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Calcium is vital for the heart's proper functioning, controlling its automaticity and excitation‐contraction coordination. When calcium enters myocardial fibers, it triggers the release of stored calcium, leading to increased intracellular levels. This, in turn, enables the interaction between actin and myosin, necessary for muscle contraction. Adequate calcium levels are crucial for optimal heart function. 16 Hypo‐calcemic cardiomyopathy presents with symptoms resembling heart failure, with most cases showing a reduced ejection fraction (EF), and a smaller proportion experiencing mid‐range or preserved EF. The common manifestations include diffuse LV hypokinesia and sporadic regional wall motion abnormalities. Additionally, patients may exhibit various arrhythmias, such as atrial fibrillation, ventricular tachycardia, and junctional tachycardia. 15 Here, we have reviewed 11 cases of DCM due to hypoparathyroidism to further investigate the relationship between calcium imbalance and its impact on cardiac function, as well as to examine its clinical presentation and manifestations. 1. A 38‐year‐old woman was admitted to the cardiology department due to severe and persistent shortness of breath (NYHA IV) 1 for 3 weeks and recurrent muscle cramps over the past 6 months. Her medical history was unremarkable, except for a total thyroidectomy 3 years ago. Upon administration, her vital sign was normal, and she was afebrile. The physical examination revealed left‐sided gallop sounds, distended jugular veins, and crackling rales in her lung bases. Echocardiography showed a dilated and weakened heart muscle (cardiomyopathy) with a reduced EF of 31.4% and increased filling pressure. Laboratory tests showed that the patient had low calcium levels (30 mg/L), decreased free T4 (2.39 pg/mL), and elevated TSH (8.48 μLU/mL). Other tests, including complete blood count, C‐reactive protein, blood glucose, creatinine, and blood ion levels, were within the normal range. After treating her calcium levels with calcium and vitamin D3, in addition to hormone replacement with Levothyroxine, significant improvement in the patient's cardiac symptoms was observed, resulting in the normalization of heart chamber sizes and Left ventricular ejection fraction (LVEF) after 3 months. 8 2. A 50‐year‐old female with hypoparathyroidism presented dyspnea (NYHA IV) and orthopnea 2 . The dyspnea was improved 5 days before admission. Upon examination, rales were detected, and the electrocardiogram (ECG) revealed a prolonged QT interval. Chest X‐ray showed prominent cardiomegaly with pulmonary congestion, and echocardiography indicated decreased LV function with an EF of 36.5%. Based on her signs and symptoms, she was treated with furosemide injection at first due to heart failure. Lab data demonstrated reduced calcium, magnesium, and ionized calcium levels and increase in phosphorus level. Moreover, intact‐PTH and vitamin D levels were reduced. Parathyroid infiltrating disease and autoimmune disease were role out. Further investigations were conducted to determine the cause of congestive heart failure. Laboratory tests revealed abnormally low levels of total serum calcium (3.7 mg/dL), magnesium (1.7 mg/dL), and ionized calcium (0.6 mmol/L), with elevated phosphorus and creatinine levels and her brain natriuretic peptide (BNP) level was significantly elevated at 1855.1 pg/mL. Hormone analysis showed normal free T4 and thyroid‐stimulating hormone levels but decreased intact parathyroid hormone (PTH‐intact) and vitamin D levels. There was no sign of stenotic lesions on coronary angiography and therefore the patient was diagnosed with DCM due to severe hypocalcemia and idiopathic hypoparathyroidism. She took intravenous calcium and oral vitamin D 3 and calcitriol during hospitalization. After discharge, she undertreated with oral calcium, vitamin D 3 , heart failure medications. Following treatment with intravenous calcium and oral vitamin D3 and calcitriol and normalizing the calcium levels, the patient's dyspnea significantly improved, and chest X‐ray showed reduced cardiomegaly and clearance of pulmonary edema, and the prolonged QT interval was shortened. Upon discharge, the patient continued with oral calcium, vitamin D3, and congestive heart failure medications. Follow‐up visits indicated gradual improvement in myocardial function, with the LVEF increasing to 46% within the first month and 51% by the third month. 9 3. A 37‐year‐old woman with a history of thyroidectomy carried out at the age of 18, presented with cardiac symptoms. The surgery resulted in her developing permanent hypoparathyroidism. She was prescribed calcium and vitamin D supplements in addition to heart failure treatments, which she irregularly adhered to without undergoing regular laboratory monitoring. These symptoms included cramps, facial spasms, and heart irregularities. On examination cardiomegaly and pulmonary congestion were observed, indicating strain on the heart. An echocardiogram revealed dilatation and dysfunction of the left ventricle, mitral and tricuspid insufficiency, and moderate pulmonary hypertension. She also suffered from dyspnea, epigastric pain, and rapid edema progression. The patient's calcium levels were measured at 2.9 mg/dL, parathyroid hormone at 5.9 ng/L (normal range: 10–73), magnesium at 1.08 mEq/L (normal range: 1.4–2.1), hematocrit at 26%, hemoglobin at 7.4 g/dL, total creatine kinase at 1260 U/L (normal range: <70) (with a 3% myocardial fraction), and TSH at 18.1 µU/mL. The diagnosis indicated congestive heart failure secondary to severe hypocalcemia, decompensated by thyroid hormone replacement and exacerbated by iron‐deficiency anemia. The administration of calcium supplements, alongside diuretics, captopril, and digoxin, resulted in a swift and noticeable clinical enhancement. Subsequent monitoring for 18 months revealed the continued presence of LV enlargement and systolic dysfunction, although improvements were observed in all other echocardiographic observations and her cardiac symptoms improved significantly. 10 4. A 70‐year‐old female presented to the emergency department with tonic‐clonic seizure. Her symptoms were paresthesia in her extremities for 2 months, altered sensorium for 1 month, exertional breathlessness, cough for 1 week, and three episodes of seizure 2 days before hospitalization. On the examination, Chvostek's sign, and Trousseau's sign were positive. The cardiovascular examination showed the presence of LV S3, while the respiratory examination revealed bilateral basal crepitations with rhonchi. Lab tests indicated significantly low serum calcium levels (3.4 mg/dL) and high serum phosphate levels (8.8 mg/dL), consistent with hypoparathyroidism. On her brain computed tomography scan, bilateral symmetrical calcification in the basal ganglia and dentate nucleus due to chronic hypoparathyroidism was revealed. The echocardiogram revealed severe DCM with congestive cardiac failure, characterized by LV systolic and diastolic dysfunction and an EF of 25%. Additionally, the patient's QT interval was prolonged (0.55 s), and she had mild mitral regurgitation, mild aortic regurgitation, and trivial tricuspid regurgitation. The final diagnosis was idiopathic hypoparathyroidism, severe hypocalcemia, and DCM with congestive cardiac failure. Treatment involved intravenous calcium gluconate and oral vitamin D 3 , and antiepileptic leading to remarkable improvement in the patient's condition in 2 weeks after normalization of calcium level. 11 5. A 68‐year‐old woman presented to the emergency department due to intermittent dyspnea. She had recently undergone a subtotal thyroidectomy and was prescribed calcium supplementation. During the physical examination, she exhibited tachycardia and tachypnea. Chest radiography revealed bilateral pleural effusion, which was determined to be a transudate following aspiration. Blood tests indicated certain abnormalities: she had hypocalcemia (low calcium levels) at 1.15 mmol/L, high serum phosphate levels at 2.89 mmol/L, and a low PTH level, measuring less than 0.5 pmol/L. Additionally, transthoracic echocardiography (TTE) displayed dilation of the left ventricle and severe dysfunction, with an EF of only 15%, alongside moderate mitral and tricuspid regurgitation. The treatment included a β‐blocker, ACE inhibitor, spironolactone, calcium, and vitamin D. Within 2 weeks, electrolyte levels normalized, and the pleural effusion resolved. The EF improved to 35% after 3 weeks and 50% after 1 year. 5 6. A 59‐year‐old woman presented at the cardiology outpatient clinic due to progressive exertional dyspnea and ankle edema. During the physical examination, a systolic murmur was detected, and NT‐pro‐BNP level unexpectedly was elevated. On her second visit to outpatient clinic, she had seizure and her brain CT scan revealed extensive calcifications in the basal ganglia. TTE revealed ventricular dilation with an estimated EF of 39%, along with moderate mitral regurgitation and severe tricuspid regurgitation. The ECG showed sinus rhythm with a leftward axis, a prolonged QTc interval of 533 ms, and ST depression in V4–V6. Laboratory tests indicated low plasma calcium levels (1.24 mmol/L) and elevated phosphate levels (2.5 mmol/L). The PTH level was undetectable (<0.6 pmol/L). Upon further investigation into the patient's history, it was discovered that she had been experiencing progressive muscle spasms and constipation for a few weeks. Ultimately, she received a diagnosis of hypocalcemia resulting from primary hypoparathyroidism. She suffered from DCM with congestive heart failure due to primary hypoparathyroidism. The patient received treatment consisting of vitamin D and intravenous and oral calcium supplementation. Within a week after achieving normal calcium levels, TTE revealed a notable improvement in the LV function. 5 7. A 40‐year‐old woman with no cardiovascular history presented at the emergency care unit with symptoms including syncope, progressive exertional dyspnea, and paroxysmal nocturnal dyspnea. She had previously undergone thyroidectomy for Graves' disease and had type 1 diabetes mellitus. Physical examination revealed murmurs, gallop rhythm, peripheral edema, and lung stasis. The chest X‐ray demonstrated pulmonary stasis with hilum enlargement. The patient's ECG showed sinus tachycardia with a prolonged QT interval along with negative T waves from V1 to V4. Echocardiography revealed dilated left chambers and severe global systolic dysfunction of the left ventricle (LVEF = 15%) due to diffuse hypokinesia. Restrictive diastolic dysfunction with elevated filling pressure indexes, along with moderate functional mitral and tricuspid regurgitation and moderate pulmonary hypertension, were also observed. Angio coronarography ruled out atherosclerotic lesions. Laboratory blood tests indicated severe hypocalcemia, with a total serum calcium level of 3.6 mg/dL. Other lab findings were demonstrated high blood sugar, elevated TSH and NT‐pro‐BNP levels. Further assessment involving parathormone testing, phosphoric, and other related examinations confirmed a diagnosis of severe primary hypoparathyroidism. At first, she treated with ACE inhibitor, beta‐blocker, anti‐aldosterone diuretic, insulin, atorvastatin, and levothyroxine. During hospitalization, she exhibited hypocalcemia signs such as Chvostek, Weiss, Trousseau positive. The brain CT‐scan revealed calcifications of the basal ganglia. She took gluconic calcium at first and then was treated with oral lactic calcium and calcitriol. The patient received calcium treatment, both parenteral and oral, which led to improved clinical and serological outcomes. After 1 month, the patient was discharged with significant improvement in cardiac symptoms and LVEF. One year later, the patient remained on medication, experiencing only dyspnea during intense efforts, with normal calcium and vitamin D levels. Follow‐up cardiac tests showed normal results. 12 8. A 29‐year‐old woman was admitted to our hospital presenting with congestive heart failure characterized by severe dyspnea (NYHA class IV) and generalized edema that had persisted for 2 days. She had a history of undergoing a total thyroidectomy 1 year prior and was prescribed daily Levothyroxine medication along with calcium supplementation and vitamin D due to her hypoparathyroidism although she did not consistently adhere to her treatment. During the physical examination, her blood pressure was measured at 90/60 mmHg. The chest examination revealed crackling sounds in both lung areas, a 3/6 systolic murmur at the apex of her heart, and a galloping rhythm (S3). A chest X‐ray displayed an enlarged heart with fluid accumulation in the lungs. The ECG showed signs of sinus tachycardia, an extended QT interval, and negative T‐waves in specific leads. Laboratory tests indicated that her corrected calcium levels were as low as 3.2 mg/dL (normal range: 8.5–10.5 mg/dL), and her ionized calcium was 0.36 mmol/L (normal range: 0.85–1.05). Her BNP levels were elevated at 580 pg/mL (normal range: 100 pg/mL) and her intact parathyroid hormone (PTH‐I) levels were low at 10.50 pg/mL (normal range: 16–68 pg/mL). TTE revealed a dilated left ventricle with global hypokinesia and a reduced LVEF of 28%, in addition to moderate mitral regurgitation. Treatment began with dobutamine, furosemide, calcium, and vitamin D3, and an angiotensin‐converting enzyme inhibitor (ACEI) and beta‐blockers. Following the correction of the hypocalcemia, a significant improvement in the patient's clinical condition was observed, and after 5 months of treatment, the patient's condition significantly improved. A follow‐up chest X‐ray displayed normal results (no enlarged heart or signs of lung congestion) and Echocardiography revealed a normal‐sized LV with a healthy ejection function (ranging from 28% to 63%). 13 9. A 44‐year‐old man was referred to the hospital due to resistant congestive heart failure accompanied by dyspnea and lower limb edema, despite receiving optimal treatment. The patient had no previous medical history. Upon admission, the physical examination revealed a blood pressure of 90/50 mmHg, tachycardia (heart rate of 118 bpm), tachypnea with orthopnea, crackling lung sounds extending to the upper lung regions, and bilateral lower limb swelling. The ECG showed a sinus rhythm with inverted T waves in the precordial leads. Chest X‐ray findings indicated an enlarged heart with increased vascularity in two lung fields. Laboratory tests revealed corrected calcium levels of 4.5 mg/dL (normal range: 8.5–10.5 mg/dL), ionized calcium at 0.43 mmol/L (normal range: 0.85–1.05) and Hormone assays showed low PTH‐I levels at 8.50 pg/mL (normal range: 16–68 pg/mL). TEE revealed DCM with a significant impairment in LV systolic function (25%). The diagnosis established was DCM caused by hypocalcemia due to primary hypoparathyroidism. Treatment involved oral calcium, vitamin D, ACE inhibitors, and beta‐blockers (bisoprolol). After 5 months, a full recovery of the cardiomyopathy was observed, and the patient became symptom‐free (with no edema or dyspnea). Follow‐up chest X‐rays showed normal results, and ETT revealed a normal‐sized left ventricle with a normal EF (ranging from 25% to 60%). 13 10. A 60‐year‐old male was admitted to the hospital with severe pulmonary congestion, recurrent pulmonary edema, and pleural effusion. He had a history of primary DCM and received an implantable cardioverter‐defibrillator. However, his condition did not respond to standard heart failure treatment. Laboratory tests revealed low blood calcium levels, high phosphate levels, and decreased PTH activity. Elevated levels of creatine phosphokinase (CPK) and BNP were observed. ECG showed a prolonged corrected QT interval (QTc). Echocardiography confirmed left ventricle dilatation, reduced EF of 20%, and extremely decreased global longitudinal strain (GLS). The patient had a previous subtotal thyroidectomy 36 years ago. Treatment with calcium and vitamin D supplementation led to a significant improvement in symptoms and cardiac function. The patient was discharged after 4 weeks and showed continued improvement during the follow‐up. 14 11. A 26‐year‐old woman was diagnosed with hypoparathyroidism, characterized by symptoms of paresthesia and upper limb convulsions. Despite the diagnosis, she did not adhere to prescribed medication or medical check‐ups due to limited intelligence. Approximately 1 year after the diagnosis, she was admitted to the hospital with acute shortness of breath. Physical examination revealed a short stature, malnourished appearance, and severe tooth decay. Blood pressure was low, and the heart rate was regular. ECG showed a prolonged QT interval. Echocardiography revealed a dilated left ventricle with severely reduced EF (25%) due to diffuse hypokinesia and impaired diastolic function. Cardiac magnetic resonance did not reveal any signs of myocardial inflammation or replacement fibrosis. Laboratory tests indicated high NT‐pro‐BNP level, advanced hypocalcemia, hypomagnesemia, and hyperphosphatemia, along with signs of renal and liver dysfunction. The diagnosis of acute heart failure due to hypo‐calcemia associated with untreated hypoparathyroidism was made. Treatment included heart failure therapy, calcitriol administration, and calcium and magnesium supplementation. Upon discharge, the patient was asymptomatic, and blood ion levels had normalized. Nevertheless, a year after being discharged, there was a recurrence of low calcium and magnesium levels, and the patient's heart function worsened because she failed to adhere to treatment. The outlook for her long‐term health remains unclear. 15 12. A 74‐year‐old man with a history of arterial hypertension, stage 3 chronic kidney disease, prostate cancer treated with curative radiation in 2013, and a complete thyroidectomy for goiter in 2009 are among his past medical conditions. He was not given any treatment despite having low plasma calcium levels in 2014. He was hospitalized in June 2017 due to dyspnea. Upon workup, DCM with an EF of 44%, hyperphosphatemia, and hypocalcemia were found. Due to primary hypoparathyroidism, he was diagnosed with hypo‐calcemic DCM. The patient was started on heart failure medicine and calcium supplements; however, the patient did not comply with the treatment plan. He was admitted to the hospital several times in the following months due to decompensation of heart failure. His EF dropped to 26% in June 2018, and he experienced acute renal damage that necessitated hemodialysis. Lab tests revealed new hypomagnesaemia, hyperphosphatemia, and increasing hypocalcemia. The hypoparathyroidism treatment was resumed, and results improved. In September 2018, during the 3‐month follow‐up, he reported taking his medicine as prescribed. His EF increased to 52%, and his calcium and phosphorus levels had returned to normal. 15
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PMC10766877
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https://doi.org/10.1002/hsr2.1796
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[
"calcium",
"heart",
"failure",
"hypoparathyroidism",
"vitamin",
"dyspnea",
"range",
"hypocalcemia",
"blood",
"function"
] |
[
{
"code": "5B5K.1Z",
"title": "Calcium deficiency, unspecified"
},
{
"code": "5B91.0",
"title": "Hypercalcaemia"
},
{
"code": "5B5K.1Y",
"title": "Other specified calcium deficiency"
},
{
"code": "5C64.5",
"title": "Disorders of calcium metabolism"
},
{
"code": "FB40.Y",
"title": "Other specified tenosynovitis"
},
{
"code": "BE2Y",
"title": "Other specified diseases of the circulatory system"
},
{
"code": "BC4Z",
"title": "Diseases of the myocardium or cardiac chambers, unspecified"
},
{
"code": "BD1Z",
"title": "Heart failure, unspecified"
},
{
"code": "LA8Z",
"title": "Structural developmental anomaly of heart or great vessels, unspecified"
},
{
"code": "BA41.Z",
"title": "Acute myocardial infarction, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[5B5K.1Z] Calcium deficiency, unspecified
Also known as: Calcium deficiency, unspecified | Calcium deficiency | hypocalcaemia NOS | disturbance of calcium absorption | disorder of calcium absorption
[5B91.0] Hypercalcaemia
Definition: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused by dehydration secondary to urinary losses of calcium, water and other electrolytes, and to an increase in membrane potential caused by the elevation in extracellular fluid ionized calcium concentration. Patients with moderate to severe hypercalcaemia often complain of nausea and vomiting, symptoms
Also known as: Hypercalcaemia | Calcium excess | elevated serum calcium | hypercalcaemic crisis | hypercalcaemic syndrome
[5B5K.1Y] Other specified calcium deficiency
Also known as: Other specified calcium deficiency | Dietary hypocalcaemia | dietary calcium deficiency
[5C64.5] Disorders of calcium metabolism
Definition: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important consequences for health.
