Title: Pauci-immune necrotizing glomerulonephritis in a 24-year-old female with negative ANCA antibodies: A Rare Case Report.

Title: A 64 -year-old male with diffuse renal large B-cell non-Hodgkin lymphoma:A rare Case Report.Hasan Haydar a,+ ,Mouhammed Sleiaya, Hadi Alabdullaha , Rouba Al-alloush a, Nour Al_alloush a , Mohamad Yasin Lutfi b, Simon Youssefc, Suaad Hamshod.a Faculty of Medicine, Hama University, Hama, Syrian Arab Republic.b Hama National Hospital,Urology Department, Hama, Syrian Arab Republic.c Hama National Hospital,pathology Department, Hama, Syrian Arab Republic.d Rheumatology department Faculty of medicine, Damascus University, Damascus ,Syrian Arab Republic.*Corresponding author: Hasan Haydar, Faculty of Medicine, Hama University, Hama, Syrian Arab Republic. email: hasanhaydar458@gmail.com+ Hasan Haydar ,Mouhammed Sleiay, Rouba Al-alloush , Nour Al_alloush, Mohamad Yasin Lutfi , Simon Youssef , Suaad Hamsho are co-first authors. All contributed equally in this paper.Emails & ORCID:Hasan Haydar: hasanhaydar458@gmail.comMouhammed Sleiay:abdmouh1234mouhmouh@gmail.comORCID: 0009-0003-8887-0739Hadi Alabdullah :dr.alabdullah.md@gmail.comRouba Al-alloush : rouba2002alloush@gmail.comNour Al_alloush: nour2005alloush@gmail.comMohamad Yasin Lutfi: Doctor85yasen@gmail.comSimon Youssef:simon.youssef.1978@gmail.comSuaad Hamsho,soha.hamsho3@gmail.com

Abstract :Background: A noval radiologic sign in patients with renal failure and UE with metabolic acidosis has recently been identified as the lentiform fork sign. On magnetic resonance imaging (MRI), the ”lentiform fork sign” has been described as bilateral symmetrical hyperintensities in the basal ganglia encircled by a hyperintese rim delineating the lentiform nucleus. Changes in uremic solute retention, aberrant blood-brain barrier transport, disorderd vascular reactivity, altered electrolyte and acid-base balance, and altered hormone metabolism are the most likely causes of the condition.Case presentation : 56-year-old man with end-stage renal disease was brought to the emergency room for a progressive change in mental status and involuntary arm movements over the previous five days, which were also accompanied by mild dyspnea.A brain MRI was performed, and it revealed hyperintensity on T2/FLAIR in the white matter surrounding the basal ganglia. The haloperidol was stopped, and there more dialysis sessions were carried out.Conclusion : intensified hemodialysis and glycemic control are the cornerstones of treating DUS with likely reversible clinical symptoms and remission of imaging abnormalities.

A 23 years old patient with bilateral hypoplastic thumbs and toes: A case report.Suaad Hamsho, Rheumatology Department, Faculty of medicine, Damascus University, Damascus, Syria.soha.hamsho3@gmail.comMouhammed Sleiay , University of Hama, Faculty of Medicine, Hama, Syriaabdmouh1234mouhmouh@gmail.com (The corresponding author)Mohammed Alaswad , University of Hama, Faculty of Medicine, Hama, Syriadr.aswad97@gmail.comHasan Alsmodi , University of Hama, Faculty of Medicine, Hama, Syriaadda85517@gmail.comKhaled Al-Hakeem , University of Hama, Faculty of Medicine, Hama, Syriakalhkym531@gmail.com