Clinics and Practice 2019-12-11T01:24:10+00:00 Francesca Baccino Open Journal Systems <p><strong>Clinics and Practice</strong>&nbsp;[ISSN 2039-7283] is a peer-reviewed, Open Access, online-only journal that publishes both&nbsp;<em>brief reports</em>&nbsp;and&nbsp;<em>case reports</em>&nbsp;in all areas of clinical medicine. Our journal would welcome any interesting description of patients, procedures and treatment in any condition or disease that can contribute to develop scientifically rigorous and clinically meaningful practice methods. <br><strong>Clinics and Practice</strong> aims at creating an innovative, rapid and collaborative background intended to help healthcare professionals finding the latest advances to answer the most pressing questions coming from the medicine/patients relationship.</p> Congenital methemoglobinemia: Rare presentation of cyanosis in newborns 2019-12-11T01:24:10+00:00 Ernestas Viršilas Lina Timukienė Arūnas Liubšys <p>Methemoglobin (MetHb) is an oxidized form on hemoglobin, which is unable to bind oxygen and consequently carry it to the tissues. Normally present in small quantities (&lt;1%) without detrimental effects, its elevation produces hypoxemia which can be profound and even lethal. Methemoglobinemia is an abnormal increase of MetHb (&gt;3%) of total hemoglobin. It can be classified in two types: hereditary and acquired. Acquired form is caused by exogenous oxidizing agents, such as nitrites or certain medications, while hereditary types of disease are the result of genetic deficiency in cytochrome B5 reductase, an enzyme responsible for MetHb reduction to hemoglobin. Little data is available on the epidemiology of methemoglobinemia. In general population only sporadic cases are described, while some isolated ethnic populations have increased incidence, possibly inherited from a common ancestor. We present a case of congenital methemoglobinemia in which detection of MetHb was hampered by faulty initial blood gas spectrometry results. A short literature review is also included.</p> 2019-11-05T12:18:46+00:00 ##submission.copyrightStatement## Primary Sjogren’s syndrome presenting as autoimmune cytopenia 2019-12-11T01:24:10+00:00 Durga Shankar Meena Gopal Krishana Bohra <p>Sjogren’s syndrome (SS) is a chronic systemic autoimmune disease, characterized by lymphocytic infiltration of lacrimal and salivary glands. Although extra glandular manifestations are uncommon, they can occur with the musculoskeletal, renal, pulmonary and hematological disease. We report the case of a 35-year-old woman presented to us with persistent unexplained bicytopenia (anemia and thrombocytopenia). Antinuclear antibody and direct Coombs test were positive. Anti-Ro/SSA and anti-La/SSB antibodies were also positive in high titer. The final diagnosis of primary SS with autoimmune cytopenia was made. Cytopenias in SS are rarely reported. Our case illustrates that clinically significant cytopenias may present as an extraglandular manifestation of SS.</p> 2019-11-06T12:15:20+00:00 ##submission.copyrightStatement## Mandibular neurofibroma: Case report of a rare tumor 2019-12-11T01:24:09+00:00 Ziad Sleiman Loubna Abboud Elie Mehanna Ramzi Mahmoud Elie Yaacoub Georges Ghanime <p>Neural tumors localized in jaw bone are relatively rare. This article presents a case of intraosseous neurofibroma of the mandible in a 37-year-old female patient. A review of clinical, radiographic, histological features and surgical management of the patient are discussed along with a review of the literature.</p> 2019-11-07T15:02:16+00:00 ##submission.copyrightStatement## Rapidly fatal encephalitis associated with atypical lymphoid proliferations of the basal ganglia subsequent to aneurysmal subarachnoid hemorrhage 2019-12-11T01:24:08+00:00 Ayesha Kar Evin L. Guilliams Joshua A. Cuoco Eric A. Marvin <p>Rapidly fatal encephalitis associated with atypical lymphoid proliferations after intracranial aneurysm rupture has not been reported. Here, we describe a 52-year-old female who presented to the emergency department with a severe headache. Imaging demonstrated aneurysmal subarachnoid hemorrhage due to a ruptured left posterior inferior cerebellar artery aneurysm, which was treated with endovascular embolization and subsequent external ventricular drain. She recovered without neurologic sequelae by day seven; however, five weeks later she represented with a severe headache associated with nausea and fever. Initial repeat imaging was unremarkable. She deteriorated quickly and was empirically treated for meningitis despite negative cerebrospinal fluid studies. Magnetic resonance imaging revealed diffuse cerebral edema within the basal ganglia and thalamus. Biopsy of the caudate nuclei revealed atypical lymphoid proliferations. She was treated accordingly with no significant improvement. This case highlights the necessity for a better understanding of the etiology, chronology, and natural history of atypical lymphoid proliferations.</p> 2019-11-11T12:44:17+00:00 ##submission.copyrightStatement##