophagus and tumor invasion was suspected . Immunostaining of the tumor biopsy showed positive staining for Melan-A, human melanoma black-45 (HMB45), and S-100 protein (+), indicating malignant melanoma of the esophagogastric junction. Contrast-enhanced computed tomography (CT) of the abdomen showed a mildly stained lesion protruding into the cardiac part of stomach and enlarged perigastric lymph nodes (the right paracardial lymph node and lesser curvature lymph node were lumped together) . No obvious distant metastasis was observed. Serum analysis indicated that squamous cell carcinoma antigen, carcinoembryonic antigen, and carbohydrate antigen 19–9 were within normal limits. A positron emission tomography (PET)– CT scan showed a high degree of fluorodeoxyglucose accumulation (maximum standardized uptake value: early = 13.2, delayed = 19.2) in the upper stomach and enlarged lymph nodes. Based on these findings, we performed proximal gastrectomy, lower esophagus resection, and double-tract reconstruction. We also performed resection of the enlarged lymph node in the lesser curvature of stomach and no obvious distant metastasis in the abdominal cavity was found. Histological examination of the resected tissue indicated an elastic, soft tumor that was located in the esophagogastric junction . Analysis of the tumor cell morphology demonstrated large, round tumor cells with nuclear atypia and high mitotic activity . Immunostaining was positive for Melan-A, HMB45, S-100 protein and SRY-box transcription factor 10 , and the patient was diagnosed with malignant melanoma of the esophagogastric junction with regional lymph node metastases. Postoperative recovery was good, and the patient was discharged on 22 days post-operation. Three months after the surgery, a follow-up CT showed subpleural masses in the lower lobe of the left lung, with bilateral pleural effusion . As previous analyses of the primary tumor had revealed BRAF -wild-type, the patient was prescribed with nivolumab, human immunoglobulin G4 monoclonal antibody, and inhibitor of programmed death-1 (PD-1) in accordance with melanoma treatment guidelines. Following three courses of nivolumab treatment, the patient presented with grade 3 renal dysfunction (Common Terminology Criteria for Adverse Events version 5.0) . The patient was prescribed steroid therapy for the immune-related adverse events that developed in response to the nivolumab treatment. Despite improved renal function, chemotherapy was discontinued at the patient's request. Five months after the presentation of renal dysfunction, a CT scan demonstrated an unstained nodule in the pancreas with dilation of the caudal pancreatic duct , although the size of the pleural metastasis was unchanged. Intensity-modulated radiotherapy (IMRT) was initiated for pancreatic metastasis treatment at 66 Gy. Six months after IMRT treatment, a CT scan revealed pancreatic nodule and pleural metastasis was shrunk. Eight months after the IMRT (13 months after nivolumab treatment completion), the pleural mass and pleural effusion had disappeared . PET–CT showed no obvious abnormal accumulation . We hypothesized that the abscopal effect was caused by the radiation therapy, and further enhanced by the nivolumab treatment, which had finished 5 months earlier; the timeline of these events is shown in Fig. 5 . Twelve months after the onset of the abscopal effect, no additional lesions were observed and the patient had discontinued all treatment. Fig. 1 Preoperative findings. a Upper gastrointestinal endoscopy image of the raised lesion with ulceration on the posterior wall of the greater curvature of the cardia b Image of tumor invasion into the lower esophagus. c Contrast-enhanced CT of the abdomen showing a mildly stained lesion protruding into the cardiac part of stomach (black arrow). d Enlarged lymph node in the lesser curvature (black arrow) Fig. 2 Pathological findings of the resected tumor. a Resected tissue of the esophagogastric junction. b Hematoxylin and eosin of the resected tumor. Immunostaining of c Melan A, d HMB45, e S-100 protein, and f SOX-10 in the resected tumor Fig. 3 CT images of the chest. a , b CT of the chest, showing nodules in the subpleural area of the lower lobe of the left lung (white arrow) Fig. 4 CT images of the abdominal area. a Abdominal CT showing unstained nodule in the pancreas (black arrow) and dilation of the caudal pancreatic duct. b CT indicating the obscured nodule in the pancreas (black arrow) after radiotherapy. c CT scan showing absence of metastatic lesions and subpleural and pleural effusion after radiotherapy. d , e PET–CT scan showing the absence of abnormal accumulation in the lung area and pancreas Fig. 5 Timeline of the treatment interventions from surgery to metastasis and complete response to treatment. Pre: previous; RT: radiation therapy; Meta: metastasis; Nivo: nivolumab; PR: partial response; CR: complete response; SD: stable disease; M: months
| 4.058594
| 0.973145
|
sec[1]/p[0]
|
en
| 0.999995
|
34882298
|
https://doi.org/10.1186/s40792-021-01336-y
|
[
"tumor",
"lymph",
"metastasis",
"pleural",
"nivolumab",
"lesion",
"curvature",
"black",
"node",
"scan"
] |
[
{
"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": "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 ===
[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
[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 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Localised adiposity
Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....
--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--> [?] Localised adiposity
Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....
--PARENT--> [?] Overweight or localised adiposity
Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E61] Carcinoma in situ of other or unspecified digestive organs
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --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--> [?] Localised adiposity\n Def: A condition characterised by accumulation of adipose tissue in specific regions of the body....\n --PARENT--> [?] Overweight or localised adiposity\n Def: Overweight is a condition characterized by excessive adiposity. Overweight is assessed by the body mass index (BMI), which is a surrogate marker of adiposity calculated as weight (kg)/height² (m²). Th...",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [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 44-year-old male patient presented to the Emergency Department on Jun 07, 2021 (Day 55) with complaints of fever, fatigue, joint pain, nausea, headache, and redness of the eyes for 2 days. The patient reported no systemic disease and a close contact with his wife infected with COVID-19, but his SARS-CoV-2 PCR test was negative on RNA from a nasopharyngeal swab (Day 0). He developed a mild upper respiratory tract infection on his quarantine days between 13–24 April 2021. Once he was admitted by the emergency room , he showed normal oxygen saturation (SpO2: 99% at room air), an elevated fever (39 °C), tachycardia (102 pulses/min), arterial blood pressure (90/60 mmHg), redness in the eyes, and abdominal right lower quadrant tenderness. Elevated inflammatory markers, including ferritin (466 µg/L), C-reactive protein (CRP: 48 mg/L), D-dimer were also found (Table 2 ). His transaminitis (aspartate aminotransferase: 96 U/L and alanine transaminase: 149 U/L) also increased (Table 2 ). Laboratory results showed white blood cells , neutrophils (82.3%), lymphocyte (12.3%, 0.74 × 10^9/L), hemoglobin (13.4 gr/L), platelet (126,000 × 10^9/L), amylase (45U/L), lipase (37U/L), total bilirubin (1.39 mg/dl), prothrombin time (16.4″), and troponin-T (0.005 µg/L). His urine tests revealed elevated proteinuria (3+) and but not nitrite (-), erythrosine (-), and leukocyte (-). Additionally, his SARS-CoV-2 PCR test was found as negative during his ER stay . Radiologically, it was not observed any pathological lesion in his abdominal and thorax CT . Hepatosteatosis (grade 1) was, however, observed in his abdominal ultrasonographic examination. Electrocardiographic results showed negative T waves and nonspecific ST-T segmental changes in V1-V6 derivations. Echocardiography also showed a slight reduction of ejection fraction (EF, 60%) and mild mitral regurgitation (Table 3 ). Fig. 1 Showing chronologically tests and treatments done on the patient. ER Emergency room, IVIG Intravenous immunoglobulin Table 2 The patient laboratory findings Days CRP mg/L Ferritin ng/mL D-dimer ng/mL AST IU/L ALT IU/L Neut % Lymph% WBC cell/uL Procal g/mL Plt cell/uL Day-0 48 466 2033 96 149 82.3 12.3 6 0.24 126 Trx-1 141 3978 1880 110 94 82.7 12.2 7.7 2.35 78 Trx -3 79 3419 964 162 155 82.2 14.2 11.7 0.85 167 Trx -5 29 1079 1120 121 197 54.8 36.3 7.3 0.21 288 Disch 3.2 424 435 404 663 65.2 55.2 5.2 0.065 265 Post-Op 1.3 400 27 31 46.8 40.6 4.3 253 Day 0 means the admission of the patient to the adult covid-19 service from the ER. IVIG and steroid treatment was given on day 1 (trx-1), day 3 (trx-3), day 5 (trx-5). The patient was discharged (Disch) on the day of the 14th, and the patient was seen day 18 (post-op) after the discharge. Neutrophil (Neut); Lymphocyte (Lymph); WBC (White blood cells); Procalcitonin (Procal); Platelet (Plt) Fig. 2 Showing the patient thorax CT on the day of hospitalization. CT revealed the patient's thorax was not involved by the disease Table 3 The patient demographical, and laboratory outcomes during the hospital stay Age (yrs), sex, race/ethnicity, location, BMI. Underlying medical conditions Clinical signs and symptoms Previous respiratory illness/SARS-CoV-2 testing SARS-CoV-2 testing at time of MIS-A admission Imaging/Other diagnostic studies Treatments Outcome and length of stay Screened microorganisms Laboratory findings 43-year old, male, caucasian , BMI:26 kg/m 2 None Fever, weakness, joint pain, abdominal pain, headache, redness eyes, skin lesions Self isolation between Apr 13-24, 2021, COVID 19 PCR (-) on Apr 13, 2021 PCR (-) on Jun 7-9, 2021; Antibody test (+) on Jun 10 2021 Thorax CT: Normal; Abdominal CT:Normal; Abdominal ultrasonography: grade 1 hepatosteatos; at initial admission:[ECHO EF:60, ECG; negative T and non-specific ST-T segmental changes (V1-V6 )]At the discharge [ECHO: EF 64% and normal ECG.] Steroid, IVIG, and LMWH Disovered completely, and discharged at 14th of the treatment Multiple blood cultures N C-reactive protein( < 5 mg/L) 144* Urine culture N D-dimers ( < 500 µg/L) 2033* Rectal swab for multi-drug resistant bacteria N Ferritin (30-400 µg/L) 3978* HBV and HCV N Lactate dehydrogenase (135-225 U/L) 589* Leptospira N White blood count (4.5-10.5x10^9/L) 11.7* Borrelia burgdorferi N Neutrophil count ( 45-78 %) 85.5* SARS-CoV-2 (PCR) N Lymphocyte count (1.32-3.57x10^9/L) 0.74** SARS-CoV-2 (Antibody test) P Platelet count (150–400x10^9/L) 78** CMV IgG P Creatinine (07-1.2mg/dl) 0.9* CMV IgM N Troponin T(0.004 µg/L<) 0.005* EBV IgG N prokalsitonin(< 0.5 µg/L) 2.35* EBV IgM N AST(<40 U/L) 404* Weil felix test N ALT(<41 U/L) 874* HIV N T.Bilirubine(1.2mg/dl<) 2.06* Rickettsia conorii N Sedimantation(mm) 61* HAV TOTAL P Amilaz(28-100 U/L) 60* HAV IgM N Lipaz(13-60 U/L) 55* Brucella N Protrombin time (11"-16.8") 16.4* TPHA N VDRL-RPR N Screen microorganisms were checked from the patient urine, blood and rectal swab during his stay at the infectious department. Throughout his hospital stay, determined his maximum (*) and minimum (**) laboratory findings were shown BMI Body mass index, P Positive, N Negative, IVIG Intravenous immune globulin, LMWH Low molecular weight heparin, * = Maximum value at the given range; ** = Minimum value at the given range
| 4
| 0.976074
|
sec[1]/p[0]
|
en
| 0.999997
|
34991644
|
https://doi.org/10.1186/s12985-021-01736-4
|
[
"sars",
"blood",
"abdominal",
"laboratory",
"stay",
"thorax",
"ivig",
"count",
"emergency",
"fever"
] |
[
{
"code": "1D65",
"title": "Severe acute respiratory syndrome"
},
{
"code": "RA01.0",
"title": "COVID-19, virus identified"
},
{
"code": "RA01.0/CA40.1Z",
"title": "COVID-19 with pneumonia, SARS-CoV-2 identified"
},
{
"code": "RA01.1/CA40.1Z",
"title": "COVID-19 with pneumonia, SARS-CoV-2 not identified"
},
{
"code": "3C0Z",
"title": "Diseases of the blood or blood-forming organs, unspecified"
},
{
"code": "MF50.4Z",
"title": "Haematuria, unspecified"
},
{
"code": "MA12.1",
"title": "Finding of cocaine in blood"
},
{
"code": "MA12.4",
"title": "Finding of steroid agent in blood"
},
{
"code": "MA12.2",
"title": "Finding of hallucinogen in blood"
},
{
"code": "MD81.3",
"title": "Acute abdomen"
}
] |
=== ICD-11 CODES FOUND ===
[1D65] Severe acute respiratory syndrome
Definition: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to pneumonia. Transmission is by direct contact, inhalation of infected respiratory secretions, or airborne transmission. Confirmation is by identification of coronavirus in a blood, stool, respiratory secretions, or body tissue sample.
Also known as: Severe acute respiratory syndrome | SARS - [severe acute respiratory syndrome]
Excludes: COVID-19, virus identified | COVID-19, virus not identified
[RA01.0] COVID-19, virus identified
Also known as: COVID-19, virus identified | 2019-new Coronavirus acute respiratory disease (deprecated) | 2019-nCoV acute respiratory disease [temporary name] (deprecated) | Coronavirus disease 2019 | SARS-CoV-2 disease
Includes: Coronavirus disease 2019 | COVID-19 NOS
Excludes: Coronavirus infection, unspecified site | Middle East respiratory syndrome | Severe acute respiratory syndrome
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
Also known as: Diseases of the blood or blood-forming organs, unspecified | Blood, lymph or spleen disease | blood condition NOS | blood disorder NOS | bone marrow disease NOS
[MF50.4Z] Haematuria, unspecified
Also known as: Haematuria, unspecified | Haematuria | blood in urine | urinary blood | haematuria NOS
[MA12.1] Finding of cocaine in blood
Also known as: Finding of cocaine in blood | cocaine in blood
[MA12.4] Finding of steroid agent in blood
Also known as: Finding of steroid agent in blood | steroid in blood
[MA12.2] Finding of hallucinogen in blood
Also known as: Finding of hallucinogen in blood | hallucinogen in blood
[MD81.3] Acute abdomen
Definition: A clinical syndrome with acute abdominal pain that is severe, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases
Also known as: Acute abdomen | acute abdominal pain syndrome | surgical abdomen | abdominal acute syndrome | severe abdomen pain
=== GRAPH WALKS ===
--- Walk 1 ---
[1D65] Severe acute respiratory syndrome
Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
--EXCLUDES--> [?] COVID-19, virus identified
--CHILD--> [?] COVID-19 with pneumonia, SARS-CoV-2 identified
--- Walk 2 ---
[1D65] Severe acute respiratory syndrome
Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
--EXCLUDES--> [?] COVID-19, virus identified
--EXCLUDES--> [?] Coronavirus infection, unspecified site
--- Walk 3 ---
[RA01.0] COVID-19, virus identified
--EXCLUDES--> [?] Middle East respiratory syndrome
Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...
--PARENT--> [?] Certain zoonotic viral diseases
--- Walk 4 ---
[RA01.0] COVID-19, virus identified
--EXCLUDES--> [?] Severe acute respiratory syndrome
Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...
--EXCLUDES--> [?] COVID-19, virus identified
--- Walk 5 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Certain conditions originating in the perinatal period
Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....
--- Walk 6 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--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 ...
|
[
"[1D65] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...\n --EXCLUDES--> [?] COVID-19, virus identified\n --CHILD--> [?] COVID-19 with pneumonia, SARS-CoV-2 identified",
"[1D65] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...\n --EXCLUDES--> [?] COVID-19, virus identified\n --EXCLUDES--> [?] Coronavirus infection, unspecified site",
"[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Middle East respiratory syndrome\n Def: A disease caused by an infection with Middle East Respiratory Syndrome coronavirus (MERS-CoA). This disease is characterised by severe acute respiratory illness with fever, cough, and shortness of bre...\n --PARENT--> [?] Certain zoonotic viral diseases",
"[RA01.0] COVID-19, virus identified\n --EXCLUDES--> [?] Severe acute respiratory syndrome\n Def: A disease of the respiratory system, caused by an infection with coronavirus. This disease is characterised by fever, headache, cough, myalgia, tachycardia, or diarrhoea. This disease may also lead to...\n --EXCLUDES--> [?] COVID-19, virus identified",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Certain conditions originating in the perinatal period\n Def: This chapter includes conditions that have their origin in the perinatal period even though death or morbidity occurs later....",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ..."
] |
1D65
|
Severe acute respiratory syndrome
|
[
{
"from_icd11": "1D65",
"icd10_code": "U04",
"icd10_title": ""
},
{
"from_icd11": "1D65",
"icd10_code": "U049",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
}
] |
U04
| |
In this case report, we present a challenging condition for a pregnant lady who complained of acute abdominal pain diagnosed with a combination of four gastric band complications including band erosion and, band migration through the gastric lumen that leads to obstruction and perforation. Among these complications, acute gastric ischemia with associated perforation has been only reported rarely . Although, the gastric band erosion with intragastric band migration consider the most worrisome complaction because of the probability of consequent obstruction, peritonitis, and sepsis . Gastric erosion and intragastric band migration may appear either in the early or in the late postoperative settings. Pathogenesis of gastric band erosion is multifactorial and is dependent on the postoperative time frame. and what is has been mentioned in the literature regarding Late band erosions, its typically occur at least 24 months after surgery and are favored to be secondary to sequela of a pressure-induced response or a foreign body rejection reaction . The majority of patient with Gastric band complications usually asymptomatic and it commonly discovered during routine screening with gastroscopy . Furthermore There are no specific symptoms that predict gastric band complications, so Symptomatic patients may present with vague abdominal pain, weight gain resulting to loss of band function, hematemesis, infection, transient or complete obstruction, and rarely bowel perforation . The radiographic and fluoroscopic studies is required during the assessment to confirm the definitive diagnosis, in early sittings it might be Uncertain in absence of previous imaging studies for comparison . In later stages, oral contrast material may be identified surrounding the portion of the band that has eroded into the gastric lumen and increasing accuracy of CT imaging by distended the stomach and by thorough review of multiplanar images . In uncertain cases, a definitive diagnosis can be made with endoscopic examination . In this case, a simple chest x-ray was performed in accordance with the guidelines for pregnant women . In addition, we performed an x-ray abdomen (one shout) erect view with oral gastrografin to provide high-quality imaging to make a definitive medical diagnosis. A fetal radiation doses of less than 50 mGy are not associated with increased fetal anomalies or fetal loss throughout pregnancy . Himpens and his colleagues reported that 50% of band removal was for complications in a cohort with 13 years’ median follow-up . In another study reported that 42% of bands were removed with or without bypass conversion in a cohort with a mean follow-up of 14 years . The majority of late complications after LABG that require surgery (to reposition, remove, or replace the band) can be managed laparoscopically. However, in cases of gastric necrosis or perforation, laparotomy has been proposed as necessary, and the use of laparoscopy has been anecdotal . In the case presented, urgent band removal was imperative. Endoscopic removal techniques have been described in the literature, regardless of whether the band is contained completely within the gastric lumen . Because endoscopic retreating of the band was unattainable, the surgical methods were indicated. In our patient during the operation, As the intraoperative finding was described, including hugely dilated of the proximal part of the stomach to the band and incredibly thickening of the stomach wall, Roux-en-Y surgery which is considered the stander operation in this kind of complications was not preferable. through literature many surgical methods have been described primarily depended on the situation interpretively, healthful lesser curvature could allow gastric tubulization, which guided us to perform a laparoscopic sleeve gastrectomy . In addition, if the greater curvature is not viable, a possible alternative may be considering a subtotal gastrectomy or a gastric bypass. If the cardia is not viable, total gastrectomy with esophagojejunostomy may be compulsory. Conversely, in cases in which the lesser or greater curvatures is completely preserved, sleeve gastrectomy may be the best option; it avoids the need for gastrointestinal anastomosis, and its related consequences . In this case the decision was made to proceed by central gastrectomy with gastrogastrostomy, As with the gastric perforation at the migrated band in the body of the stomach beside huge dilatation above the slipped band combined and contamination of the area, the first option was to do gastric bypass above the perforation area. But due to chronic obstruction, the wall of the stomach was very thick so they will discrepancy with small bowel and the anastomosis will leak, For this reason, we preferred to do central gastrectomy, so, the suture will hold better. Furthermore, this method was carried out effectively as an alternative management for gastric ulcers in an attempt to avoid postoperative dumping syndrome and bile reflux, complaints that were repeatedly seen after conventional distal gastrectomy with a Billroth-I anastomosis as well as intraoperative manual dilatation of pylorus, which provide prevention from pyloric stenosis caused by pyloric spasms .
| 4.191406
| 0.939941
|
sec[6]/p[0]
|
en
| 0.999999
|
32473550
|
https://doi.org/10.1016/j.ijscr.2020.04.087
|
[
"band",
"gastric",
"complications",
"that",
"gastrectomy",
"this",
"perforation",
"stomach",
"erosion",
"obstruction"
] |
[
{
"code": "DC51.1",
"title": "Peritoneal adhesions"
},
{
"code": "LB18",
"title": "Congenital anomalies of intestinal fixation"
},
{
"code": "GA15.3",
"title": "Old laceration of cervix uteri"
},
{
"code": "LA88.Y",
"title": "Other specified congenital anomaly of a ventricle or the ventricular septum"
},
{
"code": "LB03.Y",
"title": "Other specified structural developmental anomalies of umbilical cord"
},
{
"code": "DA4Z",
"title": "Diseases of stomach, unspecified"
},
{
"code": "DA60.Z",
"title": "Gastric ulcer, unspecified"
},
{
"code": "QF01.Y",
"title": "Other specified acquired absence of organs"
},
{
"code": "LB13.Z",
"title": "Structural developmental anomalies of stomach, unspecified"
},
{
"code": "DA42.73",
"title": "Chronic atrophic gastritis of unknown aetiology"
}
] |
=== ICD-11 CODES FOUND ===
[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
[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
[GA15.3] Old laceration of cervix uteri
Definition: An injury of the cervix, caused by trauma subsequent to procedures that lacerate the cervix, such as vaginal delivery, induced abortion, or surgery. This condition is characterised by tearing of the cervix uteri tissue.
Also known as: Old laceration of cervix uteri | old cervical tear | old laceration of cervix | old cervix tear | postpartum cicatrix of cervix
Excludes: Perineal laceration during delivery
[LA88.Y] Other specified congenital anomaly of a ventricle or the ventricular septum
Also known as: Other specified congenital anomaly of a ventricle or the ventricular septum | Congenital right ventricular anomaly | Right ventricular hypoplasia | Hypoplastic right ventricle | Right ventricular myocardial sinusoids
[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
[DA4Z] Diseases of stomach, unspecified
Also known as: Diseases of stomach, unspecified | disorder of stomach | gastropathy NOS | gastric disease NOS | stomach disease NOS
[DA60.Z] Gastric ulcer, unspecified
Also known as: Gastric ulcer, unspecified | Gastric ulcer | stomach ulcer | Cushings ulcer | cushing's ulcer of stomach
[QF01.Y] Other specified acquired absence of organs
Also known as: Other specified acquired absence of organs | Acquired absence of part of head or neck | Acquired absence of eye | absence of eye | absence of eyeball
[LB13.Z] Structural developmental anomalies of stomach, unspecified
Also known as: Structural developmental anomalies of stomach, unspecified | Structural developmental anomalies of stomach | Malformations of stomach
[DA42.73] Chronic atrophic gastritis of unknown aetiology
Definition: Persistent or recurrent inflammation of the gastric mucosa with atrophy leading to decreased hydrochloric acid concentration in the gastric juice. Atrophic gastritis frequently progresses from chronic gastritis.
Also known as: Chronic atrophic gastritis of unknown aetiology | Gastric atrophy | atrophic gastritis | AG - [atrophic gastritis] | CAG - [chronic atrophic gastritis]
Includes: Gastric atrophy
=== GRAPH WALKS ===
--- Walk 1 ---
[DC51.1] Peritoneal adhesions
Def: Disorders of peritoneum sticking by scar tissue or fibrosis...
--EXCLUDES--> [?] Adhesions of large intestine with obstruction
Def: Large bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....
--CHILD--> [?] Postoperative obstruction of the large intestine
--- Walk 2 ---
[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....
--PARENT--> [?] Obstruction of small intestine
Def: Hindrance of the passage of luminal contents in the small intestine. Obstruction of the small intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...
--- Walk 3 ---
[LB18] Congenital anomalies of intestinal fixation
Def: 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 t...
--PARENT--> [?] Structural developmental anomalies of the digestive tract
Def: Any condition caused by failure of the digestive tract to correctly develop during the antenatal period....
--CHILD--> [LB11] Congenital diverticulum of pharynx
Def: A condition caused by failure of the pharynx to correctly develop during the antenatal period. This condition may present with difficulty swallowing, or may be asymptomatic. Confirmation is through ob...
--- Walk 4 ---
[LB18] Congenital anomalies of intestinal fixation
Def: 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 t...
--PARENT--> [?] Structural developmental anomalies of the digestive tract
Def: Any condition caused by failure of the digestive tract to correctly develop during the antenatal period....
--CHILD--> [LB10] Structural developmental anomalies of salivary glands or ducts
Def: Any condition caused by failure of the salivary glands and ducts to correctly develop during the antenatal period....
--- Walk 5 ---
[GA15.3] Old laceration of cervix uteri
Def: An injury of the cervix, caused by trauma subsequent to procedures that lacerate the cervix, such as vaginal delivery, induced abortion, or surgery. This condition is characterised by tearing of the c...
--EXCLUDES--> [?] Perineal laceration during delivery
Def: An injury characterised by a laceration to the maternal perineum during delivery....
--CHILD--> [?] First degree perineal laceration during delivery
Def: Perineal lacerations involving the fourchette, perineal skin, and vaginal mucous membrane but not the underlying fascia and muscle....
--- Walk 6 ---
[GA15.3] Old laceration of cervix uteri
Def: An injury of the cervix, caused by trauma subsequent to procedures that lacerate the cervix, such as vaginal delivery, induced abortion, or surgery. This condition is characterised by tearing of the c...
--EXCLUDES--> [?] Perineal laceration during delivery
Def: An injury characterised by a laceration to the maternal perineum during delivery....
--CHILD--> [?] First degree perineal laceration during delivery
Def: Perineal lacerations involving the fourchette, perineal skin, and vaginal mucous membrane but not the underlying fascia and muscle....
|
[
"[DC51.1] Peritoneal adhesions\n Def: Disorders of peritoneum sticking by scar tissue or fibrosis...\n --EXCLUDES--> [?] Adhesions of large intestine with obstruction\n Def: Large bowel obstruction resulting from intraabdominal adhesion due to laparotomy, trauma, and intraabdominal inflammation such as endometriosis....\n --CHILD--> [?] Postoperative obstruction of the large intestine",
"[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 --PARENT--> [?] Obstruction of small intestine\n Def: Hindrance of the passage of luminal contents in the small intestine. Obstruction of the small intestine can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is ...",
"[LB18] Congenital anomalies of intestinal fixation\n Def: 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 t...\n --PARENT--> [?] Structural developmental anomalies of the digestive tract\n Def: Any condition caused by failure of the digestive tract to correctly develop during the antenatal period....\n --CHILD--> [LB11] Congenital diverticulum of pharynx\n Def: A condition caused by failure of the pharynx to correctly develop during the antenatal period. This condition may present with difficulty swallowing, or may be asymptomatic. Confirmation is through ob...",
"[LB18] Congenital anomalies of intestinal fixation\n Def: 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 t...\n --PARENT--> [?] Structural developmental anomalies of the digestive tract\n Def: Any condition caused by failure of the digestive tract to correctly develop during the antenatal period....\n --CHILD--> [LB10] Structural developmental anomalies of salivary glands or ducts\n Def: Any condition caused by failure of the salivary glands and ducts to correctly develop during the antenatal period....",
"[GA15.3] Old laceration of cervix uteri\n Def: An injury of the cervix, caused by trauma subsequent to procedures that lacerate the cervix, such as vaginal delivery, induced abortion, or surgery. This condition is characterised by tearing of the c...\n --EXCLUDES--> [?] Perineal laceration during delivery\n Def: An injury characterised by a laceration to the maternal perineum during delivery....\n --CHILD--> [?] First degree perineal laceration during delivery\n Def: Perineal lacerations involving the fourchette, perineal skin, and vaginal mucous membrane but not the underlying fascia and muscle....",
"[GA15.3] Old laceration of cervix uteri\n Def: An injury of the cervix, caused by trauma subsequent to procedures that lacerate the cervix, such as vaginal delivery, induced abortion, or surgery. This condition is characterised by tearing of the c...\n --EXCLUDES--> [?] Perineal laceration during delivery\n Def: An injury characterised by a laceration to the maternal perineum during delivery....\n --CHILD--> [?] First degree perineal laceration during delivery\n Def: Perineal lacerations involving the fourchette, perineal skin, and vaginal mucous membrane but not the underlying fascia and muscle...."