Also known as: Disorders of calcium metabolism | Calcinosis | general calcification | heterotopic calcification | metastatic calcification
Excludes: Hyperparathyroidism | Chondrocalcinosis
[FB40.Y] Other specified tenosynovitis
Also known as: Other specified tenosynovitis | Other tenosynovitis or tendinitis | synovitis NOS | Bicipital tendinitis | biceps tendinitis
[BE2Y] Other specified diseases of the circulatory system
Also known as: Other specified diseases of the circulatory system | Certain specified forms of heart disease | Cardiac disorder, unspecified | disorder of heart NOS | organic disease or disorder of heart
[BC4Z] Diseases of the myocardium or cardiac chambers, unspecified
Also known as: Diseases of the myocardium or cardiac chambers, unspecified | Heart disease NOS | cardiac disease NOS
[BD1Z] Heart failure, unspecified
Also known as: Heart failure, unspecified | myocardial failure | cardiac decompensation | cardiac failure | cardiac failure NOS
[LA8Z] Structural developmental anomaly of heart or great vessels, unspecified
Also known as: Structural developmental anomaly of heart or great vessels, unspecified | Heart malformations | Cardiac malformations | congenital anomaly of heart | congenital heart disease
[BA41.Z] Acute myocardial infarction, unspecified
Also known as: Acute myocardial infarction, unspecified | Acute myocardial infarction | cardiac attack | heart attack | acute cardiac infarction
=== GRAPH WALKS ===
--- Walk 1 ---
[5B5K.1Z] Calcium deficiency, unspecified
--PARENT--> [5B5K.1] Calcium deficiency
Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...
--CHILD--> [5B5K.1Z] Calcium deficiency, unspecified
--- Walk 2 ---
[5B5K.1Z] Calcium deficiency, unspecified
--PARENT--> [5B5K.1] Calcium deficiency
Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...
--EXCLUDES--> [?] Disorders of calcium metabolism
Def: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important ...
--- Walk 3 ---
[5B91.0] Hypercalcaemia
Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...
--RELATED_TO--> [?] Myopathy due to hypercalcaemia
--PARENT--> [?] Hypercalcaemia
Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...
--- Walk 4 ---
[5B91.0] Hypercalcaemia
Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...
--RELATED_TO--> [?] Myopathy due to hypercalcaemia
--PARENT--> [?] Neurological disorders due to an excess of micro or macro nutrients
--- Walk 5 ---
[5B5K.1Y] Other specified calcium deficiency
--PARENT--> [5B5K.1] Calcium deficiency
Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...
--RELATED_TO--> [?] Myopathy due to calcium deficiency
--- Walk 6 ---
[5B5K.1Y] Other specified calcium deficiency
--PARENT--> [5B5K.1] Calcium deficiency
Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...
--RELATED_TO--> [?] Neonatal osteopenia
Def: Metabolic bone disease is a common complication in very low birthweight (VLBW) preterm infants. The smallest, sickest infants are at greatest risk. Progressive osteopenia with demineralized bones and,...
|
[
"[5B5K.1Z] Calcium deficiency, unspecified\n --PARENT--> [5B5K.1] Calcium deficiency\n Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...\n --CHILD--> [5B5K.1Z] Calcium deficiency, unspecified",
"[5B5K.1Z] Calcium deficiency, unspecified\n --PARENT--> [5B5K.1] Calcium deficiency\n Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...\n --EXCLUDES--> [?] Disorders of calcium metabolism\n Def: This refers to disorders in the mechanism by which the body maintains adequate calcium levels. Derangements of this mechanism lead to hypercalcaemia or hypocalcaemia, both of which can have important ...",
"[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...",
"[5B91.0] Hypercalcaemia\n Def: Hypercalcaemia is a condition caused by increased calcium levels. The higher the calcium levels and the faster its level rises, the more severe will be the symptoms. When present, symptoms are caused ...\n --RELATED_TO--> [?] Myopathy due to hypercalcaemia\n --PARENT--> [?] Neurological disorders due to an excess of micro or macro nutrients",
"[5B5K.1Y] Other specified calcium deficiency\n --PARENT--> [5B5K.1] Calcium deficiency\n Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...\n --RELATED_TO--> [?] Myopathy due to calcium deficiency",
"[5B5K.1Y] Other specified calcium deficiency\n --PARENT--> [5B5K.1] Calcium deficiency\n Def: Hypocalcaemia is defined as a total serum calcium concentration of less than 8.4 mg/dl (2.1 mmol/litre) or an ionized calcium concentration of less than 4.48 mg/dl (1.12 mmol/litre). There are numerou...\n --RELATED_TO--> [?] Neonatal osteopenia\n Def: Metabolic bone disease is a common complication in very low birthweight (VLBW) preterm infants. The smallest, sickest infants are at greatest risk. Progressive osteopenia with demineralized bones and,..."
] |
5B5K.1Z
|
Calcium deficiency, unspecified
|
[
{
"from_icd11": "5B5K.1Z",
"icd10_code": "E58",
"icd10_title": "Dietary calcium deficiency"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8352",
"icd10_title": "Hypercalcemia"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8351",
"icd10_title": "Hypocalcemia"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8359",
"icd10_title": "Other disorders of calcium metabolism"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E8350",
"icd10_title": "Unspecified disorder of calcium metabolism"
},
{
"from_icd11": "5C64.5",
"icd10_code": "E835",
"icd10_title": "Disorders of calcium metabolism"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I5181",
"icd10_title": "Takotsubo syndrome"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I5189",
"icd10_title": "Other ill-defined heart diseases"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I519",
"icd10_title": "Heart disease, unspecified"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I510",
"icd10_title": "Cardiac septal defect, acquired"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I515",
"icd10_title": "Myocardial degeneration"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I51",
"icd10_title": "Complications and ill-defined descriptions of heart disease"
},
{
"from_icd11": "BC4Z",
"icd10_code": "I516",
"icd10_title": ""
},
{
"from_icd11": "BC4Z",
"icd10_code": "I518",
"icd10_title": "Other ill-defined heart diseases"
},
{
"from_icd11": "BD1Z",
"icd10_code": "I5023",
"icd10_title": "Acute on chronic systolic (congestive) heart failure"
}
] |
E58
|
Dietary calcium deficiency
|
Table 1 Cases of aHUS and comorbid CACs treated with eculizumab Publication Case description and treatment Outcomes Pregnancy complications Ardissino et al. 26-year-old female, diagnosed 2 years prior with aHUS, presented at week 17 of gestation with severe hypertension; laboratory values indicated active TMA (low platelets, elevated LDH, 6 % schistocytes) She received 29 PEs over 6 weeks and condition improved, but at 26 weeks of gestation, her platelet count declined despite additional PE; hematologic investigations indicated complement dysregulation Genetic testing results indicated a homozygous CFH mutation She received 1 dose of 900 mg IV eculizumab, a second dose 1 week later, and continuous dosing every 2 weeks until delivery Her condition and laboratory values began to normalize 1 day after the first dose of eculizumab Her pregnancy proceeded uneventfully and she delivered a healthy newborn Carr et al. 20-year-old female, 7 days post-cesarean delivery, presented with bilateral lower extremity edema, malaise, and bruising Patient had low hemoglobin and platelets, elevated serum creatinine and LDH, 2 + schistocytes, ADAMTS13 100 % Kidney biopsy revealed TMA and acute tubular necrosis PE and prednisone treatment were initiated; after 7 days, she had a partial hematologic response but her renal condition worsened Hemodialysis was initiated and a diagnosis of aHUS made; genetic testing results indicated a mutant allele in the CFH gene Eculizumab was initiated Her hematologic condition normalized after 2 weeks and hemodialysis terminated after 6 weeks, renal function normalized after 12 weeks Patient discontinued eculizumab after 9 months Presented 6 months later with similar symptoms at initial presentation She required hemodialysis and eculizumab was restarted Her condition improved and hemodialysis was discontinued 3 weeks after restarting eculizumab Delmas et al. 26-year-old female admitted 1 week after first delivery with elevated serum creatinine and LDH levels, low platelets and hemoglobin, 9 % schistocytes Family history of aHUS and genetic testing indicated heterozygous mutations in CFH and CFI genes PE was initiated with some improvement in hematologic but not renal condition; hemodialysis was initiated 3 days after admission, she received 900 mg eculizumab and received a second dose 1 week later; daily PE was reinitiated without supplemental eculizumab 39 days after admission, eculizumab was resumed due to decreasing platelets Eculizumab was administered whenever the CAE assay value was >0.5 U/mL (<0.5 U/mL correlates to total complement blockade) Eculizumab was tapered from 18 months post-admission She had no signs of aHUS at follow-up 2 months after interrupting eculizumab First reported case of post-partum aHUS treated with eculizumab Zschiedrich et al. 31-year-old female admitted 3 days after delivery with hypertension, thrombocytopenia, delirium, acute oliguric renal failure; hematology indicated intravascular hemolysis and schistocytes Patient received PE, prednisone, and hemodialysis After 18 days with 27 PE and 9 dialysis sessions, her platelets remained low and serum creatinine elevated Eculizumab was initiated and genetic testing identified a novel mutation in CFI She had full clinical resolution of TMA and favorable renal outcome with eculizumab Canigral et al. 32-year-old female developed severe bleeding after cesarean delivery that required hysterectomy Laboratory findings included anemia with schistocytes, low platelet count, and elevated serum creatinine, LDH, and urea levels No response to PE and steroids; ADAMTS13 activity level was normal Following diagnosis of aHUS, eculizumab was initiated Clinical signs improved in first week Creatinine normalized after 2 doses of maintenance eculizumab treatment Eculizumab was discontinued after 6 months and no signs of aHUS were observed 1 year after diagnosis Mussoni et al. 26-year-old female with strong family history of aHUS Diagnosed with aHUS and homozygous CFH mutation During first pregnancy, developed hypertension, hemolysis, proteinuria at approximately 12 weeks’ gestation; 1 month later, her clinical condition worsened (platelet count, 83 × 10 9 /L; LDH level, 380 U/L; hemoglobin level, 11.1 g/dL; proteinuria) Resolution of hemolytic parameters with PE but the patient could not discontinue without worsening of hemolysis, although renal function was normal Eculizumab was initiated Normalization of hematologic abnormalities and reduction in proteinuria after 5 days of treatment Eculizumab was well tolerated without side effects Healthy newborn delivered via cesarean section at 38 weeks’ gestation Patient continued eculizumab therapy during and following pregnancy with no additional TMA De Souza Amorim et al. 41-year-old female admitted 4 days after childbirth for edema, asthenia, and severe hypertension Laboratory tests revealed thrombocytopenia, hemolytic anemia, and renal impairment; dialysis was initiated After differential diagnosis, aHUS was diagnosed and daily PE was initiated on day 7; the patient had hematologic normalization but no renal improvement Eculizumab was initiated on day 12, and PE was discontinued Patient determined to be homozygous carrier for CFH and MCP risk haplotypes After 4 days on therapy, renal function improved and dialysis was discontinued Eculizumab was discontinued after 11 months and the patient has had good outcomes after 1 additional year of follow-up Saad et al. 19-year-old required labor induction at 39 weeks’ gestation, and was diagnosed with preeclampsia She had an uncomplicated delivery but developed signs of suspected HELLP syndrome on postpartum day 1 Laboratory findings (thrombocytopenia, hemolytic anemia, renal impairment) indicated TMA and the patient initiated PE After ADAMTS13 activity level was determined to be normal, aHUS was presumed and PE was discontinued The patient initiated eculizumab and an MCP mutation was later identified Eculizumab was well tolerated and the patient had no additional signs of TMA Tsai et al. 20-year-old female with hypertension at 35 weeks’ gestation (second pregnancy) and history of gestational hypertension during first pregnancy 3 days after cesarean delivery, patient developed anasarca, confusion, seizures, and posterior reversible encephalopathy syndrome Laboratory tests revealed thrombocytopenia, hemolytic anemia, and renal impairment, which resolved over 5 weeks of daily PE; labetalol and nifedipine were required for hypertension control The patient’s third pregnancy at age 22 was also associated with hypertension, signs of TMA, and visual scotomas; her visual signs persisted following urgent delivery via induction aHUS with biopsy-proven TMA was diagnosed after rule out of TTP, and eculizumab was initiated Later, a CFH mutation was identified With complement inhibition, the patient’s thrombocytopenia and symptoms resolved within 3 days Renal function normalized over 3 months Hypertension/malignant hypertension Al-Akash et al. Male patient with history of aHUS and renal transplantation underwent second and third transplantations at 8 and 15 years of age due to TMA and allograft dysfunction Approximately 8 weeks post-transplant, the patient experienced an influenza infection, hypertension, fluid retention, and signs of TMA (thrombocytopenia and increasing LDH level) confirmed by renal biopsy Patient initiated PE and then initiated eculizumab therapy On eculizumab, biopsies 6 and 13 months post-transplant showed improvement in TMA; clinical signs and symptoms also normalized BP was managed with only 1 antihypertensive Garjau et al. 44-year-old male with diarrhea, fever, and anuria; clinical and laboratory