Middle-aged Patient Research Articles

Multimodality imaging of transient perivascular inflammation of carotid artery (TIPIC) syndrome: a case report

BackgroundTransient Perivascular Inflammation of Carotid artery syndrome is a rare clinicoradiological entity characterized by inflammation of the carotid artery wall with surrounding perivascular inflammatory changes. This is a self-limiting condition and necessitates awareness and high degree of suspicion to differentiate from other serious pathologies involving the carotid artery.Case presentationA middle aged asian male patient presented with acute onset of intense pain in the right lateral aspect of neck. Ultrasonography and Magnetic Resonance Imaging showed wall thickening of the common carotid artery and carotid bulb with surrounding inflammation in the perivascular soft tissues. He was treated with brief course of oral anti-inflammatory medications. The patient’s symptoms improved and imaging findings resolved in 2 weeks.ConclusionsBeing infrequently encountered in clinical practice, recognition of transient perivascular inflammation of carotid artery syndrome by the physician is of prime importance. Prompt radiological investigation and follow-up imaging are crucial for accurate diagnosis, thereby leading to appropriate treatment.

A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management.

Needle fracture during dental local anesthetic injections is a rare but significant, potentially serious complication. Various approaches for the location and removal of broken needles have been described; however, there are several difficulties and concerns related to the potential complications and critical anatomic challenges peculiar to the head and neck region. In this case, we describe the diagnostic approaches utilized in locating a broken needle that migrated in the pterygomandibular space following gag reflex, and sudden head movement of a middle-aged male patient. A meticulous diagnostic approach was employed to locate the needle utilizing CBCT scan, CT scan with contrast, and C-arm X-ray machine. The needle was successfully retrieved using an angled hemostat inserted through an oral incision, guided by a C-arm X-ray machine and ENT endoscopic instruments. While careful planning could prevent many complications that may arise during oral surgical procedures, inadvertent events leading to serious complications should be addressed using the appropriate and timely diagnostic techniques pre-and intra-operatively.

368. UNIPORTAL VATS MCKEOWN ESOPHAGECTOMY FOR LOWER THIRD ESOPHAGEAL SQUAMOUS CELL CANCER

Abstract https://wetransfer.com/downloads/bc83bc97967d74f093629397fd7b5ed720230505000919/8c1e7aa0e8a6b089152303025bfbfd7120230505000947/ff511d Background Minimally invasive esophagectomy has become the standard surgical procedure for the carcinoma esophagus worldwide. It is performed with multiport VATS or robotically. Uniport VATS technique has gained a recent popularity among thoracic surgeons for resecting lung cancers. Here we describe our technique of performing uniportal McKeown esophagectomy in semi prone position without using carbon dioxide. Methods The surgery was performed on a middle aged male patient who was diagnosed with a locally advanced squamous cell cancer of lower third of the esophagus. Multidisciplinary meeting planned three cycles of Docetaxel, cisplatin and 5 fluorouracil regimen and subsequent surgery was planned after patient had a partial response. Results The thoracic phase was performed by uniport VATS and abdominal phase was performed by standard multiport technique. Neck anastomosis was performed with linear stapler in side to side manner. Total time of the surgery was 280 minutes. Intraoperative and postoperative period was uneventful. Patient was discharged home on ninth postoperative day on oral diet. Conclusion Uniportal VATS McKeown Esophagectomy is a feasible and safe technique with all short term advantages of minimally invasive approach. The coaxial ergonomics together with the semi prone positioning, allows the best surgical maneuvering.

Comparison of serum lipoprotein(a) levels in young and middle-aged patients presenting for the first time with ST-elevation myocardial infarction: a single-centre study.