] |
DC51.1
|
Peritoneal adhesions
|
[
{
"from_icd11": "DC51.1",
"icd10_code": "K660",
"icd10_title": "Peritoneal adhesions (postprocedural) (postinfection)"
},
{
"from_icd11": "LB18",
"icd10_code": "Q433",
"icd10_title": "Congenital malformations of intestinal fixation"
},
{
"from_icd11": "GA15.3",
"icd10_code": "N881",
"icd10_title": "Old laceration of cervix uteri"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K259",
"icd10_title": "Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K255",
"icd10_title": "Chronic or unspecified gastric ulcer with perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K254",
"icd10_title": "Chronic or unspecified gastric ulcer with hemorrhage"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K257",
"icd10_title": "Chronic gastric ulcer without hemorrhage or perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K250",
"icd10_title": "Acute gastric ulcer with hemorrhage"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K256",
"icd10_title": "Chronic or unspecified gastric ulcer with both hemorrhage and perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K253",
"icd10_title": "Acute gastric ulcer without hemorrhage or perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K252",
"icd10_title": "Acute gastric ulcer with both hemorrhage and perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K251",
"icd10_title": "Acute gastric ulcer with perforation"
},
{
"from_icd11": "DA60.Z",
"icd10_code": "K25",
"icd10_title": "Gastric ulcer"
},
{
"from_icd11": "QF01.Y",
"icd10_code": "Z9049",
"icd10_title": "Acquired absence of other specified parts of digestive tract"
},
{
"from_icd11": "LB13.Z",
"icd10_code": "Q402",
"icd10_title": "Other specified congenital malformations of stomach"
}
] |
K660
|
Peritoneal adhesions (postprocedural) (postinfection)
|
The 44-year-old man in this study was presented with sudden-onset, persistent epigastralgia and had undergone living donor living transplantation (LDLT) for familial amyloid polyneuropathy at 42 years of age, with the left hepatic lobe graft donated by his wife. During LT, biliary reconstruction was performed by hepaticojejunostomy with a Roux limb via the antecolic route as the common bile duct was removed for the sake of the following domino LT. The peritoneal defect related to Roux-en-Y anastomosis was primarily closed with several 4–0 silk interrupted sutures. Although he had experienced repeated episodes of small bowel obstruction, which had all recovered fully following conservative management, at 5, 9, and 14 months post-transplantation, continuous epigastralgia and repeated vomiting for 7 h during the present admission prompted clinical suspicion of bowel strangulation. Abdominal guarding and rigidity in the epigastric region were noted on examination. The body temperature was 37.1 °C. The blood pressure and heart rate were 132/86 mmHg and 105 bpm, respectively. The white blood cell count was elevated at 11,500/μl comprised of 89% neutrophils. However, no significant abnormalities in liver functional tests were observed. We suspected an abdominal emergency and performed an abdominal CT scan that demonstrated dilated, fluid-filled small bowel loops with poor enhancement of the intestinal wall . In particular, the Roux limb was markedly dilated . Further, a “whirl” appearance and ascites were depicted indicating small bowel volvulus . We immediately performed emergent surgery at 6 h after hospital arrival. On laparotomy, no intraperitoneal adhesions were observed. We identified an internal hernia through Petersen’s defect , with a small bowel loop incarcerated beneath the mesenterium of Roux limb through Petersen’s defect causing ischemia of the limb. Following gentle manual repositioning of the incarcerated jejunum, the ischemic color of both the small bowel loop and the Roux limb gradually ameliorated. Although the former recovered completely in color, the appearance of the latter failed to regain normal color. As a treatment plan, we elected to perform a second-look operation after 48 h for precisely evaluating the condition of the limb. On re-exploration, the Roux limb remained partially dark in color indicating the possibility of remaining ischemic damage. Intraoperative endoscopic examination was performed to determine the most appropriate definitive treatment, revealing partial ischemic injury affecting the mucosa only and that the hepaticojejunostomy was intact. On the basis of endoscopic findings, we decided to perform a resection of the portion of limb affected by mucosal necrosis, followed by a jejunojejunostomy in a side-to-side fashion. Consequently a reanastomosis of the hepaticojejunostomy using a newly made limb could be avoided, a procedure that may be complicated by technical difficulty and considered a high-risk procedure in emergent settings. The postoperative course was uneventful and the patient was discharged from hospital on postoperative day 43. Unfortunately, CT imaging at 1 month after discharge showed dilatation of both the limb and intrahepatic bile ducts . We diagnosed stenosis of the limb and performed percutaneous transhepatic biliary drainage (PTBD) from a dilated terminal branch of B2 using a 7.2 Fr straight tube. Cholangiography via PTBD demonstrated segmental stenosis of the limb likely due to ischemic changes in the serosa; however, the hepaticojejunostomy appeared intact. PTBD tube was changed to 12 Fr internal-external drainage tube and placed across the jejunal stenosis , followed by balloon dilation with 12 mm diameter . Although a balloon dilation procedure was required five times, the stenotic site was successfully dilated and the PTBD tube was eventually removed 2 years after the emergency event . Recurrence of Roux limb stenosis or intrahepatic bile duct dilatation has not been observed thereafter. Fig. 1 Enhanced abdominal CT scan on an arrival a Coronal plane. b , c Transverse plane. a – c CT demonstrated dilated, fluid-filled small bowel loops with poor enhancement of the bowel wall. Arrows indicate a markedly dilated Roux limb. c. The triangle arrow indicates a “whirl” appearance Fig. 2 Operative findings. We identified an internal hernia through Petersen’s defect between the limb and mesocolon ( triangle arrow ). The incarcerated small bowel loop resulted in ischemia of the Roux limb ( arrow ) Fig. 3 Intraoperative endoscopy view during re-exploration. Intraoperative endoscopic findings revealed only partial ischemic injury to the mucosa only Fig. 4 Stenosis of Roux limb at a month after discharge and the treatments. a CT showed dilatation of both the limb and intrahepatic bile ducts. Arrow indicates stenosis of the limb. b Tube cholangiogram through a PTBD tube of 12 Fr inserted across the stenotic lesion of Roux limb. Arrows indicate stenosis of the limb. The triangle arrow indicates the intact hepaticojejunostomy anastomosis. c Balloon dilation of the stenotic portion of the limb (12 mm in diameter). d The PTBD tube was removed 2 years after the emergency event. Arrows indicate the expanded limb
| 3.960938
| 0.979004
|
sec[1]/p[0]
|
en
| 0.999996
|
28831719
|
https://doi.org/10.1186/s40792-017-0364-5
|
[
"limb",
"roux",
"bowel",
"small",
"stenosis",
"tube",
"dilated",
"ptbd",
"hepaticojejunostomy",
"ischemic"
] |
[
{
"code": "ND56.1",
"title": "Open wound of unspecified body region"
},
{
"code": "LB9Z",
"title": "Structural developmental anomalies of the skeleton, unspecified"
},
{
"code": "FB56.6",
"title": "Other specified soft tissue disorders"
},
{
"code": "5B51&XS25",
"title": "Severe wasting in infants, children or adolescents"
},
{
"code": "ND55",
"title": "Other injuries of leg, level unspecified"
},
{
"code": "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"
}
] |
=== ICD-11 CODES FOUND ===
[ND56.1] Open wound of unspecified body region
Also known as: Open wound of unspecified body region | cut NOS | open wound NOS | penetrating wound NOS | Puncture wound with foreign body unspecified body region
Excludes: Traumatic amputations involving multiple body regions | Open wounds involving multiple body regions | traumatic amputation NOS
[LB9Z] Structural developmental anomalies of the skeleton, unspecified
Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS
[FB56.6] Other specified soft tissue disorders
Also known as: Other specified soft tissue disorders | Fat necrosis | fatty necrosis | Profichet's disease | Sloughing of fascia
[ND55] Other injuries of leg, level unspecified
Also known as: Other injuries of leg, level unspecified | other injuries of lower limb, level unspecified | Superficial injury of leg, level unspecified | Abrasion of leg, level unspecified | Contusion of leg, level unspecified
Excludes: Fracture of leg, level unspecified | Injuries involving multiple body regions
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[ND56.1] Open wound of unspecified body region
--EXCLUDES--> [?] Traumatic amputations involving multiple body regions
--EXCLUDES--> [?] Other injuries of arm, level unspecified
--- Walk 2 ---
[ND56.1] Open wound of unspecified body region
--EXCLUDES--> [?] Open wounds involving multiple body regions
--EXCLUDES--> [?] Traumatic amputations involving multiple body regions
--- Walk 3 ---
[LB9Z] Structural developmental anomalies of the skeleton, unspecified
--PARENT--> [?] Structural developmental anomalies of the skeleton
Def: A deformation established before birth of an anatomical structure of one or more bones....
--CHILD--> [LB72] Structural developmental anomalies of shoulder girdle
Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....
--- Walk 4 ---
[LB9Z] Structural developmental anomalies of the skeleton, unspecified
--PARENT--> [?] Structural developmental anomalies of the skeleton
Def: A deformation established before birth of an anatomical structure of one or more bones....
--CHILD--> [LB71] Structural developmental anomalies of facial bones
Def: Any condition caused by failure of the facial bones to correctly develop during the antenatal period....
--- Walk 5 ---
[FB56.6] Other specified soft tissue disorders
--PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified
Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....
--CHILD--> [FB56.2] Myalgia
Def: This is a disorder characterised by pain in a muscle or group of muscles....
--- Walk 6 ---
[FB56.6] Other specified soft tissue disorders
--PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified
Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....
--CHILD--> [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified
|
[
"[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions\n --EXCLUDES--> [?] Other injuries of arm, level unspecified",
"[ND56.1] Open wound of unspecified body region\n --EXCLUDES--> [?] Open wounds involving multiple body regions\n --EXCLUDES--> [?] Traumatic amputations involving multiple body regions",
"[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB72] Structural developmental anomalies of shoulder girdle\n Def: Any condition caused by failure of the shoulder girdle to correctly develop during the antenatal period....",
"[LB9Z] Structural developmental anomalies of the skeleton, unspecified\n --PARENT--> [?] Structural developmental anomalies of the skeleton\n Def: A deformation established before birth of an anatomical structure of one or more bones....\n --CHILD--> [LB71] Structural developmental anomalies of facial bones\n Def: Any condition caused by failure of the facial bones to correctly develop during the antenatal period....",
"[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --CHILD--> [FB56.2] Myalgia\n Def: This is a disorder characterised by pain in a muscle or group of muscles....",
"[FB56.6] Other specified soft tissue disorders\n --PARENT--> [FB56] Specified soft tissue disorders, not elsewhere classified\n Def: This is a group of other disorders, which are not classified elsewhere, affecting tissues that connect, support, or surround other structures and organs of the body, not being bone....\n --CHILD--> [FB56.0] Foreign body granuloma of soft tissue, not elsewhere classified"
] |
ND56.1
|
Open wound of unspecified body region
|
[
{
"from_icd11": "ND56.1",
"icd10_code": "T141",
"icd10_title": ""
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q8789",
"icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q8781",
"icd10_title": "Alport syndrome"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q742",
"icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q749",
"icd10_title": "Unspecified congenital malformation of limb(s)"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q740",
"icd10_title": "Other congenital malformations of upper limb(s), including shoulder girdle"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q741",
"icd10_title": "Congenital malformation of knee"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q875",
"icd10_title": "Other congenital malformation syndromes with other skeletal changes"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q748",
"icd10_title": "Other specified congenital malformations of limb(s)"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q89",
"icd10_title": "Other congenital malformations, not elsewhere classified"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q65-Q79",
"icd10_title": ""
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q73",
"icd10_title": "Reduction defects of unspecified limb"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q730",
"icd10_title": "Congenital absence of unspecified limb(s)"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q731",
"icd10_title": "Phocomelia, unspecified limb(s)"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q74",
"icd10_title": "Other congenital malformations of limb(s)"
}
] |
T141
| |
A 76‐year‐old man presented with dyspnea persisting for 6 months. He had no family history of cancer. Chest radiograph showed substantial left pleural effusion, and chest computed tomography (CT) demonstrated extensive thickening of the left parietal pleura. A full‐body CT scan did not reveal any metastatic lesions. Parietal pleural biopsy revealed biphasic malignant mesothelioma. The patient received various chemotherapy treatments for 67 months, which included 3 cycles of cisplatin and pemetrexed, 3 cycles of carboplatin and pemetrexed, 27 cycles of pemetrexed alone, and 2 cycles of gemcitabine and 10 cycles of radiation. However, the tumor showed repeated remission and recurrence, resulting in multi‐organ metastases including dissemination of cells to the left lung, bones, parabronchial lymph nodes, and peritoneum. The patient's performance status dropped to 2. The best supportive care was being considered as there was no effective chemotherapy. Around the same time, NIVO monotherapy as a second‐line treatment for patients with malignant mesothelioma 12 was approved to be covered under insurance. Approximately 5 months after the last chemotherapy, the patient was initiated on NIVO monotherapy (NIVO 240 mg/body intravenously every 2 weeks). However, on the 15th day after the start of the second course of NIVO therapy, a rapid increase in the levels of liver enzymes was noted . The total bilirubin level was 0.6 mg/dL (normal range, 0.4–1.5 mg/dl); furthermore, it was consistently within the normal range at 0.4–0.7 mg/dl throughout the subsequent clinical course. The patient showed no symptoms of hepatitis and was negative for markers for hepatitis A virus, hepatitis B virus, hepatitis C virus, cytomegalovirus (CMV), and Epstein‐Barr virus (EBV). In addition, serum immunoglobulin G (IgG), IgG4, and IgM levels were normal, and anti‐nuclear, anti‐mitochondrial, and anti‐smooth muscle antibodies were all negative. The patient had no history of alcohol consumption. On abdominal CT, no obstructive lesions were detected in the extrahepatic and intrahepatic bile ducts, gallbladder stones were not observed, and no significant changes were noted in the pancreas and duodenal papilla. Bile secretion appeared good on examination of the biliary scintigram. These findings suggested intrahepatic cholestasis. Based on the above clinical data, NIVO‐induced hepatic irAEs were suspected, and the third course of NIVO therapy was abandoned. To verify the diagnosis of hepatic irAEs, a liver biopsy was performed. The biopsy period corresponded to the 47 th day from the start of the first course of NIVO therapy. Biopsy revealed various pathological findings, the details of which are described under the section, “Liver pathology.” The severity of hepatic irAEs was graded based on the Common Terminology Criteria for Adverse Events of the National Cancer Institute, version 5.0. 13 When the liver enzymes increased rapidly, the serum levels of both ALT and AST (transaminases) corresponded to grade 3, and those of both ALP and γ‐GTP (biliary enzymes) corresponded to grade 4. 13 However, after the discontinuation of NIVO therapy, the serum levels of transaminases rapidly decreased to grade 2 or 1. In contrast, biliary enzyme levels showed a slight decreasing tendency once, but persisted at grade 3 . Based on the treatment for grade 2 irAEs, the patient was started on 20 mg/day oral prednisolone (PSL). The recommended initial dose is 0.5–1 mg/kg/day, 10 , 11 at which time the patient weighed approximately 35 kg and was 160 cm in height. Even after continuing the steroid treatment for 3 weeks, the serum levels of transaminases did not improve completely from grade 2 to grade 1 or less. In addition, biliary enzyme levels remained at grade 3 . Therefore, the treatment has been changed to comply with grade 3 irAE management. 10 Methylprednisolone (mPSL) was initially administered intravenously at 20 mg/day for 5 days and then at 50 mg/day for 7 days (recommended initial dose of 1–2 mg/kg/day 10 , 11 ), and its dose was gradually tapered. The treatment was administered until just before death, and eventually, mPSL was administered for 78 days . During this treatment, the serum levels of transaminases improved from grade 2 to grade 1, but did not normalize. In addition, biliary enzymes persisted at grades 2 or 3 . At this time, the patient had no signs of infectious diseases, and the second‐line option with mycophenolate mofetil (MMF) was considered. 4 , 10 , 11 , 14 However, the patient developed cachexia, due to peritoneal dissemination and multi‐organ metastases, and his general condition continued to worsen. Administration of MMF was abandoned due to high risk of infection. Approximately 5.5 months after the start of the first course of NIVO therapy, the patient died of advanced cachexia and autopsied. The patient did not have disseminated intravascular coagulation. At autopsy, the tumor had extensively disseminated to the peritoneum (maximum diameter of 8 cm) and had metastasized to multiple organs (maximum diameter of 6.5 cm), including the left lung and left kidney. However, therapeutic effects were minimal. There were no lesions in any of the organs suggesting a serious infection.
| 4.109375
| 0.964355
|
sec[1]/p[0]
|
en
| 0.999997
|
34987810
|
https://doi.org/10.1002/ccr3.5174
|
[
"grade",
"nivo",
"cycles",
"however",
"course",
"serum",
"biliary",
"biopsy",
"liver",
"enzymes"
] |
[
{
"code": "EH90.Z",
"title": "Pressure ulcer of unspecified grade"
},
{
"code": "EH90.0",
"title": "Pressure ulceration grade 1"
},
{
"code": "GA91.6",
"title": "Low grade intraepithelial lesion of prostate"
},
{
"code": "2E67.22",
"title": "High grade squamous intraepithelial lesion of vagina"
},
{
"code": "EH90.1",
"title": "Pressure ulceration grade 2"
},
{
"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 ===
[EH90.Z] Pressure ulcer of unspecified grade
Also known as: Pressure ulcer of unspecified grade | Pressure ulceration | pressure injury | pressure ulcer | decubitus ulcer
[EH90.0] Pressure ulceration grade 1
Definition: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. It can be difficult to detect in individuals with dark skin but affected areas may differ in colour from the surrounding skin. The presence of pressure ulceration grade 1 may indicate persons at risk of progressing to frank ulceration.
Also known as: Pressure ulceration grade 1 | pressure injury stage 1 | pressure injury stage 1 with nonblanchable erythema | pressure ulcer category 1 | stage I pressure injury
Includes: pressure injury stage 1 with nonblanchable erythema
[GA91.6] Low grade intraepithelial lesion of prostate
Definition: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by premalignant transformation and abnormal development of the prostatic epithelial tissue.
Also known as: Low grade intraepithelial lesion of prostate | Low grade PIN - [prostatic intraepithelial neoplasia] | Low grade prostatic intraepithelial neoplasia | PIN - [prostatic intraepithelial neoplasia] grade 1 to 2 | Low grade dysplasia of prostate
Includes: Low grade prostatic intraepithelial neoplasia
Excludes: high grade dysplasia of prostate | PIN III | high grade PIN
[2E67.22] High grade squamous intraepithelial lesion of vagina
Also known as: High grade squamous intraepithelial lesion of vagina | vaginal intraepithelial neoplasia grade II | moderate vaginal dysplasia | vaginal intraepithelial neoplasia grade 2 | VaIN - [vaginal intraepithelial neoplasia] grade 2
[EH90.1] Pressure ulceration grade 2
Definition: Pressure injury with partial thickness loss of dermis. It presents as a shallow open ulcer with a red or pink wound bed without slough or as a serum-filled or serosanguinous blister which may rupture.
This category should not be used to describe skin tears, tape burns, incontinence associated dermatitis, maceration or excoriation
Also known as: Pressure ulceration grade 2 | bedsore stage II | pressure injury stage 2 | pressure ulcer category 2 | pressure injury stage 2 with partial thickness skin loss
Includes: pressure injury stage 2 with partial thickness skin loss
[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 ---
[EH90.Z] Pressure ulcer of unspecified grade
--PARENT--> [EH90] Pressure ulceration
Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...
--CHILD--> [EH90.2] Pressure ulceration grade 3
Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...
--- Walk 2 ---
[EH90.Z] Pressure ulcer of unspecified grade
--PARENT--> [EH90] Pressure ulceration
Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...
--EXCLUDES--> [?] Erosion or ectropion of cervix uteri
Def: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium...
--- Walk 3 ---
[EH90.0] Pressure ulceration grade 1
Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...
--PARENT--> [EH90] Pressure ulceration
Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...
--EXCLUDES--> [?] Erosion or ectropion of cervix uteri
Def: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium...
--- Walk 4 ---
[EH90.0] Pressure ulceration grade 1
Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...
--PARENT--> [EH90] Pressure ulceration
Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...
--CHILD--> [EH90.2] Pressure ulceration grade 3
Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...
--- Walk 5 ---
[GA91.6] Low grade intraepithelial lesion of prostate
Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by...
--PARENT--> [GA91] Inflammatory or other diseases of prostate
Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....
--PARENT--> [?] Diseases of prostate
--- Walk 6 ---
[GA91.6] Low grade intraepithelial lesion of prostate
Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by...
--EXCLUDES--> [?] High grade intraepithelial lesion of prostate
Def: High grade prostatic intraepithelial neoplasia characterised by the presence of severe architectural and cytologic abnormalities....
--PARENT--> [?] Neoplasms of the male genital organs
|
[
"[EH90.Z] Pressure ulcer of unspecified grade\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --CHILD--> [EH90.2] Pressure ulceration grade 3\n Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...",
"[EH90.Z] Pressure ulcer of unspecified grade\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --EXCLUDES--> [?] Erosion or ectropion of cervix uteri\n Def: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium...",
"[EH90.0] Pressure ulceration grade 1\n Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --EXCLUDES--> [?] Erosion or ectropion of cervix uteri\n Def: A condition of the cervix uteri, caused by an increase in the total estrogen level in the body. This condition is characterised by protrusion and transformation of the endocervical columnar epithelium...",
"[EH90.0] Pressure ulceration grade 1\n Def: Pressure ulceration grade I is a precursor to skin ulceration. The skin remains intact but there is non-blanchable redness of a localised area, usually over a bony prominence. The area may be painful,...\n --PARENT--> [EH90] Pressure ulceration\n Def: Pressure ulcers result from localised injury and ischaemic necrosis of skin and underlying tissues due to prolonged pressure, or pressure in combination with shear; bony prominences of the body are th...\n --CHILD--> [EH90.2] Pressure ulceration grade 3\n Def: Pressure ulcer with full thickness skin loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. There may...",
"[GA91.6] Low grade intraepithelial lesion of prostate\n Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by...\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --PARENT--> [?] Diseases of prostate",
"[GA91.6] Low grade intraepithelial lesion of prostate\n Def: A condition of the prostate, caused by an alteration or mutation in cell growth, or prostatic epithelial cells that are dividing more rapidly than normal epithelium. This condition is characterised by...\n --EXCLUDES--> [?] High grade intraepithelial lesion of prostate\n Def: High grade prostatic intraepithelial neoplasia characterised by the presence of severe architectural and cytologic abnormalities....\n --PARENT--> [?] Neoplasms of the male genital organs"
] |
EH90.Z
|
Pressure ulcer of unspecified grade
|
[
{
"from_icd11": "EH90.Z",
"icd10_code": "L89623",
"icd10_title": "Pressure ulcer of left heel, stage 3"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89621",
"icd10_title": "Pressure ulcer of left heel, stage 1"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89899",
"icd10_title": "Pressure ulcer of other site, unspecified stage"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89620",
"icd10_title": "Pressure ulcer of left heel, unstageable"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89622",
"icd10_title": "Pressure ulcer of left heel, stage 2"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89892",
"icd10_title": "Pressure ulcer of other site, stage 2"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89519",
"icd10_title": "Pressure ulcer of right ankle, unspecified stage"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89891",
"icd10_title": "Pressure ulcer of other site, stage 1"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89610",
"icd10_title": "Pressure ulcer of right heel, unstageable"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89893",
"icd10_title": "Pressure ulcer of other site, stage 3"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89890",
"icd10_title": "Pressure ulcer of other site, unstageable"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89629",
"icd10_title": "Pressure ulcer of left heel, unspecified stage"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89619",
"icd10_title": "Pressure ulcer of right heel, unspecified stage"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L8945",
"icd10_title": "Pressure ulcer of contiguous site of back, buttock and hip, unstageable"
},
{
"from_icd11": "EH90.Z",
"icd10_code": "L89894",
"icd10_title": "Pressure ulcer of other site, stage 4"
}
] |
L89623
|
Pressure ulcer of left heel, stage 3
|
One week after termination of the root canal treatment, surgery was scheduled in order to finally clarify the diagnosis of this osteolytic process. Due to a respiratory infection of the patient, surgery was postponed for another week. Because of the findings collected during clinical and radiographic examinations as well as endodontic treatment, the surgical procedure was planned to be carried out as minimally-invasive and tissue conservative as possible. At that time, the most probable diagnosis was that of an infected radicular cyst proceeding from the mesial root of tooth 36. This diagnosis was possible despite the prior positive pulp sensibility of teeth 36 considering that only the mesial root was affected by the lesion and the vitality of the distal root was responsible for the results of the pulp sensibility test. Prior to the start of the surgical procedure, again the sensibility of the mental nerve was tested as well as the sensibility of the teeth 34, 35, and 37. No limitations could be detected. Local anaesthesia was performed with articaine with supplement of epinephrine 1:100,000 (Ultracain forte, Sanofi-Aventis, Frankfurt, Germany) via infiltration anaesthesia. The design of the full thickness flap was as minimally-invasive as possible. The papilla 34 to 35 was detached, marginal incision was made along 35 to 36. Due to the close anterior positional relationship of the mental foramen to the space-consuming lesion, the decision was reached to perform a distal vertical relief incision, which was directly distal from the papilla 36 to 37. The mucoperiosteal flap was elevated with a raspatory, followed by blunt preparation with a gauze pad up to 1 cm near the expected mental foramen. Thereby, the nerve was gently exposed and could be protected by the use of a narrow, blunt retractor. The bony access was chosen in a more distal position above the suspected space-occupying lesion, and initially prepared with a rose head bur followed by a diamond bur after the color of the bone changed to darker. When the covering bone, which was consecutively put into 4 % formalin and turned in for histopathological examination, was completely removed, the dark red color of the lesion appeared. Surprisingly, the consistence of the lesion seemed not to be firm elastic as expected for an anticipated cystic lesion. In the contrary, the lesion appeared very solid, it was hardly possible to achieve a slight impression. At this point, it was clear that the originally planned surgical intervention could not be an ordinary biopsy. Moreover, due to the consistence and topographic location of the tissue in the lesion, it appeared also obligate to avoid an incision biopsy to minimize any risk for the alveolar nerve. The risk of an axonal injury was too high, because of the obscure position of the mental nerve. Therefore, the original plan to take a surgical probe excision, was neglected and in lieu thereof the entire removal of the tissue was intended. Thus, different sinus-lifting elevators (Frios â SinusSet, Dentsply IH GmbH, Mannheim, Germany) were used to carefully prepare the lesion in the posterior region. It was possible to detach the mass off the bony wall. In combination with gentle swinging and shaking movements the inferior alveolar nerve could be depicted in the posterior region. Integrity of the nerve could be controlled via mild pulling on the nerve covering tissue and observing the little movements outside the mental foramen. The same procedure was performed in the anterior part of the bony cavity until the nerve was depicted here also. The strong adherence of the nerve enclosing tissue was detached by spreading the mass with tweezers and blunt preparation with a scissor precisely to the border of the nerve sheath, beginning from the edges to the centre. Finally, both structures could be separated, whereupon the nerve was exposed in the middle of the bony cavity without any conspicuous damages or alterations of the nerve sheath . The removed tissue was also put into 4 % formalin and turned in for histopathological verification . A minimally-invasive apicoectomy of the mesial root of tooth 36 was performed. The distal root tip remained untouched during surgery and was purely treated with an orthograde root filling prior to the surgical intervention. As an X-ray prior to the surgical intervention showed that the sealer of the mesial root has been overfilled apically in terms of the orthograde filling though , the exceeding sealer was cured with access from the lesion’s lumen intraoperatively and the root tip was then minimally reduced by using surgical drills. Since the orthograde root canal fillings were of high quality and very solid, no retrograde cavity with following filling were implemented . The bony wall of the defect was gently scraped with a sharp spoon without any contact to the nerve. Thereby, a good blood seepage was achieved. The access flap was adapted with single button sutures (Ethibond 5-0-, Ethicon/ Johnson & Johnson, Neuss, Germany) in a more coronal position to cover the former vestibular gingival recession the teeth 45 and 46. Subsequently, after surgery, pain stimulus caused by stitches with a dental probe was realized by the patient.
| 4.054688
| 0.952637
|
sec[3]/p[0]
|
en
| 0.999998
|
36639813
|
https://doi.org/10.1186/s13005-022-00346-x
|
[
"nerve",
"root",
"lesion",
"tissue",
"possible",
"that",
"mental",
"bony",
"minimally",
"mesial"
] |
[
{
"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": "DA07.4",
"title": "Root anomaly"
},
{
"code": "DA0A.3",
"title": "Retained dental root"
},
{
"code": "MD80.Y",
"title": "Other specified symptoms or signs of the orofacial complex"
},
{
"code": "NA0D.06",
"title": "Root fracture"
},
{
"code": "8B9Z",
"title": "Nerve root or plexus disorders, unspecified"
}
] |
=== 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
[DA07.4] Root anomaly
Definition: 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 which are the most anomaly in one fused root, 2 or 3 fused roots, even 4 fused roots, round apical root or dilacerations.