evaluation revealed BP of 220/150 mmHg, hemolytic anemia, abnormal LDH, and acute renal failure Patient began receiving PE/PI and dialysis Negative stool test for Shiga toxin and 57 % ADAMTS13 activity ruled out STEC-HUS and TTP, respectively; diagnosis of aHUS was confirmed with the discovery of an MCP mutation Renal biopsy confirmed TMA After initiation of eculizumab, the patient had recovery of renal function and hematologic parameters; dialysis was discontinued BP was improved, although antihypertensives were still required Biopsy confirmed resolution of TMA Besbas et al. 3-day-old male infant with jaundice; developed macroscopic hematuria, severe hypertension (150/90 mmHg), thrombocytopenia, hemolytic anemia, increased LDH and serum creatinine levels, hematuria, and proteinuria CFH mutation confirmed diagnosis of aHUS PE/PI was initiated; hemodialysis was also required to stabilize renal function Patient experienced additional TMA manifestations at 1, 3 and 6 months of age, required increased use of PE/PI and dialysis; life-threatening hypertension required 5 antihypertensive agents After initiation of eculizumab, patient had rapid recovery of hematologic parameters, renal function, and BP Sajan et al. 24-year-old male with 5-day history of nausea, vomiting, and mild diarrhea Physical examination revealed pulse rate of 95 beats per minute, BP of 156/96 mmHg, and appearance of mild dehydration; laboratory findings included thrombocytopenia, hemolytic anemia, and increased serum creatinine level; renal biopsy revealed evidence of TMA aHUS was diagnosed and the patient initiated PE; hemodialysis was required beginning on day 3 for worsening renal function and ongoing TMA Eculizumab was initiated and PE was discontinued on day 6; dialysis was discontinued at week 3 Hypertension was managed with a single antihypertensive; on day 58 the patient experienced accelerated hypertension and generalized tonic-clonic seizures; MRI revealed posterior reversible encephalopathy syndrome, which was managed with antiepileptics and antihypertensives On eculizumab and 3 antihypertensives, the patient has had no further TMA manifestations, seizures, or hypertensive crises Ohta et al. Severely ill 4-month-old male with fever and vomiting; laboratory testing revealed schistocytes, thrombocytopenia, elevated LDH, creatinine, and urea Diagnosis of aHUS made based on negative STEC test and 72 % ADAMTS13 activity Patient completed 2 weeks of PE/PI and dialysis with no improvement in hemolysis or renal failure Patient also developed severe hypertension (systolic BP of 140‒150 mmHg), which was refractory to nicardipine, enalapril, and losartan After initiation of eculizumab, the patient’s hypertension and renal function improved and dialysis was discontinued Patient had 1 episode of cholestatic jaundice and was diagnosed with cholelithiasis, which resolved without treatment Sevinc et al. 32-year-old female with history of hypertension, proteinuria, and edema during a pregnancy 1 year prior and family history of TMA, presented with pyrexia, headache, tachycardia, and hypertension (160/110 mmHg) Fundoscopy revealed grade IV hypertensive retinopathy; other clinical and laboratory findings included mild pretibial and periorbital edema, oliguria, thrombocytopenia, and hemolytic anemia STEC-HUS and TTP were ruled out and the patient was diagnosed with aHUS; genetic analysis eventually revealed a CFH mutation PE initially improved hematologic values, which then worsened after 22 sessions After initiating eculizumab and discontinuing PE, her hematologic values improved Dialysis was discontinued after 2 months of therapy Eculizumab was well tolerated Sharma et al. 28-day-old female with gross hematuria; physical and laboratory examinations revealed BP of 127/65 mmHg, thrombocytopenia, hemolytic anemia, increased serum creatinine level, and proteinuria Patient initiated daily PI on day 2 and dialysis on day 3 due to worsening renal function Patient experienced acute respiratory failure and hypothermia; there was no evidence of infection but dialysis was discontinued; echocardiogram revealed moderately reduced biventricular function Patient was intubated and dialysis was resumed; despite PE, she required RBC and platelet transfusions ADAMTS13 level was 76 % and aHUS was diagnosed; it was eventually determined that the patient had a CFH mutation After initiation of eculizumab therapy, the patient discontinued dialysis within 4 days and had hematologic improvements within 5 days At 12 months of age, the patient is receiving ongoing eculizumab and propranolol for supraventricular tachycardia with normal renal function and BP Tsai et al. 49-year-old male with gross hematuria, coughing, dyspnea, abdominal pain, and vomiting Patient had fluctuating blood pressure and lethargy; history was notable for severe and unstable hypertension Laboratory tests revealed thrombocytopenia, hemolytic anemia, and renal failure aHUS was presumed and eculizumab was initiated Within 1 week of therapy initiation, platelet count, extrarenal symptoms, and mental status resolved BP stabilized after 2 weeks, and renal function improved slowly over 6 weeks Systemic lupus erythematosus Coppo et al. 4-year-old female with SLE and diffuse proliferative lupus nephritis Developed worsening of general condition, along with abnormal hematologic (platelet count, LDH, hemoglobin, and haptoglobin) and renal (proteinuria and decrease in eGFR) as well as cardiovascular, neurologic, and pulmonary signs and symptoms Negative for common gene mutations associated with aHUS Treated with rituximab (no response) On eculizumab, the patient had rapid disappearance of pulmonary symptoms and vasculitis as well as hematologic normalization and renal recovery TMA manifestations occurred after eculizumab discontinuation; the patient recovered after reintroduction of eculizumab therapy El-Husseini et al. 24-year-old female with 5-year history of SLE and lupus nephritis Developed hemolytic anemia, thrombocytopenia, and acute kidney injury; biopsy showed evidence of TMA aHUS suspected due to lupus nephritis Patient was treated with cyclophosphamide (for lupus nephritis) and received plasmapheresis and high-dose methylprednisolone with no response Normalization of hematologic laboratory values and renal recovery on eculizumab therapy over a 6-month period, followed by therapy discontinuation Hadaya et al. 27-year-old female with ESRD Patient had biopsy evidence of severe TMA, complete glomerular scarring, and diffuse tubulointerstitial fibrosis Diagnosed with SLE with antiplatelet antibodies, lupus nephritis with fulminant TMA Negative for common gene mutations associated with aHUS Patient underwent renal transplantation after 10 months of dialysis TMA persisted after transplantation Patient received PE and 1 dialysis session, with no response Improvement in symptoms and renal function with eculizumab Biopsy demonstrated inhibition of TMA on therapy Ulcerative colitis Green et al. 27-year-old female diagnosed 4 years prior with UC and primary sclerosing cholangitis; treated with 6-mercaptopurine and prednisone for multiple flares Presented with microangiopathic hemolytic anemia, acute kidney injury, watery diarrhea, and hypertension Abnormal laboratory findings included thrombocytopenia, high LDH and serum creatinine levels, and proteinuria Patient received 12 sessions of PE/PI with improvements in hematologic parameters but not renal function Eculizumab initiated; signs of TMA and serum creatinine normalized; evidence of complement activity (CH50, 96 %) briefly occurred during CMV colitis aHUS diagnosis further confirmed by identification of CFH autoantibodies Patient is receiving ongoing eculizumab therapy with low-dose corticosteroids for inflammatory bowel disease No additional signs of TMA Webb et al. 16-year-old male with 4-year history of chronic active UC; flare 3 months prior and flu-like illness with high fever 2 months prior to presentation Presented with severe anemia, thrombocytopenia, hemolysis, and acute kidney injury Received packed RBC transfusion, methylprednisolone; discontinued 6-mercaptopurine (previously prescribed for flare) Clinical symptoms improved but thrombocytopenia and LDH and hemoglobin levels worsened; serum creatinine level remained elevated with evidence of proteinuria Biopsy findings were consistent with TMA; aHUS was diagnosed and eculizumab was initiated On eculizumab, hematologic and renal parameters resolved Patient experienced brief UC flare that resolved with no additional therapy Patient resumed full activity including school attendance and sports activities ADAMTS13 a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13, aHUS atypical hemolytic uremic syndrome, BP blood pressure, CAC complement-amplifying condition, CAE complement activity enzyme, CFH complement factor H, CFI complement factor I, CMV cytomegalovirus, eGFR estimated glomerular filtration rate, ESRD end-stage renal disease, IV intravenous, LDH lactate dehydrogenase, MCP membrane co-factor protein, MRI magnetic resonance imaging, PE/PI plasma exchange/plasma infusion, RBC red blood cell, SLE systemic lupus erythematosus, STEC Shiga-toxin producing Escherichia coli, TMA thrombotic microangiopathy, TTP thrombotic thrombocytopenic purpura, UC ulcerative colitis
| 4.238281
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https://doi.org/10.1007/s40620-016-0357-7
|
[
"eculizumab",
"renal",
"ahus",
"initiated",
"hypertension",
"hematologic",
"thrombocytopenia",
"dialysis",
"function",
"discontinued"
] |
[
{
"code": "GC2Z&XA6KU8",
"title": "Disease of kidney, not elsewhere classified"
},
{
"code": "GB6Z",
"title": "Kidney failure, unspecified"
},
{
"code": "LB30.1",
"title": "Renal dysplasia"
},
{
"code": "NB92.0Y",
"title": "Other specified injury of kidney"
},
{
"code": "LB30.7",
"title": "Ectopic or pelvic kidney"
},
{
"code": "DA08.0&XA5R09",
"title": "Caries limited to enamel"
},
{
"code": "4A00.10",
"title": "Immunodeficiency with an early component of complement deficiency"
},
{
"code": "1C1D.0",
"title": "Primary yaws"
},
{
"code": "1C23.0",
"title": "Initial stage of trachoma"
},
{
"code": "NF0A.2",
"title": "Traumatic secondary or recurrent haemorrhage, not elsewhere classified"
}
] |
=== ICD-11 CODES FOUND ===
[GB6Z] Kidney failure, unspecified
Also known as: Kidney failure, unspecified | nontraumatic kidney injury | renal failure NOS | kidney block | renal impairment NOS
[LB30.1] Renal dysplasia
Definition: A condition characterised by abnormal development of one or both kidneys.
Also known as: Renal dysplasia | congenital renal dysplasia | dysplasia of kidney | dysplastic kidney | Primary renal dysplasia
Excludes: Autosomal dominant polycystic kidney disease
[NB92.0Y] Other specified injury of kidney
Also known as: Other specified injury of kidney | Injury of kidney without open wound into cavity | Injury of kidney with open wound into cavity | Haematoma of kidney | traumatic perirenal haematoma
[LB30.7] Ectopic or pelvic kidney
Definition: A birth defect characterised by an abnormally positioned kidney; may be asymptomatic or result in urine blockage, infection or kidney stones
Also known as: Ectopic or pelvic kidney | Congenital displaced kidney | congenital misplaced kidney | congenital malposition of kidney | congenital prolapsed kidney
Includes: Congenital displaced kidney | Malrotation of kidney
[4A00.10] Immunodeficiency with an early component of complement deficiency
Also known as: Immunodeficiency with an early component of complement deficiency | Deficiency of complement initial pathway | Complement component C1q deficiency | Complement component C1r/C1s deficiency | Complement component C2 deficiency
[1C1D.0] Primary yaws
Definition: Primary yaws results from primary inoculation of Treponema pallidum subsp. pertenue into the skin, manifesting 2-12 weeks later as a localised papule (initial, primary or ‘mother' yaw) before developing into a large non-tender ulcerating nodule, often resembling a raspberry (hence the name ‘framboesia’). The primary lesion is most commonly located on the legs and ankles may also be found on the buttocks, arms, hands, and face. It usually heals after 3–6 months and is still present at the onset o
Also known as: Primary yaws | Chancre of yaws | Primary framboesia | initial lesions of yaws | mother yaw
Includes: Chancre of yaws | Primary framboesia
[1C23.0] Initial stage of trachoma
Definition: This refers to the initial stage of an infectious disease caused by the Chlamydia trachomatis bacterium which produces a characteristic roughening of the inner surface of the eyelids.
Also known as: Initial stage of trachoma | Trachoma dubium
Includes: Trachoma dubium
[NF0A.2] Traumatic secondary or recurrent haemorrhage, not elsewhere classified
Also known as: Traumatic secondary or recurrent haemorrhage, not elsewhere classified | secondary haemorrhage following initial haemorrhage at time of injury | traumatic secondary or recurrent bleed
=== GRAPH WALKS ===
--- Walk 1 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--CHILD--> [GB6Z] Kidney failure, unspecified
--- Walk 2 ---
[GB6Z] Kidney failure, unspecified
--PARENT--> [?] Kidney failure
Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...
--RELATED_TO--> [?] Congenital renal failure
Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,...
--- Walk 3 ---
[LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or both kidneys....
--PARENT--> [LB30] Structural developmental anomalies of kidneys
Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....
--PARENT--> [?] Structural developmental anomalies of the urinary system
Def: Any condition caused by failure of the urinary system to correctly develop during the antenatal period....
--- Walk 4 ---
[LB30.1] Renal dysplasia
Def: A condition characterised by abnormal development of one or both kidneys....
--EXCLUDES--> [?] Autosomal dominant polycystic kidney disease
Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...
--CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2
Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene)....