Lipoprotein(a) [Lp(a) ] is associated with coronary artery disease due to its atherogenic and thrombogenic nature. In this study, we aimed to compare the level of Lp(a) in young and middle-aged patients with ST-elevation myocardial infarction (STEMI). This retrospective study included 287 patients aged 20-65 years who presented to the emergency department for the first time due to STEMI. The patients were divided into two groups: 20-45 years (young group, n = 111) and 46-65 years (middle-aged group, n = 176). The groups were compared in terms of demographic characteristics, co-morbidities and laboratory findings. In the young group, smoking (99, 89.2% vs 130, 73.9%; p = 0.001), family history of coronary artery disease (75, 67.6% vs 80, 45.5; p < 0.001), serum Lp(a) level [38.1 ± 27.9 (93 ± 68) vs 23.5 ± 23.2 mg/dl (57 ± 56 nmol/l); p < 0.001], triglyceride level [219.1 ± 231.9 (2.48 ± 2.62) vs 170.2 ± 105.6 mg/dl (1.92 ± 1.19 mmol/l); p = 0.018), ejection fraction (52.4 ± 6.1 vs 47.2 ± 7.7%; p = 0.004) and single-vessel disease (83, 74.8% vs 110, 62.5%; p = 0.031) were higher than in the middle-aged group. In multivariable logistic regression analyses, family history (OR: 2.073, 95% CI: 1.210-3.549; p = 0.008), low high-density lipoprotin cholesterol level (OR: 1.032, 95% CI: 1.003-1.062; p = 0.029) and Lp(a) elevation (OR: 1.981, 95% CI: 1.871-3.991; p < 0.001) were possible independent risk factors for STEMI in young patients. Lp(a) level was found to be a higher and a possible independent risk factor in young patients who presented with STEMI for the first time, compared to the middle-aged patient group. Lp(a) is a highly atherogenic molecule and it has been associated with stroke, heart failure, aortic stenosis, as well as coronary artery disease. Measurement of Lp(a) levels may be recommended in young patients with high cardiovascular risk.

Angiolymphoid Hyperplasia with Eosinophilia of the External Auditory Canal.

Angiolymphoid hyperplasia with eosinophilia is a rare, benign, vaso-proliferative disease with a dense eosinophilic inflammatory infiltrate seen in the intradermal or subcutaneous region. It is also termed an epitheloid hemangioma, and it mostly affects females rather than males. It is seen as reddish to brown, fleshy, proliferative, papular, or nodular lesion affecting the head and neck region, most commonly the auricular and periauricular regions. The aetiology is unknown, but the most likely causes are trauma, infection, and hyperestrogenic condition like pregnancy or the use of oral contraceptive agents. It usually measures about 2-3cm in size. It should be differentiated from Kimura disease, which is characterized by chronic inflammation and large subcutaneous nodules in the head and neck region. Here is a rare case report of angiolymphoid hyperplasia in a middle-aged male patient involving the external auditory canal of the left ear.

Primary Biliary Cirrhosis Scenario of Libyan Patients in Tripoli University Hospital

Background and aims. Primary biliary cirrhosis (PBC) is an autoimmune, slowly progressive, cholestatic, liver disease characterized by a triad of chronic cholestasis, circulating anti-mitochondrial antibodies (AMA), and characteristic liver biopsy. A variant, called PBC-autoimmune hepatitis (AIH) overlap, is characterized by the above findings of PBC together with findings of elevated ALT, elevated Ig G, and ASMA. PBC is hypothesized to be related to environmental exposure in genetically vulnerable individuals. It typically occurs in middle-aged females. The aim of the current study is to describe the clinical and biochemical profile of adult Libyan Primary Biliary Cirrhotic patients. Method. This was a case series study conducted by reviewing the medical records of the 50 patients diagnosed as PBC and followed in gastro-enterology clinic in Tripoli university hospital during the study period. A relevant data obtained from the records in a preformed case sheet. Result. The total number of the diagnosed Primary Biliary Cirrhotic patients were 50 patients. All of them were females. Patient age during the study were from 35 to 65 years, about 90% of patients were symptomatic like gastrointestinal symptoms (jaundice in 100%, abdominal distention in 24%, and encephalopathy in 5 patients 10%), while, non- gastrointestinal symptoms like fatigue and weakness in 35 patients70%, skin disorders(pruritis) were diagnosed in 18 patients 36%), dyslipidemia in 15 patients 30%, and osteopenia in 7 patients 14%. Serological tests (AMA) was positive in ail patients and (ASMA) in 20% of patients, biochemical profile showed that Alkaline phosphatase was raised in all patients, while, 10 patients had raised AST and ALT 20%. Conclusion: middle-aged female patient with jaundice, fatigue and elevated alkaline phosphatase should be routinely undergoing serological testing (AMA) to check for primary biliary cirrhosis which should subsequently be verified by liver biopsy.