Also known as: Root anomaly | Supernumerary roots
[DA0A.3] Retained dental root
Definition: Complete or fragment of root structure that remains in the jaw usually as result of fracture during the corresponding tooth extraction procedure.
Also known as: Retained dental root | dental root | dental root retention
[MD80.Y] Other specified symptoms or signs of the orofacial complex
Also known as: Other specified symptoms or signs of the orofacial complex | Bleeding gums | gum haemorrhage | gingival haemorrhage | gingiva haemorrhage
[NA0D.06] Root fracture
Definition: A fracture involving dentin, cementum and the pulp.
Also known as: Root fracture | Fracture of tooth root
[8B9Z] Nerve root or plexus disorders, unspecified
Also known as: Nerve root or plexus disorders, unspecified
=== GRAPH WALKS ===
--- Walk 1 ---
[8C1Z] Mononeuropathy of unspecified site
--PARENT--> [?] Mononeuropathy
--CHILD--> [8C10] Mononeuropathies of upper limb
Def: Damage to a single nerve or nerve group of the upper 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--> [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 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
--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....
--- 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--> [8C10] Mononeuropathies of upper limb\n Def: Damage to a single nerve or nerve group of the upper 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--> [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...",
"[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 --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....",
"[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 39-year-old Japanese man visited our hospital with a 3-day history of mild headache, shoulder stiffness, and a feeling of dizziness. As the headache was only slight, he was able to remember what he was doing when the headache first developed. The patient was able to live a normal daily life prior to visiting our hospital with his symptoms. An initial examination on first presentation revealed that the patient was 170.0 cm in height, weighed 69.0 kg, and had a body mass index of 23.9. His blood pressure was 152/80 mmHg, with a regular pulse rate of 46 beats/min, and his body temperature was 35.9 °C. Physical examination revealed mild stiffness in the neck. No neurological findings were evident, and the patient’s laboratory data were normal. CT did not show any obvious abnormalities indicating hemorrhage or infraction. However, the Sylvian fissures were not clearly visible bilaterally due isoattenuating SAH in the Sylvian fissures (slightly hyperattenuating on the left) . Interestingly, the patient had visited our hospital 2 years ago complaining of occipital headache, nausea, and vomiting. At that time, CT was performed, which showed no abnormalities but provides useful normal comparison images . Another finding worth mentioning on Fig. 1a was mild hydrocephalus - seen as enlargement of the third ventricle - again, in comparison to the previous CT . Consequently, he was diagnosed with a tension headache. Comparing the current CT images to those from his previous visit, we observed a clear difference in the sulcus in the cerebral cortex, which appeared to be narrower and was accompanied by cerebral edema. In addition, Fig. 2a is at the level of the midbrain (mesencephalon) that traverses the infundibulum of third ventricle, interpeduncular cistern, there appears to be hyperattenuating blood in the medial portion of the left Sylvian fissure and extending into the anterior interhemispheric fissure, and shows mild dilation of the temporal horns of the lateral ventricles (looks like a moustache). In addition, the suprasellar cistern seem on this slice is filled with isoattenuating blood . In the center of the suprasellar cistern is cerebrospinal fluid (CSF) that is hypoattenuating in the dilated infundibulum of the third ventricle. These CT findings become clear in comparison to the previous CT . Thus, we suspected SAH, although the patient’s CT did not show obvious signs of SAH . Next, CT angiography (CTA) revealed an aneurysm between A1 and A2 of the left anterior cerebral artery . The patient received emergency neurosurgical clipping. He progressed after surgery without developing the initial complications and was discharged from our hospital without sequela. Fig. 1 Computed tomography (CT) image of the current patient showing Sylvian fissures, which were not clearly visible bilaterally ( a ), compared to a CT image of the same patient taken 2 years ago when the patient complained of occipital headache, nausea, and vomiting. At that time, no abnormalities were detected ( b ). There was mainly isoattenuating SAH in the Sylvian fissures (slightly hyperattenuating on the left) and mild hydrocephalus - seen as enlargement of the third ventricle ( a ) in comparison to the previous CT ( b ). An arrow indicates Sylvian fissure, and an arrowhead indicates the dilated third ventricle Fig. 2 The slice is at level of the midbrain (mesencephalon) that traverses the infundibulum of third ventricle, interpeduncular cistern. In a , there appears to be hyperattenuating blood in the medial portion of the left Sylvian fissure and the anterior interhemispheric fissure, and shows mild dilation of the temporal horns of the lateral ventricles (looks like a moustache). In the center of the suprasellar cistern is CSF (hypoattenuating) in the dilated infundibulum of the third ventricle. These CT findings become clear in comparison to the previous CT ( b ). The SAH seen is in proximity to this left ACA aneurysm. An arrow indicates the temporal horns of the lateral ventricles. Arrowheads indicate hyperattenuating blood. An asterisk indicates CSF (hypoattenuating) in the dilated infundibulum of the third ventricle Fig. 3 Typical non-contrast CT images of SAH showing blood in the subarachnoid space. The slice is at the level of the suprasellar cistern in a . Blood filling the basal cisterns, and there is hyperattenuating blood in the suprasellar cistern spreading laterally into the medial portion of the Sylvian fissures. In addition, there is blood that has refluxed into the fourth ventricle. An arrow indicates the blood in the suprasellar cistern. An arrowhead indicates blood in the fourth ventricle. The slice is at the level of the midbrain (mesencephalon) in b . There is blood in the perimesencephalic cistern extending anteriorly into the anterior interhemispheric fissure at the level of the midbrain. Blood extending bilaterally into the Sylvian fissures. An arrow indicates the blood in the anterior interhemispheric fissure and the blood in lateral extents of the Sylvian fissures are indicated by arrowheads Fig. 4 CT angiography (CTA) showing an aneurysm of which size was about 3.0 mm between A1 and A2 of the left anterior cerebral artery. The aneurysm is indicated by an arrow
| 4.09375
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|
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|
en
| 0.999996
|
27756236
|
https://doi.org/10.1186/s12883-016-0726-9
|
[
"blood",
"sylvian",
"ventricle",
"cistern",
"that",
"fissures",
"fissure",
"indicates",
"headache",
"hyperattenuating"
] |
[
{
"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": "9C83.01",
"title": "Vertical gaze palsy"
},
{
"code": "LA05.51",
"title": "Cortical dysplasia"
},
{
"code": "LA05.50",
"title": "Polymicrogyria"
},
{
"code": "LA89.Z",
"title": "Functionally univentricular heart, unspecified"
},
{
"code": "BC45",
"title": "Cardiomegaly"
}
] |
=== 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
[9C83.01] Vertical gaze palsy
Definition: A palsy of vertical gaze is an incomplete or absent movement of the two eyes in the vertical direction of gaze.
Also known as: Vertical gaze palsy | Paralysis of downgaze | Paralysis of upgaze | Paralysis of combined upgaze and downgaze | Vertical one-and-a-half syndrome
[LA05.51] Cortical dysplasia
Definition: A condition caused by failure of the cortex to correctly develop during the antenatal period, or by trauma. This condition is characterised by epileptic seizures. This condition may also present with learning impairments.
Also known as: Cortical dysplasia | Focal cortical dysplasia | Focal cortical dysplasia type I | Focal cortical dysplasia type Ia | Focal cortical dysplasia type Ib
[LA05.50] Polymicrogyria
Definition: Polymicrogyria (PMG) is a cerebral cortical malformation characterised by excessive cortical folding and by shallow sulci. Microscopic examination reveals abnormal cortical layering. Topographic distribution of PMG is variable, but bilateral symmetrical perisylvian PMG (BPP) is the most frequent form. PMG is manifested by mild intellectual deficit, epilepsy, and pseudobulbar palsy, which causes difficulties with speech learning and feeding. The severity of PMG is highly dependent on the location
Also known as: Polymicrogyria | Bilateral polymicrogyria | Bilateral perisylvian polymicrogyria | Bilateral frontoparietal polymicrogyria | Bilateral parasagittal parieto-occipital polymicrogyria
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues
Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...
--- Walk 2 ---
[3C0Z] Diseases of the blood or blood-forming organs, unspecified
--PARENT--> [03] Diseases of the blood or blood-forming organs
Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....
--EXCLUDES--> [?] Pregnancy, childbirth or the puerperium
Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...
--- Walk 3 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 4 ---
[MF50.4Z] Haematuria, unspecified
--PARENT--> [MF50.4] Haematuria
Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...
--EXCLUDES--> [?] Recurrent or persistent glomerular haematuria
Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...
--- Walk 5 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.1] Finding of cocaine in blood
--- Walk 6 ---
[MA12.1] Finding of cocaine in blood
--PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system
--CHILD--> [MA12.2] Finding of hallucinogen in blood
|
[
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --RELATED_TO--> [?] Neoplasms of haematopoietic or lymphoid tissues\n Def: A neoplasm arising from hematopoietic or lymphoid cells found in the bone marrow, peripheral blood, lymph nodes and spleen (organs of the hematopoietic or lymphoid system). Hematopoietic or lymphoid c...",
"[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of the blood or blood-forming organs\n Def: This chapter includes diseases of the blood as well as diseases of blood forming organs....\n --EXCLUDES--> [?] Pregnancy, childbirth or the puerperium\n Def: A group of conditions characterised as occurring during the period of time from conception to delivery (pregnancy), during labour and delivery (childbirth) or during the approximately six weeks after ...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MF50.4Z] Haematuria, unspecified\n --PARENT--> [MF50.4] Haematuria\n Def: Hematuria means presence of blood or red blood cells (RBCs) in the urine. There are two types of hematuria: gross hematuria (when one can see the blood in the urine) and microscopic hematuria (when th...\n --EXCLUDES--> [?] Recurrent or persistent glomerular haematuria\n Def: The presence in the urine of glomerular origin red blood cells (RBCs). In microscopic haematuria the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBC...",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.1] Finding of cocaine in blood",
"[MA12.1] Finding of cocaine in blood\n --PARENT--> [MA12] Clinical findings of drugs, medicaments and biological substances in blood, blood-forming organs, or the immune system\n --CHILD--> [MA12.2] Finding of hallucinogen in blood"
] |
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
|
[
{
"from_icd11": "3C0Z",
"icd10_code": "D75A",
"icd10_title": "Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7581",
"icd10_title": "Myelofibrosis"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7582",
"icd10_title": "Heparin induced thrombocytopenia (HIT)"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D7589",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D759",
"icd10_title": "Disease of blood and blood-forming organs, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D763",
"icd10_title": "Other histiocytosis syndromes"
},
{
"from_icd11": "3C0Z",
"icd10_code": "Q899",
"icd10_title": "Congenital malformation, unspecified"
},
{
"from_icd11": "3C0Z",
"icd10_code": "III",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D70-D77",
"icd10_title": ""
},
{
"from_icd11": "3C0Z",
"icd10_code": "D75",
"icd10_title": "Other and unspecified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D77",
"icd10_title": "Other disorders of blood and blood-forming organs in diseases classified elsewhere"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D758",
"icd10_title": "Other specified diseases of blood and blood-forming organs"
},
{
"from_icd11": "3C0Z",
"icd10_code": "D76",
"icd10_title": "Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R310",
"icd10_title": "Gross hematuria"
},
{
"from_icd11": "MF50.4Z",
"icd10_code": "R312",
"icd10_title": "Other microscopic hematuria"
}
] |
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
Only one patient presented with progressive nasal obstruction without external swelling. Patients had no fever, necrosis, or pus over the skin or in the nasal cavity. The time from disease occurrence to diagnosis ranged from one month to two years. Although the tissue biopsies were performed before sending the patients to the university hospital, the tissue biopsies were performed several times without correct diagnosis. The details of each case are presented in Table 1 . The lesions were first suspected of being tumors rather than an infectious process because of their progression and firm consistency. Pathological reports from previous biopsies were acute and chronic inflammation, angiolymphoid hyperplasia with eosinophilia (ALHE), granuloma etc. Computerized tomography (CT) scans showed enhancing soft tissue infiltration in the affected area . At our university hospital with Conidiobolomycosis in the differential diagnosis, repeated biopsies were done with a large amount of tissue taken for culture and pathologic examination. In the No. 6 patient who had a preoperative diagnosis of inverted papilloma, intraoperatively the infiltrating lesion was a firm to hard consistency, so the differential diagnosis was changed. The pathological diagnosis of Entomophthoramycosis came from the presentation of large fungal hyphae surrounded with eosinophilic material (Splendore-Hoeppli phenomenon) and eosinophils infiltration in H&E staining. The fungus could be seen better in the periodic acid-Schiff (PAS) and Gomori Methenamine-Silver stain (GMS). Tissue culture showed Conidiobolus spp. in two out of seven patients. The No. 4 patient was diagnosed upon clinical presentation, therapeutic response and history of the same disease five years ago . All seven patients responded well after corrected diagnosis and medical treatment. The response was obviously seen within two weeks of treatment, and then the treatment was continued for six months to a year. The protocol of medication varied, but usually contained a combination regimen of itraconazole and potassium iodide (KI)/co-trimoxazole. Itraconazole dosage is 400 mg/day, KI 30 mg/kg/day and co-trimoxazole 2400 mg of sulfamethoxazole/day. The No. 2 and 3 patients have continued the treatment and followed up at their local hospitals. The No. 6 and 7 patients are in the course of treatment. Blood monitoring of side effects was regularly performed every two to three months; thyroid function for KI and liver enzymes for itraconazole were assessed until complete treatment. Two patients (No. 5 and 6) had to stop KI because of hypothyroidism. Table 1 Characteristics of the cases. Table 1 No Age Year Occupation Presenting symptoms Duration Physical findings Underlying disease Blood eosinophil (%) Previous pathologic report Diagnosis Fungal culture treatment Results at last visit 1 57 2009 Barber persisting nasal obstruction 1 mo infiltrating lesion at right inferior turbinate Hypertension 3.2 1. ALHE pathologic report NG KI 2 wk Itraconazole + co-trimoxazole 8 mo no recurrence at 1 year after complete treatment 2 69 2012 Agriculturist progressive rhinofacial swelling, nasal obstruction 3 mo 2 mo firm rhinofacial swelling, infiltrating lesion at nasal vestibule None 17.9 1. Lymphoid hyperplasia 2. Acute and chronic inflammation 3. ALHE differential diagnosis of lymphoma pathologic report NG Itraconazole marked improvement at 2 months 3 59 2013 – progressive rhinofacial swelling, nasal obstruction 3 mo firm rhinofacial swelling None – 1. chronic inflammation with foreign body reaction pathologic report NG Itraconazole marked improvement at 2.5 months 4 41 2013 Agriculturist 2008 Entomophthoramycosis culture positive of Conidiobolus coronatus nasal obstruction and swelling 2 mo firm nasal swelling None 7.6 poorly form granuloma clinical and therapeutic diagnosis NG Co-trimoxazole + Itraconazole 8 mo completely resolved and no recurrence 1 month after complete treatment 5 47 2018 Worker for Disaster Prevention and Mitigation nasal obstruction, rhinofacial swelling 2 y 3 mo firm rhinofacial swelling, infiltrating lesion and nasal vestibule and inferior turbinate None 5.4 3 times biopsy chronic inflammation Differential diagnosis of lymphoma pathologic report and culture Conidiobolus spp. KI 5 mo + Itraconazole complete resolve at 10 months of treatment 6 71 2018 – nasal obstruction, rhinofacial swelling 8 mo 1 mo Infiltrating lesion and mass in the right nasal cavity None 22.2 Papilloma Pathologic report NG KI 3 mo + Itraconazole 6.5 mo complete resolve 7 27 2019 – epistaxis, nasal swelling 2 mo nasal swelling and infiltrating lesion at nasal vestibules congenital HIV infection 17.8 acute and chronic inflammation pathologic report and culture Conidiobolus spp. Itraconazole improvement at two weeks of treatment mo: month, ALHE: angiolymphoid hyperplasia with eosinophilia, NG: no growth, KI: Potassium iodide, y; year, wk: week. Fig. 2 A Axial CT scans showed enhancing soft tissue infiltration over the skin and subcutaneous tissue of left nasal vestibule, inferior turbinate and nasal cavity. The H & E (B) and PAS (C) stains showed large fungal hyphae with surrounding eosinophilic material, chronic inflammation and fibrosis. Fig. 2
| 4.09375
| 0.611328
|
sec[2]/p[1]
|
en
| 0.999997
|
32714524
|
https://doi.org/10.1016/j.amsu.2020.07.013
|
[
"nasal",
"swelling",
"itraconazole",
"pathologic",
"obstruction",
"patients",
"tissue",
"rhinofacial",
"firm",
"inflammation"
] |
[
{
"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": "FA36.Z",
"title": "Effusion of joint, unspecified"
},
{
"code": "MA01.Z",
"title": "Enlarged lymph nodes, unspecified"
},
{
"code": "MD82",
"title": "Intra-abdominal or pelvic swelling, mass or lump"
},
{
"code": "ME61",
"title": "Subcutaneous swelling, mass or lump of uncertain or unspecified nature"
},
{
"code": "GB90.Y",
"title": "Other specified disorders of kidney or ureter"
}
] |
=== 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
[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
[MA01.Z] Enlarged lymph nodes, unspecified
Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy
[MD82] Intra-abdominal or pelvic swelling, mass or lump
Definition: This refers to the presence of abdominal or pelvic wall swelling, mass or tumour in the abdominal and pelvic regions. These mass or tumours can be recognised by visual examination and/or palpation.
Also known as: Intra-abdominal or pelvic swelling, mass or lump | Abdominal mass without further specification | mass in abdomen | intra-abdominal lump | intra-abdominal mass
Excludes: Abdominal distension | Ascites
[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
[GB90.Y] Other specified disorders of kidney or ureter
Also known as: Other specified disorders of kidney or ureter | Other secondary disorders of kidney or ureter | Other disorders of kidney and ureter NEC | Inflammatory diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis | Infectious diseases of the renal pelvis or the ureter without tubulo-interstitial nephritis
=== 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--> [MA82.1] Dysphonia
Def: Difficulty and/or pain in phonation or speaking....
--- 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--> [MA82.0] Aphonia
Def: Aphonia is the inability to produce voice. It is considered more severe than dysphonia. Like dysphonia, aphonia can be caused by voice strain or overuse, injury, by structural laryngeal anomalies or b...
--- 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--> [CA01] Acute sinusitis
Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries 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 ...
--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 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 ...
--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...
|
[
"[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--> [MA82.1] Dysphonia\n Def: Difficulty and/or pain in phonation or speaking....",
"[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--> [MA82.0] Aphonia\n Def: Aphonia is the inability to produce voice. It is considered more severe than dysphonia. Like dysphonia, aphonia can be caused by voice strain or overuse, injury, by structural laryngeal anomalies or b...",
"[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--> [CA01] Acute sinusitis\n Def: Recent onset and/or short duration inflammation of the mucosa in one or more of the paranasal sinuses (maxillary, ethmoid, frontal and sphenoid) arising from infection or other causes such as caries 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 --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...",
"[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 --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..."
] |
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
|
The patient was a 45 year old female. In November 2020, she found that his skin and sclera were yellow stained, and went to the local hospital to take the magnetic resonance imaging. It was suggested that the internal and external bile ducts of the liver were expanded in stages, combined with pancreatic duct expansion. The widest diameter of the common bile duct was about 1.3 cm. The computed tomography (CT) examination in our hospital showed that the uncinate process of the head of pancreas was an irregular nodule with unclear boundary and infiltrative appearance, accompanied by low-level biliary obstruction. There are multiple lymph nodes in peripancreatic, retroperitoneal, left gastric region, mesenteric root, hilar region and portal space, and the possibility of metastasis is high. Subcapsular nodules in left inner lobe of liver, nature undetermined, alert for metastasis. Blood test showed that alanine transaminase (ALT): 271 U/L, aspartate transaminase (AST): 154 U/L, total bilirubin (TBIL): 92.8 umol/l, direct bilirubin (DBIL): 78.9 umol/l, indirect bilirubin (IBIL): 13.9 umol/l. On December 1, 2020, encoscopic retrograde cholangio-pancreatography (ERCP), nasobiliary drainage tube implantation and endoscopic ultrasound pancreatic biopsy were performed. Pathology showed adenocarcinoma. On December 22, 2020, ERCP and fully covered metal biliary stent implantation were performed. The postoperative laboratory results showed that ALT: 50 U/L, AST: 28 U/L, TBIL: 22.8 umol/l, DBIL: 14.4 umol/l, IBIL: 8.4 umol/l. From December 31, 2020 to May 28, 2021, seven cycles of albumin bound paclitaxel combined with Tegafur regimen were performed (the seventh cycle was single drug Tegafur). The best efficacy was partial remission (PR), and CA19-9 decreased from 7693 U/ml to 18.09 U/ml. Grade I sensory peripheral neuropathy was found. Bone scanning was taken during the treatment , the density of lumbar 1 vertebral body increased, and bone metastasis was considered in combination with CT. On July 1, 2021, CT reexamination showed that the nodules in the left lobe of the liver were slightly fuller than before, and the duodenal wall was thicker than before. Continue to take Tegafur for 4 cycles. 25 fractions of radiotherapy for pancreas and L1 vertebral body were given in the external hospital. On October 29, 2021, the CT reexamination of the hospital suggested multiple small nodules in both lungs, and metastasis was considered. CA19-9 rose to 1015 U/ml. It was evaluated as progressive disease (PD). The patient was treated with albumin bound paclitaxel combined with gemcitabine for 2 cycles at the local hospital. During this period, grade III leukopenia and grade I thrombocytopenia occurred. On January 5, 2022, CT reexamination showed that the irregular soft tissue shadow at the uncinate process of the pancreatic head was larger than before, and the maximum cross-section is now about 3.3 cm × 2.0 cm. There were slightly low-density nodules scattered in the liver, which increased and enlarged compared with the previous ones, and the largest one was about 2.2cm×1.7cm. Metastasis was considered. The lesion of lumbar 1 vertebral body was enlarged. Multiple small nodules were found in both lungs, which were increased and enlarged compared with the previous ones. The largest one is about 0.5cm. Metastasis is considered. On January 11, 2022, CT guided liver tumor puncture was performed. Postoperative pathology suggested that moderately differentiated adenocarcinoma infiltration was seen in the liver tissue. In combination with history and morphology, pancreatic origin was considered. The replacement scheme was irinotecan, anlotinib combined with tislelizumab for 1 cycle. CA19-9 was 10625 U/ml. 2022.2.22 Next-Generation Sequencing result from 520 gene panel of liver metastases showed EGFR exon 19 mutation (p.E746_s752 > V), KRAS wild-type, tumor mutation burden (TMB) 2 mutations/Mb (Mb stands for every million bases), microsatellite stability (MSS). Immunohistochemistry showed EGFR/ErbB2 2+, ErbB2 1+. On March 5, 2022, she began to take furmonertinib 80mg every day. On May 25, 2022, CA19-9 decreased to 300 U/ml. CT showed the tumor foci of uncinate process of pancreatic head and liver were smaller than before. Liver abscess occurred during the treatment, which gradually subsided after symptomatic treatment. On July 25, 2022, CA19-9 increased to 1000 U/ml. Imaging showed that multiple nodules in both lungs were partially smaller than before, and some were similar to before. Uneven density shadow of thoracic vertebra, with higher density than before, metastasis is considered. The progression-free survival (PFS) of furmonertinib was 4.7 months . On August 2022, the treatment regimen was changed to nimotuzumab, capecitabine combined with oxaliplatin. After 1 cycle, the patient was reexamined due to poor physical condition. CT showed that liver metastases increased and enlarged compared with the previous period, with the largest being about 5.7cm × 3.6cm, suggesting that the effect of nimotuzumab combined with chemotherapy was not good . The patient had no previous medical history. The patient’s grandmother had liver cancer and had died, and no genetic tests had been performed.
| 3.867188
| 0.980469
|
sec[1]/p[0]
|
en
| 0.999996
|
PMC10117981
|
https://doi.org/10.3389/fonc.2023.1151178
|
[
"that",
"liver",
"metastasis",
"combined",
"nodules",
"umol",
"considered",
"pancreatic",
"about",
"multiple"
] |
[
{
"code": "8A80.Z",
"title": "Migraine, unspecified"
},
{
"code": "QA76",
"title": "Medication or substance that is known to be an allergen without injury or harm"
},
{
"code": "PL13.6",
"title": "Medication or substance that is known to be an allergen, as mode of injury or harm"
},
{
"code": "9C40.A0",
"title": "Papilloedema"
},
{
"code": "PA6Z",
"title": "Unintentional fall from unspecified height"
},
{
"code": "DB9Z",
"title": "Diseases of liver, unspecified"
},
{
"code": "DB97.Z",
"title": "Inflammatory liver disease, unspecified"
},
{
"code": "DB99.7",
"title": "Hepatic failure without mention whether acute or chronic"
},
{
"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 ===
[8A80.Z] Migraine, unspecified
Also known as: Migraine, unspecified | Migraine
[QA76] Medication or substance that is known to be an allergen without injury or harm
Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.
Also known as: Medication or substance that is known to be an allergen without injury or harm
Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance
[9C40.A0] Papilloedema
Definition: Optic disc swelling that results from increased intracranial pressure
Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure
Includes: Optic disc swelling that results from increased intracranial pressure
[PA6Z] Unintentional fall from unspecified height
Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS
[DB9Z] Diseases of liver, unspecified
Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy
[DB97.Z] Inflammatory liver disease, unspecified
Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS
[DB99.7] Hepatic failure without mention whether acute or chronic
Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS
[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 ---
[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 2 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.2] Chronic migraine
Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...
