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Lungu M, Oprea VD, Stoleriu G, Ionescu AM, Zaharia AL, Croitoru A, Stan B, Niculet E. Madelung's Disease Evolving to Liposarcoma: An Uncommon Encounter. Life (Basel) 2024; 14:521. [PMID: 38672791 PMCID: PMC11051324 DOI: 10.3390/life14040521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: Madelung's disease-known also as Benign Symmetric Adenolipomatosis (BSA) or Multiple Symmetric Lipomatosis (MSL), is a rare subcutaneous tissue disease characterized by the proliferation of non-encapsulated fat tissue with mature adipocytes. Patients develop symmetrical fatty deposits of varying sizes, (located particularly around the neck, shoulders, upper and middle back, arms, abdomen, and thighs), having clinical, esthetic, and psychiatric repercussions. (2) Methods: We report a case diagnosed with BSA upon admission to the Neurological and Internal Medicine Departments of the Emergency Clinical Hospital of Galati. (3) Results: This patient developed compressive phenomena and liposarcoma with liver metastasis, followed by death shortly after hospital presentation. The histopathology examination confirmed right latero-cervical liposarcoma and round cell hepatic metastasis. The specific metabolic ethiopathogenic mechanism has not been elucidated, but the adipocytes of BSA are different from normal cells in proliferation, hormonal regulation, and mitochondrial activity; a rare mitochondrial gene mutation, together with other interacting genetic or non-genetic factors, have been considered in recent studies. A thorough literature search identified only three cases reporting malignant tumors in BSA patients. (4) Conclusions: The goal of our paper is to present this rare case in the oncogenic synergism of two tumors. In the management of this BSA disorder, possible malignant transformation should be considered, although only scarce evidence was found supporting this.
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Affiliation(s)
- Mihaiela Lungu
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Ap. Andrei” Clinical County Emergency Hospital, 800579 Galati, Romania
| | - Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Ap. Andrei” Clinical County Emergency Hospital, 800579 Galati, Romania
| | - Gabriela Stoleriu
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Spiridon” Clinical Emergency County Hospital Iasi, 700111 Iasi, Romania
| | - Ana-Maria Ionescu
- Faculty of Medicine and Pharmacy, Ovidius University of Constanța, 900470 Constanța, Romania;
| | - Andrei Lucian Zaharia
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Ap. Andrei” Clinical County Emergency Hospital, 800579 Galati, Romania
| | - Ana Croitoru
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Ap. Andrei” Clinical County Emergency Hospital, 800579 Galati, Romania
| | - Bianca Stan
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Ap. Andrei” Clinical County Emergency Hospital, 800579 Galati, Romania
| | - Elena Niculet
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania (A.L.Z.); (A.C.)
- “St. Ap. Andrei” Clinical County Emergency Hospital, 800579 Galati, Romania
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Marinescu MC, Oprea VD, Munteanu SN, Nechita A, Tutunaru D, Nechita LC, Romila A. Carbohydrate Antigen 125 (CA 125): A Novel Biomarker in Acute Heart Failure. Diagnostics (Basel) 2024; 14:795. [PMID: 38667440 PMCID: PMC11048787 DOI: 10.3390/diagnostics14080795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostic, prognostic and therapeutic guidance of patients hospitalized for acute heart failure; Our review aims to summarize in an easy-to-follow flow recent relevant research evaluating the possible use and the clinical value of measuring CA 125 serum levels in acute HF. METHODS A thorough search in the main international databases identified a relevant pool of 170 articles, providing recently published data for this narrative review that used PRISMA guidelines. RESULTS There are data to sustain the role of carbohydrate antigen 125 (CA 125), a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow-up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than N-terminal pro b-type natriuretic peptide (NT-pro BNP)-a classical and more utilized marker of heart failure) in several scenarios of acute heart failure. CONCLUSIONS Although the mechanism behind the upregulation of serum CA 125 in patients with congestive HF has not been confirmed nor fully understood.
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Affiliation(s)
- Mihai Cristian Marinescu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Sorina Nicoleta Munteanu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Aurel Nechita
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Ioan Emergency Clinical Hospital for Children, 800487 Galați, Romania
| | - Dana Tutunaru
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Luiza Camelia Nechita
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Aurelia Romila
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
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Sârbu F, Lungu M, Oprea VD, Romila A. Early depressive manifestations in patients with dementia caused by Alzheimer's disease. Exp Ther Med 2024; 27:56. [PMID: 38234622 PMCID: PMC10790160 DOI: 10.3892/etm.2023.12344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/17/2023] [Indexed: 01/19/2024] Open
Abstract
Previous studies on the complex interplay between depression and dementia in patients with Alzheimer's disease revealed that early-life depression is a risk factor for dementia. Both depression and dementia appear to share common etiopathological mechanisms. In the present study, a comprehensive retrospective analysis was performed on a study group of patients with dementia suffering from previously diagnosed depression. The aim was to assess potentially relevant clinical and imaging parameters that can be used to characterize depression as a risk factor for dementia in later life. Statistically significant data correlating cognitive scores with the moment of depression onset and the length of time period to the diagnosis of dementia were identified. Furthermore, at the moment of depression diagnosis, structural cerebral alterations tended to appear more frequently in women compared with men. However, this sex-associated difference is not maintained after the moment of dementia diagnosis. Results from the present study contributed additional data to the evidence supporting a relationship between a history of depression and the occurrence of Alzheimer's disease, discussing relevant clinical and imaging parameters featured in patients with dementia and their inter-relations.