"All diseases are in some ways identical, but in some ways, they are specific". Clinical case

The discrepancy between the clinical performance and a specific disease is often encountered in clinical practice and is a rather life-threatening condition and raises many questions about the timely and, more importantly, correct differential diagnosis of the disease, as well as the optimal management and the choice of conservative and/ or surgical treatment. This publication raises issues of etiology for discussion and proposes for consideration the diagnosis and further management of multivessel coronary disease in a middle-aged patient without severe complaints and clinical performance. Timely surgery made it possible to prevent further irreversible consequences for the life and health of the patient.

"The best operation is the one that was not done". Case report

The combination of arterial and venous thrombosis is relatively rare in clinical practice, but it is a life-threatening condition and raises many questions for the clinician team about the optimal management and the choice of preferred conservative and/or surgical methods of treatment. The publication raises issues of etiology for discussion and suggests for consideration the management of combined thrombosis of the arterial and venous lower limb systems in a middle-aged patient without risk factors predisposing to thrombosis. The combination of optimal anticoagulant therapy, optimal terms and scope of conservative treatment and minimally invasive interventional arterial revascularization made it possible to restore viability and preserve the lower limb and its functional status in full without unfavorable consequences for the patient’s health.

"Hidden threat". Case report

Nervous system tumors are not the most common cancer in the population. However, the clinical manifestations of brain tumors (BTs) are very multifaceted and can mask a wide range of pathologies, which poses a difficult task for doctors to suspect a cancer and start treating the patient as soon as possible. An atypical clinical course of the BTs is described, which caused a rather long path to diagnosis in a middle-aged patient.

Management of mad honey intoxication with suspected anaphylaxis in Nepal: a case report.

The authors reported the case of a middle-aged male patient who presented with blurring of vision, passage of loose stools, vomiting, and profuse sweating after ingestion of honey. He also had a history of loss of consciousness. On presentation, he was hypotensive and tachypneic with cold, clammy extremities. His ECG showed sinus bradycardia. The authors made a diagnosis of mad honey intoxication with suspected anaphylaxis. The authors treated him with intravenous normal saline, epinephrine, and atropine. He again developed hypotension and bradycardia in a few hours, for which hydrocortisone was administered, following which his heart rate was normalized in 2h. Overall, the recovery time in our patient was 8h. The patient was counseled to avoid consuming mad honey and did well on his monthly follow-up. Our patient had signs and symptoms suggesting intoxication following ingestion of mad honey with suspicion of anaphylaxis. Similar to other reported cases, the patient had sinus bradycardia and hypotension. Epinephrine and atropine were administered to treat hypotension and bradycardia, respectively. Also, refractory hypotension was managed by intravenous hydrocortisone. Usually, atropine and saline infusion are sufficient to manage these cases, and simultaneous use of epinephrine and atropine should be avoided unless indicated. Our case highlighted the approach to diagnosing and treating mad honey intoxication with suspected anaphylaxis.

Coexistence of TSH-secreting adenoma and primary hypothyroidism: a case report and review of literature

BackgroundThyrotropin-secreting adenoma (TSHoma) is the least common type of pituitary adenoma, these patients often present with symptoms of hyperthyroidism. When TSHoma patients combined with autoimmune hypothyroidism, it is critically difficult to diagnose for the specific confusion in the results of thyroid function test.Case presentationOne middle-aged male patient was presented with a sellar tumor on cranial MRI for headache symptoms. After hospitalization, a significant increase in thyrotropin (TSH) was revealed by the endocrine tests, while free thyronine (FT3) and free thyroxine (FT4) decreased, and the diffuse destruction of thyroid gland was revealed by thyroid ultrasound. Based on the endocrine test results, the patient was diagnosed as autoimmune hypothyroidism. After the multidisciplinary discussion, the pituitary adenoma was removed by endoscopic transnasal surgery, until the tumor was completely excised, for which TSHoma was revealed by postoperative pathology. A significant decrease of TSH was revealed by the postoperative thyroid function tests, the treatment for autoimmune hypothyroidism was conducted. After 20 months of follow-up, the thyroid function of patient had been improved significantly.ConclusionWhen the thyroid function test results of patients with TSHoma are difficult to interpret, the possibility of combined primary thyroid disease should be considered. TSHoma combined with autoimmune hypothyroidism is rare, which is difficult to diagnose. The multidisciplinary collaborative treatment could help to improve the outcomes of treatment.