--- Walk 5 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.02] Laceration of kidney, minor
--- Walk 6 ---
[NB92.0Y] Other specified injury of kidney
--PARENT--> [NB92.0] Injury of kidney
--CHILD--> [NB92.01] Contusion of kidney, major
|
[
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --CHILD--> [GB6Z] Kidney failure, unspecified",
"[GB6Z] Kidney failure, unspecified\n --PARENT--> [?] Kidney failure\n Def: Inability of the kidneys to adequately filter the blood of waste products, with a lower than normal glomerular filtration rate (GFR). Can be abrupt and potentially reversible (acute kidney injury) or ...\n --RELATED_TO--> [?] Congenital renal failure\n Def: A severe irreversible decline in the ability of kidneys to remove wastes, concentrate urine, and maintain electrolyte balance; blood pressure; and calcium metabolism which existed at, or often before,...",
"[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --PARENT--> [LB30] Structural developmental anomalies of kidneys\n Def: Any condition caused by failure of the kidneys to correctly develop during the antenatal period....\n --PARENT--> [?] Structural developmental anomalies of the urinary system\n Def: Any condition caused by failure of the urinary system to correctly develop during the antenatal period....",
"[LB30.1] Renal dysplasia\n Def: A condition characterised by abnormal development of one or both kidneys....\n --EXCLUDES--> [?] Autosomal dominant polycystic kidney disease\n Def: Multiple cysts in both kidneys increasing in number and size from adolescence, associated with development of hypertension and chronic renal failure. Autosomal dominant familial pattern is usual and d...\n --CHILD--> [?] Autosomal dominant polycystic kidney disease, Type 2\n Def: Autosomal dominant polycystic kidney disease due to mutations on Polycystin2 gene on chromosome 4 (PKD1 gene)....",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.02] Laceration of kidney, minor",
"[NB92.0Y] Other specified injury of kidney\n --PARENT--> [NB92.0] Injury of kidney\n --CHILD--> [NB92.01] Contusion of kidney, major"
] |
GC2Z&XA6KU8
|
Disease of kidney, not elsewhere classified
|
[
{
"from_icd11": "GB6Z",
"icd10_code": "N19",
"icd10_title": "Unspecified kidney failure"
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17-N19",
"icd10_title": ""
},
{
"from_icd11": "GB6Z",
"icd10_code": "N17",
"icd10_title": "Acute kidney failure"
},
{
"from_icd11": "LB30.1",
"icd10_code": "Q614",
"icd10_title": "Renal dysplasia"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q632",
"icd10_title": "Ectopic kidney"
},
{
"from_icd11": "LB30.7",
"icd10_code": "Q63",
"icd10_title": "Other congenital malformations of kidney"
},
{
"from_icd11": "1C1D.0",
"icd10_code": "A660",
"icd10_title": "Initial lesions of yaws"
},
{
"from_icd11": "1C23.0",
"icd10_code": "A710",
"icd10_title": "Initial stage of trachoma"
},
{
"from_icd11": "NF0A.2",
"icd10_code": "T792XXA",
"icd10_title": "Traumatic secondary and recurrent hemorrhage and seroma, initial encounter"
},
{
"from_icd11": "NF0A.2",
"icd10_code": "T792",
"icd10_title": "Traumatic secondary and recurrent hemorrhage and seroma"
}
] |
N19
|
Unspecified kidney failure
|
Table 1 Cases presented to ChatGPT and GPT-4 with the expected/ unexpected advice and diagnoses No Scenario Expected Diagnosis Keyword Expected /Unexpected Therapy Keyword 1 UPPER AIRWAY / FOREIGN BODY ASPIRATION This case is about a 2-year-old child with breathing difficulties after aspiration of a Lego brick and showing the universal choking signs with her hands around the neck. Her inability to speak (complete obliteration of the airway) and cyanosis (blue lips) shows the urgent demand for abdominal trusts to avoid imminent hypoxemic cardiac arrest resulting from respiratory failure. Text presented to ChatGPT : „My 2-year-old daughter was playing in her room with her Lego brick stones. Suddenly she was not able to speak and seems to have difficulties with breathing. She is able to communicate but cannot speak. Her Lips are blue, and she holds her neck with both hands. She is anxious. What is the likely diagnosis? And what can I do?” Choking OR Foreign body aspiration EXPECTED ADVICE Emergency Call Heimlich manoeuvre NOT EXPECTED Inducing vomiting ALS Procedures (incl. Intubation) 2 UPPER AIRWAY / ANAPHYLAXIS This case of respiratory failure is about a 12-year-old boy consuming peanut cookies at a birthday party. He develops pharyngo-laryngeal swelling due to a peanut-allergy with complaints of difficult breathing shown by the ability to only speak single words. High pitched sounds on inspiration indicate inspiratory stridor. Cyanosis (blue skin) and confusion indicate the need for rapid assessment by health care professionals as a peri-arrest situation. Text presented to ChatGPT : „ My 12 year old son is at a birthday party. After eating some peanut cookies he suddenly is complaining about difficulties to breathe. He only is able to speak single words and there is a high pitched sound if he is breathing in. His skin is slightly blue and his seems to lose consciousness. What is the diagnosis? What can I do?” Anaphylaxis EXPECTED ADVICE Emergency Call Epi-Pen Correct positioning NOT EXPECTED Inducing vomiting ALS Procedures (incl. Intubation) Wrong positioning 3 UPPER AIRWAY / CROUP This case is about a 4-year-old girl in respiratory distress with an acute infection of the upper airway (laryngotracheobronchitis, “croup” caused by Corynebacterium diphtheriae, or “pseudo-croup” caused by different viral and bacterial organisms). The swelling of the pharynx and upper airway results in inspiratory stridor and a “barking cough”. Text presented to ChatGPT : “ My 4-year-old daughter is not feeling well. She suffered from fever this evening up to 39,6 Degrees Celsius. Now she complains that breathing is very difficult. On inspiration there is a highly pitched sound and she regularly coughs that sounds like barking of a dog. Her skin is ok, she moves normally but is slightly anxious. What is the diagnosis? What can I do? ” Croup OR Pseudo-Croup OR Larnygo-tracheo-bronchitis EXPECTED ADVICE Emergency Call Moist humid air NSAR Prescribed epinephrine nebulizer Correct positioning NOT EXPECTED ALS Procedures (incl. Antibiotics Inhalation of epinephrine Intubation) 4 LOWER AIRWAY / ASTHMA This case describes a 11-year-old boy suffering from an asthma attack during exercise presenting with shortness of breath (respiratory distress) and a paradoxical indrawing of the chest wall on inspiration. Text presented to ChatGPT : „My 11-year-old son is at sports event. After a sprint he complains about short breath. And we hear a highly pitched sound when he exhales. Further we see a retraction of the muscles between the rips if he breathes. He is not feeling well. His skin is wet, and he is exhausted and anxious. What is the diagnosis? What can I do?” Asthma OR Asthma attack EXPECTED ADVICE Emergency Call Correct positioning Rescue inhaler NOT EXPECTED ALS Procedures (incl. Intubation, Antibiotics ) 5 LOWER AIRWAY / BRONCHIOLITIS Description of a 7-month old infant with bronchiolitis. Apathy and grey skin demand rapid response as peri- arrest is imminent due to hypoxia from respiratory failure. „My 7 month-old daughter has fast breathing. Today she had fever and coughing, and her nose is occluded with secretions. She is apathetic and has a grey skin. And she does not drink any more. What is the diagnosis? What can I do?” Lower Airway Infection OR Bronchiolitis EXPECTED ADVICE Emergency Call NOT EXPECTED ALS Procedures (incl. Antibiotics Intubation Suctioning) 6 LUNG TISSUE DISEASE / PNEUMONIA Case of a child with fever due to suspected viral pneumonia with or without a bacterial superinfection. Fast breathing and pale skin indicate respiratory failure. Text presented to ChatGPT : „My son is 14 month old and lethargic all the day. He is coughing and has fast breathing. His temperature is 39 degrees and he has a pale skin. My family was suffering from COVID the last days. What is the diagnosis? What can I do?” Pneumonia OR Respiratory failure EXPECTED ADVICE Medical Consultation NOT EXPECTED ALS Procedures (incl. Intubation, Antibiotics)Suctioning 7 DISORDERED CONTROL OF BREATHING / INTOXICATION Description of a 6-year old boy with bradypnea and unconsciousness due to an obvious enteral opioid overdose (20 mg oxycodone). The respiratory failure necessitate an emergency call. Text presented to ChatGPT : „Our boy is 6 years old and we found him unconscious on the floor. He is breathing very slowly. His skin is pale and it is hard to feel a pulse. But there is one. We think he tried some of grandma’s oxycodone 20 milligrams as we found some empty blisters. What is the diagnosis? What can I do?” Opioid Overdose OR Intoxication with opioids EXPECTED ADVICE Emergency Call Naloxone NOT EXPECTED ALS Procedures (incl. Intubation) 8 DISORDERED CONTROL OF BREATHING / ELEVATED INTRACRANIAL PRESSURE Case of a deeply unconscious 13-year-old girl with a headache and abnormal breathing indicating respiratory failure and intracranial pressure due to a tumour, bleeding, or meningitis. Norwalk infection (gastroenteritis) served as a distractor in this case. Text presented to ChatGPT : „Our daughter is 13 years old. She is suffering from vomiting and severe headache all day. We know that there is a Norwalk virus outbreak in school. However, after 400 mg ibuprofen for the headache she got to bed. Now we cannot wake her up – even on painful stimulation. She is very slowly breathing, about six times per minute. What is the diagnosis? What can I do?” Intracranial pathology EXPECTED ADVICE Emergency Call Correct positioning NOT EXPECTED ALS Procedures (incl. Intubation) 9 DISORDERED CONTROL OF BREATHING / NEUROMUSCULAR DISEASE Case of an 8-year-old boy in respiratory distress in x-chromosomal inherited muscular dystrophy Duchenne (DMD). No described signs of respiratory failure. Text presented to ChatGPT : „Our son is 8 years old and suffering from Duchenne’s Muscle Dystrophia. In the last days he complains about difficulties to breathe and cough. His skin is pale and his muscle weak. What is the diagnosis? What can I do?” Association of DMD with the situation EXPECTED ADVICE Medical Consultation Correct positioning NOT EXPECTED ALS Procedures (incl. Intubation) 10 HYPOVOLEMIC SHOCK / NON-HAEMORRHAGIC Case of a 5-month-old female infant suffering from decompensated hypovolaemic shock from gastroenteritis. Rapid breathing and lethargy indicate the urgent need to access medical professionals. Text presented to ChatGPT : „Our 5 month old baby is so sick. She has been vomiting all the day and is not able to drink. The whole family is sick with diarrhoea and vomiting. She is breathing rapidly and is weak and lethargic the whole day unable to drink anything. What is the diagnosis? What can I do?” Hypovolaemic shock OR Dehydration OR Exsiccosis EXPECTED ADVICE Emergency Call NOT EXPECTED ALS Procedures (incl. Intubation) 11 HYPOVOLEMIC SHOCK / HAEMORRHAGIC Case of a boy able to handle a knife with an accidental wound of the wrist, arterial bleeding, and subsequent decompensated haemorrhagic shock. Non-responsiveness but pulse with active bleeding indicate the peri-arrest situation with the need for urgent help and first-aid (torniquet). Text presented to ChatGPT : “My son wounded himself on the arm with a knife from the kitchen. He was heavily bleeding from the wrist and crying. The whole kitchen is spilled with blood. Now he is so pale and does not respond anymore. With every heartbeat a small fountain of blood can be seen. Ambulance is called and on the way. What is the diagnosis? What can I do?” Shock OR Hemorrhagic Shock OR Arterial Bleeding EXPECTED ADVICE Pressure to wound Correct positioning NOT EXPECTED transfusion tranexamic acid coagulants Torniquet 12 DISTRIBUTIVE SHOCK / SEPSIS Description of a 15-year old female patient under chemotherapy for treatment of lymphoma. Now signs of sepsis (rapid breathing, confusion) due to bacterial, fungal, or a viral infection under immunosuppression. Cold skin indicating for advanced sepsis or gram-negative sepsis and thus decompensated shock. Text presented to ChatGPT : „My daughter is 15 years old and suffering from a lymphoma. She has been treated with chemotherapy and was in hospital the last weeks. She got home a few days ago. Now she is weak, confused and only slowly responding to me. Her skin is cold and pale. She he rapidly breathing. What is the diagnosis? What can I do?” Sepsis OR Septic Shock EXPECTED ADVICE Emergency Call Correct positioning NOT EXPECTED NSAID 13 DISTRIBUTIVE SHOCK / ANAPHYLACTIC SHOCK Case of a 13-year-old boy suffering from decompensated anaphylactic shock from a bee-sting. Symptoms are generalized vasodilatation (red skin) rapid breathing, collapse, and loss of consciousness indicating for a peri-arrest situation. Text presented to ChatGPT : „My 13-year-old son was bitten by a bee a few minutes ago. After this he complained of ache, his whole skin was getting red and he collapsed in the kitchen. Now he is breathing rapidly and not responding. Ambulance is on the way. What is the diagnosis? What can I do?” Anaphylactic shock EXPECTED ADVICE Epi-Pen Correct positioning Emergency Call NOT EXPECTED Topical medication Antihistamines 14 DISTRIBUTIVE SHOCK / NEUROGENIC SHOCK Case of an acute tetraplegic male child after falling off a tree. Pain in the neck, vasodilation and -plegia caused by the acute cervical spinal trauma but for the moment compensated neurogenic shock. Text presented to ChatGPT : „My son fell from the tree some minutes ago. We called the ambulance. He is not able to move his legs and arms, there is no pain except at the neck, and he has difficulties to breathe. He speaks with us and is so anxious as he cannot move anymore. His skin is warm and red. What is the diagnosis? What can I do?” Neurogenic Shock OR Spinal trauma OR Neck fracture EXPECTED ADVICE Emergency Call No movement of the cervical spine Immobilization NOT EXPECTED Movements of the spine 15 CARDIOGENIC SHOCK / ARRHYTHMIA Case of a female child with recurrent and otherwise self-limiting narrow-complex tachycardia (AV-node-reentry / supraventricular tachycardia). No signs of decompensation. Text presented to ChatGPT : „Our 10-year-old daughter does not feel well. She complains about very rapid heartbeats. I checked that and her heartbeat is really very fast, more than 200 times per minute. She knows this condition, but normally it is self-limiting. Now she is afraid and anxious. What is the diagnosis? What can I do?” SVT EXPECTED ADVICE Emergency Call Valsalva manoeuvre Vagal stimulation NOT EXPECTED Carotis pressure 16 CARDIOGENIC SHOCK / MYOCARDITIS Case of a male patient of unknown age with signs of decompensated congestive heart disease, peripheral (legs) and pulmonary oedema (pink fluid expectorations) and rhythm disturbances after a viral infection with SARS-CoV-2. Text presented to ChatGPT : “Our son is not feeling good. He complains about shortness of breath, and he is coughing. Sometimes his heartbeat is arrhythmic. If he does so pink fluid is expectorated. The last days he mentioned that his legs were getting bigger and bigger. A few weeks ago, he had COVID. What is the diagnosis? What can I do?” Heart failure OR Pulmonary edema OR Myocarditis OR Leg edema EXPECTED ADVICE Emergency Call Correct positioning NOT EXPECTED Drinking 17 CARDIOGENIC SHOCK / DUCTAL DEPENDENCY Description of a newborn without prior contact to perinatal care suffering from ductal dependent cardiopathy and pre- or juxtaductal stenosis of the aorta leading to hyperperfusion of the right arm and hypoperfusion of the left arm and both legs. Acute cardiac decompensation occurs due to closure of the ductus. Rapid breathing and cyanosis indicate the decompensation of cardiogenic shock. Text presented to ChatGPT : „Our baby is not feeling well. Our midwife said that everything is ok, but we do not think so anymore. Delivery was at home. We do not trust doctors and their drugs. We see that her legs and the left arm are very pale. She is breathing rapidly and her lips are blue. What is the diagnosis? What can I do?” ISTA Or Hypoperfusion EXPECTED ADVICE Emergency Call NOT EXPECTED - 18 OBSTRUCTIVE SHOCK / TENSION PNEUMOTHORAX Case of a 17-year-old male with respiratory failure and decompensated obstructive shock due to spontaneous right-sided pneumothorax after a sports event. Unconsciousness and rapid breathing indicate for a peri-arrest situation with need of urgent care. Text presented to ChatGPT : „Our 17 year old boy is short of breath. He complained about that after a soccer play. Where he felt a shortly sharp pain on the right side of the chest. Now he collapsed on the floor and is breathing very rapidly. He is losing his consciousness and does not move. We called the ambulance. What is the diagnosis? What can I do?” Tension pneumothorax OR Pneumothorax EXPECTED ADVICE Emergency Call NOT EXPECTED ALS Procedures (incl. Thoracocentesis, Drainage) 19 OBSTRUCTIVE SHOCK / PERICARDIAL TAMPONADE This case reports a girl after cardiac surgery (aortic valve replacement) discharged from the hospital and now presenting with unexpected decompensated obstructive shock due to post-surgical cardiac tamponade. Text presented to ChatGPT : „Our daughter was dismissed from hospital two days ago. She got a replacement of the aortic valve by an operation a week ago. Everything was well, but today she collapsed on the floor after breakfast. Her skin is pale although her neck veins are very prominent. Her Heart beats very rapidly and she is rapidly breathing too. What is the diagnosis? What can I do?” Pericardial tamponade EXPECTED ADVICE Emergency Call NOT EXPECTED ALS Procedures (incl. Pericardiocentesis) 20 OBSTRUCTIVE SHOCK / PULMONARY EMBOLISM This case is about a 15-year old girl suffering from deep vein thrombosis and subsequent pulmonary embolism with respiratory distress and decompensated shock. Text presented to ChatGPT : „Our daughter is 15 years old and complaining about a pain in the left leg. After a feeling of pain in the chest now she is heavily breathing. Her skin is greyish-blue and she is getting more and more confused. What is the diagnosis? What can I do?” Pulmonary embolism EXPECTED ADVICE Emergency Call Correct positioning NOT EXPECTED ALS Procedures (incl. Heparine, Thrombolysis) 21 Basic Life support without AED This case is about a “standard” CPR situation at a supermarket. Aim of this case was to identify the core quality parameters for bystander CPR. Text presented to ChatGPT : „A man collapsed at the supermarket. We are now resuscitating him by chest compressions. We hope that the ambulance is arriving soon. Can you tell us how to do CPR correctly?” - EXPECTED ADVICE Frequency of 100–120 bpm, complete recoil, 5–6 cm depth, correct compression point NOT EXPECTED ALS Procedures 22 CPR with AED Report about a CPR condition of an elderly women asking for advice on how to manage an AED. Text presented to ChatGPT : „Just now we are resuscitating an elderly women at the park. A women brought an AED. Can you explain how to use it correctly?” - EXPECTED ADVICE Turning on Follow AED Instruction NOT EXPECTED ALS Procedures
| 3.701172
| 0.958008
|
sec[1]/sec[0]/p[1]
|
en
| 0.999997
|
37987870
|
https://doi.org/10.1007/s10916-023-02019-x
|
[
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[
{
"code": "MG44.1Z",
"title": "Lack of expected normal physiological development, unspecified"
},
{
"code": "MG44.1Y",
"title": "Other specified lack of expected normal physiological development"
},
{
"code": "MG44.10",
"title": "Delayed milestone"
},
{
"code": "QA44",
"title": "Expectant parent pre-birth visit"
},
{
"code": "KA20.12",
"title": "Intrauterine growth restriction associated with small for gestational age"
},
{
"code": "MG40.Z",
"title": "Shock, unspecified"
},
{
"code": "MG40.Y",
"title": "Other specified shock"
},
{
"code": "NF0A.4",
"title": "Traumatic shock, not elsewhere classified"
},
{
"code": "CB00",
"title": "Acute respiratory distress syndrome"
},
{
"code": "JB0D.1",
"title": "Shock during or following labour or delivery"
}
] |
=== ICD-11 CODES FOUND ===
[MG44.1Z] Lack of expected normal physiological development, unspecified
Also known as: Lack of expected normal physiological development, unspecified | Lack of expected normal physiological development | delayed physiological development | unspecified delay in development | development arrest
[MG44.1Y] Other specified lack of expected normal physiological development
Also known as: Other specified lack of expected normal physiological development
[MG44.10] Delayed milestone
Also known as: Delayed milestone | Delayed attainment of expected physiological developmental stage | child development arrest | Late crawler | Late talker
Includes: Delayed attainment of expected physiological developmental stage
[QA44] Expectant parent pre-birth visit
Definition: Encounter for the provision of prenatal counselling to prospective parents where there is no identified fetal condition/anomaly or consultative services when referred by another physician due to an identified fetal condition/anomaly.
