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Case Report
- Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report
- Hari Priya Raghvan, Caroline Ho Siew Ling, Wee Shiang Yui, Boo Yang Liang, Ehram Jamian, Indhira Subbiah
- J Yeungnam Med Sci. 2025;42:17. Published online December 19, 2024
- DOI: https://doi.org/10.12701/jyms.2025.42.17
- 722 View
- 115 Download
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Abstract
PDF - Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse. A 46-year-old female with underlying CML in lymphoid blast crisis, previously treated with chemotherapy and tyrosine kinase inhibitors, presented with visual disturbances. Imaging and cerebrospinal fluid analysis confirmed leukemic infiltration of the CNS without evidence of a systemic disease. Isolated CNS involvement is an atypical complication of CML and presents significant therapeutic challenges owing to the blood-brain barrier, which limits the efficacy of systemic therapies. Subsequently, the patient was treated with intrathecal chemotherapy targeting the CNS. Despite aggressive treatment, CNS relapse remains a major concern due to the limited penetration of standard therapies into the CNS. This case underscores the importance of early recognition of CNS symptoms in CML patients, particularly in those with blast crisis, and highlights the need for tailored therapeutic strategies to manage this rare and challenging manifestation.
Review article
- Long-term management of Graves disease: a narrative review
- Hyo-Jeong Kim
- J Yeungnam Med Sci. 2023;40(1):12-22. Published online November 4, 2022
- DOI: https://doi.org/10.12701/jyms.2022.00444
- 13,889 View
- 507 Download
- 3 Web of Science
- 5 Crossref
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Abstract
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- Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient’s drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.
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Citations
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- A 30-year-old male patient who experienced recurring weakness in bilateral upper and lower extremities: a clinical vignette
Soo Hyun Ahn, Mathieu Boudier-Revéret, Seoyon Yang, Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 42: 27. CrossRef - Commentary: Azathioprine as an adjuvant therapy in severe Graves’ disease: a randomized controlled open-label clinical trial
Madhukar Mittal, Azher Rizvi
Frontiers in Endocrinology.2024;[Epub] CrossRef - Total Thyroidectomy – A Cost-effective Alternative to Anti-Thyroid Drugs in the Management of Grave's Disease
Erivelto Volpi, Leonardo M. Volpi
Clinical Thyroidology.2023; 35(5): 183. CrossRef - Evaluation of the Abbott Alinity i Thyroid-Stimulating Hormone Receptor Antibody (TRAb) Chemiluminescent Microparticle Immunoassay (CMIA)
Deborah J. W. Lee, Soon Kieng Phua, Yali Liang, Claire Chen, Tar-Choon Aw
Diagnostics.2023; 13(16): 2707. CrossRef - Mechanisms and Treatment Options for Hyperthyroid-Induced Osteoporosis: A Narrative Review
Robert M Branstetter, Rahib K Islam, Collin A Toups, Amanda N Parra, Zachary Lee, Shahab Ahmadzadeh, Giustino Varrassi, Sahar Shekoohi, Alan D Kaye
Cureus.2023;[Epub] CrossRef
- A 30-year-old male patient who experienced recurring weakness in bilateral upper and lower extremities: a clinical vignette
Case Report
- A Case reports of a Surgical Correctiona of the Mandibular Retrusion.
- Nan Hee Im, Jin Ho Park, Byung Rho Chin, Hee Kyung Lee
- Yeungnam Univ J Med. 1995;12(2):393-399. Published online December 31, 1995
- DOI: https://doi.org/10.12701/yujm.1995.12.2.393
- 1,859 View
- 1 Download
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Abstract
PDF
- Mandibular retrusion showing the facial problem with a marked maxillarry incisors protrusion and chin deficiency, resulting in a highly convex profile is uncommon in Korea.. The large incisor overjet and deep-bite create functional limitations and unpleasing esthetic result. The majority of theses cases are susceptible to correction by orthodontic therapeutic methods. But severe Class II retrognathic cases in which orthodontic treatment alone has not been capable of achieving good results. Orthognathic surgery offers several approaches. In this case, mandibular advancement by bilateral sagittal split ramus osteotomy and augmentation genioplasty has a special surgical problems. The suprahyoid muscle gorup are lengthened if the body of the mandible is surgically repositioned anteriorly. Instability of results and relapse return to original position shoud predicted during post-surgical muscular readjustment.. To maintain maximum correction with this technique, it is suggested that the mandibular body be well rotated forward at time of surgical intervention and overcorrected anteriory as much as possible. So, the authors report the case with review of concerned literature.
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