--- Walk 3 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 4 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm
--PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm
--- Walk 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--> [PL13.2] Drug-related injury or harm in the context of correct administration or dosage, 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--> [PL13.1] Underdosing, as mode of injury or harm
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.1] Migraine with aura\n Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso...",
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --PARENT--> [?] Health care related circumstances influencing the episode of care without injury or harm",
"[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",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm"
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
Patient instructed to gaze straight ahead while making the impression of the socket with light bodied rubber base impression material. The impression material was slowly injected into the socket taking care to avoid any air bubbles. The patient was instructed to make various eye movements to get functional impression of the eye. The impression material was reinforced with a syringe needle cover to hold it in place and for ease of removal after it sets . After boxing the eye region, external facial impression was made with irreversible hydrocolloid , allowing the material to combine with that of the extruded material, this facilitates the retrieval of the entire impression. In globe formation, a 2-piece dental stone mold was poured to immerse the lower part of the impression. After the stone had set, separating media was applied on the surface. Then the second layer was poured. Grooves were made on all four sides of the cast for proper reorientation of the cast. The impression was separated from the cast of the defect and lubricated the stone cast with a thin coating of vaseline. The lubricated socket of the working cast was filled with molten wax and after solidification; the retrieved wax form was smoothened and polished for try-in on the patient's face . Vaseline was applied to the tissue surface of the wax pattern to avoid irritation to the tissues, was placed into the clinical defect by introducing it first under the upper lid, and then over the retracted lower lid. Several minutes are required for relaxation of the protective blepharospasm, which may occur when the wax pattern is first placed in the socket. With the wax form in place, and with the patient's eyes closed, both socket areas were palpated simultaneously to compare globe sizes. Modify the wax pattern and its corneal prominence, where necessary, to duplicate the shape of the natural eye and eyelid drape of both eyes was matched. Retract the eyelids and corneal surface was exposed to adjust the wax form to give the best duplication of globe contour. The corrected wax pattern was flasked and processed in tooth-colored acrylic prematched with natural sclera of the unaffected contralateral eye, selected using the tooth-colored acrylic shade guide. Processed resin globe was retrieved from the flasking matrix in a way that preserved the outer stone matrix and later allows reseating of the modified globe back into this matrix for eventual reprocessing of the globe's original contour. In iris characterization, a processed resin globe, with a high polish, placed in the patient's socket for evaluation, and made necessary adjustment to effectively simulate the normal corneal contour as accurately as possible. The patient was instructed to hold an erect position and to gaze straight ahead and observed from the side to determine the iris plane relationship with the normal eye. The distance from the pupil of the normal eye to the midline was used in establishing the horizontal position of the prosthetic pupil center and marked on the globe. The vertical position of the pupil center is determined and marked by the canthus relationships. The diameter of the iris was measured holding a ruler close to the normal steadied eye. The globe form with its marked pupillary center is removed and the iris size that is 1 mm smaller than the diameter of the measured iris is circumscribed with a compass from the established point. Return the globe to the clinical defect and the outlined iris evaluated in relation to that of the eyelids. Accurate iris positioning is critical in the establishment of a natural appearance. The ocular globe modified by cutting away resin within the circumscribed area providing a chamber to house a photographic digital image. In color characterization and globe completion, the iris photographic image of approximately 1 mm smaller than the diameter of the measured patient's iris was cut as this will be compensated for, by the magnification caused by the overlay of clear acrylic resin in the completed prosthesis. If necessary, further customization and color modifications are performed using professional quality color pencils. The paper iris was covered with three light coats of water resistant spray and attached to the excavated recess of the globe. The remaining outer corneal surface was characterized by removing a thin layer of acrylic resin and using professional quality color pencils, scleral blood vessels were drawn along the outer periphery. Soft color tones of yellow and brown were added onto the medial canthal area to simulate the normal eye . Evaluation was done in the patient and the characterized globe form was returned to its original position within the initial flasking matrix. The space created over the disk and between the reduced outer corneal surface of the globe and the stone matrix of the flasking was packed and processed with clear acrylic resin. The retrieved processed ocular globe was trimmed and polished to a high finish using pumice and was critically evaluated for lid drape, contour, iris color and dimension . The patient was taught to properly insert and remove the appliance and the importance of careful cleansing and handling of the prosthesis was emphasized.
| 4.023438
| 0.742676
|
sec[1]/p[1]
|
en
| 0.999997
|
25206192
|
https://doi.org/10.5005/jp-journals-10005-1190
|
[
"globe",
"iris",
"impression",
"socket",
"resin",
"color",
"material",
"stone",
"surface",
"cast"
] |
[
{
"code": "LA10.Y",
"title": "Other specified structural developmental anomalies of ocular globes"
},
{
"code": "LA10.Z",
"title": "Structural developmental anomalies of ocular globes, unspecified"
},
{
"code": "NA06.Z",
"title": "Injury of eye or orbit, unspecified"
},
{
"code": "LA10.0",
"title": "Microphthalmos"
},
{
"code": "NA06.9&XA0M40",
"title": "Contusion of eyeball"
},
{
"code": "4B23",
"title": "Immune reconstitution inflammatory syndrome"
},
{
"code": "LA11.3",
"title": "Aniridia"
},
{
"code": "9A93",
"title": "Adhesions or disruptions of iris or ciliary body"
},
{
"code": "9A90.2",
"title": "Iris atrophy"
},
{
"code": "9A90.1",
"title": "Degeneration of iris"
}
] |
=== ICD-11 CODES FOUND ===
[LA10.Y] Other specified structural developmental anomalies of ocular globes
Also known as: Other specified structural developmental anomalies of ocular globes | Cyclopia | synophthalmia | Congenital cystic eye | Congenital malformations of the eye
[LA10.Z] Structural developmental anomalies of ocular globes, unspecified
Also known as: Structural developmental anomalies of ocular globes, unspecified | Structural developmental anomalies of ocular globes | Malformations of ocular globes
[NA06.Z] Injury of eye or orbit, unspecified
Also known as: Injury of eye or orbit, unspecified | Injury of eye or orbit | Injury of eye NOS | eye injury | injury of globe of eye
[LA10.0] Microphthalmos
Also known as: Microphthalmos | globe of eye small | Microphthalmia | small eyeball | Hypoplasia of eye
Includes: Dysplasia of eye | Hypoplasia of eye | Rudimentary eye
[4B23] Immune reconstitution inflammatory syndrome
Definition: This is a condition seen in some cases of AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelming inflammatory response that paradoxically makes the symptoms of infection worse.
Also known as: Immune reconstitution inflammatory syndrome | Immune reconstitution syndrome | IRIS - [immune reconstitution inflammatory syndrome] | HIV-associated immune reconstitution inflammatory syndrome | Immune reconstitution inflammatory syndrome [IRIS], HIV-associated
[LA11.3] Aniridia
Definition: Aniridia is a congenital ocular malformation characterised by the complete or partial absence of the iris. It can be isolated or part of a syndrome (isolated and syndromic aniridia).
Also known as: Aniridia | Absence of iris | agenesis of iris | aplasia of iris | congenital absence of iris
[9A93] Adhesions or disruptions of iris or ciliary body
Definition: This refers to adhesions and disruptions of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. The colour of the iris is often referred to as "eye colour." It is also of the circumferential tissue inside the eye composed of the ciliary muscle and ciliary processes. It is triangular in horizontal section and is coated by a double layer, the ciliary epithelium.
Also known as: Adhesions or disruptions of iris or ciliary body | Synechiae of iris NOS | synechia | Anterior synechiae, iris | anterior synechia
Includes: Anterior synechiae, iris | Goniosynechiae | Iridodialysis
Excludes: Corectopia
[9A90.2] Iris atrophy
Also known as: Iris atrophy | atrophic iris | essential iris atrophy | Progressive essential iris atrophy
[9A90.1] Degeneration of iris
Definition: This refers to the change of tissue to a lower or less functionally active form, of the thin, circular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina. The color of the iris is often referred to as "eye color."
Also known as: Degeneration of iris | Pigmentary degeneration of iris | Acute bilateral depigmentation of iris | Translucency of iris
=== GRAPH WALKS ===
--- Walk 1 ---
[LA10.Y] Other specified structural developmental anomalies of ocular globes
--PARENT--> [LA10] Structural developmental anomalies of ocular globes
Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....
--EXCLUDES--> [?] Holoprosencephaly with cyclopia or synophthalmia
--- Walk 2 ---
[LA10.Y] Other specified structural developmental anomalies of ocular globes
--PARENT--> [LA10] Structural developmental anomalies of ocular globes
Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies of the eye, eyelid or lacrimal apparatus
Def: Any condition caused by failure of the eye, eyelid and lacrimal apparatus to correctly develop during the antenatal period....
--- Walk 3 ---
[LA10.Z] Structural developmental anomalies of ocular globes, unspecified
--PARENT--> [LA10] Structural developmental anomalies of ocular globes
Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....
--EXCLUDES--> [?] Holoprosencephaly with cyclopia or synophthalmia
--- Walk 4 ---
[LA10.Z] Structural developmental anomalies of ocular globes, unspecified
--PARENT--> [LA10] Structural developmental anomalies of ocular globes
Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....
--CHILD--> [LA10.2] Buphthalmos
Def: A condition characterised by enlargement of the globe of the eye....
--- Walk 5 ---
[NA06.Z] Injury of eye or orbit, unspecified
--PARENT--> [NA06] Injury of eye or orbit
--CHILD--> [NA06.2] Retained foreign body following penetrating wound of orbit
--- Walk 6 ---
[NA06.Z] Injury of eye or orbit, unspecified
--PARENT--> [NA06] Injury of eye or orbit
--CHILD--> [NA06.2] Retained foreign body following penetrating wound of orbit
|
[
"[LA10.Y] Other specified structural developmental anomalies of ocular globes\n --PARENT--> [LA10] Structural developmental anomalies of ocular globes\n Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....\n --EXCLUDES--> [?] Holoprosencephaly with cyclopia or synophthalmia",
"[LA10.Y] Other specified structural developmental anomalies of ocular globes\n --PARENT--> [LA10] Structural developmental anomalies of ocular globes\n Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the eye, eyelid or lacrimal apparatus\n Def: Any condition caused by failure of the eye, eyelid and lacrimal apparatus to correctly develop during the antenatal period....",
"[LA10.Z] Structural developmental anomalies of ocular globes, unspecified\n --PARENT--> [LA10] Structural developmental anomalies of ocular globes\n Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....\n --EXCLUDES--> [?] Holoprosencephaly with cyclopia or synophthalmia",
"[LA10.Z] Structural developmental anomalies of ocular globes, unspecified\n --PARENT--> [LA10] Structural developmental anomalies of ocular globes\n Def: Any condition caused by failure of the ocular globes to correctly develop during the antenatal period....\n --CHILD--> [LA10.2] Buphthalmos\n Def: A condition characterised by enlargement of the globe of the eye....",
"[NA06.Z] Injury of eye or orbit, unspecified\n --PARENT--> [NA06] Injury of eye or orbit\n --CHILD--> [NA06.2] Retained foreign body following penetrating wound of orbit",
"[NA06.Z] Injury of eye or orbit, unspecified\n --PARENT--> [NA06] Injury of eye or orbit\n --CHILD--> [NA06.2] Retained foreign body following penetrating wound of orbit"
] |
LA10.Y
|
Other specified structural developmental anomalies of ocular globes
|
[
{
"from_icd11": "LA10.Z",
"icd10_code": "Q11",
"icd10_title": "Anophthalmos, microphthalmos and macrophthalmos"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058X9A",
"icd10_title": "Other injuries of unspecified eye and orbit, initial encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S0591XA",
"icd10_title": "Unspecified injury of right eye and orbit, initial encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058X2A",
"icd10_title": "Other injuries of left eye and orbit, initial encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058X1A",
"icd10_title": "Other injuries of right eye and orbit, initial encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S0592XS",
"icd10_title": "Unspecified injury of left eye and orbit, sequela"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S0592XD",
"icd10_title": "Unspecified injury of left eye and orbit, subsequent encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058X1S",
"icd10_title": "Other injuries of right eye and orbit, sequela"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S0592XA",
"icd10_title": "Unspecified injury of left eye and orbit, initial encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058X2S",
"icd10_title": "Other injuries of left eye and orbit, sequela"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058X2D",
"icd10_title": "Other injuries of left eye and orbit, subsequent encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S0591XS",
"icd10_title": "Unspecified injury of right eye and orbit, sequela"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S0590XA",
"icd10_title": "Unspecified injury of unspecified eye and orbit, initial encounter"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S05",
"icd10_title": "Injury of eye and orbit"
},
{
"from_icd11": "NA06.Z",
"icd10_code": "S058",
"icd10_title": "Other injuries of eye and orbit"
}
] |
Q11
|
Anophthalmos, microphthalmos and macrophthalmos
|
A 77-year-old Caucasian man presented with a livid discoloration of the left ear, which had first appeared about five days prior to the patient’s flight home from Colombia, where he had spent a two-week vacation, including a stay of several days on a banana plantation in the department of Cundinamarca. The patient remembered a mosquito bite to his left ear during his stay in Colombia. Since his return, he had been experiencing increasing weakness and shortness of breath. The patient had been diagnosed with CLL four years earlier and was currently on ibrutinib therapy. Upon presentation, the patient was in a stable cardiorespiratory state (blood pressure 139/75 mmHg [18.5/10.0 kPa]), heart rate was 92 beats per minute, body temperature was 36.6 °C (309.8 K), and peripheral oxygen saturation (SpO 2 ) was 100% with 2 L of oxygen. Physical examination showed a lividly discolored area on the left ear and several erythematous, elevated, nodule-like skin lesions disseminated on the torso and extremities (Fig. 1 b, including an eschar-like necrotic skin lesion on the right forearm. CLL treatment with ibrutinib was discontinued. Laboratory tests demonstrated abnormal serum electrolytes (sodium 132 mmol/L, potassium 3.2 mmol/L), acute renal insufficiency (serum creatinine 2.6 mg/dL [229.8 μmol/L], blood urea nitrogen 37 mg/dL [6.2 mmol/L]), mild anemia (hemoglobin, 13.2 g/dL [8.20 mmol/L]), metabolic acidosis (pH 7.353, HCO 3 17.6 mmol/L, lactate 3.9 mmol/L), and elevated C-reactive protein . The leukocyte count was within the normal range with a relative increase in monocytes (leukocytes 5.04 G/L with 35% neutrophils, 31% lymphocytes, and 25% monocytes). A chest computed tomography (CT) scan revealed bilateral pulmonary lesions . Given the patient’s recent travel history and the eschar-like presentation of some of the lesions, a tropical disease was suspected. Skin biopsies were obtained from the right ear and right forearm after starting antimicrobial treatment with piperacillin/tazobactam (4.5 g tid) in combination with liposomal amphotericin B (400 mg/day) and doxycycline (100 mg bid) to provide empiric coverage against leishmania, endemic mycosis such as histoplasmosis, and atypical bacterial infections such as rickettsiosis. Within 24 h of the biopsy, the patient’s condition rapidly deteriorated. He developed further skin lesions as well as a rapidly progressive phlegmon starting from the biopsy site on the right forearm. The patient was transferred to the intensive care unit (ICU) due to septic shock and required high-dose catecholamine therapy along with mechanical ventilation. Antibiotic therapy was escalated to imipenem, doxycycline, and amphotericin B. Surgical excision was performed on the progressively inflamed area on the right arm . Histological evaluation showed an acute phlegmonous infection with necrosis . Blood cultures remained sterile. The skin specimens were tested for chagas, babesia, leishmania, endemic mycosis, tuberculosis, cryptococcosis, and rickettsia, but yielded negative results. Finally, microbiological cultures of the necrotic area on the patient’s ear, right forearm, and bronchoalveolar lavage (BAL) revealed the growth of P. aeruginosa , with comparable antibiotic susceptibility testing results showing susceptibility to piperacillin, ceftazidime, cefepime, carbapenems, aztreonam, and aminoglycosides. Thus, a diagnosis of Ecthyma gangrenosum was established. After 8 days of antibiotic treatment and almost daily surgical debridement of the right arm, the patient’s clinical condition significantly improved while the microbiological cultures remained sterile. Liposomal amphotericin B and doxycycline were stopped, and treatment with piperacillin (4 g tid) was continued. Surgical debridement was not performed for skin lesions apart from those on the right arm because these nodules either disappeared or significantly decreased in size, and the systemic inflammatory markers (CRP) also normalized with antimicrobial treatment. Finally, antimicrobial treatment was discontinued 50 days after the patient’s initial presentation, and he was transferred to a rehabilitation facility . Fig. 1 Skin and lung lesions caused by P. aeruginosa . a Livid discoloration of the left ear on day 0. b Erythematous skin lesions on the patient’s leg. c Chest CT scan showing bilateral pulmonary lesions. d Phlegmonous inflammation of the right arm. e Skin lesions upon secondary presentation before surgical incision Fig. 2 Hematoxylin and eosin (H&E) stained tissue section of the right forearm showing acute phlegmonous inflammation Fig. 3 Schematic showing the treatments, microbiological, and laboratory findings over the course of both hospital admissions. The location “skin” includes wound swabs, punctates, and biopsy specimen. Abbreviations: ED: emergency department, CPR: cardiopulmonary resuscitation; CSF: cerebrospinal fluid; P: Pseudomonas aeruginosa ; Ef: Enterococcus faecium ; −: no bacterial growth; BAL: bronchoalveolar lavage; Pip: piperacillin; Cipro: ciprofloxacin; L: linezolid; Vanco: vancomycin; S: surgical incisions/ debridement; IVIG: intravenous immunoglobulin. Conversion in SI units: 1 mg/dL CRP = 95.2 mmol/L; 1 mg/dL creatinine = 88.4 μmol/L
| 4.085938
| 0.972168
|
sec[1]/p[0]
|
en
| 0.999995
|
33845789
|
https://doi.org/10.1186/s12879-021-05998-9
|
[
"skin",
"lesions",
"mmol",
"forearm",
"piperacillin",
"blood",
"area",
"like",
"antimicrobial",
"amphotericin"
] |
[
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "ME66.Y",
"title": "Other specified skin changes"
},
{
"code": "EM0Y",
"title": "Other specified diseases of the skin"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "ME66.1",
"title": "Changes in skin texture"
},
{
"code": "FA5Z",
"title": "Arthropathies, unspecified"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "MD41",
"title": "Clinical findings on diagnostic imaging of lung"
},
{
"code": "GC2Z&XA6KU8",
"title": "Disease of kidney, not elsewhere classified"
},
{
"code": "GB42.1",
"title": "Albuminuria, Grade A3"
}
] |
=== 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
[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
[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
[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
=== 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....
--CHILD--> [ME66.2] Excess and redundant skin
Def: A condition which typically occurs in formerly grossly obese individuals following massive weight loss, as following bariatric surgery or severe calorie restriction....
--- 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....
--CHILD--> [ME66.0] Abnormal sensitivity to light or UV radiation of uncertain or unspecified nature
--- 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--> [?] Neonatal phototherapy burn
Def: Burn resulting from phototherapy administered to neonate, usually for the treatment of neonatal jaundice....
--- 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...
--CHILD--> [?] Inflammatory dermatoses
Def: A large group of skin disorders in which inflammation plays an important role....
|
[
"[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 --CHILD--> [ME66.2] Excess and redundant skin\n Def: A condition which typically occurs in formerly grossly obese individuals following massive weight loss, as following bariatric surgery or severe calorie restriction....",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --CHILD--> [ME66.0] Abnormal sensitivity to light or UV radiation of uncertain or unspecified nature",
"[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--> [?] Neonatal phototherapy burn\n Def: Burn resulting from phototherapy administered to neonate, usually for the treatment of neonatal jaundice....",
"[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 --CHILD--> [?] Inflammatory dermatoses\n Def: A large group of skin disorders in which inflammation plays an important role...."
] |
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": "FA5Z",
"icd10_code": "M00-M25",
"icd10_title": ""
},
{
"from_icd11": "FC0Z",
"icd10_code": "XIII",
"icd10_title": ""
},
{
"from_icd11": "MD41",
"icd10_code": "R911",
"icd10_title": "Solitary pulmonary nodule"
},
{
"from_icd11": "MD41",
"icd10_code": "R91",
"icd10_title": "Abnormal findings on diagnostic imaging of lung"
}
] |
L989
|
Disorder of the skin and subcutaneous tissue, unspecified
|
A 69-year-old Japanese man suffered from intermittent abdominal pain and repetitive diarrhea for a month, and visited the nearest hospital. He had habits of drinking alcohol and smoking. His past history included only prostate hypertrophy and his family history was unremarkable. A colonoscopy revealed mucosal erosion accompanied with converging folds and luminal stenosis at the splenic flexure. Biopsy tissue obtained from the erosion showed the histology of non-specific colitis without neoplastic cells [IgG4-positive cells: 2 cells/high power field (HPF)]. Computed tomography (CT) revealed a focally enlarged pancreatic tail with heterogeneous contrast enhancement. The tail of the pancreas showed soft tissue proliferation surrounding the pancreas that appeared to adhere to the descending colon, accompanied with small amount of effusion. A contrast enema revealed an irregularly narrowed segment of the large bowel at the splenic flexure. His symptoms had been resistant to any medications (e.g., tiquizium bromide, camostat mesilate, or miyarisan) and he had lost 7 kg of weight during the previous two months. Pancreatic tail cancer invading to the colon had to be ruled out, so the patient was referred to our hospital. Blood tests showed an increasing level of serum amylase (703 U/L) and c reactive protein (3.0 mg/dL). Serum tumor markers (carcinoembryonic antigen and carbohydrate antigen 19–9) and HbA1c were within the normal range, but serum IgG , IgG4 , and IgE (317 IU/mL, normal: ≤173 IU/mL) were all elevated. Antinuclear antibody and rheumatoid arthritis particle agglutination were also increased in the serum (positive at ×80 and ×160 dilution, respectively). Endoscopic ultrasound (EUS) showed mosaic high echoic foci within the low-echoic, swollen pancreatic tail, with a capsule-like rim structure . Endoscopic retrograde cholangiography (ERC) showed diffusely thin intrahepatic bile ducts . Pancreatography demonstrated a stenosis of the MPD despite the high pressure of contrast injection . Intraductal ultrasound of the bile duct showed no remarkable findings . Biopsied tissues from the bile duct and major papilla were non-neoplastic and showed only a scattering of IgG4-positive cells (3 cells/HPF). On the following day, the patient complained of mild left hypochondralgia and had a high level of serum amylase (667 U/L), suggesting a development of mild post-ERCP pancreatitis. Pancreatic cancer was excluded by an EUS-guided fine needle aspiration biopsy (FNAB) performed from the gastric body using a 22-gauge needle (Echotip®, COOK, Bloomington, USA). The obtained specimens showed neither cancer tissue nor IgG4-positive plasma cells. 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) demonstrated abnormal uptakes at the pancreatic tail (SUVmax: 7.2), and at the lymph nodes of mediastinal and inguinal region . No OOIs suggestive of AIP, such as biliary stricture, retroperitoneal fibrosis, enlargement of salivary or lachrymal glands, were apparent in any of the image examinations. A rapid steroid trial was initiated with 30 mg/day of prednisolone based on the suspected diagnosis of AIP and the continued need to exclude pancreatic cancer, since the imaging findings did not fulfill any of the diagnostic criteria for AIP . A steroid response was not obvious at two weeks after steroid initiation, but improvement in the pancreatic tail enlargement and peripancreatic effusion was recognized by abdominal ultrasonography (US) and CT at one month after steroid initiation . The second look ERCP demonstrated a non-remarkable change in the biliary tract but obvious improvement of stenosis of the MPD . The following CF confirmed the wide opening of the colon. This steroid response satisfied the international consensus diagnostic criteria (ICDC) , but did not fulfill the Japanese criteria . The patient’s symptoms disappeared and his subsequent progress was uneventful. Figure 1 Colonoscopic views at the splenic flexure before (A) and after (B) steroid therapy. The erosion associated with a converging fold and luminal stenosis (A) . Healed erosion with an indistinct mucosal vascular pattern (B) . Figure 2 Enhanced computed tomography showing an enlarged pancreatic tail, before (A) and after (B) steroid initiation. A swollen pancreas, adhesive to the descending colon (large arrow), with a capsule-like rim (arrow head) and effusion (small arrow) around the left kidney (A) . Minimized pancreatic swelling and decreased effusion (B) . Figure 3 Contrast enema showing an irregular stenosis of the colon at the splenic flexure. Figure 4 Endoscopic ultrasonographic view showing the low-echoic, enlarged pancreatic tail with a marginal capsule-like rim (arrowhead). Figure 5 Endoscopic retrograde cholangiopancreatography. Thin structure of the intrahepatic bile duct (A) . Pancreatography showing a stenosis of the main pancreatic duct before steroid therapy (B) . Reopening of the main pancreatic duct after the steroid initiation (C) . Figure 6 18 F-fluorodeoxyglucose positron emission tomography showing abnormal uptake of 18 F-fluorodeoxyglucose at the pancreatic tail (large arrow), as well as at the lymph nodes of the mediastinum (arrowhead) and inguinalis (small arrow).
| 4.070313
| 0.977051
|
sec[1]/p[0]
|
en
| 0.999997
|
25280867
|
https://doi.org/10.1186/1471-230X-14-173
|
[
"pancreatic",
"tail",
"steroid",
"stenosis",
"cells",
"colon",
"serum",
"duct",
"arrow",
"erosion"
] |
[
{
"code": "DC3Z",
"title": "Diseases of pancreas, unspecified"
},
{
"code": "DC3Y",
"title": "Other specified diseases of pancreas"
},
{
"code": "LB21.3",
"title": "Agenesis-aplasia of pancreas"
},
{
"code": "LB21.Z",
"title": "Structural developmental anomalies of pancreas, unspecified"
},
{
"code": "DC35.0",
"title": "Atrophy of pancreas"
},
{
"code": "LC30",
"title": "Developmental defects of hair or hair growth"
},
{
"code": "2E61.Y&XA3QC5",
"title": "Carcinoma in situ of tail of pancreas"
},
{
"code": "2E92.8",
"title": "Benign neoplasm of pancreas"
},
{
"code": "2C6Z",
"title": "Malignant neoplasms of breast, unspecified"
},
{
"code": "6C4H.Y",
"title": "Other specified disorders due to use of non-psychoactive substances"
}
] |
=== ICD-11 CODES FOUND ===
[DC3Z] Diseases of pancreas, unspecified
Also known as: Diseases of pancreas, unspecified
[DC3Y] Other specified diseases of pancreas
Also known as: Other specified diseases of pancreas | Calculus of pancreas | pancreas calculi | pancreas duct calculus | pancreas duct lithiasis
[LB21.3] Agenesis-aplasia of pancreas
Definition: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas.
Also known as: Agenesis-aplasia of pancreas | Congenital absence of pancreas | Congenital pancreas absence | Congenital pancreatic absence | Absent pancreas
[LB21.Z] Structural developmental anomalies of pancreas, unspecified
Also known as: Structural developmental anomalies of pancreas, unspecified | Structural developmental anomalies of pancreas | malformations of pancreas | anomalies of pancreas | congenital abnormality of pancreas
[DC35.0] Atrophy of pancreas
Also known as: Atrophy of pancreas | pancreatic atrophy | pancreas ductal atrophy
[LC30] Developmental defects of hair or hair growth
Also known as: Developmental defects of hair or hair growth | congenital malformation of hair and hair growth | Temporal triangular alopecia | Triangular alopecia | Congenital sporadic alopecia
[2E92.8] Benign neoplasm of pancreas
Definition: A non-metastasizing neoplasm arising from the pancreas.
Also known as: Benign neoplasm of pancreas | benign pancreatic neoplasm | benign tumour of pancreas | Acinar cell cystadenoma of pancreas | Serous cystadenoma of pancreas
Excludes: Benign neoplasm of endocrine pancreas
[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
[6C4H.Y] Other specified disorders due to use of non-psychoactive substances
Also known as: Other specified disorders due to use of non-psychoactive substances | Steroid dependence
=== GRAPH WALKS ===
--- Walk 1 ---
[DC3Z] Diseases of pancreas, unspecified
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--RELATED_TO--> [?] Structural developmental anomalies of pancreas
--- Walk 2 ---
[DC3Z] Diseases of pancreas, unspecified
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--CHILD--> [DC31] Acute pancreatitis
Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system...
--- Walk 3 ---
[DC3Y] Other specified diseases of pancreas
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--CHILD--> [DC32] Chronic pancreatitis
--- Walk 4 ---
[DC3Y] Other specified diseases of pancreas
--PARENT--> [?] Diseases of pancreas
Def: This is a group of conditions characterised as being in or associated with the pancreas....
--RELATED_TO--> [?] Structural developmental anomalies of pancreas
--- Walk 5 ---
[LB21.3] Agenesis-aplasia of pancreas
Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....
--PARENT--> [LB21] Structural developmental anomalies of pancreas
--CHILD--> [LB21.0] Annular pancreas
Def: Annular pancreas is a distinct form of duodenal atresia in which the head of the pancreas forms a ring around the second portion of the duodenum. During the neonatal period, the clinical picture is do...
--- Walk 6 ---
[LB21.3] Agenesis-aplasia of pancreas
Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....
--PARENT--> [LB21] Structural developmental anomalies of pancreas
--CHILD--> [LB21.2] Accessory pancreas
Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo...
|
[
"[DC3Z] Diseases of pancreas, unspecified\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --RELATED_TO--> [?] Structural developmental anomalies of pancreas",
"[DC3Z] Diseases of pancreas, unspecified\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC31] Acute pancreatitis\n Def: Inflammation of the pancreas with sudden onset. Pathological changes range from oedema to necrosis. While mild cases often recover without complications, severe cases have high mortality due to system...",
"[DC3Y] Other specified diseases of pancreas\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --CHILD--> [DC32] Chronic pancreatitis",
"[DC3Y] Other specified diseases of pancreas\n --PARENT--> [?] Diseases of pancreas\n Def: This is a group of conditions characterised as being in or associated with the pancreas....\n --RELATED_TO--> [?] Structural developmental anomalies of pancreas",
"[LB21.3] Agenesis-aplasia of pancreas\n Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....\n --PARENT--> [LB21] Structural developmental anomalies of pancreas\n --CHILD--> [LB21.0] Annular pancreas\n Def: Annular pancreas is a distinct form of duodenal atresia in which the head of the pancreas forms a ring around the second portion of the duodenum. During the neonatal period, the clinical picture is do...",
"[LB21.3] Agenesis-aplasia of pancreas\n Def: This refers to the failure of an organ to develop during embryonic growth and development due to the absence of primordial tissue of the pancreas....\n --PARENT--> [LB21] Structural developmental anomalies of pancreas\n --CHILD--> [LB21.2] Accessory pancreas\n Def: Accessory pancreas is an asymptomatic embryopathy characterised by the presence of pancreatic tissue in other sites of the body such as the splenic pedicle, gonadic pedicles, intestinal mesentery, duo..."