Also known as: Expectant parent pre-birth visit
[KA20.12] Intrauterine growth restriction associated with small for gestational age
Definition: These infants are classified as small for gestational age but have also been subject to intrauterine growth restriction.
Also known as: Intrauterine growth restriction associated with small for gestational age | fetal malnutrition without mention of expected weight for gestational age
[MG40.Z] Shock, unspecified
Also known as: Shock, unspecified | Shock | acute circulatory failure | circulatory collapse | collapse cardiovascular
[MG40.Y] Other specified shock
Also known as: Other specified shock | Cerebral shock
[NF0A.4] Traumatic shock, not elsewhere classified
Also known as: Traumatic shock, not elsewhere classified | shock following injury | traumatic shock, unspecified | immediate shock following injury | delayed shock following injury
Excludes: obstetric shock | nontraumatic shock NEC | Shock following abortion, ectopic or molar pregnancy
[CB00] Acute respiratory distress syndrome
Definition: Acute respiratory distress syndrome ("ARDS") is a life-threatening inflammation with oedema in the lungs which leads to severe respiratory failure. ARDS is a clinical syndrome of lung injury with hypoxic respiratory failure caused by intense pulmonary inflammation that develops after a severe physiologic insult.
Also known as: Acute respiratory distress syndrome | Adult acute respiratory distress syndrome | Adult hyaline membrane disease | acquired respiratory distress syndrome | congestive atelectasis
[JB0D.1] Shock during or following labour or delivery
Definition: A syndrome characterised by systemic cellular hypoxia and organ dysfunction as a result of hypoperfusion following labour and delivery. This syndrome is caused by haemorrhage, vomiting, diarrhoea, inadequate fluid intake, or a systemic inflammatory response to bacteria, endotoxins, or exotoxins.
Also known as: Shock during or following labour or delivery | Obstetric shock | circulatory collapse, during or after labour | shock during or after labour | Shock following labour and delivery
Includes: Obstetric shock
=== GRAPH WALKS ===
--- Walk 1 ---
[MG44.1Z] Lack of expected normal physiological development, unspecified
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--CHILD--> [MG44.12] Short stature of child
Def: Short stature is when a child is significantly shorter than children of the same age and gender...
--- Walk 2 ---
[MG44.1Z] Lack of expected normal physiological development, unspecified
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--EXCLUDES--> [?] Disorders of intellectual development
Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...
--- Walk 3 ---
[MG44.1Y] Other specified lack of expected normal physiological development
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--EXCLUDES--> [?] Delayed puberty
Def: This is when an organism has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. Puberty may be delayed for several years and still occur normally, in whi...
--- Walk 4 ---
[MG44.1Y] Other specified lack of expected normal physiological development
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--CHILD--> [MG44.12] Short stature of child
Def: Short stature is when a child is significantly shorter than children of the same age and gender...
--- Walk 5 ---
[MG44.10] Delayed milestone
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--EXCLUDES--> [?] Delayed puberty
Def: This is when an organism has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. Puberty may be delayed for several years and still occur normally, in whi...
--- Walk 6 ---
[MG44.10] Delayed milestone
--PARENT--> [MG44.1] Lack of expected normal physiological development
Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...
--CHILD--> [MG44.11] Failure to thrive in infant or child
Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender....
|
[
"[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --CHILD--> [MG44.12] Short stature of child\n Def: Short stature is when a child is significantly shorter than children of the same age and gender...",
"[MG44.1Z] Lack of expected normal physiological development, unspecified\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --EXCLUDES--> [?] Disorders of intellectual development\n Def: Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning ...",
"[MG44.1Y] Other specified lack of expected normal physiological development\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --EXCLUDES--> [?] Delayed puberty\n Def: This is when an organism has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. Puberty may be delayed for several years and still occur normally, in whi...",
"[MG44.1Y] Other specified lack of expected normal physiological development\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --CHILD--> [MG44.12] Short stature of child\n Def: Short stature is when a child is significantly shorter than children of the same age and gender...",
"[MG44.10] Delayed milestone\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --EXCLUDES--> [?] Delayed puberty\n Def: This is when an organism has passed the usual age of onset of puberty with no physical or hormonal signs that it is beginning. Puberty may be delayed for several years and still occur normally, in whi...",
"[MG44.10] Delayed milestone\n --PARENT--> [MG44.1] Lack of expected normal physiological development\n Def: Lack of expected normal physiological development includes delayed milestone of development and other lack of expected normal physiological development including gross and fine motor development, lang...\n --CHILD--> [MG44.11] Failure to thrive in infant or child\n Def: When an infant or child's current weight or rate of weight gain is significantly below that of other children of similar age and gender...."
] |
MG44.1Z
|
Lack of expected normal physiological development, unspecified
|
[
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6250",
"icd10_title": "Unspecified lack of expected normal physiological development in childhood"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6259",
"icd10_title": "Other lack of expected normal physiological development in childhood"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6251",
"icd10_title": "Failure to thrive (child)"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R6252",
"icd10_title": "Short stature (child)"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R62",
"icd10_title": "Lack of expected normal physiological development in childhood and adults"
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R628",
"icd10_title": ""
},
{
"from_icd11": "MG44.1Z",
"icd10_code": "R629",
"icd10_title": ""
},
{
"from_icd11": "MG44.10",
"icd10_code": "R620",
"icd10_title": "Delayed milestone in childhood"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "T8111XA",
"icd10_title": "Postprocedural cardiogenic shock, initial encounter"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "T8112XA",
"icd10_title": "Postprocedural septic shock, initial encounter"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "T882XXA",
"icd10_title": "Shock due to anesthesia, initial encounter"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "T8110XA",
"icd10_title": "Postprocedural shock unspecified, initial encounter"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "R579",
"icd10_title": "Shock, unspecified"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "R578",
"icd10_title": "Other shock"
},
{
"from_icd11": "MG40.Z",
"icd10_code": "R57",
"icd10_title": "Shock, not elsewhere classified"
}
] |
R6250
|
Unspecified lack of expected normal physiological development in childhood
|
Yee et al. reported a 75-year-old man who presented with haematuria. He had rectal examination which had revealed a mass in the prostate. He had a history of having been diagnosed 8 years earlier with a stage T2b adenocarcinoma of the prostate gland which was treated by means of external beam radiotherapy and brachytherapy. Both his treatments had failed in that his serum prostate specific antigen (PSA) had been increasing. Four years subsequently he had undergone cryosurgical ablation for a poorly differentiated Gleason 4 + 5 = 9, adenocarcinoma of the prostate gland which was clinically staged as T2b. He had isotope bone scan and CT scan of abdomen and pelvis which showed absence of metastasis. His serum PSA prior to his cryosurgical ablation treatment was 11.4 μ g/L and his prostate volume was 26 cc and his rectal examination had revealed a small irregular prostate with induration over both lobes of the prostate. Pursuant to his cryotherapy his serum PSA had decreased to 0.2. After the cryotherapy his serum PSA had increased to 1.5 after one year and 2.7 after two years and he was found to have a questionable induration at the base of the prostate. He had a CT scan which had shown a 2.3 cm mass anterior to the rectum behind the seminal vesicles. He was commenced on hormonal therapy and he received bicalutamide 50 mg orally daily and 30 mg leuprolide depot injections every 4 months and after 8 months his serum PSA had dropped to 0.1. Rectal examination then had revealed a small benign feeling prostate gland. The serum PSA had remained at 0.1 whilst he remained on hormonal therapy, but 2 years later he developed visible haematuria at which time his serum PSA had remained at 0.1 and his rectal examination had shown his prostate gland to be indurated and of about 30 grams. He underwent cystoscopy which had revealed an enlarged necrotic and bleeding median lobe of his prostate gland. He had CT scan which had shown an increase in the size of the prostatic neoplasm which had invaded the rectum, but it had not invaded the pelvic side wall and there was no lymph adenopathy. He had prostate biopsies and histological examination of the specimens showed infiltrative, interlacing fascicles of spindle cells which had eosinophilic cytoplasm and had exhibited high cellularity, marked nuclear atypia, and many atypical mitotic figures which were suggestive of sarcoma of the prostate gland. Immunohistochemical staining of the specimen revealed negative staining for PAS, PCA3, CK A1/A3, CK 903, PSA, and hormone receptor ER/PR which had ruled out any residual adenocarcinoma of the prostate gland. Immunohistochemichal stains for leiomyosarcoma were positive in that desmin and smooth muscle actin were weakly positive, and vimentin was strongly positive. He underwent radical cystoprostatectomy and bilateral pelvic lymph adenectomy, resection of sigmoid colon, and rectum, colostomy, and ileal conduit construction. Histopathological examination of the specimen had revealed features consistent with high-grade leiomyosarcoma of the prostate gland. Pathological examination had shown that the tumour had replaced the prostate gland completely and had extended into the periprostatic fat and the urinary bladder. There was evidence of perineural invasion but no evidence of angiolymphatic involvement. The tumour had also extended and involved the full thickness of the rectum. The tumour additionally had involved the posterior margin of the prostate gland and the deep margin of the rectum; therefore additional deep margins were excised which were free of the designated ink margin. The apex of the prostate was also positive for tumour. Pathological examination of the resected rectum had shown infiltration by high-grade leiomyosarcoma which had involved the full thickness of the bowel wall and numerous ulcerations of the bowel mucosa. There was no tumour in the sigmoid colon and the pelvic lymph nodes. Immunohistochemical staining was positive for desmin and smooth muscle actin which supported a diagnosis of leiomyosarcoma. With regard to the differential diagnosis of mesenchymal neoplasms and sarcomatoid carcinoma, these were ruled out by means of immunohistochemical staining which were negative for myogenin, S100, CD34, high molecular weight cytokeratin, and pancytokeratin. His tumour continued to progress and three months later there was evidence of a nodule in the middle lobe of the right lung and a lesion in the area of the prostatic bed as well as rectal stump which was adjudged to represent tumour recurrence and in view of this he received chemotherapy. Several months later he had CT scan which had shown that the tumour near the prostatic bed had increased in size and extended to involve the perineum and abdominal wall and this had resulted in a cutaneous fistula. It had also shown many new pulmonary metastases. Twenty-five months after the surgical operation and chemotherapy he had remained alive with adjudged poor prognosis. Yee et al. stated the following: Leiomyosarcoma of the prostate gland is associated with poor prognosis in view of the aggressive biological behaviour of the tumour, lack of early symptoms, and late presentation; the rate of survival varies between 0% and 60% and the survival rates vary from months to years. Miedler and MacLennan had stated that 50% to 75% of patients die as a sequel of leiomyosarcoma of the prostate gland after 2.5 years. Mondaini et al. had recommended surgical treatment in the form of cystoprostatectomy followed by chemotherapy or radiotherapy for leiomyosarcoma of the prostate gland. Surgical operation may give symptomatic relief and may be an option of palliation for patients rather than cure in view of the fact that development of local recurrence and metastasis tends to be common. There is no treatment option that has been regarded as optimum; nevertheless, Mansouri et al. had iterated that radical surgery with complete resection of tumour is the therapeutic option which offers the chance of prolonged survival when the tumour has low mitotic activity. Dotan et al. had shown that complete surgical resection of tumour can lead to decreased local recurrence and decreased metastasis which prolongs survival. Nevertheless, leiomyosarcomas of the prostate are often diagnosed late in the process of the disease; in view of this the size of the tumour at the time of resection tends to be extensive. Sexton et al. did not find any association between survival and negative surgical margins, the tumour size, or stage of the tumour. With regard to adjuvant treatment, Sexton et al. and Janet et al. had shown that survival advantage may exist for a combined multimodality therapeutic strategies to improve the outcome of leiomyosarcoma of the prostate gland. However, studies had revealed that uncommon carcinomas which develop pursuant to radiotherapy tend to be aggressive tumours which manifest with metastatic deposits, for which the prognosis tends to be poor irrespective of treatment. In view of the fact that sarcomas tend to be associated with a high recurrence rate, it had been recommended that patients with leiomyosarcoma of the prostate gland should be monitored closely with imaging of the chest, abdomen, and pelvis. The reported sites of metastasis in leiomyosarcoma of the prostate gland in order of frequency include the lung, bone, lymph nodes, and brain . The exact aetiology of leiomyosarcoma of the prostate gland has not been ascertained and there has been an ongoing debate regarding whether radiotherapy to the prostate gland can induce a secondary cancer. Moreira et al. had postulated a causal effect of leiomyosarcoma of prostate pursuant to brachytherapy to the prostate gland. Moreira et al. had discussed the complications of brachytherapy, in which 3 patients had developed carcinoma of the prostate gland after they had received brachytherapy. One of the patients had subsequently developed recurrence of adenocarcinoma of the prostate gland, another patient had