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Affiliation(s)
- Fabiola Sârbu
- Elisabeta Doamna Psychiatric Hospital of Galati, 800179 Galați, Romania
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
| | - Mihaela Lungu
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
- St. Apostle Andrei, Clinical Emergency County Hospital, 800578 Galati, Romania
| | - Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
- St. Apostle Andrei, Clinical Emergency County Hospital, 800578 Galati, Romania
| | - Aurelia Romila
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800216 Galati, Romania
- St. Apostle Andrei, Clinical Emergency County Hospital, 800578 Galati, Romania
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Zaharia AL, Tutunaru D, Oprea VD, Tănase CE, Croitoru A, Stan B, Voinescu DC, Ionescu AM, Coadǎ CA, Lungu M. Thrombomodulin Serum Levels-A Predictable Biomarker for the Acute Onset of Ischemic Stroke. Curr Issues Mol Biol 2024; 46:677-688. [PMID: 38248346 PMCID: PMC10813863 DOI: 10.3390/cimb46010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
The early diagnosis of acute ischemic stroke (AIS) can be challenging in cases presenting with a scarcity of clinical signs, normal cerebral imaging in early stages and a lack of specific serum markers. Thrombomodulin has been shown to be associated with cerebrovascular ischemic events and can be considered an important biomarker for the acute onset of ischemic stroke. In our study, we compared the serum levels of thrombomodulin (sTM) between a relevant patient group of 70 AIS patients and a control group of patients without AIS admitted into the neurology department between June 2022 and May 2023. sTM levels were measured at 24 h and 48 h after patients' admissions into the hospital. There was a significant difference between the two groups (AIS: 23.2 ± 9.17 ng/mL vs. controls: 3.64 ± 1.72 ng/mL; p-value < 0.001). sTM values were correlated with the score of neurological deficits, with gender and dyslipidemia. The association of sTM values with the acute onset of AIS as an end point was significant, which allows rapid therapeutic interventions, even in the absence of a well-defined clinical syndrome (AUC = 0.99). Reanalysis of the patients after propensity score matching increased the power of sTM as a biomarker (AUC = 1). sTM represents a potentially useful biomarker to diagnose the onset of an AIS, even in scarce clinical presentations, which makes thrombomodulin a valuable indicator for early treatment initiation.
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Affiliation(s)
- Andrei-Lucian Zaharia
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
| | - Dana Tutunaru
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
| | - Violeta Diana Oprea
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
| | - Claudiu Elisei Tănase
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
- “St. Joan” Pediatric Clinical Emergency Hospital Galati, 800487 Galati, Romania
| | - Ana Croitoru
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
| | - Bianca Stan
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
| | - Doina Carina Voinescu
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
| | - Ana-Maria Ionescu
- Faculty of Medicine and Pharmacy, Ovidius University of Constanța, 900470 Constanța, Romania;
| | - Camelia Alexandra Coadǎ
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Mihaiela Lungu
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania; (A.-L.Z.); (A.C.); (B.S.); (D.C.V.); (M.L.)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800216 Galati, Romania;
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Marinescu M, Oprea VD, Nechita A, Tutunaru D, Nechita LC, Romila A. The Use of Brain Natriuretic Peptide in the Evaluation of Heart Failure in Geriatric Patients. Diagnostics (Basel) 2023; 13:diagnostics13091512. [PMID: 37174904 PMCID: PMC10177186 DOI: 10.3390/diagnostics13091512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 05/15/2023] Open
Abstract
Heart failure is one of the main morbidity and mortality factors in the general population and especially in elderly patients. Thus, at the European level, the prevalence of heart failure is 1% in people under 55 years of age but increases to over 10% in people over 70 years of age. The particularities of the elderly patient, which make the management of heart failure difficult, are the presence of comorbidities, frailty, cognitive impairment and polypharmacy. However, elderly patients are under-represented in clinical trials on the diagnosis and treatment of heart failure. The need for complementary methods (biomarkers) for differential and early diagnosis of heart failure is becoming more and more evident, even in its subclinical stages. These methods need to have increased specificity and sensitivity and be widely available. Natriuretic peptides, in particular B-type natriuretic peptide (BNP) and its fraction NTproBNP, have gained an increasingly important role in the screening, diagnosis and treatment of heart failure in recent years.