Case Study: A Heart Transplant Recipient with New, Severe Headache (P3-12.011)

<h3>Objective:</h3> To describe a case and raise awareness of tick-borne disease as an important cause of secondary headache in transplant recipients. <h3>Background:</h3> Tick-borne illness is an uncommon but important cause of secondary headache, especially within the transplant population. Organ transplant recipients have a 2.3-fold relative risk of death and of severe, systemic infection. Identification of risk factors for tick-borne disease is essential to reduce morbidity and mortality in this patient population. <h3>Design/Methods:</h3> Case Study <h3>Results:</h3> A middle-aged patient with history of a prior heart transplant was admitted with headache for four days. The pain was mild initially but soon worsened and was exacerbated by bright lights, coughing, and changes in head position. He had never experienced similar pain or migraine. Medications included daily sirolimus, tacrolimus, and prednisone. The patient lived in the rural Midwest. The patient was afebrile and other vital signs were stable. Exam was notable for positive Jolt accentuation and negative Kernig/Brudzinski signs and no noticeable rashes. He was oriented but was unable to spell the word “world” backwards. Otherwise, exam was normal. Lumbar puncture revealed clear CSF with 0 RBC/cumm, 0 Nucleated cells/cumm, Protein 57 mg/dL (H), Glucose 62 mg/dL (serum glucose 100 mg/dL). Bacterial/fungal cultures demonstrated no organisms on Cytospin gram staining. VZV, CMV, WNV, and HSV PCR analyses were sent. Other labs were significant for hyponatremia (132 mmol/L), leukopenia (1.9 K/cumm), microcytic anemia (Hgb 10.9 g/dL, MCV 74 fL), and thrombocytopenia (81 K/cumm). CT Head and MRI brain were normal. This patient’s CSF viral PCR studies returned negative. A qualitative blood PCR assay for <i>Ehrlichia chaffeensis, E. ewingii</i>, and <i>E. canis</i> returned positive. The patient received doxycycline for a 10-day course with improvement. <h3>Conclusions:</h3> Identification of tick-borne disease in patients with a history of chronic immune suppression is necessary to avoid complications related to this relatively uncommon cause of infection. <b>Disclosure:</b> Dr. Anderson has nothing to disclose. Mary Petrulis has nothing to disclose. Dr. Wu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Progentec. Dr. Wu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Wu has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuroimmunology. Dr. Wu has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Department of Justice.

Total Knee Arthroplasty (TKA): When Do the Risks of TKA Overcome the Benefits? Double Risk of Failure in Patients up to 65 Years Old.

The aim of this study was to document the survival rate in the middle-aged patient group up to 65 years old and to compare it with other age groups of patients undergoing total knee arthroplasty (TKA) for knee osteoarthritis (OA). The Register of Orthopaedic Prosthetic Implants (RIPO) regional registry was used to analyze the results of patients <80 years old affected by primary OA and treated with TKA from 2000 to 2019. The database was investigated according to the age group: younger than 50 years, 50-65 years, or 66-79 years, with the aim to estimate revision surgeries and implant survivorship. A total of 45,488 TKAs for primary OA were included in the analysis (M: 11,388; F: 27,846). The percentage of patients <65 years old increased from 13.5% to 24.8% between 2000 and 2019 (P < 0.0001). The survival analysis showed an overall influence of age on the implant revision rate (P < 0.0001), with an estimated survival rate of 78.7%, 89.4%, and 94.8% at 15 years in the 3 groups, respectively. Compared with the older-aged group, the relative risk of failure was 3.1 (95% confidence interval [CI] = 2.2-4.3; P < 0.001) higher in patients <50 years old and 1.8 (95% CI = 1.6-2.0; P < 0.001) higher in patients 50-65 years old. TKA use in the middle-aged patient population up to 65 years old increased significantly over time. These patients present a double risk of failure with respect to older patients. This is particularly important considering the increasing life expectancy and the emergence of new joint preserving strategies, which could postpone the need for TKA to an older age.