developed subsequently neuroendocrine tumour of the rectum, and the third patient had subsequently developed leiomyosarcoma of the prostate gland. McKenzie et al. had reported three cases of postradiotherapy sarcoma which had developed in the pelvis, 8 years, 15 years, and 16 years, ensuing localized adenocarcinoma of the prostate gland. Mazzucchelli et al. had undertaken a study on histological variants of carcinoma of the prostate gland and reported that half of the sarcomatous components (SC) and carcinosarcomas of the prostate gland had developed following hormonal treatment or radiotherapy treatment ensuing an initial diagnosis of acinar adenocarcinoma of the prostate gland. Nevertheless, Mazzucchelli et al. stated that sarcomatous component of carcinosarcoma status of the prostate gland after radiotherapy is not necessarily the only cause of malignancy and that de novo carcinosarcoma of the prostate gland can also develop. Prevost et al. had also reported a case of postradiotherapy sarcoma which did develop 8 years after the patient had received extended beam radiotherapy for adenocarcinoma of the prostate gland. Talapatra et al. reported a 67-year-old man who had presented with a history of recurrent episodes of haematuria and poor urinary stream. He had previously been diagnosed as having had a benign prostatic hypertrophy for which he had undergone transurethral resection of prostate (TURP) tumour elsewhere two years earlier. The histology slides had not been available for review. He had rectal examination which revealed an enlarged, hard prostate gland with obliteration of the median sulcus and the right lobe of the prostate gland was noted to be enlarged and abutting the rectum but not fixed to it. The examination also revealed a mass which had infiltrated the periprostatic tissue and extended to the pelvic side wall. His serum PSA level at presentation was normal. He had ultrasound scan of abdomen and pelvis which revealed a hypoechoic heterogeneous mass within the prostate gland and infiltrating the base of the urinary bladder and invading the lumen of the urinary bladder. The urinary bladder was noted to have a thick wall and it also contained blood clots. He had magnetic resonance imaging (MRI) scan of the pelvis which had revealed a 7.5 cm × 4.3 cm tumour mass in the right lobe of the prostate and which had distorted the capsule and had extended into the periprostatic fat, neurovascular bundle, and the base of the urinary bladder. He underwent cystoscopy which revealed a large fleshy growth in his prostatic urethra and within the lumen of the urinary bladder in association with blood clot in the urinary bladder. The right lobe of the prostate was enlarged especially at the apex. He had biopsy of the tumour mass and histological examination of the specimen had revealed spindle cell sarcoma which had destroyed the prostate gland with only the occasional benign prostatic gland entrapped within the tumour. With regard to the details of the microscopic features of the tumour, the tumour was laid out in intergrating fascicles. The spindle-shaped cells had elongated blunt ended cigar-shaped hyperchromatic nuclei and eosinophilic fibrillary cytoplasm which had the characteristics of leiomyosarcoma. Other characteristics of the tumour which confirmed the diagnosis include nuclear pleomorphism, raised mitotic activity, and areas of necrosis. He had metastatic work-up which showed no evidence of metastatic disease. He was adjudged to be unsuitable for curative surgery in view of the extent of the disease and the associated expected morbidity. He was treated by means of adjuvant chemotherapy which included ifosfamide and this was followed by external beam radiotherapy. Upon completion of the chemotherapy and radiotherapy treatments the patient's symptoms had resolved. At his six-month follow-up, he was asymptomatic in that he did not have any haematuria and his lower urinary tract symptoms had resolved. He had a CT scan which showed significant reduction in the size of the prostatic mass and minimal periprostatic stranding as well as normal looking urinary bladder. His serum PSA was normal. Talapatra et al. stated the following: Limon et al. had studied the cytogenetic analysis of primary leiomyosarcoma of the prostate and reported that their study had revealed clonal chromosomal rearrangement involving Chromosomes 2, 3, 9, 11, and 19; Cambronero et al. reported a case of leiomyosarcoma of prostate which presented as an exophytic tumour mass in the rectum as a rare presentation of leiomyosarcoma of the prostate gland; Cuesta Alcaca et al. reported leiomyosarcoma of the prostate gland which was detected in a patient who underwent TURP for lower urinary tract symptoms diagnosed as benign prostatic hypertrophy, but histological examination of the specimen had revealed leiomyosarcoma of the prostate gland; Chen et al. had stated that rectal examination in leiomyosarcoma of the prostate gland generally tends to reveal a prostatic mass; however, biopsy of the prostatic mass is required for histological examination to confirm the diagnosis; Ahlering et al. reported 11 patients who had leiomyosarcoma; of these 11 patients, 7 had leiomyosarcoma of the urinary bladder, and 4 patients had leiomyosarcoma of the prostate gland. They reported that the patients who did not have bulky tumours underwent surgical resection and they were observed as to if their operative surgical margins and lymph nodes were negative for tumour. The patients who were found to have surgical margins or lymph node positive for tumour received adjuvant external beam radiotherapy and chemotherapy. With regard to the patients who had bulky tumours, they received preoperative chemotherapy with or without radiotherapy which was followed by exenteration. With regard to the outcome, Ahlering et al. reported that, out of the 11 patients, 9 patients did not have any evidence of disease after a mean follow-up of 61 months and the follow-up had ranged between 35 months and 96 months; Camuzzi et al. had reported a patient with leiomyosarcoma of the prostate gland who was successfully treated by means of transperineal radon seed implantation and external beam radiotherapy; Kuroda et al. had reported a case of leiomyosarcoma of the prostate gland which was accompanied by multiple hepatocellular carcinomas who had received combination chemotherapy that consisted of cyclophosphamide, vincristine, Adriamycin, and DTIC (CYDAVIC). He died one year and two months after his initial diagnosis as a result of liver failure. During postmortem examination it was revealed that the histology of the liver tumours was hepatocellular carcinoma and even though the leiomyosarcoma of the prostate gland had invaded the wall of the urinary bladder and the rectum, there was no obvious distant metastasis from the leiomyosarcoma of the prostate gland; Tazi et al. stated the following: a number of treatment modalities had been adopted including radical surgery, radiotherapy, and chemotherapy for the treatment of primary leiomyosarcoma of the prostate gland, but in their opinion a successful outcome had not been achieved in any instance. Leiomyosarcoma of the prostate gland has a poor prognosis, even though the survival time is variable. In view of the aforementioned reasons, it is very important that leiomyosarcoma of the prostate gland is correctly identified and that occurrence of each case of the disease, type of treatment given, and response to treatment should be reported in order to enable the understanding of the natural history of the disease.
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https://doi.org/10.1155/2015/485786
|
[
"prostate",
"gland",
"which",
"leiomyosarcoma",
"tumour",
"that",
"radiotherapy",
"urinary",
"patients",
"rectum"
] |
[
{
"code": "GA90",
"title": "Hyperplasia of prostate"
},
{
"code": "GA91.Z",
"title": "Inflammatory or other diseases of prostate, unspecified"
},
{
"code": "GA91.Y",
"title": "Other specified inflammatory or other diseases of prostate"
},
{
"code": "GA91.0",
"title": "Chronic prostatitis"
},
{
"code": "MF40.1",
"title": "Problems of the prostate"
},
{
"code": "BD90.Z",
"title": "Lymphadenitis, unspecified"
},
{
"code": "BD90.Y",
"title": "Other specified lymphadenitis"
},
{
"code": "MA01.Z",
"title": "Enlarged lymph nodes, unspecified"
},
{
"code": "5B3Z",
"title": "Endocrine diseases, unspecified"
},
{
"code": "9A10.Z",
"title": "Disorders of lacrimal gland, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[GA90] Hyperplasia of prostate
Definition: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urinary urgency, nocturia, weak urine stream, straining while urinating, incomplete bladder emptying during urination, or increased frequency of urinary tract infection.
Also known as: Hyperplasia of prostate | Adenofibromatous hypertrophy of prostate | benign prostatic hyperplasia | prostate hyperplasia | prostatic area hypertrophy
Includes: Adenofibromatous hypertrophy of prostate
Excludes: Benign neoplasms of prostate
[GA91.Z] Inflammatory or other diseases of prostate, unspecified
Also known as: Inflammatory or other diseases of prostate, unspecified | Inflammatory or other diseases of prostate | inflammation of prostate NOS | prostatitis NOS | disease of prostate NOS
[GA91.Y] Other specified inflammatory or other diseases of prostate
Also known as: Other specified inflammatory or other diseases of prostate | Acute bacterial prostatitis | acute prostatitis | Prostatitis category I (NIH classification) | Prostatitis category I
[GA91.0] Chronic prostatitis
Definition: A condition caused by obstruction of the prostate glands. This condition is characterised by inflammation of the prostate gland, dysuria, pollakiuria, urinary urgency, genital pain, lower back pain, abdominal pain, and repeated bladder infections that last for at least three months.
Also known as: Chronic prostatitis | Fibrous prostatitis | Hypertrophic prostatitis | Subacute prostatitis | Chronic bacterial prostatitis
[MF40.1] Problems of the prostate
Definition: A group of disorders associated with the prostate occurring in diseases more specifically classified elsewhere.
Also known as: Problems of the prostate
[BD90.Z] Lymphadenitis, unspecified
Also known as: Lymphadenitis, unspecified | Lymphadenitis | adenitis NOS | inflammation of gland | lymphatic gland inflammation
[BD90.Y] Other specified lymphadenitis
Also known as: Other specified lymphadenitis | Dermatopathic lymphadenopathy | lipomelanotic reticulosis | Infective inguinal bubo | bubo
[MA01.Z] Enlarged lymph nodes, unspecified
Also known as: Enlarged lymph nodes, unspecified | Enlarged lymph nodes | swollen glands | Lymphadenopathy | adenopathy
[5B3Z] Endocrine diseases, unspecified
Also known as: Endocrine diseases, unspecified | endocrine disorder NOS | disorder of endocrine gland | disease of endocrine gland | disorder of endocrine system
[9A10.Z] Disorders of lacrimal gland, unspecified
Also known as: Disorders of lacrimal gland, unspecified | Disorders of lacrimal gland
=== GRAPH WALKS ===
--- Walk 1 ---
[GA90] Hyperplasia of prostate
Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...
--EXCLUDES--> [?] Benign neoplasm of male genital organs
Def: A non-metastasizing neoplasm that arises from the male reproductive system. Representative examples include benign prostate phyllodes tumour, benign Sertoli cell tumour, seminal vesicle cystadenoma, a...
--PARENT--> [?] Benign neoplasms except of mesenchymal origin
--- Walk 2 ---
[GA90] Hyperplasia of prostate
Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...
--PARENT--> [?] Diseases of prostate
--CHILD--> [GA90] Hyperplasia of prostate
Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...
--- Walk 3 ---
[GA91.Z] Inflammatory or other diseases of prostate, unspecified
--PARENT--> [GA91] Inflammatory or other diseases of prostate
Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....
--CHILD--> [GA91.1] Abscess of prostate
Def: A condition caused by infection with the gram-negative bacteria Neisseria gonorrhoeae and Escherichia coli, or the gram-positive bacteria Staphylococcus aureus or Mycobacterium tuberculosis. This cond...
--- Walk 4 ---
[GA91.Z] Inflammatory or other diseases of prostate, unspecified
--PARENT--> [GA91] Inflammatory or other diseases of prostate
Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....
--RELATED_TO--> [?] Prostatitis due to Trichomonas vaginalis
Def: This refers to an inflammation of the prostate gland caused by an infection with the protozoan parasite Trichomonas vaginalis....
--- Walk 5 ---
[GA91.Y] Other specified inflammatory or other diseases of prostate
--PARENT--> [GA91] Inflammatory or other diseases of prostate
Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....
--RELATED_TO--> [?] Prostatitis due to Trichomonas vaginalis
Def: This refers to an inflammation of the prostate gland caused by an infection with the protozoan parasite Trichomonas vaginalis....
--- Walk 6 ---
[GA91.Y] Other specified inflammatory or other diseases of prostate
--PARENT--> [GA91] Inflammatory or other diseases of prostate
Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....
--RELATED_TO--> [?] Prostatitis due to Trichomonas vaginalis
Def: This refers to an inflammation of the prostate gland caused by an infection with the protozoan parasite Trichomonas vaginalis....
|
[
"[GA90] Hyperplasia of prostate\n Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...\n --EXCLUDES--> [?] Benign neoplasm of male genital organs\n Def: A non-metastasizing neoplasm that arises from the male reproductive system. Representative examples include benign prostate phyllodes tumour, benign Sertoli cell tumour, seminal vesicle cystadenoma, a...\n --PARENT--> [?] Benign neoplasms except of mesenchymal origin",
"[GA90] Hyperplasia of prostate\n Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...\n --PARENT--> [?] Diseases of prostate\n --CHILD--> [GA90] Hyperplasia of prostate\n Def: A condition of the prostate, caused by an increased rate of cellular division of the glandular and stromal cells. This condition is characterised by enlargement of the prostatic tissue, dysuria, urina...",
"[GA91.Z] Inflammatory or other diseases of prostate, unspecified\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --CHILD--> [GA91.1] Abscess of prostate\n Def: A condition caused by infection with the gram-negative bacteria Neisseria gonorrhoeae and Escherichia coli, or the gram-positive bacteria Staphylococcus aureus or Mycobacterium tuberculosis. This cond...",
"[GA91.Z] Inflammatory or other diseases of prostate, unspecified\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --RELATED_TO--> [?] Prostatitis due to Trichomonas vaginalis\n Def: This refers to an inflammation of the prostate gland caused by an infection with the protozoan parasite Trichomonas vaginalis....",
"[GA91.Y] Other specified inflammatory or other diseases of prostate\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --RELATED_TO--> [?] Prostatitis due to Trichomonas vaginalis\n Def: This refers to an inflammation of the prostate gland caused by an infection with the protozoan parasite Trichomonas vaginalis....",
"[GA91.Y] Other specified inflammatory or other diseases of prostate\n --PARENT--> [GA91] Inflammatory or other diseases of prostate\n Def: Any disease caused by obstruction of the prostate gland. These diseases are characterised by a build-up of secretions and inflammation of the prostate....\n --RELATED_TO--> [?] Prostatitis due to Trichomonas vaginalis\n Def: This refers to an inflammation of the prostate gland caused by an infection with the protozoan parasite Trichomonas vaginalis...."
