A 36-year-old woman with bilateral facial and hand weakness and impaired truncal sensation

Article Abstract:

A 36-year-old woman was admitted to a hospital with symptoms of a peripheral nerve disease. Five years before admission, she began experiencing numbness in her shoulders and eventually developed numbness and weakness in her hands. She also lost sensation on her trunk. Medical examination at the hospital revealed enlarged tonsils, which led the doctors to suspect she had Tangier disease. Tangier disease is a genetic disorder of fat metabolism characterized by a defect in the production of apolipoprotein A-I, which is a component of high-density lipoprotein (HDL) cholesterol. Research on patients with Tangier disease revealed that HDL removes cholesterol from cells. In its absence, cholesterol accumulates in cells. This could affect myelin production, among other things, which could explain the peripheral nerve disorders that occur in some people with Tangier disease. The only known treatment for Tangier disease is a low-cholesterol diet and cholesterol-lowering drugs.

Peripheral nerve diseases, Peripheral nervous system diseases, Lipid metabolism disorders, Lipidosis

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A 56-year-old woman with abdominal pain, anemia, and a pelvic mass

Article Abstract:

A 56-year-old woman was diagnosed with granulosa-cell tumor of the ovary. These tumors consist of multiple cysts filled with blood or fluid and seldom spread to other body sites. She was admitted to a hospital with anemia, abdominal pain and a pelvic mass diagnosed at another hospital. Ultrasound and CT scans confirmed the mass and detected fluid around the liver. Exploratory laparotomy revealed a ruptured mass on the left ovary and blood in the abdominal cavity. Microscopic examination of cells taken from the ovary revealed that it was a granulosa-cell tumor that had ruptured. Her abdominal pain was most likely caused by the blood irritating her peritoneal tissue. Her uterus, Fallopian tubes and ovaries were removed and she was subsequently treated with cyclophosphamide, doxorubicin and cisplatin.

Ovarian tumors, Granulosa cell tumor

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