Objective: To delineate the explore potential etiological contributions to subcutaneous panniculitis-like T-cell lymphoma (SPTCL) in adults with sickle cell disease. Sickle cell disease (SCD) is an inherited hematologic disorder where standard treatment may enhance risk of the development of rare comorbidities like SPTCL. Methods: We reviewed the scientific literature and only found one case report detailing the development of SPTCL in an adult with SCD. Results: We reviewed 1 case reports and the general literature on hematolymphoid disorders. We discovered that there are several potential mechanisms to explain SPTCL in SCD but no conclusive evidence to support either. We reported radiographic, serological, immune, and hematological finding from the previous case. Conclusions: SPTCL is a complex disorder with a likely multifactoral etiology. The development of the disease in adults with SCD is rare but possible as evidenced by a published case report. We advocate for additional attention to the intersection of these two diseases for the purpose of better understanding their etiology and epidemiology. More research is needed.

We report two cases of retroperitoneal fibrosis that emerged during a clinical course of moderate chronic kidney disease. In both cases, we observed an elevation in the serum CRP and IgG4 levels without an increase in the white blood cell count. The patients were treated with prednisolone. Their clinical conditions improved with a decrease in the serum IgG4 to total IgG ratio. The present cases suggest the importance of a differential diagnosis of retroperitoneal fibrosis in the medical care of chronic kidney disease patients, and we propose a useful biomarker for retroperitoneal fibrosis, which we suspect is associated with IgG4-related disease.

General MedicineVolume 16, Issue 1 p. 50-50 Error and CorrectionOpen Access Error and Correction This article corrects the following: Thanks to Reviewers—2014 Volume 15Issue 2General Medicine pages: 160-160 First Published online: December 24, 2014 First published: 27 March 2015 https://doi.org/10.14442/general.16.50About ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume16, Issue1March 2015Pages 50-50 RelatedInformation

Background: Japanese medical student education lacks emphasis on teaching clinical reasoning skills. To partially remedy this situation, we developed a prototypic web-based module for tutors to teach clinical reasoning. We report the medical students' opinions of this module. Methods: Twenty-four students from two Japanese medical universities were randomly assigned to the two tutored virtual classrooms, each classroom with six students, or to the self-study group, 12 students, after taking the Internet-based Sequential Question and Answer pretest. After four weeks, each of the 24 students took the Sequential Question and Answer posttest. The entire 24 students answered a questionnaire about the Sequential Question and Answer tests; all 12 tutored students answered a questionnaire about the web-based tutored module. Results: Although both tutored and self-study Sequential Question and Answer posttest scores increased, the increases of the tutored group's posttest compared to the self-study posttest group were not statistically significant (p = 0.066). Ninety-two percent of the students rated the Sequential Question and Answer tests as an improved way to learn case presentation and clinical reasoning. Moreover, 79% of students felt that the Sequential Question and Answer tests were an effective way to learn clinical information. The tutored students rated the web-based tutored seminars as an ‘excellent to fair’ method to learn clinical reasoning using a five-point ‘excellent to poor’ scale. Conclusions: We developed a prototypic web-based module for tutors to teach clinical reasoning to medical students. The students' opinion supported the modular components of the web-based seminar format, Sequential Question and Answer test, and the tutoring syllabus as an effective way to improve learning clinical reasoning, case presentation, and medical information. Students also suggested refinements of the prototypic module.

We report a case of a 75-year-old female, with a known history of Hashimoto's disease, who was admitted with anorexia, nausea and vomiting. Laboratory data revealed hyponatremia and hypothyroidism. Despite thyroid hormone replacement with synthetic thyroxine, the patient had persistent hyponatremia. Further investigations revealed secondary adrenal insufficiency but otherwise normal pituitary function, based on a rapid adrenocorticotrophic hormone (ACTH) test as part of a combined anterior pituitary stimulation test. She was diagnosed with isolated ACTH deficiency (IAD) with concomitant Hashimoto's disease. Adrenal insufficiency should be considered in patients with hypothyroidism and persistent hyponatremia. In patients with Hashimoto's disease who are found to have concomitant hypoadrenalism, IAD should also be suspected after primary adrenal insufficiency is ruled out.