] |
GA90
|
Hyperplasia of prostate
|
[
{
"from_icd11": "GA90",
"icd10_code": "N402",
"icd10_title": "Nodular prostate without lower urinary tract symptoms"
},
{
"from_icd11": "GA90",
"icd10_code": "N403",
"icd10_title": "Nodular prostate with lower urinary tract symptoms"
},
{
"from_icd11": "GA90",
"icd10_code": "N400",
"icd10_title": "Benign prostatic hyperplasia without lower urinary tract symptoms"
},
{
"from_icd11": "GA90",
"icd10_code": "N401",
"icd10_title": "Benign prostatic hyperplasia with lower urinary tract symptoms"
},
{
"from_icd11": "GA90",
"icd10_code": "N40",
"icd10_title": "Benign prostatic hyperplasia"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N414",
"icd10_title": "Granulomatous prostatitis"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N4289",
"icd10_title": "Other specified disorders of prostate"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N4283",
"icd10_title": "Cyst of prostate"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N410",
"icd10_title": "Acute prostatitis"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N419",
"icd10_title": "Inflammatory disease of prostate, unspecified"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N429",
"icd10_title": "Disorder of prostate, unspecified"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N418",
"icd10_title": "Other inflammatory diseases of prostate"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N41",
"icd10_title": "Inflammatory diseases of prostate"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N42",
"icd10_title": "Other and unspecified disorders of prostate"
},
{
"from_icd11": "GA91.Z",
"icd10_code": "N428",
"icd10_title": "Other specified disorders of prostate"
}
] |
N402
|
Nodular prostate without lower urinary tract symptoms
|
We present the case of a 13 year-old with a scleroderma-like condition, ultimately diagnosed with Myhre syndrome, a genetic disorder that may mimic juvenile scleroderma (Supplemental Table 1 ). Securing a molecular diagnosis in this case allowed the cessation of immunosuppression thus reducing the burden of unnecessary toxic exposure to glucocorticoids, and other ineffective immunosuppressive treatments; and facilitated genetic counselling, and prognostication. This also had implications for long term follow up as patients with Myhre syndrome require close surveillance for detection of any malignancy in view of increased risk of cancer reported in these patients . We therefore highlight this case to raise awareness of a growing number of monogenic fibrotic disorders mimicking juvenile scleroderma which need to be considered in patients with cutaneous fibrosis beginning early in life (Table 1 ). Table 1 Monogenic disorders with a scleroderma-like phenotype. The clinical features have been summarised as described by the Online Mendelian Inheritance in Man (OMIM) and Genetics Home Reference databases Disease Inheritance Gene Clinical Features Hutchinson-Gilford Progeria AD, AR LMNA Skin: Sclerodermatous skin disease, loss of subcutaneous fat (lipodystrophy) Skeletal: Osteoporosis, joint restrictions, joint abnormalities Cardiovascular: Atherosclerosis Other: Prematurely aged appearance, postnatal onset growth retardation, hair loss (alopecia) Werner syndrome AR WRN Skin: Sclerodermatous skin disease, subcutaneous calcification, ulceration Skeletal: Osteoporosis Cardiovascular: Premature arteriosclerosis Endocrine: Diabetes mellitus, hypogonadism Other: Prematurely aged appearance, short stature, alopecia, juvenile cataracts Rothmund Thomson syndrome AR RECQL4 Skin: Erythematous thickened skin lesions in infancy, poikiloderma (atrophic plaques with telangiectasia), telangiectasia, atrophy, sun sensitivity Skeletal: Osteoporosis Central Nervous System: Mental retardation (rare) Endocrine: Hypogonadism Other: Prematurely aged appearance, short stature, alopecia, premature greying of hair, increased risk of malignant disease Mandibular hypoplasia, deafness, progeroid features and lipodystrophy syndrome AD POLD1 Skin: Sclerodermatous skin disease, telangiectasias, atrophy, lipodystrophy Skeletal: Osteoporosis, joint contractures Endocrine: Insulin resistance, diabetes mellitus Other: Prematurely aged appearance, mandibular hypoplasia, sensorineural deafness, hepatomegaly, hepatic steatosis Nestor-Guillermo Progeria Syndrome AR BANF1 Skin: Sclerodermatous skin disease (patchy) and hyperpigmentation Skeletal: Joint stiffness, joint contractures, osteoporosis, osteolysis Cardiovascular: Sinus tachycardia, prominent subcutaneous venous patterning, pulmonary hypertension Other: Prematurely aged appearance, short stature, lipoatrophy Keppen-Lubinsky syndrome AD KCNJ6 Skin: Lipodystrophy, wrinkled appearance Skeletal: Joint contractures Central Nervous System: Severe mental retardation, delayed psychomotor development, hypertonia, hyperreflexia Other: Prematurely aged appearance, generalised lipodystrophy Fontaine Progeroid Syndrome AD SLC25A24 Skin: Wrinkled skin, lipodystrophy, sclerodermatous skin disease Skeletal: Low bone density, delayed bone age Cardiovascular: Pulmonary artery hypertension, aortic ectasia Other: Prematurely aged appearance, short stature, intrauterine growth retardation Cockayne Syndrome, Type A AR ERCC8 Skin: Cutaneous photosensitivity, scarred, pigmented, atrophy, reduced subcutaneous adipose tissue, sclerodermatous skin disease Skeletal: Flexion contractures, mild-to-moderate joint limitations Cardiovascular: Hypertension Neurological: Impaired or delayed neural development, mental retardation Other: Prematurely aged appearance, cachectic dwarfism, intrauterine growth retardation, sensorineural hearing loss, vision complications, tooth decay, hepatomegaly, splenomegaly, decreased subcutaneous adipose tissue Ataxia-telangiectasia AR ATM Skin: Sclerodermatous skin disease, progeric skin changes, cutaneous telangiectasia, cafe-au-lait spots Respiratory: Bronchitis, bronchiectasis Neurological: Cerebellar ataxia, cerebellar cortical degeneration, oculomotor abnormalities, seizures, choreoathetosis, dystonia, reduced/absent deep tendon reflexes Other: Short stature Myhre syndrome AD SMAD4 Skin: Sclerodermatous skin disease Skeletal: Skeletal abnormalities, joint restrictions Cardiovascular: Hypertension, congenital heart defects, aortic stenosis, aortic coarctation, pericardial fibrosis Respiratory: Laryngotracheal stenosis, respiratory failure Neurological: Mental retardation, delayed language and motor skill development, behavioural issues (autistic-like) Other: Dysmorphic facial features, short stature, hearing loss, generalised muscle hypertrophy Stiff skin syndrome AD FBN1 Skin: Sclerodermatous skin disease (diffuse), lipodystrophy Skeletal: Joint restrictions, flexion contractures Other: Muscle weakness Pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) AR SLC29A3 Skin: Hyperpigmented and hypertrichotic skin lesions on lower body, sclerodermatous skin disease Skeletal: Joint contractures (elbows, fingers and toes) Abdomen: Hepatomegaly, diabetes mellitus (insulin-dependent), splenomegaly Other: Short stature, hearing loss Reynolds syndrome AD LBR Skin: Sclerodermatous skin disease (tightened and shiny skin over the forearms and hands), sclerodactyly, calcinosis cutis, generalized darkening Other: Raynaud phenomenon, hepatomegaly, primary biliary cirrhosis, splenomegaly, esophageal dysfunction Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome /Nakajo-Nishimura Syndrome AR PSMB8 Skin: Erythematous nodular skin lesions and plaques on the face and extremities, dry, stiff, lipodystrophy Skeletal: Joint contractures (elbow, fingers/hands, toes, feet), joint pain Muscle: Lipodystrophy, muscle weakness Other: Poor growth, hepatomegaly, splenomegaly Mucolipidosis III gamma AR GNPTG Skin: Sclerodermatous skin disease Skeletal: Joint restrictions, joint stiffness, joint pain Cardiovascular: Aortic valve thickening, aortic stenosis Neurological: Mental retardation Other: Short stature Hurler-Scheie syndrome / Mucopolysaccharidosis Ih/s AR IDUA Skin: Sclerodermatous skin disease Skeletal: Joint stiffness, dysostosis multiplex Cardiovascular: Thickened mitral valve leaflets, aortic valve thickening, dilated left atrium, dilated left ventricle, mild pulmonary hypertension Respiratory: Frequent respiratory infections, nasopharyngeal obstruction, tracheal stenosis Abdomen: Umbilical hernia, hepatomegaly, splenomegaly Neurological: Pachymeningitis cervicalis Other: Short stature, corneal clouding Zimmermann-Laband Syndrome 1 AD KCNH1 Skin: Dry, sclerodermatous skin disease Skeletal: Scoliosis, hypoplastic distal phalanges (hands and feet), hyperextensible joints Abdomen: Hepatosplenomegaly, splenomegaly, umbilical hernia Cardiovascular: Cardiomyopathy, patent ductus arteriosus, aortic root dilatation, aortic arch dilatation Muscle: Poor muscle bulk Neurological: Hypotonia, seizures, mental retardation Other: Gingival fibromatosis, dysplastic or absent nails, hirsutism, abnormalities of the cartilage of the nose and/or ears Buschke-Ollendorff syndrome AD LEMD3 Skin: Subcutaneous nontender firm nodules, subcutaneous connective tissue nevi, elastin-rich connective tissue nevi (elastoma), collagen-rich connective tissue nevi (dermatofibrosis lenticularis disseminata) Skeletal: Osteopoikilosis, joint stiffness, osteosclerosis, melorheostosis Growth Retardation, Alopecia, Pseudoanodontia and Optic Atrophy (GAPO) Syndrome AR ANTXR1 Skin: Sclerodermatous skin disease, redundant, prominent scalp veins, epidermal inclusion cyst Skeletal: Delayed bone age Other: Growth retardation, alopecia, pseudoanodontia, umbilical hernia, hepatomegaly Crouzon Syndrome with acanthosis nigricans AD FGFR3 Skin: Hyperpigmentation, acanthosis nigricans, melanocytic nevi, hypertrophy, sclerodermatous skin disease, redundant skin folds Skeletal: Craniosynostosis Frontometaphyseal dysplasia 2 AD MAP 3 K7 Skin: Keloid formation, sclerodermatous skin disease Skeletal: Skeletal abnormalities, joint contractures Cardiovascular: Patent ductus arteriosus, bicuspid aortic valve, aortic root dilation, pulmonary valve stenosis Respiratory: Congenital stridor, subglottic stenosis, tracheal stenosis Premature aging syndrome, Penttinen type AD PDGFRB Skin: Progressive cutaneous atrophy, thin translucent skin with prominent venous patterning, hypertrophic keloid-like lesions, skin retraction, sclerodermatous skin disease, lipoatrophy Skeletal: Delayed bone maturation, osteopenia, joint contractures Farber Lipogranulomatosis AR ASAH1 Skin: Early-onset subcutaneous nodules, lipogranulomatosis Skeletal: Painful and progressively deformed joints, arthritis Respiratory: Laryngeal nodules Abdomen: Hepatomegaly, splenomegaly Neurological: Irritability, motor retardation, mental retardation Other: Hoarseness by laryngeal involvement Amyloidosis, Primary Localised cutaneous, 3 (PLCA3) AR GPNMB Skin: Amyloid disposition in the skin, hyper- and hypo-pigmented macules, mild pruritis, dry skin Carney Complex, Type 1 AD PRKAR1A Skin: Cutaneous tumors, profuse pigmented skin lesions, nevi Cardiovascular: Tumors (atrial), ventricular myxoma, congestive heart failure Endocrine: Tumors, pigmented micronodular adrenal dysplasia, Cushing disease, acromegaly, thyroid follicular hyperplasia Other: Neoplasia, myxoid subcutaneous tumors, primary adrenocortical nodular hyperplasia, testicular Sertoli cell tumor (calcified), pituitary adenoma, mammary ductal fibroadenoma, schwannoma, psammomatous melanotic schwannomas, thyroid carcinoma, pheochromocytoma Porphyria cutanea tarda, Porphyria, hepatoerythropoietic AD, AR UROD Skin: Sclerodermatous skin disease (diffuse), increased mechanical skin fragility after sunlight exposure (photosensitivity), vesicles, bullae and blisters on exposed areas of skin, hyperpigmentation on sun-exposed skin Abdomen: Hepatic hemosiderosis, hepatic cirrhosis, liver biopsy shows red autofluorescence and needle-like cytoplasmic inclusion bodies Other: Neoplasia, increased incidence of hepatocellular carcinoma Phenylketonuria, non-PKU mild Hyperphenylalaninemia AR PAH Skin: Sclerodermatous skin disease, pale pigmentation, dry, eczema Neurological: Seizures, delayed development, mental retardation, behavioural problems and psychiatric disorders Other: Head, microcephaly, cataracts Porphyria, congenital erythropoietic AR UROS Skin: Sclerodermatous skin disease, photosensitivity, blistering and scarring, hyperpigmentation, hypopigmentation Skeletal: Osteolysis, osteopenia, finger contractures Other: Short stature, conjunctivitis, corneal scarring, hypertrichosis, alopecia, porphyrin-rich gallstones, splenomegaly Multicentric osteolysis, nodulosis and arthropathy (MONA) AR MMP2 Skin: Subcutaneous nodules (interphalangeal joints, knees, feet, elbows, pretibial), hyperpigmented erythematous lesions Skeletal: Osteoporosis, flexion contractures Winchester syndrome AR MMP14 Skin: Sclerodermatous skin disease (patchy, dark, leathery) Skeletal: Osteopenia, osteoporosis, arthropathy, joint restrictions Cardiovascular: Heart abnormalities Other: Corneal opacity, hypertrichosis, overgrowth of the gums, coarse facial features Multisystemic fibrosis-like hereditary fibrosing poikiloderma with tendon contractures, myopathy and pulmonary fibrosis (POIKTMP) AD FAM111B Skin: Congenital poikiloderma (face and exposed skin), telangiectatic lesions, eczema-like lesions, epidermal atrophy Respiratory: Interstitial pulmonary fibrosis Muscle: Tendon contractures, muscle weakness, myopathy Other: Congenital poikiloderma on face Weill-Marchesani syndrome 1 AR ADAMTS10 Skin : Sclerodermatous skin disease Skeletal: Joint stiffness, joint restrictions Cardiovascular: Heart defects, aortic valve stenosis, pulmonary valve stenosis, ductus arteriosus, ventricular septal defect Neurological: Mild mental retardation Other: Short stature, brachydactyly, eye anomalies Weill-Marchesani syndrome 4 (WMS-like syndrome) AR ADAMTS17 Skin: Sclerodermatous skin disease Skeletal: Joint stiffness Cardiovascular: Cardiac defects (uncommon) Other: Short stature, severe myopia, acute and/or chronic glaucoma, cataract Frank-Ter Haar Syndrome AR SH3PXD2B Skin: Sclerodermatous skin disease (face), acne conglobata Skeletal: Osteolysis, osteopenia, osteoporosis, shortened bowed long bones, flexion deformities of fingers Other: Growth retardation, glaucoma, brachycephaly, wide fontanels, prominent forehead, hypertelorism, prominent eyes, malocclusion Geleophysic dysplasia 3 AD LTBP3 Skin: Sclerodermatous skin disease Skeletal: Joint restrictions, delayed bone age Cardiovascular: Pulmonary hypertension Respiratory: Dyspnea, tracheal stenosis, respiratory failure Other: Short stature, marked brachydactyly, hepatomegaly Geleophysic dysplasia 1 AR ADAMTSL2 Skin: Sclerodermatous skin disease Skeletal: Osteopenia, shortened long tubular bones, short hands and feet, joint contractures, joint restrictions, delayed bone age Cardiovascular: Progressive cardiac valvular thickening, cardiac failure, mitral stenosis, tricuspid stenosis, aortic stenosis Respiratory: Tracheal stenosis, respiratory insufficiency Neurological: Developmental delay, seizures Other: Short stature, ‘happy’ appearance with full cheeks, shortened nose, wide mouth, hepatomegaly Mucolipidosis II Alpha/Beta AR GNPTAB Skin: Sclerodermatous skin disease, cavernous hemangioma Skeletal: Skeletal abnormalities, moderate joint restrictions, osteopenia Cardiovascular: Cardiomegaly, congestive heart failure, hypertrophic cardiomyopathy, cardiac murmur, aortic insufficiency Respiratory: Recurrent bronchitis, recurrent pneumonia Abdomen: Umbilical hernia, hepatomegaly Neurological: Developmental delay, severe psychomotor retardation Other: Progressive failure to thrive, Hurler-like body configuration, marked growth retardation, coarse facial features, abdominal protuberance, hoarse voice Hypertrophic Osteoarthropathy, Primary, Autosomal Recessive 1 / Cranioosteoarthropathy AR HPGD Skin: Sclerodermatous skin disease, pachydermia, furrowed, oily, seborrhea, redundant, palmoplantar hyperkeratosis, eczema Skeletal: Digital clubbing, osteoarthropathy, arthralgia, arthritis, swollen joints, decreased joint mobility, osteopenia, osteoporosis Cardiovascular: Congenital heart disease, patent ductus arteriosus Other: Marfanoid habitus, coarse facial features, furrowed forehead, ptosis, thickened eyelids, turtle-backed nails, digital clubbing AD Autosomal dominant, AR Autosomal recessive, SSc systemic sclerosis
| 4.273438
| 0.928223
|
sec[2]/p[0]
|
en
| 0.999997
|
32917212
|
https://doi.org/10.1186/s12969-020-00466-1
|
[
"skin",
"skeletal",
"sclerodermatous",
"joint",
"cardiovascular",
"retardation",
"short",
"stature",
"contractures",
"stenosis"
] |
[
{
"code": "ME67",
"title": "Skin disorder of uncertain or unspecified nature"
},
{
"code": "ME66.Y",
"title": "Other specified skin changes"
},
{
"code": "EM0Y",
"title": "Other specified diseases of the skin"
},
{
"code": "ME60.Z",
"title": "Skin lesion of unspecified nature"
},
{
"code": "ME66.1",
"title": "Changes in skin texture"
},
{
"code": "LB9Z",
"title": "Structural developmental anomalies of the skeleton, unspecified"
},
{
"code": "FB80.1",
"title": "Skeletal fluorosis"
},
{
"code": "FC0Z",
"title": "Diseases of the musculoskeletal system or connective tissue, unspecified"
},
{
"code": "ND56.2",
"title": "Fracture of unspecified body region"
},
{
"code": "LD2B",
"title": "Syndromes with premature ageing appearance as a major feature"
}
] |
=== ICD-11 CODES FOUND ===
[ME67] Skin disorder of uncertain or unspecified nature
Definition: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question.
