Ultrasound-guided Erector spinae planae block was practiced after induction of general anesthesia on a male heart patient to perform a nephrectomy, with the aim of an opioid-sparing approach. We founded an important hemodynamic instability 15 minutes after the execution of the block and we want to investigate the possible causes.

Neuropsychiatric systemic lupus erythematosus (NPSLE) is usually associated with a worse prognosis. However, there are few effective treatments for NPSLE. We described protein A immunoadsorption treatment for a patient with NPSLE. The patient’s brain lesions was improved rapidly after two sessions of protein A immunoadsorption combination with immunosuppressive agent treatment.

Neck masses can be a challenge because several cancers metastasize in this area. Head and neck tumors are more commonly responsible of lymph nodes in neck. However, also gastric cancer can be metastatic in this area. We present a rare case of neck gastric meta with negative Virchow's lymph node.

Coronavirus disease 2019 (COVID-19) can cause various complications. Pneumothorax secondary to COVID-19 is relatively uncommon and bilateral pneumothorax is even more so. In patients with poor general health to undergo surgery for pneumothorax, internal treatments are essential to relieving refractory pneumothorax.

A 75-year-old male presented with an immediately threatened grade IIb acute ischemia of the left leg due to thrombosis of a femoro-infrapopliteal prosthetic bypass graft. After an urgent Computed Tomography Angiography, an urgent graft thrombectomy was performed using a 5 Fr Fogarty catheter, which had a troublesome distal passage.

Rheumatoid arthritis (RA) is a chronic inflammatory disease, characterized by symmetric and destructive polyarthritis with a broad spectrum clinical manifestation of various organs. Rheumatoid neutrophilic dermatitis (RND) is an unusual distinctive manifestation of RA and typically develops in severe RA. 51-year-old female presented with a skin rash involving her extremities.

Snake bite is a common and very important issue threatening health worldwide. Patients who develop hemorrhagic or non-hemorrhagic blisters following snakebite, in addition to anti-venom, need broad-spectrum antibiotics and sometimes emergency surgical procedures and hospitalization to prevent serious complications such as necrotizing fasciitis, compartment syndrome.

The study investigates the case of a total thyroidectomy, where after dissection multiple nodules showed two malignant patterns by immunohistochemistry. Molecular analysis based on DNA methylation profile was used to further inspect the origin of the coexisting neoplasms. We confirmed the presence of malignant skin melanoma involving medullary thyroid cancer.

A growing number of studies indicate a broad range of neurological manifestations, including seizures, occur in patients with COVID-19 infection. We report a 29-yers old female with status epilepticus and positive SARS-CoV-2 in the cerebrospinal fluid. Our findings support previous reports suggesting seizure as a possible symptom of COVID-19 infection.

Incomplete obliteration of urachus during the fetal period can lead to urachal abnormalities, such as urachal sinus. Therefore, it should be considered as a significant differential diagnosis in abdominal pain or umbilical discharge patients. This article presents a young patient with a urachal sinus mimicking umbilical pilonidal sinus symptoms.

A 73-year-old woman with occult hepatitis B virus (HBV) infection was diagnosed with hepatocellular carcinoma (HCC). Serum HBV core-related antigen (HBcrAg) was elevated and HBV covalently closed circular DNA (cccDNA) was presented in the liver tissue. This report shows HBcrAg might be a predictive factor for development of HCC.

Maternal diabetes insipidus does not usually adversely affect the course of pregnancy. We present a rare case of central diabetes insipidus diagnosed at 31 weeks of gestation with fetal oligohydramnios successfully treated with intranasal desmopressin. To date, only three cases of diabetes insipidus with oligohydramnios have been reported.

Drug reaction with eosinophilia and systemic symptoms is a quite unusual condition related to drug reaction. A case report of sulfasalazine-induced liver failure is described. The patient was submitted to liver transplantation. Liver transplantation is an option when DRESS is associated with acute liver failure, but the prognosis remains poor.

We report a rare case of monoclonal gammopathy of renal significance with immunotactoid glomerulopathy and severe nephrotic syndrome. The patient was diagnosed with a B-cell IgM κ clone and her nephrotic syndrome is responding well to bortezomib, dexamethasone, and rituximab.

There are few reports on pregnancy and childbirth of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients. We present a woman who diagnosed with HAM/TSP and used a wheelchair in daily life. She had no neurological impairments and no obstetrical complications during her three courses of pregnancy and childbirth.

Schizophrenia is associated to somatic disorders especially cardio-vascular and auto-immune. Through this case report, we describe an association with hypertrophic osteoarthropathy (HPO). For this patient it was a paraneoplastic paraneoplastic syndrome secondary to lung cancer. This syndrome is rare but important to recognize since it could hide a life-threatening condition.

A 31-year-old male Caucasian patient developed reinfection with SARS-CoV-2, 2 ½ months after an initial episode of ICU admission for respiratory support due to COVID-19. The second episode was in the form of malaise, aphthous gingival ulcer, and desquamating palmar lesion.

Rosai Dorfman disease is a rare cause of sinus histiocytosis with massive lymphadenopathy, in developing countries it mimics tuberculosis and malignancies like lymphoma and its often mismanaged. A high index of suspicion is necessary for its diagnosis. It resolves spontaneously therefore observation is currently the advocated approach for its management.