] |
DC3Z
|
Diseases of pancreas, unspecified
|
[
{
"from_icd11": "DC3Z",
"icd10_code": "K8681",
"icd10_title": "Exocrine pancreatic insufficiency"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K8689",
"icd10_title": "Other specified diseases of pancreas"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K869",
"icd10_title": "Disease of pancreas, unspecified"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K868",
"icd10_title": "Other specified diseases of pancreas"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K87",
"icd10_title": "Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K80-K87",
"icd10_title": ""
},
{
"from_icd11": "DC3Z",
"icd10_code": "K86",
"icd10_title": "Other diseases of pancreas"
},
{
"from_icd11": "DC3Z",
"icd10_code": "K871",
"icd10_title": ""
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q450",
"icd10_title": "Agenesis, aplasia and hypoplasia of pancreas"
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q38-Q45",
"icd10_title": ""
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q45",
"icd10_title": "Other congenital malformations of digestive system"
},
{
"from_icd11": "LB21.Z",
"icd10_code": "Q452",
"icd10_title": "Congenital pancreatic cyst"
},
{
"from_icd11": "LC30",
"icd10_code": "Q840",
"icd10_title": "Congenital alopecia"
},
{
"from_icd11": "LC30",
"icd10_code": "Q842",
"icd10_title": "Other congenital malformations of hair"
},
{
"from_icd11": "2E92.8",
"icd10_code": "D136",
"icd10_title": "Benign neoplasm of pancreas"
}
] |
K8681
|
Exocrine pancreatic insufficiency
|
A 42-year-old female patient presented in June 2022 with a complaint of gradual progressive painless diminution of vision in the left eye that started 16 months earlier. Clinical history revealed an episode of sudden, profound, painless diminution of vision in the same eye that had occurred 18 months earlier in December 2020. At the time of that episode, visual acuity in the left eye was as low as hand motion, but gradually improved over a period of 4 months to reach 3/60. However, after that initial partial improvement, visual acuity in the left eye progressively deteriorated from 3/60 to become 1/60 at the time of presentation. Through medical history and earlier investigations i.e. FFA, SD-OCT macula , we concluded that the episode of acute drop of vision in the left eye was caused by left CRAO for which the patient had undergone an extensive systemic workup that established a diagnosis of SLE according to EULAR/ARC criteria with positive ANA, positive anti-Cardiolipin Ab, positive beta2 Glycoprotein Ab, fever, thrombocytopenia and non-cicatricial alopecia . The rheumatologist prescribed the patient HCQ at a dose of 400 mg/day which is equivalent to 5.3 mg/kg/day and oral steroids with varying doses throughout the course of treatment ranging between 20 and 60 mg/day. At the time of presentation, ophthalmological examination revealed BCVA 6/6 OD and 1/60 OS, unremarkable anterior segment examination, right normal fundus, left bull's eye maculopathy and temporal optic disc pallor with attenuated retinal vessels .SD-OCT macula was performed which revealed foveal and parafoveal outer retinal defects involving the RPE, ELM, IS/OS as well as intraretinal degenerative cysts and generalized thinning and atrophy of the neurosensory retina in the left eye while the right eye was normal . Therefore, a diagnosis of left advanced HCQ maculopathy was made after exclusion of other possible causes of unilateral bull's eye maculopathy e.g. resolved unilateral acute idiopathic maculopathy (UAIM), subretinal fibrosis and uveitis syndrome (SFU), asymmetric cone or cone/rod dystrophy, benign concentric annular macular dystrophy, Stargardt's disease and traumatic maculopathy. These causes were excluded because none of them matches the clinical picture of our case for variable reasons e.g. the negative family history and the strictly unilateral involvement with completely normal right eye with BCVA 6/6 and intact color vision, excludes dystrophies. Moreover, the insidious rather than acute onset, the absence of signs of uveitis, the strict monofocal foveal and parafoveal involvement as opposed to multifocality, the regular oval edges of bull's eye rather than irregular pigmented edges, exclude UAIM and SFU as possible etiologies. Furthermore, the negative history of ocular or head trauma excludes traumatic maculopathy. Consequently, a recommendation to stop HCQ was conveyed to the rheumatologist who shifted the patient to Leflunomide.What is atypical about this case is the rather early onset maculopathy which manifested in the advanced form of bull's eye maculopathy after only 16 months of HCQ treatment compared to the reported incidence which is < 1% at 5 years. Another unusual aspect is the strictly unilateral involvement where the left eye shows advanced maculopathy while the right eye is normal. We assume that the early onset monocular HCQ maculopathy may be related to the CRAO that affected the same eye prior to HCQ treatment. Fig. 1 SD-OCT macula of the left eye (left), Fundus photography and FFA of the left eye(right) one week after the acute drop of vision in the left eye that had occurred 18 months prior to presentation to our clinic. OCT shows diffuse, intense hyperreflectivity of the inner retinal layers. Fundus photograph and FFA show the cherry red spot appearance and the surrounding whitening of the macular area and the corresponding widening of FAZ (right) Fig. 2 Fundus photography of the left eye (right) and SD-OCT macula of the left eye (left) at the time of presentation to our clinic 16 months after HCQ treatment. Fundus photograph shows the bull's eye appearance in the macula with a darkly pigmented parafoveal ring. OCT shows the foveal and parafoveal outer retinal defect affecting RPE, ELM, IS/OS. There are also intraretinal degenerative cyst, irregular foveal contour and generalized thinning of neurosensory retina Fig. 3 Normal SD-OCT macula of the right eye (left) and normal fundus photography of the right eye (right) at time of presentation to our clinic 16 months after HCQ treatment Fig. 4 Bilateral fundus photography and FFA at the time of presentation to our clinic 16 months after HCQ treatment. Fundus photography shows the bull's eye appearance in the macula of the left eye, the attenuated arteriolar caliber and exaggerated choroidal pattern in the left eye compared to the right eye due to generalized atrophy of the inner retina secondary to the old CRAO. FFA shows right normal angiogram and left FAZ widening and two concentric parafoveal rings, an inner subtle hyperfluorescent ring representing RPE window defect and an outer larger hypofluorescent ring corresponding to the darkly pigmented parafoveal ring seen in the fundus photograph
| 4.121094
| 0.975098
|
sec[1]/p[0]
|
en
| 0.999997
|
36376841
|
https://doi.org/10.1186/s12886-022-02657-8
|
[
"maculopathy",
"that",
"fundus",
"macula",
"time",
"bull",
"parafoveal",
"vision",
"which",
"photography"
] |
[
{
"code": "9B78.3Y",
"title": "Other specified degeneration of macula or posterior pole"
},
{
"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": "9B70",
"title": "Inherited retinal dystrophies"
},
{
"code": "GC40.Z",
"title": "Pelvic organ prolapse, unspecified"
},
{
"code": "9B61",
"title": "Choroidal dystrophy"
},
{
"code": "2B72.Y",
"title": "Other specified malignant neoplasms of stomach"
}
] |
=== ICD-11 CODES FOUND ===
[9B78.3Y] Other specified degeneration of macula or posterior pole
Also known as: Other specified degeneration of macula or posterior pole | Persistent placoid maculopathy | Angioid streaks of macula | angioid streaks | angioid streaks of choroid
Includes: Angioid streaks of macula | Puckering of macula | Toxic maculopathy
[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
[9B70] Inherited retinal dystrophies
Also known as: Inherited retinal dystrophies | hereditary retinal dystrophies | Amaurosis - hypertrichosis | Autosomal dominant late-onset retinal degeneration | Bothnia retinal dystrophy
Includes: Leber congenital amaurosis | Stargardt disease | Vitreoretinal dystrophy
[GC40.Z] Pelvic organ prolapse, unspecified
Also known as: Pelvic organ prolapse, unspecified | Pelvic organ prolapse | female genital prolapse | female prolapse | incompetence of pelvic fundus
[9B61] Choroidal dystrophy
Also known as: Choroidal dystrophy | hereditary choroidal dystrophies | generalised choroidal dystrophy | hereditary choroidopathy | Chorioretinopathy - microcephaly, autosomal dominant
Includes: Choroideremia | Gyrate atrophy, choroid
Excludes: ornithinaemia
[2B72.Y] Other specified malignant neoplasms of stomach
Also known as: Other specified malignant neoplasms of stomach | Carcinoma of stomach | gastric carcinoma | Carcinoma of fundus of stomach | Metastatic stomach carcinoma [primary stomach carcinoma spreading elsewhere]
=== GRAPH WALKS ===
--- Walk 1 ---
[9B78.3Y] Other specified degeneration of macula or posterior pole
--PARENT--> [9B78.3] Degeneration of macula or posterior pole
--CHILD--> [9B78.30] Reticular pseudodrusen
Def: Histologically located above the retinal pigment epithelium, this finding is often associated with other retinal disease....
--- Walk 2 ---
[9B78.3Y] Other specified degeneration of macula or posterior pole
--PARENT--> [9B78.3] Degeneration of macula or posterior pole
--CHILD--> [9B78.3Z] Degeneration of macula or posterior pole, unspecified
--- Walk 3 ---
[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 4 ---
[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 5 ---
[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 6 ---
[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
|
[
"[9B78.3Y] Other specified degeneration of macula or posterior pole\n --PARENT--> [9B78.3] Degeneration of macula or posterior pole\n --CHILD--> [9B78.30] Reticular pseudodrusen\n Def: Histologically located above the retinal pigment epithelium, this finding is often associated with other retinal disease....",
"[9B78.3Y] Other specified degeneration of macula or posterior pole\n --PARENT--> [9B78.3] Degeneration of macula or posterior pole\n --CHILD--> [9B78.3Z] Degeneration of macula or posterior pole, unspecified",
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.1] Migraine with aura\n Def: Recurrent attacks, lasting minutes, of unilateral fully-reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and asso...",
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --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....",
"[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"
] |
9B78.3Y
|
Other specified degeneration of macula or posterior pole
|
[
{
"from_icd11": "9B78.3Y",
"icd10_code": "H35373",
"icd10_title": "Puckering of macula, bilateral"
},
{
"from_icd11": "9B78.3Y",
"icd10_code": "H35372",
"icd10_title": "Puckering of macula, left eye"
},
{
"from_icd11": "9B78.3Y",
"icd10_code": "H35371",
"icd10_title": "Puckering of macula, right eye"
},
{
"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"
}
] |
H35373
|
Puckering of macula, bilateral
|
The initial manifestation of MS in our patient raised several red flags, suggesting a severe disease course, such as persisting and disabling symptoms, almost no recovery after the first steroid pulse, and a high lesion load at baseline, including spinal and infratentorial Gad-enhancing lesions. In addition, intrathecal IgM synthesis is associated with an unfavorable prognosis ( 5 ). Thus, following an acute relapse treatment, we aimed at a highly effective immunodepletion therapy with ocrelizumab. However, when the mostly fatal Marburg variant of MS became evident, we were forced to take a more aggressive therapeutic approach. This decision was made since, of the 28 cases documented in the literature, only 11 (39%) survived, of whom only two (18%) had a favorable outcome. Of note is that the Marburg MS is still poorly defined as an MS variant in its own right as demonstrated by the heterogeneous nomenclature found in the literature (e.g., malign MS, acute fulminant MS, acute malignant MS, rapidly progressive MS, etc.). As a result, the clinician is faced with uncertainty regarding the potential transferability of previous therapeutic approaches. While there are cases in which mitoxantrone or alemtuzumab were successfully applied ( 6 , 7 ), we advocate the use of cyclophosphamide as this agent not only effectively targets immune cells but also mobilizes HSC. These can then be harvested for later therapeutic use in the form of autologous hematopoietic stem cell transplantation, which has proven to be a potent therapy for highly active relapsing–remitting MS ( 8 ) and might therefore be effective as a long-term therapy in Marburg MS as well. Furthermore, following the high-dose cyclophosphamide protocol of Krishnan et al. ( 4 ) and using ocrelizumab as a maintenance therapy, we were able to prevent permanent disability and to achieve an almost complete clinical and drastic radiological improvement. As most other reported cases were fatal, this will provide the unique opportunity to monitor the long-term disease course. Regarding the pharmacodynamics of our treatment, we did not measure the cyclophosphamide levels in our patient. However, a case series of seven patients from 1,983 compared cyclophosphamide levels in the serum and CSF of MS patients following oral administration and showed identical levels, which demonstrated the high CNS penetration of this medication ( 9 ). As our patient had a reduced level of consciousness, we decided for intravenous administration. So far, there have been two case reports with favorable outcomes using the protocol that we applied ( 4 , 10 ). Of note is that the cyclophosphamide treatment was primarily intended as a rescue therapy for the fulminant disease course and not as a means of stem cell mobilization. In general, the doses needed for effective immunosuppression are far higher than those required for stem cell mobilization ( 11 ). Beyond the Marburg MS cases, the dose that we applied was also evaluated in refractory MS patients ( 12 ). Regarding side effects, high doses of cyclophosphamide can induce hemorrhagic cystitis, hepatic damage, and cardiac necrosis ( 13 ) as well as infertility and ovarian endocrine failure ( 14 ). However, neither during the acute treatment phase nor during follow-up for 6 months were any of these side effects observed. Concerning ocrelizumab, this medication depletes CD20-positive B and T cells ( 15 ) within days but may take up to 3 months to reach its maximal effect. However, upon consultation with the patient, we decided to use it as a maintenance therapy due to her concerns described above. With regard to disease biomarkers, serum NfL levels in MS reflect ongoing disease activity and correlate with worsening of disability, lesion load ( 16 ), and risk for relapses. Accordingly, we found a rapid increase of NfL levels in our patient which doubled within a period of 7 days, reflecting the fulminant disease course. On the other hand, our data suggest that NfL may also be a suitable tool to monitor therapy response in Marburg MS, as we found it to steadily decrease following the HiCy treatment. To our knowledge, this is the first case of Marburg MS where data on this serological biomarker of CNS damage were collected during disease and recovery. Another interesting feature of our case was that, while we found positive OCBs, the MRZ reaction was negative. In MS, the MRZR, a polyspecific antiviral immune response against measles, rubella, and varicella zoster virus has a specificity of ~97% ( 17 ). Unfortunately, the majority of the other Marburg MS case reports did not include information on this laboratory marker so that, at present, its significance in Marburg MS remains unclear. Lastly, it is an important feature of this case that the severe disease reactivation occurred shortly after anti-pneumococcus vaccination. Of note is that there have been recent studies describing a worsening of MS after the administration of live attenuated vaccines like yellow fever ( 18 ), but inactivated vaccines, like pneumococcal vaccination, are usually considered safe regarding MS activity. In summary, we trust that this report will contribute to a more successful management of Marburg MS.
| 4.308594
| 0.463135
|
sec[2]/p[0]
|
en
| 0.999998
|
34248832
|
https://doi.org/10.3389/fneur.2021.696807
|
[
"this",
"that",
"marburg",
"cyclophosphamide",
"course",
"however",
"cases",
"regarding",
"which",
"effective"
] |
[
{
"code": "4A01.03",
"title": "Transient hypogammaglobulinaemia of infancy"
},
{
"code": "8A80.Z",
"title": "Migraine, unspecified"
},
{
"code": "QA76",
"title": "Medication or substance that is known to be an allergen without injury or harm"
},
{
"code": "PL13.6",
"title": "Medication or substance that is known to be an allergen, as mode of injury or harm"
},
{
"code": "9C40.A0",
"title": "Papilloedema"
},
{
"code": "PA6Z",
"title": "Unintentional fall from unspecified height"
},
{
"code": "1D60.1Z",
"title": "Marburg disease, virus unspecified"
},
{
"code": "1D60.1Y",
"title": "Other specified Marburg disease"
},
{
"code": "1D60.10",
"title": "Marburg virus disease"
},
{
"code": "1D60.11",
"title": "Atypical Marburg disease"
}
] |
=== 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]
[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
[1D60.1Z] Marburg disease, virus unspecified
Also known as: Marburg disease, virus unspecified | Marburg disease | green monkey disease | vervet monkey disease | MARD - [Marburg disease]
[1D60.1Y] Other specified Marburg disease
Also known as: Other specified Marburg disease
[1D60.10] Marburg virus disease
Definition: Marburg disease caused by Marburg virus or Ravn virus.
Also known as: Marburg virus disease | MVD - [Marburg Virus Disease] | Marburg haemorrhagic fever | MHF - [Marburg haemorrhagic fever]
[1D60.11] Atypical Marburg disease
Also known as: Atypical Marburg disease
=== 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--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells
--- 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 ---
[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 4 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--PARENT--> [?] Headache disorders
--- Walk 5 ---
[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 6 ---
[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
|
[
"[4A01.03] Transient hypogammaglobulinaemia of infancy\n --PARENT--> [4A01.0] Immunodeficiencies with predominantly antibody defects\n Def: A disorder characterised by an inability to mount a normal immune response due to antibody (i.e. immunoglobulin) defects...\n --CHILD--> [4A01.02] Specific antibody deficiency with normal immunoglobulin concentrations or normal number of B cells",
"[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....",
"[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 --PARENT--> [?] Headache disorders",
"[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"
] |
4A01.03
|
Transient hypogammaglobulinaemia of infancy
|
[
{
"from_icd11": "4A01.03",
"icd10_code": "D807",
"icd10_title": "Transient hypogammaglobulinemia of infancy"
},
{
"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"
}
] |
D807
|
Transient hypogammaglobulinemia of infancy
|
The case hereby presented of LC-related hemobilia has been the only one we have registered over the last ten years, accounting for 0.001% of patients with acute cholecystitis operated on in emergency (within 72 hours of admission) and, including elective surgery, accounting for 0.0003% of all the patients undergoing LC over the same span. Hemobilia complicating LC has become a well-known serious event reported in plenty of issues. Symptoms and signs appear within 4 weeks from LC in 80% of cases , and only in 3 issues, this complication occurred one year after surgery or even later . Upper gastrointestinal bleeding with melena is the commonest sign of hemobilia and is observed in 90% of cases, whereas abdominal pain is present in 70% and jaundice in 60% of patients; the classic Quincke's triad comprehending melena, pain in the right upper quadrant, and jaundice is observed in 20–40% of patients. In the case described a nonobstructive jaundice was present even before LC; therefore, this sign could not be helpful for diagnostic suspicion. In around 60% of cases, a pseudoaneurysm of RHA is found, in some cases branching off the superior mesenteric artery , less frequently false aneurysms of common hepatic artery or cystic artery are found . In the present case, a small pseudoaneurysm of RHA arising from the superior mesenteric artery was the cause of hemobilia, ERCP showed a biliary leak in the hepatic bed, but the existence of an arterobiliary fistula remained unvisualized by the imaging techniques. Allegedly, the incidence of vascular injuries during LC ranges between 0.25% and 0.8% , whereas the incidence of biliary injuries ranges between 0.2% and 1% ; LC-related hemobilia due to pseudoaneurysm accounts for 4.5% of biliary lesions, that is, around 0.0004% of LC procedures , nearly the same as in our experience. TAE of hepatic branches is the first line procedure, whereas open or laparoscopic surgery should be advocated only in case of unsuccessful coil embolization. TAE may be followed by rebleeding and require a second embolization or emergency laparotomy . In the case presented, one single coil embolization of RHA obtained the definite management of haemorrhage. To date, no definite pathogenetic explanation of hemobilia following LC has been given. Because titanium clips are often found next to pseudoaneurysms and monopolar coagulation is usually adopted by laparoscopic surgeons, mechanical and thermal injuries both to biliary and vascular structures have been considered responsible for this complication. If an inadvertent thermal damage occurs, a char of a biliary duct may ensue, followed weeks later by its detachment; bile erosion of a vascular char may also play a role in the pathogenesis of bleeding, while fistulization into the biliary tree may explain hemobilia. Hemobilia may also occur after elective hepatobiliary surgery and emergency open or converted cholecystectomy, during which clips are never (or seldom) employed: instead, severe local inflammation may entail difficult dissection and thermal damage, which must be the real causes of inadvertent vascular injuries in such cases [ 27 – 31 ]. Pseudoaneurysms of hepatic or cystic artery can be even secondary to acute or chronic cholecystitis , and perhaps in some cases, this vascular lesion is present even before LC. The size of pseudoaneurysms increases with the time and may reach the noticeable size of 7 cm, as observed when cholecystitis is managed nonoperatively for long time or, less frequently, when the vascular lesion complicates LC and becomes symptomatic long time later . In the case presented, the patient had complained for months of abdominal pain, and the histologic examination showed a thick walled gallbladder with acute inflammation and chronic cholecystitis: the pseudoaneurysm was a tiny one (4 mm), hence inadvertent thermal damage must have been the only real cause of the vascular complication herein described. The cases reported in the literature often refer to surgical histories of difficult, time-consuming LC carrying the risk of inadvertent vascular injuries with occurrence of a pseudoaneurysm thereafter. Suggestions about prevention of such events cannot be found in the specific literature of this complication. Anyway, we have enough data to argue that when dealing with thick walled gallbladders, the adoption of bipolar coagulation or ultrasonic dissection represents a good piece of advice, especially when dissection digs deep into the liver bed. Under such circumstances, possible thermal damages may be prevented by employing ultrasonic coagulation, since the potential carbonization to surrounding tissues is minimal compared to laser , monopolar, and even bipolar coagulation [ 34 – 37 ]. Hence, the consequences of inadvertent injuries to biliary structures should be minimized by using ultrasonic instrumentation, and haemostasis in the hepatic bed should be achieved by absorbable hemostats products rather than by monopolar coagulation. When the cystic artery arises low in Calot's triangle, below the cystic duct, the surgeon can suspect the presence of a replaced or aberrant RHA branching off the superior mesenteric artery, which can be found in 5–25% of subjects.
| 4.25
| 0.757813
|
sec[2]/p[0]
|
en
| 0.999996
|
22606431
|
https://doi.org/10.1155/2011/925142
|
[
"hemobilia",
"vascular",
"cases",
"artery",
"biliary",
"injuries",
"this",
"even",
"pseudoaneurysm",
"hepatic"
] |
[
{
"code": "DC14.0",
"title": "Haemorrhage of bile duct"
},
{
"code": "BE2Z",
"title": "Diseases of the circulatory system, unspecified"
},
{
"code": "BE2Y",
"title": "Other specified diseases of the circulatory system"
},
{
"code": "BD4Z",
"title": "Chronic arterial occlusive disease, unspecified"
},
{
"code": "ND56.5",
"title": "Injury of blood vessel of unspecified body region"
},
{
"code": "4A4Z",
"title": "Nonorgan specific systemic autoimmune disorders, unspecified"
},
{
"code": "JB20.Z",
"title": "Single spontaneous delivery, unspecified"
},
{
"code": "QA48.0",
"title": "Care or examination immediately after delivery"
},
{
"code": "BD5Z",
"title": "Diseases of arteries or arterioles, unspecified"
},
{
"code": "BD52",
"title": "Certain specified disorders of arteries or arterioles"
}
] |
=== ICD-11 CODES FOUND ===
[DC14.0] Haemorrhage of bile duct
Also known as: Haemorrhage of bile duct | Haemobilia
Includes: Haemobilia
[BE2Z] Diseases of the circulatory system, unspecified
Also known as: Diseases of the circulatory system, unspecified | circulatory disease NOS | cardiovascular disease NOS | cardiovascular system disease NOS | CVS - [cardiovascular system] disease
[BE2Y] Other specified diseases of the circulatory system
Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart
[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
[ND56.5] Injury of blood vessel of unspecified body region
Also known as: Injury of blood vessel of unspecified body region | Injury of blood vessel(s) NOS | blood vessel wound | blood vessel trauma | Avulsion of blood vessel
Excludes: multiple injuries of blood vessels NOS
[4A4Z] Nonorgan specific systemic autoimmune disorders, unspecified
Also known as: Nonorgan specific systemic autoimmune disorders, unspecified | systemic autoimmune disease | systemic collagen vascular disease | systemic vascular disease | autoimmune disease NOS
[JB20.Z] Single spontaneous delivery, unspecified
Also known as: Single spontaneous delivery, unspecified | Single spontaneous delivery | spontaneous delivery NOS | normal delivery NOS | uncomplicated delivery
[QA48.0] Care or examination immediately after delivery
Also known as: Care or examination immediately after delivery | care and observation in uncomplicated delivery cases | postpartum care immediately after delivery | postpartum examination immediately after delivery | Postpartum care after hospital delivery
Excludes: Complications predominantly related to the puerperium
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[DC14.0] Haemorrhage of bile duct
--PARENT--> [DC14] Certain specified biliary diseases
Def: This is a group of conditions characterised as being in or associated with the biliary tract, the passageway for bile, which are not classified elsewhere....
--EXCLUDES--> [?] Benign neoplasm of gallbladder, extrahepatic bile ducts or ampulla of Vater
--- Walk 2 ---
[DC14.0] Haemorrhage of bile duct
--PARENT--> [DC14] Certain specified biliary diseases
Def: This is a group of conditions characterised as being in or associated with the biliary tract, the passageway for bile, which are not classified elsewhere....
--EXCLUDES--> [?] Malignant neoplasms of hepatobiliary system
--- Walk 3 ---
[BE2Z] Diseases of the circulatory system, unspecified
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--CHILD--> [?] Ischaemic heart diseases
--- Walk 4 ---
[BE2Z] Diseases of the circulatory system, unspecified
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--RELATED_TO--> [?] Functional vascular disorders of the skin
Def: Skin disorders due to disturbances in vascular tone and skin blood flow....
--- Walk 5 ---
[BE2Y] Other specified diseases of the circulatory system
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--RELATED_TO--> [?] Symptoms, signs or clinical findings of the circulatory system
--- Walk 6 ---
[BE2Y] Other specified diseases of the circulatory system
--PARENT--> [11] Diseases of the circulatory system
Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...
