A 37-year-old patient with type 1 diabetes had been recently diagnosed with collagenous colitis (CC) after sigmoidoscopy. She rapidly progressed from a fortnight of watery diarrhoea, to a malabsorptive state with severe dehydration and acute kidney injury. This necessitated admission to an intensive care unit for emergency dialysis. She was subsequently diagnosed with collagenous enterocolitis affecting gastric, small bowel and colonic mucosa which required systemic steroid therapy. Physicians caring for patients with CC should be aware of the potential extreme manifestations of upper gastrointestinal collagenous deposition.
Headache is one of the most encountered presentations worldwide. Hence, the approach in which practitioners take in investigating, diagnosing and managing it is crucial given the high complication rates from secondary causes seen more commonly in the elderly population. We discuss a case of a patient with chronic headaches, features of occipital neuralgia and neck pain who was eventually diagnosed with Crowned Dens Syndrome (CDS). We intend to highlight this unique presentation of Calcium Pyrophosphate crystal deposition (CPPD) disease in the spine and the need to consider a broad range of differentials especially in an elderly individual presenting with headaches.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.