A 45-year-old gentleman presented with nephrotic-range proteinuria (6 g/day) and acute renal impairment. Blood tests revealed active lupus serological markers. He had no other extra-renal lupus manifestations. Renal biopsy showed Class IV lupus nephritis (activity score, 12/24; chronicity score, 1/12; 3 out of 12 glomeruli showed cellular crescents).
Dr. Priscilla Wong, Dr. Lydia Tam, Prof. LS Tam, 20171110000000
This case report highlights that psoriatic arthritis is a heterogenous disease affecting multiple disease domains, and effective treatment requires thorough assessment of each of these different domains.
With increasing affordability and availability of international travel, many endemic infections once restricted to overseas regions are now not uncommonly seen in our locality. Three cases of important arthropod-borne infections from returned travellers are reported and discussed.
Dr. Michael Kwan-Lung Ko, Dr. Siu-Yin Wong, 20170710000000
Case 1: A 79-year-old male patient presented initially with acute coronary syndrome and newly diagnosed myeloproliferative neoplasm with high white blood cell and platelet counts. He was stabilized and subsequently discharged with dual antiplatelet therapy (DAPT) (aspirin plus clopidogrel) and hydroxyurea.
Case 2: A 62-year-old female patient with a history of decompensated cryptogenic cirrhosis presented with acute variceal haemorrhage with haematemesis. Emergency OGD revealed three columns of grade 3 oesophageal varices with fibrin clot noted on one of them.
Case 3: A 51-year-old female patient with a history of systemic lupus erythematosus and hyperlipidaemia was referred to our hepatology clinic for evaluation of deranged liver function.
An 82-year-old lady with hypertension and hyperlipidaemia presented with 2 weeks’ history of increasing breathing difficulty. She had flu-like illness 2 weeks ago with some residual dry cough. Physical examination showed low-grade fever of 37.8°C with mildly elevated jugular venous pressure and mild pedal oedema. There was no obvious murmur, and chest auscultation revealed bilateral basal crepitations. Her blood pressure was 130/80 mm Hg. She required oxygen 1 L/min to maintain blood oxygen saturation level (SpO2) of 94 percent.
Dr. Adrian Ka-Chun Cheng, Dr. Felix Hon-Wai Chan, 20170407000000
Case 1: An 80-year-old man was admitted via the Accident and Emergency Department for syncope.
Case 2: The
patient was an 88-year-old woman with background type 2 diabetes, chronic renal
impairment (estimated creatinine clearance, 15 mL/minute), hypertension, lumbar
spondylosis and Parkinson’s disease.
Case 3: An
82-year-old man was admitted to the medical ward for dizziness for 2 days.
Dr. Loey Lung-Yi Mak, Dr. Michael Ka-Shing Cheung, Prof. Man-Fung Yuen, 20170119000000
A 61-year-old man was referred to our centre due to deranged liver function tests (LFT) in 2010. He had enjoyed good past health and had been asymptomatic all along. He worked as a banker and drank small amounts of alcohol on occasions. Upon admission, he was found to be obese with body mass index (BMI) of 36.2 kg/m2. His blood pressure was 173/86 mm Hg. Physical examination was otherwise unremarkable.
In addition to an intensive weight loss programme, the use of continuous positive airway pressure (CPAP) could improve absolute weight loss in individuals with obesity and obstructive sleep apnoea (OSA), according to a study presented at ENDO 2019.
Long-acting beta2-agonist (LABA) plus long-acting muscarinic antagonist (LAMA) combinations compare with inhalers containing both LABA and corticosteroid (LABA-ICS) in terms of reducing chronic obstructive pulmonary disease (COPD) exacerbations, although the LAMA-LABA combination is more favourable as it is associated with fewer episodes of severe pneumonia, according to a study.
Extremely premature neonates who have been exposed to pre-eclampsia in utero are at high risk of developing severe respiratory distress syndrome and severe bronchopulmonary dysplasia, according to a study.