--CHILD--> [?] Ischaemic heart diseases
|
[
"[DC14.0] Haemorrhage of bile duct\n --PARENT--> [DC14] Certain specified biliary diseases\n Def: This is a group of conditions characterised as being in or associated with the biliary tract, the passageway for bile, which are not classified elsewhere....\n --EXCLUDES--> [?] Benign neoplasm of gallbladder, extrahepatic bile ducts or ampulla of Vater",
"[DC14.0] Haemorrhage of bile duct\n --PARENT--> [DC14] Certain specified biliary diseases\n Def: This is a group of conditions characterised as being in or associated with the biliary tract, the passageway for bile, which are not classified elsewhere....\n --EXCLUDES--> [?] Malignant neoplasms of hepatobiliary system",
"[BE2Z] Diseases of the circulatory system, unspecified\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --CHILD--> [?] Ischaemic heart diseases",
"[BE2Z] Diseases of the circulatory system, unspecified\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --RELATED_TO--> [?] Functional vascular disorders of the skin\n Def: Skin disorders due to disturbances in vascular tone and skin blood flow....",
"[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --RELATED_TO--> [?] Symptoms, signs or clinical findings of the circulatory system",
"[BE2Y] Other specified diseases of the circulatory system\n --PARENT--> [11] Diseases of the circulatory system\n Def: This refers to diseases of the organ system that passes nutrients (such as amino acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases...\n --CHILD--> [?] Ischaemic heart diseases"
] |
DC14.0
|
Haemorrhage of bile duct
|
[
{
"from_icd11": "BE2Z",
"icd10_code": "I998",
"icd10_title": "Other disorder of circulatory system"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I999",
"icd10_title": "Unspecified disorder of circulatory system"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I4949",
"icd10_title": "Other premature depolarization"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I4940",
"icd10_title": "Unspecified premature depolarization"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I499",
"icd10_title": "Cardiac arrhythmia, unspecified"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I498",
"icd10_title": "Other specified cardiac arrhythmias"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I271",
"icd10_title": "Kyphoscoliotic heart disease"
},
{
"from_icd11": "BE2Z",
"icd10_code": "IX",
"icd10_title": ""
},
{
"from_icd11": "BE2Z",
"icd10_code": "I27",
"icd10_title": "Other pulmonary heart diseases"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I30-I52",
"icd10_title": ""
},
{
"from_icd11": "BE2Z",
"icd10_code": "I494",
"icd10_title": "Other and unspecified premature depolarization"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I52",
"icd10_title": "Other heart disorders in diseases classified elsewhere"
},
{
"from_icd11": "BE2Z",
"icd10_code": "I520",
"icd10_title": ""
},
{
"from_icd11": "BE2Z",
"icd10_code": "I521",
"icd10_title": ""
},
{
"from_icd11": "BE2Z",
"icd10_code": "I528",
"icd10_title": ""
}
] |
I998
|
Other disorder of circulatory system
|
A timeline of the case is illustrated in Table 1 . In March 2010, a 49-year-old Caucasian male with an unremarkable past medical history consulted his general practitioner with severe hypertension (initially presenting at 260/106 mm Hg). After a 1-month trial of antihypertensives (calcium channel and then angiotensin receptor blockade), without significant clinical benefit, he was referred for a renal ultrasound. A left-sided 7 cm adrenal mass was noted on ultrasound, and the patient was subsequently investigated for an adrenal lesion. Biochemical investigations were most in keeping with a phaeochromocytoma, including borderline-raised urinary normetadrenalines (3.7 μmol/24 h), an unremarkable overnight dexamethasone suppression test, and normal plasma renin and aldosterone levels (all results listed in Table 1 ). An adrenal-focussed CT was undertaken, confirming the mass was consistent with a phaeochromocytoma. Table 1 Timeline of case report events. Date Clinical event March 2010 49-year-old male presents to the GP with hypertension. Limited response to treatment was reported after an initial 1-month trial of anti-hypertensives (initially 260/106 mm Hg). Secondary hypertension investigations: - USS kidneys – left-sided 7 cm adrenal mass. - 24-hour urine normetadrenaline – 3.7 μmol/24 h, repeat 0.6 μmol/24 h (range: 0.4–3.4). - 24-hour urine metadrenaline – 0.8 μmol/24 h, repeat 0.3 μmol/24 h (range: 0.3–1.7). - Overnight dexamethasone suppression test unremarkable. - CT adrenals – 7.4 × 6.5 × 6.2 cm left adrenal mass, compatible with a phaeochromocytoma. No other abnormality identified. - Nuclear medicine MIBG scan: no evidence of abnormal MIBG uptake, particularly in relation to the abnormal left adrenal gland noted on previous ultrasound/CT. - Plasma renin – within normal range at 3.0 ng/mL/h. - Plasma aldosterone – within normal range at 377 pmol/L; repeat 516 pmol/L. July 2010 Left adrenalectomy for assumed phaeochromocytoma. Post-operative histology suggestive of an adrenocortical carcinoma: - Weiss criteria – positive features – sample contains less than 25% clear cells; significant nuclear pleomorphism; evidence of capsular invasion; extension into the adjacent peri-adrenal fat; the tumour cells involve vascular sinusoids; single focus highly suspicious for invasion of the tumour cells into a larger blood vessel. - Mitotic rate = 2 mitoses per 50 high power fields (×40). - Immunohistochemistry – tumour cells express melan A and calretinin; no expression of chromogranin or reaction with an antibody cocktail to cytokeratin. Where the percentage of pleomorphic cells is increased, a higher proportion of tumour cells are in active cell cycle (as indicated by the number of cells reacting with the Ki67 antibody). Subsequent radiotherapy to adrenal bed, following positive margins on histology. January 2014 Liver metastases identified on MRI in segments II, III, IVa, and IVb. Sized 52 mm in segment IVa and 12.5 mm in segment IVb, with the remaining metastases smaller than 10 mm. MRI abdomen, CTCAP, and FDG PET all undertaken pre-resection at the point of relapse. Left hepatectomy was undertaken. Adjuvant mitotane was declined by patient choice, due to toxicity profile. March 2015 MRI liver, CT liver with contrast, and CT chest undertaken. Arterially enhancing lesions were noted in liver segments V and VII (8 mm and 9 mm in size, respectively). Radiofrequency ablation undertaken. May 2018 Further liver metastases noted at MDT in segments VI and VII . SIRT discussed with patient and offered due to low toxicity profile. July and August 2019 FDG PET,CTCAP and MRI abdomen were undertaken, with segment VI and VII lesions re-imaged (42 mm and 70 mm in size, respectively). First round of SIRT was offered and well tolerated. Subsequent round of SIRT offered. February 2020 Post-SIRT imaging shows a ‘marked response’ to liver lesions, defined by the radiology team as a marked reduction in the size of the segment VII lesion to 34 mm. Although MRI of the liver also notes a slight reduction in the size of segment VI lesion, the very high T2 signal is suggestive of necrosis and response. Liver function unchanged. November 2020 Disease progression noted near the previously noted segment VI lesion (five subcapsular lesions, including a 40 mm and 26 mm deposit). January and February 2021 Multiple rounds of SIRT. April 2021 ‘Size reduction response’ in all lesions post SIRT, but residual arterial enhancement was noted in segment VI lesion (30 mm diameter). Mindful of no clear arterial supply to this lesion, transarterial chemoembolisation (TACE) offered for this lesion. October 2021 TACE undertaken. February 2022 Disease progression in liver segments VII and VIII . MRI found disease progression in segment VIII of the liver with a conglomerate of metastases forming a 55 mm mass adjacent to the previously treated lesion, as well as avidly enhancing lesions in segment VII of the liver. Further round of SIRT provided. May 2022 Ablation of residual disease. June 2022 Presents with paraplegia following spinal and base of skull metastases. September 2022 Patient dies aged 61, 12 years after the initial diagnosis and 9 years after the diagnosis of metastatic disease.
| 4.078125
| 0.955566
|
sec[1]/p[0]
|
en
| 0.999997
|
39108463
|
https://doi.org/10.1530/EO-23-0041
|
[
"liver",
"segment",
"adrenal",
"lesion",
"undertaken",
"cells",
"sirt",
"lesions",
"metastases",
"phaeochromocytoma"
] |
[
{
"code": "DB9Z",
"title": "Diseases of liver, unspecified"
},
{
"code": "DB97.Z",
"title": "Inflammatory liver disease, unspecified"
},
{
"code": "DB99.7",
"title": "Hepatic failure without mention whether acute or chronic"
},
{
"code": "LB20.0Y",
"title": "Other specified structural developmental anomalies of liver"
},
{
"code": "LB20.0Z",
"title": "Structural developmental anomalies of liver, unspecified"
},
{
"code": "ME93.0",
"title": "Segmental and somatic dysfunction"
},
{
"code": "8A06.1",
"title": "Segmental myoclonus"
},
{
"code": "EC23.0",
"title": "Non-syndromic genetically-determined hypermelanosis or lentiginosis"
},
{
"code": "GB40/MF8Y&XT8W",
"title": "Chronic nephritic syndrome : focal and segmental glomerular lesions"
},
{
"code": "LB73.24",
"title": "Segmentation anomalies of vertebrae"
}
] |
=== ICD-11 CODES FOUND ===
[DB9Z] Diseases of liver, unspecified
Also known as: Diseases of liver, unspecified | liver disease | liver condition NOS | organ liver disease | hepatopathy
[DB97.Z] Inflammatory liver disease, unspecified
Also known as: Inflammatory liver disease, unspecified | Certain specified inflammatory liver diseases | Nonspecific reactive hepatitis | inflammatory liver disease | hepatitis NOS
[DB99.7] Hepatic failure without mention whether acute or chronic
Also known as: Hepatic failure without mention whether acute or chronic | liver decompensation | liver function failure | hepatic failure NOS | liver failure NOS
[LB20.0Y] Other specified structural developmental anomalies of liver
Also known as: Other specified structural developmental anomalies of liver | Alagille syndrome | Alagille-Watson syndrome | Arteriohepatic dysplasia | Syndromic bile duct paucity
[LB20.0Z] Structural developmental anomalies of liver, unspecified
Also known as: Structural developmental anomalies of liver, unspecified | Structural developmental anomalies of liver | Malformations of liver | congenital anomaly of liver | congenital malformation of liver
[ME93.0] Segmental and somatic dysfunction
Also known as: Segmental and somatic dysfunction | segmental dysfunction | somatic dysfunction | Segmental and somatic dysfunction, head region | Segmental and somatic dysfunction, occipitocervical region
[8A06.1] Segmental myoclonus
Definition: Rhythmic or semi-rhythmic involuntary contractions of muscle groups supplied by one or more contiguous segments of the brainstem and/or spinal cord.
Also known as: Segmental myoclonus | Spinal segmental myoclonus | Propriospinal myoclonus
[EC23.0] Non-syndromic genetically-determined hypermelanosis or lentiginosis
Also known as: Non-syndromic genetically-determined hypermelanosis or lentiginosis | Familial progressive hyperpigmentation | Familial generalised lentiginosis | Inherited patterned lentiginosis | Centrofacial lentiginosis
[LB73.24] Segmentation anomalies of vertebrae
Definition: Any condition caused by failure of the vertebrae to correctly develop during the antenatal period. These conditions are characterised by an abnormal number of fully developed vertebrae. Confirmation is through verification of absent or improperly formed vertebrae by imaging.
Also known as: Segmentation anomalies of vertebrae | Isolated hemivertebra | Multiple segmentation anomalies of vertebrae
=== GRAPH WALKS ===
--- Walk 1 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--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
--RELATED_TO--> [?] Structural developmental anomalies of liver
--- Walk 3 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--CHILD--> [DB97.1] Hepatic berylliosis
--- Walk 4 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--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 5 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--CHILD--> [DB99.1] Hepatic cyst
Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue. It may contain air, fluids, or semi-solid material of the liver....
--- Walk 6 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--RELATED_TO--> [?] Cirrhotic cardiomyopathy
Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation...
|
[
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --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 --RELATED_TO--> [?] Structural developmental anomalies of liver",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --CHILD--> [DB97.1] Hepatic berylliosis",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --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....",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.1] Hepatic cyst\n Def: This is a closed sac, having a distinct membrane and division compared to the nearby tissue. It may contain air, fluids, or semi-solid material of the liver....",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Cirrhotic cardiomyopathy\n Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation..."
] |
DB9Z
|
Diseases of liver, unspecified
|
[
{
"from_icd11": "DB9Z",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7689",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K769",
"icd10_title": "Liver disease, unspecified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K77",
"icd10_title": "Liver disorders in diseases classified elsewhere"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K762",
"icd10_title": "Central hemorrhagic necrosis of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K70-K77",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K778",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K72",
"icd10_title": "Hepatic failure, not elsewhere classified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K76",
"icd10_title": "Other diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K768",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7581",
"icd10_title": "Nonalcoholic steatohepatitis (NASH)"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7589",
"icd10_title": "Other specified inflammatory liver diseases"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K759",
"icd10_title": "Inflammatory liver disease, unspecified"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K752",
"icd10_title": "Nonspecific reactive hepatitis"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K75",
"icd10_title": "Other inflammatory liver diseases"
}
] |
K7681
|
Hepatopulmonary syndrome
|
A 67-year-old man presenting with chest discomfort and nausea was transferred to the nearby hospital. He was diagnosed with acute myocardial infarction; an intra-aortic balloon pump (IABP) was inserted, and he was taken to the catheter room. His angiogram findings revealed left anterior descending coronary artery occlusion with a thrombus that was aspirated immediately. Echocardiography revealed a pericardial effusion suggestive of left ventricular rupture, and he was referred to our unit for surgery. The patient had been consulting a local physician for hypertension, diabetes mellitus, and hyperlipidemia. He had a 47-year history of daily smoking. His blood pressure was 143/92 mmHg, and the pulse rate was 86 beats/min. His blood oxygen saturation (SpO 2 ) level was 98% with 8 L/min of oxygen therapy. His chest radiography findings showed remarkable cardiomegaly with pulmonary congestion. The 12-lead electrocardiogram findings demonstrated sinus rhythm with ST elevation and poor R progression in leads V1–4. Laboratory findings showed that the cardiac enzymes, creatine kinase and creatine kinase-MB, were elevated at 196 and 17 IU/L (peak level of creatine kinase-MB), respectively, and reached 2223 and 14 IU/L 3 days later. Troponin I level was remarkably elevated at 19.26 ng/mL on admission. A median sternotomy was performed, and he underwent drainage of the pericardial bleeding and hemostasis of the left ventricular oozing rupture without cardiopulmonary bypass. A tissue-sealing seat was applied to the left ventricle epicardium using human fibrinogen, thrombin, and aprotinin. During surgery, we performed a transesophageal echocardiogram (TEE), which revealed a small slit formation of the ventricular septum; however, it showed no shunt between the right and left ventricles. The patient was transferred to the intensive care unit in a stable condition. A transthoracic echocardiogram showed akinetic regions of the large anterior segment and apex of the left ventricle. Although the slitted interventricle septum was depicted with fluttering motions, no shunt was indicated (Additional file 1 : Video S1). However, 15 h later, he presented with sudden cardiogenic shock requiring extra-corporeal membrane oxygenation (ECMO). The patient could not be weaned from ECMO, and a TEE performed 5 days later showed the new onset of a left ventricular septal aneurysm . The left ventriculogram also revealed a saccular aneurysm-like protrusion at the ventricular septum , which caused severe left ventricular acute failure and ECMO support dependence. Then, the patient was taken to the operating room for surgical repair. Re-sternotomy was performed, and cardiopulmonary bypass was instituted from the superior and inferior veins to the ascending aorta. A left ventricular vent tube was inserted via the right upper pulmonary vein. The ascending aorta was clamped and the heart was arrested with antegrade cardioplegia. Then, the left ventricle was incised at the lateral portion of the left anterior descending coronary artery. The ventricular septal wall had a dissection with a single tear into the left ventricle, forming a large aneurysm . The septal dissection was obliterated with a large suture through the right ventricle from the septum using 3-0 polypropylene suture with Teflon felt . Inside the left ventricle, a 4 × 6-cm oval fabric patch was placed over the infarcted septal wall, including the rupture, and was sutured with pledget 3-0 polypropylene . An additional aortocoronary bypass graft with a saphenous vein graft was performed. Cardiopulmonary bypass was weaned off with ECMO and IABP. Hemostasis was secured, and the surgery was completed. The patient was weaned off ECMO on postoperative day (POD) 1. The IABP was removed on POD 5, and the patient was extubated on POD 15. He was complicated by a small left temporal lobe infarction. After 4 months, he was transferred to another hospital for rehabilitation and was discharged 1 year later. Fig. 1 Transesophageal echocardiogram. A ventricular septal dissection is shown with communication to the left ventricle via a small orifice-generating aneurysm. LV left ventricle, RV right ventricle Fig. 2 Left ventriculogram revealing a saccular aneurysm-like protrusion at the ventricular septum (white arrow) Fig. 3 a Left ventriculotomy showing a small orifice at the ventricular septum. From this orifice, a septal dissecting aneurysm was formed. b Obliteration of the septal dissection. The left ventricle patch was placed over the infarcted septal wall including tear and sutured with pledget 3-0 polypropylene. c The orifice of the septal dissection was located at the middle part of the ventricular septum. d A large suture was passed through the right ventricle from the septum using 3-0 polypropylene with Teflon felt. e , f A fabric oval patch was seated down on the ventricular septum and sutured with pledget 3-0 polypropylene. g A schematic picture of the surgical procedure. The green bar indicates the fabric patch. The small black bars indicate the Teflon pledgets. ( ∗) indicates the orifice of the septal dissection. LV left ventricle, LAD left ascending coronary artery, LCX left circumflex coronary artery, PA pulmonary artery
| 3.949219
| 0.978027
|
sec[1]/p[0]
|
en
| 0.999998
|
33638712
|
https://doi.org/10.1186/s40792-021-01141-7
|
[
"ventricular",
"ventricle",
"septal",
"septum",
"aneurysm",
"dissection",
"artery",
"small",
"ecmo",
"polypropylene"
] |
[
{
"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": "LA88.Z",
"title": "Congenital anomaly of a ventricle or the ventricular septum, unspecified"
},
{
"code": "LA8E.Z",
"title": "Congenital anomaly of atrial septum, unspecified"
},
{
"code": "LA88.4Z",
"title": "Ventricular septal defect, unspecified"
},
{
"code": "LA8B.0",
"title": "Congenital aortopulmonary window"
},
{
"code": "BC43.1Y",
"title": "Other specified hypertrophic cardiomyopathy"
}
] |
=== 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
[LA88.Z] Congenital anomaly of a ventricle or the ventricular septum, unspecified
Also known as: Congenital anomaly of a ventricle or the ventricular septum, unspecified | Congenital anomaly of a ventricle or the ventricular septum
[LA8E.Z] Congenital anomaly of atrial septum, unspecified
Also known as: Congenital anomaly of atrial septum, unspecified | Congenital anomaly of atrial septum | congenital malformation of atrial septum
[LA88.4Z] Ventricular septal defect, unspecified
Also known as: Ventricular septal defect, unspecified | Ventricular septal defect | interventricular septal defect | interventricular septum defect | ventricular septum defect
[LA8B.0] Congenital aortopulmonary window
Definition: A congenital cardiovascular malformation in which there is side-to-side continuity of the lumens of the ascending aorta and pulmonary trunk in association with separate aortic and pulmonary valves or their atretic remnants.
Additional information: side-to-side continuity of the lumens of the aorta and pulmonary arterial tree, which is distinguished from common arterial trunk (truncus arteriosus) by the presence of two arterial valves or their atretic remnants, and involvement of the pulmonary t
Also known as: Congenital aortopulmonary window | aorticopulmonary window | aorticopulmonary fenestration | aorticopulmonary septal defect | aortopulmonary septal defect
Includes: Aortic septal defect | Aortopulmonary window
[BC43.1Y] Other specified hypertrophic cardiomyopathy
Also known as: Other specified hypertrophic cardiomyopathy | Nonfamilial hypertrophic cardiomyopathy | Idiopathic isolated hypertrophic cardiomyopathy | Asymmetrical hypertrophy | Asymmetrical septal hypertrophy
=== 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 ...
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--- Walk 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 ...
--PARENT--> [?] Structural developmental anomaly of heart or great vessels
Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....
--- Walk 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--> [BC41] Acquired ventricular abnormality
Def: A postnatal pathological change in form or function of a ventricle....
--- 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--> [BC41] Acquired ventricular abnormality
Def: A postnatal pathological change in form or function of a ventricle....
--- 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...
--CHILD--> [BA41.0] Acute ST elevation myocardial infarction
Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:...
|
[
"[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....",
"[LA89.Z] Functionally univentricular heart, unspecified\n --PARENT--> [LA89] Functionally univentricular heart\n Def: The term “functionally univentricular heart” describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ...\n --PARENT--> [?] Structural developmental anomaly of heart or great vessels\n Def: A congenital malformation of the heart and/or great vessels or an acquired abnormality unique to the congenitally malformed heart....",
"[BC45] Cardiomegaly\n --PARENT--> [?] Diseases of the myocardium or cardiac chambers\n Def: This refers to diseases of a type of involuntary striated muscle found in the walls and histological foundation of the heart, with specific reference to the atrial and ventricular chambers, as well as...\n --CHILD--> [BC41] Acquired ventricular abnormality\n Def: A postnatal pathological change in form or function of a ventricle....",
"[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--> [BC41] Acquired ventricular abnormality\n Def: A postnatal pathological change in form or function of a ventricle....",
"[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 --CHILD--> [BA41.0] Acute ST elevation myocardial infarction\n Def: ST elevation myocardial infarction (STEMI) is an acute myocardial infarction with developing ST elevation in two contiguous leads of the electrocardiogram. The criteria of ST elevation are as follows:..."
] |
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
|
This current case illustrated the successful conservative management of peroneal nerve palsy resulting from prolonged cross-legged sitting, with complete recovery achieved through appropriate supportive treatment and rehabilitation. Peroneal nerve palsy is the most common entrapment neuropathy of the lower extremity and ranks third in frequency after ulnar and median neuropathies . Foot drops, often associated with numbness in the lower extremity, should always be considered in the differential diagnosis of such presentations . The etiology of peroneal nerve palsy includes both traumatic and non-traumatic factors , with local compression at the fibular head being the most frequent cause . The peroneal nerve’s anatomical course makes it vulnerable to compression and injury, as it directly contacts the periosteum of the fibular neck over a 10-mm length and remains subcutaneous for approximately 4 cm . Cases of foot drop following prolonged cross-legged sitting have been reported in the literature, particularly in the 1970s, among agricultural workers who sat in this position for extended periods. This condition was historically referred to as "strawberry picker’s palsy" . Foot drop is the most common symptom associated with peroneal nerve palsy, though its exact incidence remains unclear . In cases of atraumatic and sudden-onset foot drop, space-occupying lesions such as synovial cysts or ganglion cysts should be considered . Although rare, compression neuropathies caused by ganglion cysts are most commonly associated with the peroneal nerve . On physical examination, patients with foot drops exhibit an abnormal gait pattern called steppage gait, characterized by the absence of ankle dorsiflexion, which disrupts both the stance and swing phases of gait. Additionally, weakness in ankle eversion may occur due to the involvement of the peroneal muscle groups innervated by the superficial peroneal nerve . In our case, gait analysis performed in our clinic’s gait laboratory revealed a steppage gait, and the strength of the ankle evertor muscles was 0/5. Clinically, involvement of the anterior compartment is more pronounced than the lateral compartment, with the extensor hallucis longus (EHL) being the most affected muscle and the last to recover . In our patient, at the two-week follow-up, dorsiflexion strength was 3/5, while EHL dorsiflexion was absent. By the one-month follow-up, both ankle dorsiflexion and EHL function had fully recovered, consistent with the literature. The Tinel test, which involves percussing the fibular head, is useful in the clinical evaluation of peroneal nerve palsy . In our patient, the Tinel test was negative. Seddon's classification of nerve injury includes three types: neurapraxia (involving myelin injury), axonotmesis (involving myelin and axon injury), and neurotmesis (involving myelin, axon, endoneurium or even perineurium, and epineurium injury) . Electrophysiological studies are helpful in diagnosing and differentiating entrapment neuropathies; however, in the absence of axonal damage, electromyography (EMG) results may be normal in the early stages. Denervation potentials typically appear two to three weeks after injury, and early studies may yield false-negative results . Additionally, magnetic resonance neurography (MRN) with T2-weighted and fat-suppression sequences can reveal focal peroneal nerve edema, nerve transections, or muscle atrophy in cases of foot drop . Initial radiographic studies, such as X-rays, are recommended to identify structural changes around the fibular head, including exostoses, tumoral lesions, or osseous pathologies caused by trauma (e.g., chronic arthritic changes or callus formation) . In our patient, two-view radiographs of the right knee ruled out structural abnormalities. EMG was not performed immediately due to the early presentation of symptoms, as acute cases may initially present findings suggestive of false-negative or axonotmesis despite the underlying condition being neurapraxia. Furthermore, in our patient, it was evident that the common peroneal nerve was involved before branching, as symptoms of both the deep and superficial peroneal nerves were observed during the physical examination. The literature includes studies advocating for early surgical decompression to ensure rapid and complete recovery, regardless of the underlying etiology . However, conservative management is the preferred initial approach in most cases, with an emphasis on identifying the underlying cause, planning an appropriate rehabilitation program, and utilizing AFO. Among the conservative treatment options, vitamin B6 has been shown to normalize plasma pyridoxal phosphate levels and alleviate symptoms of peripheral neuropathy within four weeks of use . In line with the literature, conservative treatment was chosen for our patient. This included the use of an AFO, as well as daily oral supplementation with B1 (500 mg), B6 (500 mg), B12 (2 mg), vitamin C (1,000 mg), vitamin D3 (1,000 IU), zinc (30 mg), and magnesium (300 mg as magnesium oxide). At the one-month follow-up, the patient’s neuropathy had completely resolved, with full recovery of muscle strength and sensation in the affected extremity.
| 4.253906
| 0.935059
|
sec[2]/p[0]
|
en
| 0.999996
|
40051926
|
https://doi.org/10.7759/cureus.78465
|
[
"peroneal",
"nerve",
"palsy",
"foot",
"injury",
"gait",
"cases",
"this",
"conservative",
"both"
] |
[
{
"code": "8C20.Y",
"title": "Other specified hereditary motor and sensory neuropathy"
},
{
"code": "NC95.30",
"title": "Laceration of peroneal artery"
},
{
"code": "8C70.5",
"title": "Scapuloperoneal muscular dystrophy"
},
{
"code": "NC94.1",
"title": "Injury of peroneal nerve at lower leg level"
},
{
"code": "8C11.3",
"title": "Lesion of common peroneal nerve"
},
{
"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"
}
] |
=== ICD-11 CODES FOUND ===
[8C20.Y] Other specified hereditary motor and sensory neuropathy
Also known as: Other specified hereditary motor and sensory neuropathy | Dejerine-Sottas syndrome | Charcot-Marie-Tooth disease type 3 | Hypertrophic neuropathy of infancy | Hereditary motor or sensory neuropathy type 3
Includes: Roussy-Levy syndrome
[NC95.30] Laceration of peroneal artery
Also known as: Laceration of peroneal artery
[8C70.5] Scapuloperoneal muscular dystrophy
Definition: Scapuloperoneal muscular dystrophies are a group of genetically heterogeneous myopathies characterised by progressive weakness and wasting of scapular and anterior leg muscles. Emery-Dreifuss muscular dystrophy is a classic scapuloperoneal muscular dystrophy associated with early contractures and cardiac arrhythmia, but other muscle disorders can also present with a scapuloperoneal phenotype.
Also known as: Scapuloperoneal muscular dystrophy | Erb muscular dystrophy | benign scapuloperoneal muscular dystrophy with early contractures | scapuloperoneal syndrome | scapuloperoneal dystrophy
Excludes: Secondary myopathies | Myasthenia gravis or certain specified neuromuscular junction disorders
[NC94.1] Injury of peroneal nerve at lower leg level
Also known as: Injury of peroneal nerve at lower leg level | injury of peroneal nerve
[8C11.3] Lesion of common peroneal nerve
Also known as: Lesion of common peroneal nerve | Lesion of lateral popliteal nerve | fibular neuropathy | Lesion of deep peroneal nerve | Lesion of superficial peroneal nerve
Excludes: Injury of peroneal nerve at lower leg level
[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
=== GRAPH WALKS ===
--- Walk 1 ---
[8C20.Y] Other specified hereditary motor and sensory neuropathy
--PARENT--> [8C20] Hereditary motor and sensory neuropathy
--PARENT--> [?] Hereditary neuropathy
--- Walk 2 ---
[8C20.Y] Other specified hereditary motor and sensory neuropathy
--PARENT--> [8C20] Hereditary motor and sensory neuropathy
--CHILD--> [8C20.2] Intermediate Charcot-Marie-Tooth disease
--- Walk 3 ---
[NC95.30] Laceration of peroneal artery
--PARENT--> [NC95.3] Injury of peroneal artery
--CHILD--> [NC95.3Z] Injury of peroneal artery, unspecified
--- Walk 4 ---
[NC95.30] Laceration of peroneal artery
--PARENT--> [NC95.3] Injury of peroneal artery
--PARENT--> [NC95] Injury of blood vessels at lower leg level
--- Walk 5 ---
[8C70.5] Scapuloperoneal muscular dystrophy
Def: Scapuloperoneal muscular dystrophies are a group of genetically heterogeneous myopathies characterised by progressive weakness and wasting of scapular and anterior leg muscles. Emery-Dreifuss muscular...
--EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders
Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...
--CHILD--> [?] Myasthenia gravis
Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a...
--- Walk 6 ---
[8C70.5] Scapuloperoneal muscular dystrophy
Def: Scapuloperoneal muscular dystrophies are a group of genetically heterogeneous myopathies characterised by progressive weakness and wasting of scapular and anterior leg muscles. Emery-Dreifuss muscular...
--EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders
Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...
--CHILD--> [?] Congenital myasthenic syndromes
Def: Congenital myasthenic syndrome (CMS) is a heterogeneous group of genetically determined diseases. There are four well-defined categories: Congenital myasthenic syndrome with presynaptic defect, Synapt...
|
[
"[8C20.Y] Other specified hereditary motor and sensory neuropathy\n --PARENT--> [8C20] Hereditary motor and sensory neuropathy\n --PARENT--> [?] Hereditary neuropathy",
"[8C20.Y] Other specified hereditary motor and sensory neuropathy\n --PARENT--> [8C20] Hereditary motor and sensory neuropathy\n --CHILD--> [8C20.2] Intermediate Charcot-Marie-Tooth disease",
"[NC95.30] Laceration of peroneal artery\n --PARENT--> [NC95.3] Injury of peroneal artery\n --CHILD--> [NC95.3Z] Injury of peroneal artery, unspecified",
"[NC95.30] Laceration of peroneal artery\n --PARENT--> [NC95.3] Injury of peroneal artery\n --PARENT--> [NC95] Injury of blood vessels at lower leg level",
"[8C70.5] Scapuloperoneal muscular dystrophy\n Def: Scapuloperoneal muscular dystrophies are a group of genetically heterogeneous myopathies characterised by progressive weakness and wasting of scapular and anterior leg muscles. Emery-Dreifuss muscular...\n --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders\n Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...\n --CHILD--> [?] Myasthenia gravis\n Def: Myasthenia gravis is the most common acquired auto-antibody mediated neuromuscular transmission disorder. Prevalence is 1–2 per 10,000 persons. Fluctuating weakness increasing with repeated activity a...",
"[8C70.5] Scapuloperoneal muscular dystrophy\n Def: Scapuloperoneal muscular dystrophies are a group of genetically heterogeneous myopathies characterised by progressive weakness and wasting of scapular and anterior leg muscles. Emery-Dreifuss muscular...\n --EXCLUDES--> [?] Myasthenia gravis or certain specified neuromuscular junction disorders\n Def: Myasthenia gravis is the most common autoimmune disease affecting the neuromuscular junction and is characterised by painless fatigable muscle weakness. It is caused by autoantibodies against neuromus...\n --CHILD--> [?] Congenital myasthenic syndromes\n Def: Congenital myasthenic syndrome (CMS) is a heterogeneous group of genetically determined diseases. There are four well-defined categories: Congenital myasthenic syndrome with presynaptic defect, Synapt..."