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Affiliation(s)
- Mihai Marinescu
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University in Galați, 800216 Galați, Romania
- "St. Apostle Andrei" Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University in Galați, 800216 Galați, Romania
- "St. Apostle Andrei" Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Aurel Nechita
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University in Galați, 800216 Galați, Romania
- "St. Ioan" Emergency Clinical Hospital for Children, 800487 Galați, Romania
| | - Dana Tutunaru
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University in Galați, 800216 Galați, Romania
- "St. Apostle Andrei" Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Luiza-Camelia Nechita
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University in Galați, 800216 Galați, Romania
- "St. Apostle Andrei" Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Aurelia Romila
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University in Galați, 800216 Galați, Romania
- "St. Apostle Andrei" Clinical Emergency County Hospital, 800578 Galați, Romania
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Lungu M, Oprea VD, Zaharia AL, Stan B, Rebegea L, Mocanu DI, Elkan EM, Niculet E, Croitoru A. Stroke-Associating Acute Limb Ischemia Due to the Rupture of a Hydatid Cyst. Curr Issues Mol Biol 2023; 45:2597-2608. [PMID: 36975540 PMCID: PMC10047644 DOI: 10.3390/cimb45030170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
(1) Background: Hydatidosis, or human cystic echinococcosis, is a zoonotic disease. Endemic in some areas, recently it has an increasing incidence in wider regions, determined by population migration. Clinical features depend on the localization and level of infection: asymptomatic or with signs related to hypersensitivity, organic functional deficiencies, expanding mass effects, cyst infection and sudden death. In rare cases, the rupture of a hydatid cyst causes emboli formation by the residual laminated membrane. (2) Methods: We performed an extensive literature review, starting from the case of a 25-year-old patient presenting with neurologic symptoms relevant for acute stroke, associating right upper limb ischemia. (3) Results: Imaging investigations revealed the source of the emboli as the rupture of a hydatid cyst, the patient presenting multiple pericardial and mediastinal localizations. Cerebral imaging confirmed an acute left occipital ischemic lesion, with complete recovery of the neurological deficit after therapy, while surgery for acute brachial artery ischemia had a favorable postoperative evolution. Specific anthelmintic therapy was initiated. An extensive literature review using available databases revealed the scarcity of data on embolism as a consequence of cyst rupture, highlighting the significant risk of clinicians overlooking this possible etiology. (4) Conclusions: An associated allergic reaction should raise the hypothesis of a hydatid cyst rupture as a cause of any level acute ischemic lesion.
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Affiliation(s)
- Mihaela Lungu
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Violeta Diana Oprea
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Andrei Lucian Zaharia
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Bianca Stan
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Laura Rebegea
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Dan Iulian Mocanu
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Eva Maria Elkan
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
- "St. Joan" Pediatric Clinical Emergency Hospital Galati, 800487 Galati, Romania
| | - Elena Niculet
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
| | - Ana Croitoru
- "St. Apostle Andrei" Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800216 Galati, Romania
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Sârbu F, Oprea VD, Tatu AL, Polea Drima E, Bojincă VC, Romila A. Hereditary Hemorrhagic Telangiectasia Associating Neuropsychiatric Manifestations with a Significant Impact on Disease Management-Case Report and Literature Review. Life (Basel) 2022; 12:life12071059. [PMID: 35888148 PMCID: PMC9320563 DOI: 10.3390/life12071059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022]
Abstract
(1) Background: Genetic hereditary hemorrhagic telangiectasia (HHT) is clinically diagnosed. The clinical manifestations and lack of curative therapeutic interventions may lead to mental illnesses, mainly from the depression–anxiety spectrum. (2) Methods: We report the case of a 69-year-old patient diagnosed with HHT and associated psychiatric disorders; a comprehensive literature review was performed based on relevant keywords. (3) Results: Curaçao diagnostic criteria based the HHT diagnosis in our patient case at 63 years old around the surgical interventions for a basal cell carcinoma, after multiple episodes of epistaxis beginning in childhood, but with a long symptom-free period between 20 and 45 years of age. The anxiety–depressive disorder associated with nosocomephobia resulted in a delayed diagnosis and low adherence to medical monitoring. A comprehensive literature review revealed the scarcity of publications analyzing the impact of psychiatric disorders linked to this rare condition, frequently associating behavioral disengagement as a coping strategy, psychological distress, anxiety, depression, and hopelessness. (4) Conclusions: As patients with HHT face traumatic experiences from disease-related causes as well as recurring emergency hospital visits, active monitoring for mental illnesses and psychological support should be considered as part of the initial medical approach and throughout the continuum of care.
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Affiliation(s)
- Fabiola Sârbu
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galati, Romania
| | - Violeta Diana Oprea
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania
- Correspondence: (V.D.O.); (A.L.T.)
| | - Alin Laurențiu Tatu
- Clinical, Medical Department, Dermatology, ReForm UDJ, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania
- Dermatology Department, Clinical Hospital of Infectious Diseases Saint Parascheva, 800179 Galati, Romania
- Correspondence: (V.D.O.); (A.L.T.)
| | - Eduard Polea Drima
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galati, Romania
| | - Violeta Claudia Bojincă
- Internal Medicine Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy in Bucharest, 020021 Bucharest, Romania;
- Department of Internal Medicine and Rheumatology, “Sf. Maria” Hospital, 011172 Bucharest, Romania
| | - Aurelia Romila
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania
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