Journal of Case Reports in Practice
Volume:6 Issue: 2, Apr 2018

Left atrial myxoma is the most common primary cardiac neoplasm, commonly grows on the upper side of atrial septum and has often mimicked connective tissue disease especially some features of vasculitis. The clinical course of the left atrial myxoma is characterized by symptoms resulting from obstructive, embolic, or “pseudovasculitis " manifestations of the tumor. Embolic ischemic manifestations are typically cerebrovascular. We described an unusual clinical presentation of left atrial myxoma in 36 years old man, which initially was assessed as PAN type vasculitis for 4 years. He presented with episodic red skin rashes, blurred vision, abdominal pain, headache and hemiparesia. Based on his symptoms, diagnosis of polyarteritis nodosa type vasculitis was made. Laboratory findings included nothing to indicate systemic vasculitis. Cardiac evaluation revealed no murmur. Brain MRI revealed left parietal cortical ischemic patchy signals. Being unresponsiveness to medical therapy led to echocardiography which demonstrated left atrial mass (2.9 in 2cm). After surgical intervention diagnosis of left atrial myxoma was approved with pathological examination. This case report emphasize that sometimes the symptoms and physical findings of cardiac tumor could simulate systemic vasculitis. Prompt clinical recognition and surgical removal are essential to prevent serious complications.

To report a case of posterior capsular opacification with significant changes in spherical equivalent after Neodymium: YAG laser capsulotomy. A 38-year- old female patient presented to our department with blurred vision of the right eye. Shehad undergone an uncomplicatedcataract surgery usingphacoemulsification about five years ago, With foldable IOL implantation in the bag being performed. She was diagnosed with posterior capsular opacification and Nd: YAG laser posterior capsulotomy was performedfor her. After one month there were significant changes in her spherical equivalent.The Neodymium: YAG laser is an effective procedure in opening opaque posterior capsule and it might cause significant spherical equivalent correction in some patients.

Systematic lupus erythematosus (SLE) is a chronic and autoimmune disease that involvement of several target organs, at emergency department (ER) it is important to consider SLE as a cause for acute organ involvement. The aims of this study were to determine the cause for emergency visits in SLE Patients, focuses of Vasculitis.

Eighty one known SLE patients based on “1982 Revised American College Of Rheumatology SLE Criteria “who had visited the emergency department of Imam Reza hospital from June 2012-December 2014 having undergone a thorough physical examination by the emergency service and classified based on demographic and SLE related sign and symptom. We focused on vasculitis and non-vacuities groups.

In total 17.3% were diagnosed as vasculitis. In the vasculitis group cutaneous vasculitis (50%), thromoembolic events (7.1%) and cerebral vasculitis (7.1%) retinal vasculitis (7.1%) and aortic involvement was seen. the first three most common causes for ER visit in SLE patients were 1) SLE flare episode along with polyarthritis, mucosal ulcer and photosensivity. 2) Vasculitis 3) Renal involvement. Mean SLEDAI and SLICC scores were 22.79 (±13.29) and 1.95 (±1.46), respectively. Regarding SLICC parameters and their relevance to vasculitis ocular, renal, gastrointestinal and neuropsychiatric damage and diabetes mellitus were the most prevalent complications among the vasculitis group (p-value = 0.03, 0.01,