] |
8C20.Y
|
Other specified hereditary motor and sensory neuropathy
|
[
{
"from_icd11": "NC94.1",
"icd10_code": "S8411XA",
"icd10_title": "Injury of peroneal nerve at lower leg level, right leg, initial encounter"
},
{
"from_icd11": "NC94.1",
"icd10_code": "S8412XA",
"icd10_title": "Injury of peroneal nerve at lower leg level, left leg, initial encounter"
},
{
"from_icd11": "NC94.1",
"icd10_code": "S8410XA",
"icd10_title": "Injury of peroneal nerve at lower leg level, unspecified leg, initial encounter"
},
{
"from_icd11": "NC94.1",
"icd10_code": "S841",
"icd10_title": "Injury of peroneal nerve at lower leg level"
},
{
"from_icd11": "8C11.3",
"icd10_code": "G5731",
"icd10_title": "Lesion of lateral popliteal nerve, right lower limb"
},
{
"from_icd11": "8C11.3",
"icd10_code": "G5732",
"icd10_title": "Lesion of lateral popliteal nerve, left lower limb"
},
{
"from_icd11": "8C11.3",
"icd10_code": "G5730",
"icd10_title": "Lesion of lateral popliteal nerve, unspecified lower limb"
},
{
"from_icd11": "8C11.3",
"icd10_code": "G5733",
"icd10_title": "Lesion of lateral popliteal nerve, bilateral lower limbs"
},
{
"from_icd11": "8C11.3",
"icd10_code": "G573",
"icd10_title": "Lesion of lateral popliteal nerve"
},
{
"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"
}
] |
S8411XA
|
Injury of peroneal nerve at lower leg level, right leg, initial encounter
|
Case 1: a 68-year-old woman was admitted to a previous medical institution because of liver dysfunction. She was diagnosed with PBC by the following biochemical and serological findings: aspartate aminotransferase (AST) 212 U/L, alanine aminotransferase (ALT) 203 U/L, total bilirubin (T-Bil) 0.9 mg/dL, alkaline phosphatase (ALP) 491 U/L, γ-glutamyl transpeptidase (γ-GTP) 212 U/L, immunoglobulin (Ig) M 534 mg/dL, and anti-mitochondrial antibody (AMA) titer 1:80. Ultrasonography (US) and computed tomography (CT) showed morphological changes indicative of liver cirrhosis. Although the patient was immediately treated with 600 mg UDCA, the response to this treatment was not sufficient. She was referred by another medical institution to our hospital for further, more detailed examinations and was subsequently admitted to our hospital due to further liver dysfunction and progressive symptoms over the previous 4 weeks, including general fatigue, appetite loss, and muscle cramp in her legs. Her initial laboratory tests revealed liver dysfunction with an antinuclear antibody (ANA) titer of 1:320 with a homogeneous pattern, and elevation of IgG to 3,517 mg/dL (Table 1 ). Serological examinations for hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) were all negative (Table 1 ). There was no history of symptoms suggestive of viral infection. International AIH score on the basis of the simplified International Autoimmune Hepatitis Group (IAIHG) scoring system and the revised AIH scoring system was 6 points and 13 points, respectively, implying a probable AIH . The HLA-DRB1 haplotype was DRB1*04:05/DRB1*15:02. Although the patient had ingested some health foods, liver dysfunction had not improved when these foods were stopped. Drug-induced lymphocyte stimulation tests for such food types were negative. Thus, the patient was eventually diagnosed on the basis of both the Paris criteria and Japanese guidelines with an autoimmune liver disease with overlapping features of PBC and AIH . We immediately administered 5 mg/day prednisolone (PSL) and 600 mg/day of UDCA . The PSL dose given was smaller than that indicated by the Japanese guidelines because of the complication of liver cirrhosis and the consequent increased risk of opportunistic infections, osteoporosis, and abnormalities in glucose metabolism. This course of treatment resulted in improvements to clinical and biochemical findings within 1 month. Since then, liver function has remained within the normal range, resulting in a constant liver cirrhotic condition of Child–Pugh class A . Furthermore, the current level of bone mineral density (BMD) is 0.396 g/cm 2 greater than the normal range (0.261–0.333 g/cm 2 ), although we continue to administer PSL at a dose of 5 mg/day. Table 1 Laboratory data at the first medical examination and comparison of environmental and genetic factors between all family members Case 1 (mother) Case 2 (daughter 1) Daughter 2 Age (years) 68 49 48 Biochemistry TP (6.5–8.3) (g/dL) 7.8 8.4 7.3 Alb (3.8–5.3) (g/dL) 2.9 3.9 4.4 T.Bil (0.2–1.2) (mg/dL) 4.25 4.79 0.56 AST (5–40) (IU/L) 328 1203 13 ALT (3–35) (IU/L) 312 1425 10 γ-GTP (10–60) (IU/L) 60 208 20 ALP (100–340) (IU/L) 418 900 149 Hematology WBC (/μL) 3400 5100 6400 RBC (350–480) (×10 4 /μL) 316 446 436 Hb (11.5–16.0) (g/dL) 10.8 14.7 13.8 Plt (12.0–40.0) (×10 4 /uL) 11.8 21.1 26.6 PT % (%) 41.6 79.8 94.0 APTT (26–38) (s) 41.0 35.1 27.7 Serology IgG (mg/dL) 3517 2261 1249 IgA (90–400) (mg/dL) 370 386 121 IgM (52–270) (mg/dL) 491 203 173 ANA (0–79) ×320 ×80 <40 AMA (0–19) (×80) ×40 Not tested AMA-M2 (0.0–6.9) 161.9 55.8 75.7 ASMA (0–19) <20 <20 Not tested Anti-LKM1 (0–16.9) <5.0 5.2 Not tested Viral marker IgM anti-HA – – Not tested HBs-Ag – – – HCV-Ab – – – IgM anti-HBc (0–0.9) (−) – Not tested IgG anti-HBc (0–0.99) (−) – Not tested HCV–RNA (PCR) (−) – Not tested HLA-DRB1 haplotype DRB1*04:05, DRB1*15:02 DRB1*04:05, DRB1*15:02 DRB1*04:05, DRB1*01:01 Smoking status/alcohol consumption Non-smoker/nil Non-smoker/nil Non-smoker/nil Occupation Housewife 18 years–present Nurse 20 years–present Nurse 20 years–present Period of time living with mother Birth–20 years Birth–20 years Previous medical history Unremarkable Unremarkable Unremarkable Medication use Nil Nil Nil Obstetric history 2 deliveries 3 deliveries 2 deliveries Serological evidence of past infection Epstein–barr virus + + Not tested Cytomegalovirus + + Not tested (−) Serological findings of a previous medical institution, ANA antinuclear antibody, AMA anti-mitochondrial antibody, AMA - M2 anti-mitochondrial antibody-M2, ASMA anti-smooth muscle antibody, LKM1 liver–kidney microsome type 1, HLA human leukocyte antigen Normal ranges given in parentheses Fig. 1 Clinical course of case 1 (mother). Following diagnosis with an autoimmune liver disease with overlapping features of primary biliary cholangitis and autoimmune hepatitis, the patient was treated with a combination of 600 mg/day ursodeoxycholic acid ( UDCA ) and 5 mg/day prednisolone ( PSL ) in accordance with the Japanese guidelines, resulting in the gradual improvement of both clinical and biochemical findings. Key: ANA antinuclear antibody, AMA-M2 anti-mitochondrial antibody-M2
| 4.097656
| 0.972656
|
sec[1]/p[0]
|
en
| 0.999997
|
27503128
|
https://doi.org/10.1007/s12328-016-0676-1
|
[
"liver",
"anti",
"tested",
"antibody",
"hepatitis",
"dysfunction",
"serological",
"mitochondrial",
"virus",
"autoimmune"
] |
[
{
"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": "JA86.Y",
"title": "Maternal care for other specified fetal problems"
},
{
"code": "MB23.1",
"title": "Antisocial behaviour"
},
{
"code": "3B4Z",
"title": "Coagulation defects, unspecified"
},
{
"code": "4A45.Z",
"title": "Antiphospholipid syndrome, unspecified"
},
{
"code": "4A43.Y",
"title": "Other specified overlap non-organ specific systemic autoimmune disease"
}
] |
=== ICD-11 CODES FOUND ===
[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
[JA86.Y] Maternal care for other specified fetal problems
Also known as: Maternal care for other specified fetal problems | Maternal care for other isoimmunization | Isoimmunization NOS | maternal antibodies NOS | pregnancy management affected by incompatibility of blood groups NOS
[MB23.1] Antisocial behaviour
Definition: Behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws, are violated.
Also known as: Antisocial behaviour | Child or adolescent antisocial behaviour
[3B4Z] Coagulation defects, unspecified
Also known as: Coagulation defects, unspecified | blood clotting disturbance | blood clotting defect | blood clotting factor deficiency | clotting abnormality
[4A45.Z] Antiphospholipid syndrome, unspecified
Also known as: Antiphospholipid syndrome, unspecified | Antiphospholipid syndrome | Hughes syndrome | Anticardiolipin syndrome
[4A43.Y] Other specified overlap non-organ specific systemic autoimmune disease
Also known as: Other specified overlap non-organ specific systemic autoimmune disease | Antisynthetase syndrome | Reynolds syndrome | Syndromic multisystem autoimmune disease due to ITCH deficiency | Eosinophilia myalgia syndrome
=== GRAPH WALKS ===
--- Walk 1 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--RELATED_TO--> [?] Structural developmental anomalies of liver
--- Walk 2 ---
[DB9Z] Diseases of liver, unspecified
--PARENT--> [?] Diseases of liver
--RELATED_TO--> [?] Metabolic or transporter liver disease
--- Walk 3 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--EXCLUDES--> [?] Acute viral hepatitis
Def: A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, wi...
--- Walk 4 ---
[DB97.Z] Inflammatory liver disease, unspecified
--PARENT--> [DB97] Certain specified inflammatory liver diseases
--EXCLUDES--> [?] Acute or subacute hepatic failure
Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....
--- Walk 5 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--CHILD--> [DB99.2] Hepatorenal syndrome
--- Walk 6 ---
[DB99.7] Hepatic failure without mention whether acute or chronic
--PARENT--> [DB99] Certain specified diseases of liver
Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....
--RELATED_TO--> [?] Cirrhotic cardiomyopathy
Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation...
|
[
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Structural developmental anomalies of liver",
"[DB9Z] Diseases of liver, unspecified\n --PARENT--> [?] Diseases of liver\n --RELATED_TO--> [?] Metabolic or transporter liver disease",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Acute viral hepatitis\n Def: A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, wi...",
"[DB97.Z] Inflammatory liver disease, unspecified\n --PARENT--> [DB97] Certain specified inflammatory liver diseases\n --EXCLUDES--> [?] Acute or subacute hepatic failure\n Def: Acute and subacute liver failure is characterised by onset of coagulopathy and/or hepatic encephalopathy within 8 weeks of onset of symptoms in a patient without previously known liver diseases....",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --CHILD--> [DB99.2] Hepatorenal syndrome",
"[DB99.7] Hepatic failure without mention whether acute or chronic\n --PARENT--> [DB99] Certain specified diseases of liver\n Def: This is a group of conditions characterised as being in or associated with the liver that are not classified elsewhere....\n --RELATED_TO--> [?] Cirrhotic cardiomyopathy\n Def: Cirrhotic cardiomyopathy is defined as chronic cardiac dysfunction in patients with cirrhosis characterised by blunted contractile responsiveness to stress/exercise and-or altered diastolic relaxation..."
] |
DB9Z
|
Diseases of liver, unspecified
|
[
{
"from_icd11": "DB9Z",
"icd10_code": "K7681",
"icd10_title": "Hepatopulmonary syndrome"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K7689",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K769",
"icd10_title": "Liver disease, unspecified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K77",
"icd10_title": "Liver disorders in diseases classified elsewhere"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K762",
"icd10_title": "Central hemorrhagic necrosis of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K70-K77",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K778",
"icd10_title": ""
},
{
"from_icd11": "DB9Z",
"icd10_code": "K72",
"icd10_title": "Hepatic failure, not elsewhere classified"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K76",
"icd10_title": "Other diseases of liver"
},
{
"from_icd11": "DB9Z",
"icd10_code": "K768",
"icd10_title": "Other specified diseases of liver"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7581",
"icd10_title": "Nonalcoholic steatohepatitis (NASH)"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K7589",
"icd10_title": "Other specified inflammatory liver diseases"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K759",
"icd10_title": "Inflammatory liver disease, unspecified"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K752",
"icd10_title": "Nonspecific reactive hepatitis"
},
{
"from_icd11": "DB97.Z",
"icd10_code": "K75",
"icd10_title": "Other inflammatory liver diseases"
}
] |
K7681
|
Hepatopulmonary syndrome
|
In our case, the patient suffered from seizures since the 1st day of life and recently became more frequent. The EEG showed burst suppression pattern that considered severe epileptic encephalopathy ( 3 ). Bastos et al,reported a patient with proteus syndrome, seen at the Emergency Department at 4 months of age, of a history of flexor spasms of the four extremities that started in the 2nd month of life at a frequency of 4–5 episodes/day. Sleep EEG revealed a high voltage burst suppression pattern with bursts lasting 1–3 s. Another patient started of seizures in the 2nd month of life was characterized by brief epileptic spasms of upper extremities. EEG showed a burst suppression pattern that lasted 3–5 s ( 4 ). Patient also had asymmetric syndromic faces, hypertrophy of the right skull and right ear. The distinction of proportionate from disproportionate overgrowth is obvious by the age of two to three years but can be difficult to assess in infancy. The typical patient with Proteus syndrome essentially has a normal limb at birth, disfiguring overgrowth developing postnatally ( 5 ). We found the child with facial phenotype in Proteus syndrome. The facial phenotype in Proteus syndrome patients with mental retardation, in some cases, is with brain malformations and seizures already described by Cohen. Manifestations include dolichocephaly, long face, a high arched palate, minor down slanting of the palpebral fissures and or minor ptosis, an open mouth at rest, wide or anteverted nares, and low nasal bridge ( 6 , 7 ). In the right cheek and neck, we found subcutaneous mass covered by linear nevy partly. Lipomas in Proteus syndrome are composed principally of mature adipocytes, and lipomas may be infiltrative or confined. Even though histopathologic finding always describes benign adipose tissue cells, the location of lesions is of great importance ( 6 ). They are typically unencapsulated fatty and fibrous masses with vascular channels, often lymphangiomatous ( 1 ). Craniocervical MRI with contrast revealed hemimegalencephaly right cerebral hemisphere. There was no specific molecular marker, or laboratory test, for the diagnosis of Proteus syndrome ( 2 ). The diagnosis is mainly based on history, clinical judgment and neuroimaging modality ( Table 1 ). The diagnosis of Proteus syndrome requires all three general criteria, plus one criterion from category A, or two criteria from category B, or three criteria from category C, although many manifestations had been recorded ( 7 , 8 ). In this case, we did not find the cerebriform connectivetissue nevus. The cerebriform connective tissue nevus was not found at birth but usually appeared during the first or second year of life and was progressive. Cerebriform connective tissue nevus and lipomas were defined under a group consisting of postnatal lesions with a delayed onset and progressive course ( 8 ). It is unknown if these lesions have an accelerated growth during puberty ( 1 ). Various syndromes considered in differential diagnosis are grouped for convenience as vascular syndromes, syndromes with pigmentation, and lipomatosis, include Klippel-Trenaunay syndrome, Hemihyperplasia/ lipomatosis syndrome, Parks Weber syndrome, Maffucci syndrome, Neurofibromatosis type 1, Epidermal nevus syndrome, Familial lipomatosis, Symmetrical Lipomatosis, Encephalocraniocutaneuslipomatosis ( 8 ). The patient had hemispherectomy procedure by callosotomy and right anterior temporal lobectomy, cortical insulectomy, anterior disconnection and presented brain dysplasia. Seizures associated with hemimegalencephaly are difficult to treat totally. Some reports of intractable seizure in Proteus syndrome treated with polytherapy of oral antiepileptic agents ( 4 ). Hemispherectomy has been used in several series to control effectively seizures ( 9 ). After hemispherectomy surgery, the patient was fully conscious, no seizures or paralysis of limbs. Good results of hemispherectomy in pediatric patients with refractory epilepsy, not only in terms of seizure control but also in terms of motor and cognitive functions. Moosa et al, stated that 73.5% patients became seizure free, and 13.5% had a reduction in seizure frequency. Although hemispherectomy produced expected postsurgical deficits, patients had reported an important improvement of quality of life, and in many patients the antiepileptic drugs could be discontinued or reduced ( 10 ). Six weeks follow up after being discharged showed that the patient in a good condition. There were no seizure or paralysis of the limb, being able to a self-prone position but could not lift his head. The long-term seizure-free rates after hemispherectomy remained stable at 63% at five years and beyond ( 9 ). Quality-of-life measures paralleled seizure outcomes. Epilepsy surgery in children with intractable epilepsy can produce significant resultin seizure control, quality of life, and development ( 10 ). In conclusion, a rare case of Proteus syndrome was reported. The patient presented with intractable seizures and did not respond to triple antiepileptic drugs. Hemispherectomy was performed to overcome the seizures. After the procedure, the patient was seizure free. The prognosis was poor.
| 4.253906
| 0.481201
|
sec[2]/p[0]
|
en
| 0.999997
|
27375761
|
N/A
|
[
"proteus",
"seizure",
"seizures",
"life",
"hemispherectomy",
"that",
"patients",
"nevus",
"lipomatosis",
"burst"
] |
[
{
"code": "LD2C",
"title": "Overgrowth syndromes"
},
{
"code": "CA40.0Y&XN3BS",
"title": "Pneumonia due to proteus"
},
{
"code": "GC08.2",
"title": "Urinary tract infection, site not specified, due to Proteus"
},
{
"code": "MG50.CY",
"title": "Other specified other antibiotic resistant Enterobacterales"
},
{
"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": "GA30.00",
"title": "Menopausal or female climacteric states"
}
] |
=== ICD-11 CODES FOUND ===
[LD2C] Overgrowth syndromes
Also known as: Overgrowth syndromes | congenital malformation syndromes involving early overgrowth | CLAPO syndrome | CLOVE syndrome | Congenital lipomatous overgrowth - vascular malformation - epidermal naevi
Excludes: Sturge-Weber syndrome | Diabetic embryopathy | Enchondromatosis
[GC08.2] Urinary tract infection, site not specified, due to Proteus
Definition: A disease of the urinary tract, caused by an infection with the gram-negative bacteria Proteus. In females, this disease is characterised by dysuria, pyuria, or pollakiuria; in males, this disease may present with urethral discharge. Transmission is unknown. Confirmation is by identification of Proteus in a urinary sample.
Also known as: Urinary tract infection, site not specified, due to Proteus
[MG50.CY] Other specified other antibiotic resistant Enterobacterales
Also known as: Other specified other antibiotic resistant Enterobacterales | Extended-spectrum beta-lactamase producing Enterobacter | Extended-spectrum beta-lactamase producing Proteus | Extended-spectrum beta-lactamase producing Providencia | Extended-spectrum beta-lactamase producing Serratia
[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
[GA30.00] Menopausal or female climacteric states
Definition: Any condition of the genital system affecting females, caused by pathological changes associated with the perimenopausal period, such as the permanent cessation of menstruation and infertility.
Also known as: Menopausal or female climacteric states | Normal menopause | menopausal NOS | change of life | climacteric
Excludes: States associated with artificial menopause
=== GRAPH WALKS ===
--- Walk 1 ---
[LD2C] Overgrowth syndromes
--EXCLUDES--> [?] Sturge-Weber syndrome
Def: Sturge-Weber syndrome is a congenital vascular malformation characterised by facial capillary malformations (classically referred to as angiomas even through they are not tumours but port-wine stains)...
--PARENT--> [?] Syndromes with vascular anomalies as a major feature
--- Walk 2 ---
[LD2C] Overgrowth syndromes
--EXCLUDES--> [?] Enchondromatosis
Def: Enchondromatosis (or Ollier disease) is defined by the presence of multiple enchondromas with an asymmetric distribution. Enchondromas are common intraosseous, usually benign, cartilaginous tumours th...
--CHILD--> [?] Internal chondromatosis
--- Walk 3 ---
[GC08.2] Urinary tract infection, site not specified, due to Proteus
Def: A disease of the urinary tract, caused by an infection with the gram-negative bacteria Proteus. In females, this disease is characterised by dysuria, pyuria, or pollakiuria; in males, this disease may...
--PARENT--> [GC08] Urinary tract infection, site not specified
--RELATED_TO--> [?] Pyuria associated with urinary tract infection
--- Walk 4 ---
[GC08.2] Urinary tract infection, site not specified, due to Proteus
Def: A disease of the urinary tract, caused by an infection with the gram-negative bacteria Proteus. In females, this disease is characterised by dysuria, pyuria, or pollakiuria; in males, this disease may...