Cecal volvulus with intestinal malrotation: a rare cause of bowel obstruction

Introduction:Cecal volvulus is a rare cause of acute abdomen in adults. It accounts for less than 1% of intestinal obstructions and 25-30% of cases of colonic volvulus. Congenital intestinal malrotation is a complex disorder due to incomplete or faulty rotation and fixation of the gut during the fetal life.Cecal volvulus associated with intestinal malrotation is a very rare presentation. Over 16 cases were reported in the literature. Case report:A 44-year-old man with no medical history, presented to the emergency department with a 2-day history of abdominal pain and bloating. On clinical examination, the abdomen was distended and tympanic to percussion, with diffuse abdominal tenderness. Abdominal X-ray (standing) showed a distended large intestine with an airfluid colonic level. CT scan showed a markedly dilated cecum measuring up to 14 cm, which were located in the left hypochondrium. A “whirl sign” and a superior mesenteric pedicle swirl were also noted. Emergency surgery was performed. Intraoperative exploration revealed a cecal volvulus with a largely distended hypermobile cecum located in the left hypochondrium, with preischemic signs within its wall. All the small gut was right-sided and the large gut left-sided, suggestive of mesenterium commune and intestinal malrotation. A right hemicolectomy withileo-transverse anastomosis was done. The postoperative course was uneventful. The patient is on regular follow up and is doing well. Conclusion:We describe a rare case of surgical management of cecal volvulus associated with intestinal malrotation in a middle-aged patient with no medical history. This case highlights the importance of early diagnosis by physical examination and radiological findings to prevent serious complications. Emergent surgery was the key to this successful management and surgical resection could offer better results with lesser recurrence rate. Bangladesh Journal of Medical Science Vol. 22 No. 02 April’23 Page : 445-448

The Role of Anamnesis in Modern Ophthalmic Practice: a Clinical Case

Eyes’ dryness continues to be the most frequent complication after LASIK. As a rule, it disappear in the vast majority of patients during the first year after surgery. The conducted studies indicate that complaints of eyes’ dryness in the preoperative period significantly increase the risk of developing a severe form of dry eye syndrome in the postoperative period, especially in middle-aged women (45–59 years) and older. The clinical case presented in this article indicates the development of a severe form of dry eye syndrome after LASIK in a middle-aged patient receiving hormone replacement therapy for menopause, complaining of a feeling of dryness and discomfort in the eyes in the preoperative period, with intolerance to contact lenses and taking antidepressants in the absence of signs of severe dry eye in the preoperative period. Consequently, surgical intervention led to the development of the mentioned above condition. It is confirmed by the literature data indicating that the above factors can cause the development of a severe form of dry eye syndrome after LASIK. Taking into account the fact that tear production tests do not always correlate with the intensity of complaints of dryness, burning sensation, pain in the eyes, the most important component at the stage of deciding on the feasibility of refractive surgery in a particular patient is the collection of anamnesis and clinical picture. When preparing patients with a history of dry eye syndrome for refractive surgery, it is necessary to inform them that they have a significantly increased risk of developing dry eye syndrome. It may persist in the long-term postoperative period, and possibly go into a chronic form. Candidates for refractive surgery in the presence of complaints characteristic of dry eye syndrome can only be those patients who respond well to therapy aimed at relieving these symptoms in the preoperative period. Taking into account the multicomponent nature of pain in dry eye syndrome — nociceptive pain, which is formed at the stage of receptor irritation in the corneal tissue, and neuropathic pain that occurs with the participation of the peripheral and central nervous system, a comprehensive approach is needed in the treatment of dry eye syndrome.

Kidney Biopsy in a Patient with Cardiorenal Metabolic Syndrome—How to Interpret Histopathology

The components of Cardiorenal Metabolic Syndrome (CRMS) include central obesity, insulin resistance, hypertension, metabolic dyslipidemia, proteinuria, and/or reduced glomerular filtration rate. Kidney biopsy is rarely performed in patients with CRMS; histopathology findings include glomerulopathy, podocytopathy, mesangial expansion and proliferation, glomerular basement thickening, global and segmental sclerosis, interstitial fibrosis and tubular atrophy, and arterial sclerosis and hyalinosis. We report a case of CRMS with slow progression during 10 years of follow-up on chronic kidney disease (CKD). The middle-aged patient had central obesity, hypertension, dyslipidemia, cardiovascular disease, type 2 diabetes mellitus, proteinuria, and CKD stage G3b-G4. Kidney biopsy, performed 3 years after the first presentation, led to the diagnosis of chronic thrombotic microangiopathy (TMA) and complement-associated glomerulopathy. This was not compatible with the medical history and the course of the disease, and previous kidney biopsy review showed metabolic nephropathy with glomerulomegaly, global and segmental glomerulosclerosis, tubular atrophy and interstitial fibrosis, arteriosclerosis, and lipid embolus in the lumen of one artery, and found neither TMA features nor C3 deposition. The reported case demonstrates the importance of an accurate and thoughtful reading and interpretation of kidney biopsy, and stresses that disregarding medical history may potentially mislead and alter the understanding of the true cause of CKD.

Persistent Primitive Olfactory Artery Aneurysm

A middle-aged adult presented to the hospital with a high-grade aneurysmal subarachnoid hemorrhage. The patient was treated with endovascular coil embolization of a ruptured basilar tip aneurysm. Angiography demonstrated multiple other aneurysms, including type I persistent primitive olfactory artery aneurysm. After complete recovery and return to independence, the patient underwent elective treatment of the persistent primitive olfactory artery aneurysm with endovascular placement of a flow diversion stent. Persistent primitive olfactory artery is an extremely rare variant of the anterior cerebral artery with an incidence of 0.14% and a known increased risk of aneurysm formation.

Subacute thyroiditis presenting as simple acute headache was misdiagnosed as meningitis: case report and literature review

BackgroundThe relationship between headache and thyrotoxicosis has been occasionally mentioned in case reports, but there are few related reports. Thus, the relationship cannot be determined. Few cases of subacute thyroiditis (SAT) presenting as simple headache have been reported.Case presentationThis case report describes a middle-aged male patient who came to our hospital with acute headache for 10 days. He was initially misdiagnosed as meningitis due to headache, fever, and increased C-reactive protein. Routine antibacterial and antiviral therapy did not improve his symptoms. Blood test suggested thyrotoxicosis, and color ultrasound suggested SAT sonography. He was diagnosed with SAT. With the treatment of SAT, the headache was relieved after the thyrotoxicosis improved.ConclusionThis patient is the first detailed report of SAT presenting with simple headache, which is helpful for clinicians to differentiate and diagnose atypical SAT.

A Precipitant Less Appreciated: A Glance at Cases of Tuberculosis Manifesting with Guillain Barre Syndrome

Guillain-Barre syndrome (GBS) is an immune triggered inflammatory polyneuropathy precipitated by various triggers by means of cross reactivity and molecular mimicry. Tuberculosis (TB) of any organ, although may produce features of peripheral neuropathy, has rarely been associated with GBS. We describe a middle-aged female patient in whom pulmonary TB manifested with GBS primarily without any prominent constitutional symptoms and review the literature to strengthen our viewpoint in this regard. The treatment with immunomodulators is beneficial with good outcome and thus early diagnosis and intervention is suggested.

The cognitive consequences of the COVID-19 infection and behavioral variant frontotemporal dementia: Is there a link?

IntroductionFrontotemporal dementia behavioral variant (bvFTD) is the most common subtype of frontotemporal dementia, characterized by early and often severely disabling alterations in personality and social conduct that carry a huge impact on the patient, family, and society.ObjectivesThe aim of the study was to correlate the clinical data collected from our patient with relevant literature and discuss the diagnosis of bvFTD in the context of the COVID-19 pandemic.MethodsCase report and a systematic review of the literature.ResultsThe middle-aged female patient we examined presented an array of psychiatric symptoms, including cognitive, behavioral, and personality changes that emerged in two months after a mild form of SARS-CoV-2 infection. Objectively, a cranial CT scan displayed frontal and anterior temporal lobe atrophy. The rapid and severe decline of the patient’s mental faculties throughout the last year, along with the circumstances in which the pathology developed, raised a question about the etiological factors that contributed to this early-onset dementia.ConclusionsAlthough diagnostic criteria are useful, frontotemporal dementia may be difficult to differentiate from other conditions because there are no disease-specific biomarkers. Correlations between the COVID-19 infection and the fulminant bvFTD symptoms remain unclear and require further investigations.Disclosure of InterestNone Declared