--PARENT--> [GC08] Urinary tract infection, site not specified
--RELATED_TO--> [?] Pyuria associated with urinary tract infection
--- Walk 5 ---
[MG50.CY] Other specified other antibiotic resistant Enterobacterales
--PARENT--> [MG50.C] Other antibiotic resistant Enterobacterales
--CHILD--> [MG50.CY] Other specified other antibiotic resistant Enterobacterales
--- Walk 6 ---
[MG50.CY] Other specified other antibiotic resistant Enterobacterales
--PARENT--> [MG50.C] Other antibiotic resistant Enterobacterales
--CHILD--> [MG50.CY] Other specified other antibiotic resistant Enterobacterales
|
[
"[LD2C] Overgrowth syndromes\n --EXCLUDES--> [?] Sturge-Weber syndrome\n Def: Sturge-Weber syndrome is a congenital vascular malformation characterised by facial capillary malformations (classically referred to as angiomas even through they are not tumours but port-wine stains)...\n --PARENT--> [?] Syndromes with vascular anomalies as a major feature",
"[LD2C] Overgrowth syndromes\n --EXCLUDES--> [?] Enchondromatosis\n Def: Enchondromatosis (or Ollier disease) is defined by the presence of multiple enchondromas with an asymmetric distribution. Enchondromas are common intraosseous, usually benign, cartilaginous tumours th...\n --CHILD--> [?] Internal chondromatosis",
"[GC08.2] Urinary tract infection, site not specified, due to Proteus\n Def: A disease of the urinary tract, caused by an infection with the gram-negative bacteria Proteus. In females, this disease is characterised by dysuria, pyuria, or pollakiuria; in males, this disease may...\n --PARENT--> [GC08] Urinary tract infection, site not specified\n --RELATED_TO--> [?] Pyuria associated with urinary tract infection",
"[GC08.2] Urinary tract infection, site not specified, due to Proteus\n Def: A disease of the urinary tract, caused by an infection with the gram-negative bacteria Proteus. In females, this disease is characterised by dysuria, pyuria, or pollakiuria; in males, this disease may...\n --PARENT--> [GC08] Urinary tract infection, site not specified\n --RELATED_TO--> [?] Pyuria associated with urinary tract infection",
"[MG50.CY] Other specified other antibiotic resistant Enterobacterales\n --PARENT--> [MG50.C] Other antibiotic resistant Enterobacterales\n --CHILD--> [MG50.CY] Other specified other antibiotic resistant Enterobacterales",
"[MG50.CY] Other specified other antibiotic resistant Enterobacterales\n --PARENT--> [MG50.C] Other antibiotic resistant Enterobacterales\n --CHILD--> [MG50.CY] Other specified other antibiotic resistant Enterobacterales"
] |
LD2C
|
Overgrowth syndromes
|
[
{
"from_icd11": "LD2C",
"icd10_code": "Q873",
"icd10_title": "Congenital malformation syndromes involving early overgrowth"
},
{
"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"
}
] |
Q873
|
Congenital malformation syndromes involving early overgrowth
|
A 51-year-old female presented with abdominal distension and fatigue that had worsened in the past 1 year and was diagnosed with a retroperitoneal tumor. There was no history of tumors, and no family history suspected of hereditary tumors. On physical examination, a palpable mass was noted from the right subcostal area to the epigastric region. Blood tests revealed impaired renal function due to inferior vena cava (IVC) obstruction caused by the tumor. Tumor markers were negative. Contrast-enhanced computed tomography (CT) of the trunk showed a hemorrhagic retroperitoneal tumor measuring 22 × 9 × 15 cm, which had increased in size from 20 × 9 × 9 cm over the past 2 months, compressing IVC and portal vein to the right abdominal side . Enlarged para-aortic lymph nodes were also noted . Whole-body 18F-fluorodeoxyglucose positron emission tomography/CT (FDG PET/CT) showed increased FDG uptake with SUVmax 8.8 in the retroperitoneal tumor but no distant metastases. Endocrinological assessments were unremarkable, ruling out pheochromocytoma based on normal levels of catecholamines and metanephrines in both blood and 24-h urine. 123I-meta-iodobenzylguanidine (MIBG) scintigraphy revealed no abnormal accumulation, excluding paraganglioma or sympathetic nerve tumors. Considering the possibility of gastrointestinal stromal tumor (GIST) or other tumors responsive to drug treatment, a needle biopsy was performed preoperatively, revealing spindle-shaped sarcoma cells which raised dedifferentiated liposarcoma as a differential diagnosis and proceeded with resection of the retroperitoneal tumor. The tumor was extensively adherent to the left liver and IVC , and resected en bloc. Combined resection of the left liver and IVC was achieved without using extracorporeal circulation or IVC reconstruction, because the patient had double IVCs which prevented venous congestion of the kidneys and lower limbs. A small, disseminated tumor was also identified and retrieved. The blood loss was 17,490 mL. She developed a Grade B biliary leakage which required drainage and was discharged on the 35th day after surgery. The resected specimen was hemorrhaged and necrotic, with white lobulated nodules and edematous changes at the margins . There was no evidence of tumor invasion into liver and IVC. Microscopic examination revealed a spindle-shaped tumor cells proliferating in a fascicular and whorl pattern , and having round-to-oval nuclei with indistinct nucleoli . Necrosis (< 50%) and increased mitotic activity of 12 per 2mm 2 suggested malignancy. Immunohistochemical staining demonstrated the tumor was positive for EMA , GLUT-1 , claudin-1 , and SSTR2A . The positivity for EMA, GLUT-1, and claudin-1 suggested differentiation toward perineurium , and malignant perineurioma was diagnosed. Of note, the tumor had no connection to the spinal leptomeninges. Negative staining for MDM2 and CDK4, CD34 and STAT6, and c-kit and DOG1 led to the exclusion of dedifferentiated liposarcoma, solitary fibrous tumor (SFT), and GIST, respectively . S100 protein was negative and H3K27e3 was retained. Cancer gene panel testing of the retroperitoneal tumor sample showed a base substitution in ARID1A , duplication of exons 5–31 in NOTCH2 , frameshift mutation in MSH6 (D387fs*4), and deletion of exons 5–9 in NF2 , none of which were treatable target in the present case. Twenty days postoperatively, a contrast-enhanced CT of the trunk revealed masses in the bilateral pelvic walls , which were diagnosed to be peritoneal dissemination. Whole-body FDG PET/CT at 50 days postoperatively showed a short-term enlargement and increased uptake of the pelvic masses . Due to the rapid enlargement of tumors in both pelvic walls, accompanied by increased abdominal distension and worsening bilateral lower leg edema, palliative radiotherapy was performed from 70 days postoperatively. However, the disease progression could not be controlled, and the patient died 6 months postoperatively. Fig. 1 Preoperative imaging findings. Contrast-enhanced CT shows a hemorrhagic retroperitoneal tumor (22 × 9 × 15 cm) compressing the IVC (arrow) and portal vein (arrowhead) ( A ) and an enlarged para-aortic lymph node (arrow) ( B ) Fig. 2 Intraoperative findings ( A ). The left lobe of the liver (arrowhead) and IVC were extensively adherent to the tumor (arrow) and were resected en bloc. The resected specimen (22 × 18 × 17.5 cm) was hemorrhaged and necrotic, with white lobulated nodules and edematous changes at the margins ( B ) Fig. 3 Histology of the resected specimen of malignant perineurioma. Spindle-shaped tumor cells proliferate in fascicular and whorl pattern with necrosis ( A H&E, ×100). Tumor cells have uniform round-to-oval nuclei with indistinct nucleoli and mitotic figures (arrows) ( B H&E, ×400) Fig. 4 Immunohistochemical staining of the resected specimen at ×200 magnification. The tumor was positive for EMA ( A ), GLUT-1 ( B ), claudin-1 ( C ), and SSTR2A ( D ) Fig. 5 Early postoperative relapse. Contrast-enhanced CT images at 20 days postoperatively ( A ) shows bilateral pelvic masses (arrows) and FDG PET/CT images at 50 days postoperatively ( B ) confirmed their rapid growth with increased FDG uptake (arrows)
| 4.085938
| 0.975586
|
sec[1]/p[0]
|
en
| 0.999997
|
38739347
|
https://doi.org/10.1186/s40792-024-01915-9
|
[
"tumor",
"retroperitoneal",
"which",
"resected",
"postoperatively",
"tumors",
"contrast",
"enhanced",
"cells",
"liver"
] |
[
{
"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": "DC5Z&XA6S21",
"title": "Diseases of peritoneum, unspecified [Retroperitoneum]"
},
{
"code": "DC50.Z",
"title": "Peritonitis, unspecified"
},
{
"code": "DC51.Y",
"title": "Other specified disorders of peritoneum or retroperitoneum"
},
{
"code": "NB91.Y&XA6S21",
"title": "Retroperitoneal laceration"
},
{
"code": "2F93",
"title": "Neoplasms of unknown behaviour of retroperitoneum"
}
] |
=== 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
[DC50.Z] Peritonitis, unspecified
Also known as: Peritonitis, unspecified | Peritonitis | peritoneum inflammation | peritonitis of undetermined cause | peritonitis of unspecified cause
[DC51.Y] Other specified disorders of peritoneum or retroperitoneum
Also known as: Other specified disorders of peritoneum or retroperitoneum | Abdominal granuloma | Peritoneal granuloma | Epiploic appendagitis | Male frozen pelvis
[2F93] Neoplasms of unknown behaviour of retroperitoneum
Also known as: Neoplasms of unknown behaviour of retroperitoneum | retroperitoneum tumour NOS
=== GRAPH WALKS ===
--- Walk 1 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs
--- Walk 2 ---
[2F9Z] Neoplasms of unknown behaviour of unspecified site
--PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs
--- Walk 3 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] 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 4 ---
[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--EXCLUDES--> [?] Breast lump or mass female
--PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system
--- Walk 5 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach
--- Walk 6 ---
[2E6Z] Carcinoma in situ of unspecified site
--PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues
--CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system
|
[
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F91] Neoplasms of unknown behaviour of middle ear, respiratory or intrathoracic organs",
"[2F9Z] Neoplasms of unknown behaviour of unspecified site\n --PARENT--> [?] Neoplasms of unknown behaviour, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2F90] Neoplasms of unknown behaviour of oral cavity or digestive organs",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] 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",
"[ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...\n --EXCLUDES--> [?] Breast lump or mass female\n --PARENT--> [?] Symptoms, signs or clinical findings involving the female genital system",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E60] Carcinoma in situ of oral cavity, oesophagus or stomach",
"[2E6Z] Carcinoma in situ of unspecified site\n --PARENT--> [?] In situ neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissues\n --CHILD--> [2E62] Carcinoma in situ of middle ear or respiratory system"
] |
2F9Z
|
Neoplasms of unknown behaviour of unspecified site
|
[
{
"from_icd11": "2F9Z",
"icd10_code": "D487",
"icd10_title": "Neoplasm of uncertain behavior of other specified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D482",
"icd10_title": "Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D37-D48",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D377",
"icd10_title": ""
},
{
"from_icd11": "2F9Z",
"icd10_code": "D48",
"icd10_title": "Neoplasm of uncertain behavior of other and unspecified sites"
},
{
"from_icd11": "2F9Z",
"icd10_code": "D489",
"icd10_title": "Neoplasm of uncertain behavior, unspecified"
},
{
"from_icd11": "ME61",
"icd10_code": "R2240",
"icd10_title": "Localized swelling, mass and lump, unspecified lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2232",
"icd10_title": "Localized swelling, mass and lump, left upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2242",
"icd10_title": "Localized swelling, mass and lump, left lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2231",
"icd10_title": "Localized swelling, mass and lump, right upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2241",
"icd10_title": "Localized swelling, mass and lump, right lower limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R2233",
"icd10_title": "Localized swelling, mass and lump, upper limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2243",
"icd10_title": "Localized swelling, mass and lump, lower limb, bilateral"
},
{
"from_icd11": "ME61",
"icd10_code": "R2230",
"icd10_title": "Localized swelling, mass and lump, unspecified upper limb"
},
{
"from_icd11": "ME61",
"icd10_code": "R220",
"icd10_title": "Localized swelling, mass and lump, head"
}
] |
D487
|
Neoplasm of uncertain behavior of other specified sites
|
The patient, a male newborn, was born for 40 min when he was admitted to our medical department because of “High-Risk Symptoms”. After 40 weeks of pregnancy, the mother gave birth naturally, and the whole process went smoothly. There was no complication of infection and abnormal blood glucose/blood pressure during pregnancy. The baby weighed 3900 g, and the length was 50 cm. The APGAR score was 9 points at 1 min and 10 points at 5 min. The physical examination report of the hospital is as follows: the vital signs of the baby were stable, and he has the appearance of a full-term infant; crying loudly, good response, flat front fontanelle, high forehead, large head circumference with a length of 38 cm; wide eye-distance, short nose, low-and-flat bridge of the nose, full nose-tip, low ear-position, short neck, blotchy moles on the back skin. Cardiopulmonary auscultation and limb muscle tone were normal. The baby had male external genitalia, the testes were descended, and there was no oedema on his dorsum of hands or feet . During the early foetal period, B-ultrasound examination showed polyhydramnios and bilateral pyelic separation of 6 mm. The results of amniocentesis showed that no obvious abnormality was found in the level of 320 bands of G-banded chromosomes in foetal amniotic fluid cells. B-ultrasound in late pregnancy suggested that amniotic fluid was still significantly elevated, head circumference was increased, and the femur length was shorter than expected. Prenatal whole-exome sequencing of the amniotic fluid showed that RAF1 mutation, p.Ser257Leu(c.770C > T)(PS2 + PS3 + PS4 + PM1 + PM2 + PP2),which was classified as a pathogenic mutation according to AMCG . His parents and grandparents had no genetic metabolic disease, and his elder brother is currently 10 years old and developed normally. Laboratory examinations after admission were as follows: rapid hypersensitivity CRP 1.72 mg/L, white blood cell 11.9 × 10 9 /L, neutrophil granulocyte percentage 37.2%, lymphocyte percentage 44.5%, haemoglobin 154 g/L and platelet 245 × 10 9 /L. A plain film chest X-ray showed that two lung markings were slightly thickened, but the cardiac silhouette was not enlarged. Echocardiography suggested an atrial-septal defect (1.7 mm). Urinary system and cranial ultrasounds were unremarkable. On the third day after admission, the baby’s respiration rate increased significantly, reaching 80–90 breaths per minute. No abnormalities were found by lung auscultation, infection index analysis, pathogen culture or chest X-ray. Brain MRI showed areas of haemorrhage in temporal lobes, bilateral parieto-occipital lobes and bilateral paraventricular white matter . Coagulation/DD/AT-III reported APTT 41.9S, PT21.3S, D-D 0.53 mg/L, and AT-III was 59.0%. Coagulation factors II/V/VII/VIII/IX/X/XI were in the normal range, XII was 54.3%, and haemoglobin levels were lower than before. After oxygen, vitamin K1 and etamsylate supplementation, the head circumference did not increase, the anterior fontanelle remained flat and soft, and the breathing gradually stabilised. The patient was hospitalised for 10 days. His respiratory rate was approximately 50 times per minute, and his haemoglobin level did not decrease significantly when he was discharged. After discharge from the hospital, the karyotype analysis result was 46, X, del (Y) (q12) . The phenotype of the neonatal whole blood exon gene showed that the phenotype of the RAF1 mutation, p.Ser257Leu(c.770C > T) (Table 1 ), which was a pathogenic variation. These findings reaffirmed the previous diagnosis of NS in this patient. Two months after discharge, the baby came to the hospital again for follow-up and showed good growth and development, and his weight had reached 6000 g. Head MRI reexamination reported that the cerebral haemorrhage had improved significantly . Echocardiography showed ventricular hypertrophy (interventricular septum 5 mm, posterior wall of the left ventricle 5 mm, the forearm of right ventricle 4 mm) . The patient is being followed up at present. Fig. 1 Appearance of the child. A Flat front fontanelle, high forehead, large head circumference, et al. B Blotchy moles on the back skin. C External genitalia are shown to be male, and the testicles are palpable on both sides Fig. 2 Magnetic resonance imaging (MRI) in newborn ( A – D All images are T1-weighted) and follow-up ( E , F T1-weighted images; G , H T2 flair images) 2 months later. A Left parietal haematoma. B Left temporal lobe haematoma. C , D Multiple haematoma in right occipital lobe. E The haematoma in the left parietal lobe has been absorbed. F The haematoma in the left temporal lobe has been absorbed. G The right occipital haematoma was absorbed more obviously than before. H Chronic subdural haematoma of left frontal region Fig. 3 Karyotype analysis result was 46, X, del (Y) (q12) Table 1 RAF1 mutation, p.Ser257Leu(c.770C > T) PTPN11 SOS1 SOS2 RAF1 RIT1 KRAS NRAS RRAS HRAS SHOC2 LZTR1 A2ML1 BRAF MAP2K1 MAP2K2 NF1 SPRED1 RASA1 PPP1CB Fig. 4 Two-dimensional echocardiogram in follow-up 2 months later. A Cardiac function EF: 60% and FS 29%. B Interventricular septum 5 mm. C Forearm of right ventricle 4 mm. D Stenosis of the left ventricle
| 4
| 0.97998
|
sec[1]/p[0]
|
en
| 0.999998
|
PMC9367063
|
https://doi.org/10.1186/s40001-022-00772-2
|
[
"haematoma",
"that",
"baby",
"head",
"blood",
"flat",
"circumference",
"significantly",
"mutation",
"ventricle"
] |
[
{
"code": "ND30",
"title": "Superficial injuries involving multiple body regions"
},
{
"code": "ND56.0",
"title": "Superficial injury of unspecified body region"
},
{
"code": "GA34.Y",
"title": "Other specified female pelvic pain associated with genital organs or menstrual cycle"
},
{
"code": "NB32.3Y",
"title": "Other injury of lung"
},
{
"code": "ND56.5",
"title": "Injury of blood vessel of unspecified body region"
},
{
"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 ===
[ND30] Superficial injuries involving multiple body regions
Also known as: Superficial injuries involving multiple body regions | Superficial injuries involving head with neck | multiple superficial injuries of head with neck | Superficial injuries of sites classifiable as injuries to the head and injuries to the neck | Superficial injuries involving thorax with abdomen, lower back or pelvis
[ND56.0] Superficial injury of unspecified body region
Also known as: Superficial injury of unspecified body region | superficial injury of limb NOS | Superficial injury NOS | scratch NOS | Cutaneous wounds, injuries or scars
Excludes: multiple superficial injuries NOS
[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle
Also known as: Other specified female pelvic pain associated with genital organs or menstrual cycle | Pelvic congestion syndrome | Pelvic varicosities | Female frozen pelvis | Female intrapelvic haemorrhage
[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
[ND56.5] Injury of blood vessel of unspecified body region
Also known as: Injury of blood vessel of unspecified body region | Injury of blood vessel(s) NOS | blood vessel wound | blood vessel trauma | Avulsion of blood vessel
Excludes: multiple injuries of blood vessels 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
[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 ---
[ND30] Superficial injuries involving multiple body regions
--PARENT--> [?] Injuries involving multiple body regions
--EXCLUDES--> [?] Frostbite
Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu...
--- Walk 2 ---
[ND30] Superficial injuries involving multiple body regions
--PARENT--> [?] Injuries involving multiple body regions
--CHILD--> [ND32] Fractures involving multiple body regions
--- Walk 3 ---
[ND56.0] Superficial injury of unspecified body region
--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...
--PARENT--> [?] Surgical wound of skin
--- Walk 4 ---
[ND56.0] Superficial injury of unspecified body region
--EXCLUDES--> [?] Superficial injuries involving multiple body regions
--CHILD--> [?] Superficial injuries involving multiple regions of the arm
--- Walk 5 ---
[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle
--PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle
Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....
--RELATED_TO--> [?] Interstitial cystitis
Def: A condition characterised by inflammation of the urinary bladder and ureters. This condition may be associated with a malformation of, or injury to, the bladder epithelium, infection with toxins, an a...
--- Walk 6 ---
[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle
--PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle
Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....
--CHILD--> [GA34.1] Vaginal laxity
|
[
"[ND30] Superficial injuries involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions\n --EXCLUDES--> [?] Frostbite\n Def: Frostbite is injury from ice formation within tissues resulting from contact with cold air, liquids or metals. It is most commonly due to excessive exposure of skin to sub-zero environmental temperatu...",
"[ND30] Superficial injuries involving multiple body regions\n --PARENT--> [?] Injuries involving multiple body regions\n --CHILD--> [ND32] Fractures involving multiple body regions",
"[ND56.0] Superficial injury of unspecified body region\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...\n --PARENT--> [?] Surgical wound of skin",
"[ND56.0] Superficial injury of unspecified body region\n --EXCLUDES--> [?] Superficial injuries involving multiple body regions\n --CHILD--> [?] Superficial injuries involving multiple regions of the arm",
"[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle\n --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle\n Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....\n --RELATED_TO--> [?] Interstitial cystitis\n Def: A condition characterised by inflammation of the urinary bladder and ureters. This condition may be associated with a malformation of, or injury to, the bladder epithelium, infection with toxins, an a...",
"[GA34.Y] Other specified female pelvic pain associated with genital organs or menstrual cycle\n --PARENT--> [GA34] Female pelvic pain associated with genital organs or menstrual cycle\n Def: A symptom affecting females, characterised by pain in the pelvic region associated with any of the genital organs or the menstrual cycle....\n --CHILD--> [GA34.1] Vaginal laxity"
] |
ND30
|
Superficial injuries involving multiple body regions
|
[
{
"from_icd11": "ND30",
"icd10_code": "T00",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T000",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T001",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T002",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T003",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T006",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T008",
"icd10_title": ""
},
{
"from_icd11": "ND30",
"icd10_code": "T009",
"icd10_title": ""
},
{
"from_icd11": "ND56.0",
"icd10_code": "T140",
"icd10_title": ""
},
{
"from_icd11": "ND56.5",
"icd10_code": "T145",
"icd10_title": ""
},
{
"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"
}
] |
T00
| |
Two days after making the patient’s name public, the medical team at the EVD-reference hospital in Madrid, acting with the patient’s express consent, publicly revealed information concerning the alleged accident that could have caused the contagion. According to these statements, made at the hospital entrance a short while after having talked to the patient various times and asking for her consent to release the details, the patient had acknowledged that she might have touched her face with the gloves when she was removing the personal protective equipment (PPE) which she had donned to attend to the second of the repatriated health workers. Subsequently, the patient issued other statements in which she did not admit to this accident and, on being asked again by her medical team, said that she felt confused about the matter . This incident raises at least two questions: Was the patient’s consent to disclose the information regarding the possible accident that might have caused contagion an autonomous decision? In order for informed consent to be considered valid, three conditions must be met : (a) the patient must have sufficient information about the consequences of the decision to be taken; (b) the patient must be able to understand the relevant information and decide in accordance with his/her preferences; and, (c) the decision must be taken voluntarily, in the absence of internal and external coercion. Bearing in mind the sheer magnitude of the media circus that surrounded the case, the social alarm and panic generated, and the patient’s clinical condition (ie, she had been diagnosed with a highly lethal disease), it is doubtful whether these requirements were strictly complied with. However preserved the patient’s ability to comprehend, possibly neither the patient nor the medical team who attended to her could have foreseen the consequences of disclosing the above information. Furthermore, the coercion stemming from the enormous pressure exerted by the media and the patient’s personal and professional circle, highlighted by her contradictory statements, raises doubts about the degree to which her decision was voluntary. What was the purpose of publicly disclosing the above information so hastily? At that particular point in time, identifying a possibility of infection was of great importance to all professionals who were attending Ebola patients, since it reduced suspicion of the PPE’s inability to afford protection. What is not so clear is whether this information was relevant to the general public. In the context of confusion and social alarm, it could be understood as a measure intended to combat panic, and transmit trust and confidence to the population, showing that the source of the contagion had been discovered and that the situation was under control. Nevertheless, far from helping to allay panic, the statements instead served to spark off a media and political scramble in search of a culprit to blame for what had occurred, thereby doing irreparable harm to the investigation targeted at clarifying what had happened . The Madrid Regional Health Minister used this revelation to blame the patient publicly for what had occurred, accusing her via television of lying, concealing information and incompetence, with derogatory comments such as, “One doesn”t need a Master’s degree to understand how to put on and take off a suit but some people are undoubtedly quicker to learn than others” . Some communication media sympathetic to the government fanned the fire, by blaming and stigmatising the victim, accusing her of being imprudent and putting many people at risk, in a strategy that appeared to be designed to deflect the blame and shield the health authorities . If the alleged accident that might have caused the contagion did indeed take place during the removal of the PPE, then this must have happened as a result of unintentional carelessness by the patient within an overall context of flaws in the protective procedures and means available, especially a lack of an adequate supervision, which are ultimately to blame for the alleged failure, a point repeatedly made by some of the health professionals at the hospital . In neither of these two cases can blame or responsibility be attached to the patient for the accident or its consequences. What is in fact called for here is to implement systems that are designed to prevent errors and, in a worst case scenario, are able to detect and correct them before they cause any harm . Indeed, if the PPE-removal protocol had been appropriate, the accident should have been detected at the time it happened. The focus must be on system errors rather than personal errors . However, the regional government, in charge of direct health care of Ebola patients, rather than admitting its responsibility for not preventing the contagion blamed and shamed the patient for it, without any compensation for the damage inflicted. It is true that the patient was to blame for her failure to disclose to the primary care centre that she had been in contact with infected people. But, even so, an active surveillance system of high-risk contacts at that time should have prevented this forgetfulness from happening.
| 3.902344
| 0.845215
|
sec[1]/sec[2]/p[1]
|
en
| 0.999996
|
27538685
|
https://doi.org/10.1186/s12910-016-0135-z
|
[
"that",
"information",
"accident",
"this",
"what",
"blame",
"contagion",
"consent",
"statements",
"which"
] |
[
{
"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": "NA07.09",
"title": "Concussion with loss of consciousness, duration unspecified or unknown due to lack of information"
},
{
"code": "PK90.0",
"title": "Anaesthesiology devices associated with injury or harm, diagnostic or monitoring devices"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
},
{
"code": "PA0Z",
"title": "Unintentional land transport traffic event injuring a user of unspecified land transport"
},
{
"code": "PA05",
"title": "Unintentional land transport traffic event injuring an occupant of a bus or coach"
}
] |
=== 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
[NA07.09] Concussion with loss of consciousness, duration unspecified or unknown due to lack of information
Also known as: Concussion with loss of consciousness, duration unspecified or unknown due to lack of information
[PK90.0] Anaesthesiology devices associated with injury or harm, diagnostic or monitoring devices
Definition: An anaesthesiology device was involved in an incident that occurred in a diagnostic or monitoring task
Also known as: Anaesthesiology devices associated with injury or harm, diagnostic or monitoring devices | Anaesthesiology devices associated with injury or harm, arterial pressure monitoring catheter | Anaesthesiology devices associated with injury or harm, pulse oxymeter giving faulty information
Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
[PA0Z] Unintentional land transport traffic event injuring a user of unspecified land transport
Also known as: Unintentional land transport traffic event injuring a user of unspecified land transport | unintentional land transport injury event in road crash | unintentional land transport injury event on road | unintentional traffic accident | car accident NOS
[PA05] Unintentional land transport traffic event injuring an occupant of a bus or coach
Also known as: Unintentional land transport traffic event injuring an occupant of a bus or coach | Bus occupant injured in transport accident | Bus collision NOS, traffic | Bus accident NOS | Bus occupant injured in collision with pedestrian or animal
=== GRAPH WALKS ===
--- Walk 1 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.2] Chronic migraine
Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...
--- Walk 2 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--CHILD--> [8A80.0] Migraine without aura
Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...
--- Walk 3 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 4 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 5 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--- Walk 6 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.1] Underdosing, as mode of injury or harm
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.2] Chronic migraine\n Def: Headache occurring on 15 or more days per month for more than three months, which, on at least eight days per month, has the features of migraine headache and is not associated with medication overuse...",
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --CHILD--> [8A80.0] Migraine without aura\n Def: Recurrent headache disorder manifesting in attacks lasting 4-72 hours. The duration of attacks may be shorter in children. Typical characteristics of the headache are unilateral location, pulsating qu...",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.1] Underdosing, as mode of injury or harm"
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
There was the left orbital pain at three days before his admission, followed by headache and double vision on the left side for one day. Examination showed that the left eye vision was 0.5, and the intraocular pressure (IOP) was 18 mmHg. Besides, proptosis, complete ptosis, conjunctival hyperemia, and nearly frozen ocular motility in all directions were observed. The pupil diameter was around 4.0 mm, and both direct and indirect responses to light were weak. Laboratory tests revealed a leukocyte count of 15.31× 10^ 9 /L with a neutrophil preponderance, and a high C-reactive protein level of 35.99 mg/L was measured. The proportion of glycosylated hemoglobin was 12.9%. The computed tomography of the orbit without contrast showed a depression in the right intraorbital wall, which could be related to old fracture, bilateral septal sinus, and maxillary sinusitis. The contrast-enhanced magnetic resonance imaging (MRI) of brain revealed slightly scattered demyelinating changes, which were not pathologically significant. No significant abnormality was observed in magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) . Following admission, the patient was diagnosed with diabetic ophthalmoplegia and treated with local analgesics, nutritional therapy, and glycemic management. As the patient had toothache one week before admission and his symptoms had not been fully disappeared, after dental examination, he was diagnosed with apical periodontitis and given ceftriaxone sodium (2 g intravenously daily) combined with metronidazole (0.6 g orally three times a day) for anti-inflammatory treatment. However, four days later, the patient had vision loss. Subsequently, on the fifth day of hospitalization, he experienced difficulty in moving his right hand when he got up. Physical examination indicated total ptosis of the left eye and paresis of extra-ocular eye movements. The left pupil diameter was 5 mm, and light reflection disappeared, accompanied by hypoesthesia of the left forehead. The right upper limb’s muscle strength was grade 4, and the right finger nose test was inaccurate, with no abnormality in the other neurological examinations. The National Institutes of Health Stroke Scale (NIHSS) score was 3 points. The MRI of brain showed infarction in the left frontal-parietal lobe and temporal-occipital junction area. Due to the onset of the disease within 4.5 h and the diffusion-weighted MRI (DWI)-fluid-attenuated inversion recovery (FLAIR) mismatch, the patient received intravenous thrombolysis with recombinant tissue plasminogen activator (r-tPA). After intravenous thrombolysis, the patient’s symptoms were improved and the NIHSS score was 2 points. Afterwards, digital subtraction angiography (DSA) was performed and revealed occlusion of the left internal carotid artery, in which the right internal carotid artery was partially compensated by the opening of the anterior communicating artery; and the posterior circulation was partially compensated by the opening of the thin posterior communicating artery. The patient was advised to undergo orbital MRI, which revealed a hyperintense lesion in the medial, lateral, inferior, and supraocular muscles, causing compression of the adjacent optic nerve. The lesion was found to be hypointense on both T1-weighted images (T1WI) and T2-weighted images (T2WI), with significantly contrast enhancement . Therefore, lumbar puncture was performed that showed cerebrospinal fluid pressure of 200 mmH 2 O, white blood cell count of 11.35 ∗ 10^ 6 /L, single-cell nucleus of 79%, glucose level of 4.91 mmol/L, chlorine level of 122.9 mmol/L, and cerebrospinal fluid protein level of 952.5 mg/L. Pseudomonas aeruginosa was found by detection of pathogenic microorganisms using metagenomic next-generation sequencing (mNGS). After a systemic evaluation, the final diagnosis was orbital inflammation caused by apical periodontitis and developed progressively, resulting in multiple neural injuries at the orbital apex. Acute ischemic stroke is caused by occlusion of the internal carotid artery due to a cavernous sinus abscess and inflammation. Therefore, the treatment was changed to linezolid (0.6 g orally every 12 h) and piperacillin-tazobactam (4.5 g intravenously every 8 h), in combination with low-dose steroids (intravenous methylprednisolone, 20 mg for 10 days), antiplatelet aggregation, and reducing intracranial pressure. Simultaneously, dental extraction was performed after dental examination. After medical treatment, the patient’s symptoms were alleviated, accompanying by reduction of pain and swelling, and slightly improvement of vision in the left eye; nonetheless, during the 1-year follow-up, the patient’s visual examination showed only light perception, and the presence of ptosis and ophthalmoplegia was still confirmed. Fig. 1 Cerebral MRI findings. A MRA shows mild atherosclerotic changes. B MRV is normal Fig. 2 MRI of brain and orbits with gadolinium contrast showing thickened and enhanced medial, lateral, inferior, and supraocular muscles. Both T1- and T2-weighted imaging were hypointense A , B . DWI and FLAIR sequences were hyperintense C , D Axial and coronal scans were markedly enhanced E , F
| 3.96875
| 0.97998
|
sec[1]/p[1]
|
en
| 0.999997
|
PMC9484228
|
https://doi.org/10.1186/s12883-022-02890-0
|
[
"artery",
"orbital",
"vision",
"contrast",
"which",
"weighted",
"pressure",
"ptosis",
"both",
"light"
] |
[
{
"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": "9A2Z",
"title": "Disorders of orbit, unspecified"
},
{
"code": "9A22.Z",
"title": "Orbital inflammation, unspecified"
},
{
"code": "9A2Y",
"title": "Other specified disorders of orbit"
},
{
"code": "LA14.2",
"title": "Structural developmental anomalies of orbit"
},
{
"code": "9A24.0",
"title": "Contraction of orbit"
}
] |
=== 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
[9A2Z] Disorders of orbit, unspecified
Also known as: Disorders of orbit, unspecified
[9A22.Z] Orbital inflammation, unspecified
Also known as: Orbital inflammation, unspecified | Orbital inflammation | inflammation of orbit | Acute inflammation of orbit | acute orbital inflammation
[9A2Y] Other specified disorders of orbit
Also known as: Other specified disorders of orbit | Orbital deformity | deformity of orbit proper | Atrophy of orbit
[LA14.2] Structural developmental anomalies of orbit
Definition: Any condition caused by failure of the orbit to correctly develop during the antenatal period.
Also known as: Structural developmental anomalies of orbit | congenital anomaly of orbit | congenital anomaly of orbit proper | specified congenital anomalies of orbit | anomaly of orbit
[9A24.0] Contraction of orbit
Also known as: Contraction of orbit | Posttrauma contraction of orbit | Postradiation contraction of orbit | Postsurgery contraction of orbit
=== GRAPH WALKS ===
--- Walk 1 ---
[BD5Z] Diseases of arteries or arterioles, unspecified
--PARENT--> [?] Diseases of arteries or arterioles
--CHILD--> [BD50] Aortic aneurysm or dissection
Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...
--- Walk 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--> [?] 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...
--CHILD--> [?] Cutaneous leukocytoclastic vasculitis
Def: Skin-limited small vessel leucocytoclastic vasculitis of unspecified or unknown aetiology...
--- Walk 4 ---
[BD52] Certain specified disorders of arteries or arterioles
--CHILD--> [BD52.0] Segmental arterial mediolysis
Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys...
--PARENT--> [BD52] Certain specified disorders of arteries or arterioles
--- Walk 5 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--CHILD--> [?] Injuries to the thorax
--- Walk 6 ---
[BD52.3] Rupture of artery
--EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes
Def: !markdown
In the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...
--PARENT--> [?] ICD Category
|
[
"[BD5Z] Diseases of arteries or arterioles, unspecified\n --PARENT--> [?] Diseases of arteries or arterioles\n --CHILD--> [BD50] Aortic aneurysm or dissection\n Def: Aortic aneurysm is a term for any swelling (dilation or aneurysm) of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location. ...",
"[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--> [?] 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...\n --CHILD--> [?] Cutaneous leukocytoclastic vasculitis\n Def: Skin-limited small vessel leucocytoclastic vasculitis of unspecified or unknown aetiology...",
"[BD52] Certain specified disorders of arteries or arterioles\n --CHILD--> [BD52.0] Segmental arterial mediolysis\n Def: Segmental arterial mediolysis is a rare noninflammatory vascular disease of the abdominal splanchnic arteries, characterised by disruption of the arterial medial layer. It will induce multiple aneurys...\n --PARENT--> [BD52] Certain specified disorders of arteries or arterioles",
"[BD52.3] Rupture of artery\n --EXCLUDES--> [?] Injury, poisoning or certain other consequences of external causes\n Def: !markdown\nIn the ICD, injury means physical or physiological bodily harm resulting from interaction of the body with energy (mechanical, thermal, electrical, chemical or radiant, or due to extreme pre...\n --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 --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
|
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