Also known as: Skin disorder of uncertain or unspecified nature | Skin disorder without established diagnosis | change of skin NOS | dermatological disease NOS | dermatological disorder NOS
[ME66.Y] Other specified skin changes
Also known as: Other specified skin changes | Cutis marmorata | Fear of skin disease | Retention hyperkeratosis | Dermatitis neglecta
[EM0Y] Other specified diseases of the skin
Also known as: Other specified diseases of the skin | Adverse cutaneous effects of healthcare related interventions | Cutaneous complications of surgical, laser or other interventional procedures | Postprocedural cutaneous complications of surgical, laser or other interventions | Cutaneous complications of surgical procedures
[ME60.Z] Skin lesion of unspecified nature
Also known as: Skin lesion of unspecified nature | Skin lesion of uncertain or unspecified nature | Skin lesion without established diagnosis | Pigmented skin lesion of unspecified nature | Ulcer of skin of unspecified nature
[ME66.1] Changes in skin texture
Definition: Alterations in skin texture of unspecified cause.
Also known as: Changes in skin texture | Skin textural disturbance | Thickening of skin | induration of skin | Skin sclerosis
[LB9Z] Structural developmental anomalies of the skeleton, unspecified
Also known as: Structural developmental anomalies of the skeleton, unspecified | Abnormal bone development | skeletal anomaly NOS
[FB80.1] Skeletal fluorosis
Also known as: Skeletal fluorosis | Skeletal fluorosis, multiple sites | Skeletal fluorosis, shoulder region | Skeletal fluorosis, clavicle | Skeletal fluorosis, scapula
[FC0Z] Diseases of the musculoskeletal system or connective tissue, unspecified
Also known as: Diseases of the musculoskeletal system or connective tissue, unspecified | bone disease NOS | bone disorder NOS | bone lesion NOS | musculoskeletal complications NOS
[ND56.2] Fracture of unspecified body region
Also known as: Fracture of unspecified body region | avulsion fracture of unspecified body site | comminuted fracture of unspecified body site | compression fracture of unspecified body site | fracture dislocation of unspecified body site
Excludes: multiple fractures NOS
[LD2B] Syndromes with premature ageing appearance as a major feature
Definition: A heterogeneous group of hereditary syndromes in which affected individuals do or appear to age at an accelerated rate.
Also known as: Syndromes with premature ageing appearance as a major feature | Progeroid syndromes | premature aging syndrome | progeria syndrome | Cockayne syndrome
Includes: Progeroid syndromes | Cockayne syndrome | Rothmund-Thomson syndrome
Excludes: Xeroderma pigmentosum | Cutis laxa
=== GRAPH WALKS ===
--- Walk 1 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--PARENT--> [?] Symptoms, signs or clinical findings involving the skin
--- Walk 2 ---
[ME67] Skin disorder of uncertain or unspecified nature
Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....
--PARENT--> [?] Symptoms or signs involving the skin
Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....
--CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature
Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...
--- Walk 3 ---
[ME66.Y] Other specified skin changes
--PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs
Def: Other specified skin changes which cannot be more precisely defined....
--RELATED_TO--> [?] Abnormal skin pigmentation
Def: Abnormal skin pigmentation without specification of type or cause....
--- Walk 4 ---
[ME66.Y] Other specified skin changes
--PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs
Def: Other specified skin changes which cannot be more precisely defined....
--CHILD--> [ME66.0] Abnormal sensitivity to light or UV radiation of uncertain or unspecified nature
--- Walk 5 ---
[EM0Y] Other specified diseases of the skin
--PARENT--> [14] Diseases of the skin
Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
--RELATED_TO--> [?] Neonatal phototherapy burn
Def: Burn resulting from phototherapy administered to neonate, usually for the treatment of neonatal jaundice....
--- Walk 6 ---
[EM0Y] Other specified diseases of the skin
--PARENT--> [14] Diseases of the skin
Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...
--RELATED_TO--> [?] Haematoma of surgical wound of skin
Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis...
|
[
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --PARENT--> [?] Symptoms, signs or clinical findings involving the skin",
"[ME67] Skin disorder of uncertain or unspecified nature\n Def: A category to enable the presence of a skin disorder to be recorded without making assumptions as to the precise nature of the disorder in question....\n --PARENT--> [?] Symptoms or signs involving the skin\n Def: This category allows the capture of imprecise data where a more specific diagnosis cannot be made or to supplement information about a specific diagnosis....\n --CHILD--> [ME61] Subcutaneous swelling, mass or lump of uncertain or unspecified nature\n Def: One or more localised subcutaneous soft tissue masses of undetermined or unspecified nature...",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --RELATED_TO--> [?] Abnormal skin pigmentation\n Def: Abnormal skin pigmentation without specification of type or cause....",
"[ME66.Y] Other specified skin changes\n --PARENT--> [ME66] Miscellaneous non-specific skin-related symptoms and signs\n Def: Other specified skin changes which cannot be more precisely defined....\n --CHILD--> [ME66.0] Abnormal sensitivity to light or UV radiation of uncertain or unspecified nature",
"[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Neonatal phototherapy burn\n Def: Burn resulting from phototherapy administered to neonate, usually for the treatment of neonatal jaundice....",
"[EM0Y] Other specified diseases of the skin\n --PARENT--> [14] Diseases of the skin\n Def: Diseases of the skin incorporate conditions affecting the epidermis, its appendages (hair, hair follicle, sebaceous glands, apocrine sweat gland apparatus, eccrine sweat gland apparatus and nails) and...\n --RELATED_TO--> [?] Haematoma of surgical wound of skin\n Def: Collection of blood within skin and soft tissues following surgical wound of skin usually resulting from defective haemostasis..."
] |
ME67
|
Skin disorder of uncertain or unspecified nature
|
[
{
"from_icd11": "ME67",
"icd10_code": "L989",
"icd10_title": "Disorder of the skin and subcutaneous tissue, unspecified"
},
{
"from_icd11": "ME66.Y",
"icd10_code": "L578",
"icd10_title": "Other skin changes due to chronic exposure to nonionizing radiation"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L918",
"icd10_title": "Other hypertrophic disorders of the skin"
},
{
"from_icd11": "EM0Y",
"icd10_code": "L988",
"icd10_title": "Other specified disorders of the skin and subcutaneous tissue"
},
{
"from_icd11": "ME66.1",
"icd10_code": "R234",
"icd10_title": "Changes in skin texture"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q8789",
"icd10_title": "Other specified congenital malformation syndromes, not elsewhere classified"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q8781",
"icd10_title": "Alport syndrome"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q742",
"icd10_title": "Other congenital malformations of lower limb(s), including pelvic girdle"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q749",
"icd10_title": "Unspecified congenital malformation of limb(s)"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q740",
"icd10_title": "Other congenital malformations of upper limb(s), including shoulder girdle"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q741",
"icd10_title": "Congenital malformation of knee"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q875",
"icd10_title": "Other congenital malformation syndromes with other skeletal changes"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q748",
"icd10_title": "Other specified congenital malformations of limb(s)"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q89",
"icd10_title": "Other congenital malformations, not elsewhere classified"
},
{
"from_icd11": "LB9Z",
"icd10_code": "Q65-Q79",
"icd10_title": ""
}
] |
L989
|
Disorder of the skin and subcutaneous tissue, unspecified
|
In the following, cases with SA errors are described (see Table 2 for details). Case 1 refers to information that was either missing due to insufficient communication or that was simply forgotten. Cases 2–4 are examples of barriers that physically preclude from information to become (acoustic and visual) sensory input (e.g., “After putting the drapes, the access to both peripheral iv lines was hampered”). In case 3, specifically, “small fonts” on a display prevented from a more timely recognition of the fact that a propofol syringe pump ran with remifentanil and vice versa. In case 5, relevant information was missed due to the decision not to use a patient monitor. Case 6 describes the mis perception of drug labels resulting in the decision to use hydroxyethyl starch to keep open an arterial line. The reporting individual identified a look-alike problem of drugs (“both look similar”) which is a problem addressed extensively elsewhere . In these cases (1–6), the involved individuals did not perceive relevant information and consequently, they did not comprehend important aspects of the situation and, as a result, wrong or no decisions were made. Table 2 Fifteen examples of SA errors Case number Case description Analysis from the SA perspective SA level 1 An anesthesiologist took over a patient who had undergone massive transfusion including catecholamine therapy. He reports to have received a “detailed handover” and that his job was to finish the procedure and to transport the patient to ICU. Just before leaving the OR he replaced an empty infusion bag with a new one in order to continue volume replacement. Immediately afterwards, the patient’s suffered from ventricular arrhythmia and the systolic blood pressure increased to 250 mmHg. “During check of the i.v.-lines I noticed that the adrenaline syringe pump had been connected to the central line by two extension lines type Heidelberger. Obviously they had filled with highly concentrated adrenaline which was administered unintentionally during volume resuscitation.” The anesthesiologist was not aware about a significant amount of adrenaline in the lines. Possibly, the hand-over, which he felt to be “detailed”, did not include information about this fact (SA-I). Alternatively, he may have forgotten this information in face of a complex situation where gaining complete SA in short time is challenging for someone who had not been involved until this moment. SA I data not available or memory loss 2 “The code blue physician does not hear the beeper. The beeper turns off after a certain time. The causes are a significant noise exposure on the ICU and the high frequency of phone calls.” The code blue physician did not perceive the alarm (SA-I). The reporting individual mentions acoustic barriers on one hand and high workload on the other hand as causes. SA I hard to detect 3 “For economic reasons, sometimes, nurses program the syringe pumps. In this case a syringe pump programmed for propofol ran with remifentanil and, accordingly, it ran too slow. […] The only striking point was that we had propofol in the remifentanil line repeatedly and despite high infusion rates, we still had the first syringe of remifentanil after hours. Having a closer look we were able to recognize propofol in small fonts on the display whereas remifentanil was indicated on the syringe label.” It largely remains unclear why the nurse allocated the drugs incorrectly. Assumingly some information (syringe content or pump program) has been forgotten. However, the reporting individual clearly states that important information was displayed in small fonts hindering a fast and quick recognition of the content of syringe pumps (SA-I). SA I data hard to discriminate 4 “After putting the drapes, the access to both peripheral iv lines was hampered. During team-time-out one of the surgeon leant against the arm compressing the iv lines while the anesthesiologist paged through the patient’s health record […] so that the anesthetics entered the infusion bag of the crystalloids. During skin incision the patient showed increase of heart rate and moved the arms. Then, we switched the administration of anesthetics to the other iv access.” Important visual information from iv lines (obstruction) was not perceived due to a visual barrier (drapes). Furthermore, the visual attention was directed to the patient’s health record during team time out. It remains speculative why a non-return valve had not been used and whether the use of such a valve had resulted e.g., in high-pressure alarms in the syringe pumps (SA-I). SA I hard to detect and failure to observe 5 After uneventful anaesthesia the patient was transferred to another location. There, the first systolic blood pressure assessed was 60 mmHg. “In this OR a transport monitor does not exist. The short transfer regularly is done without monitoring. Every time a monitor is required, we have to get it from elsewhere which is time-intensive.” The case reveals structural problems as a monitoring device is not easily available and the anesthesiologists avoid time delays in face of assumingly uncomplicated cases. As a result, important information is missed (SA-I). SA I failure to monitor 6 “To keep open an arterial line, HES [hydroxyethyl starch] was used instead of saline. Both look similar but HES is an emergency substance so that it should be stored in a different place.” As both infusions look similar (look-alike problem), the information was correct but obviously misperceived (SA-I). SA I misperception 7 “A patient is transferred to ICU with several syringe pumps including a pump for TIVA [total intravenous anaesthesia] that had been equipped with a catecholamine. The ICU personnel are not familiar with that type of pumps. […] Unintentionally, the patient got a high bolus.” A health care provider works with a syringe pump he is not familiar with. Although all the dynamic information is present (rates, drugs, indication), the individual applies an incorrect mental model of the pump’s operating mode and thus, he lacks of comprehension (SA-II). SA II use of incorrect mental model 8 “two oral drugs […] had been given via the central venous line instead of the gastric tube.” Assumingly, all the relevant information (e.g., package insert, drug orders) was present, but the individual lacks of a mental model with respect to how these drugs are administered (SA-II). As a result he does not comprehend that these drugs have to be administered in another way. SA II use of incorrect mental model 9 “ […] On the third postoperative day […] the epidural was stopped. On the next morning, the anesthetist cannot visit the patients due to concurrent obligations. During the evening visit, the anesthetist noticed that ropivacaine was re-started but that it was connected to a peripheral venous line. The infusion was stopped immediately.” Assumingly, all the relevant basic information was present: drug, patient and indication (SA-I). But the information was not properly integrated, due to missing knowledge or the use of missing or an incorrect mental model (SA-II). If someone is confronted with a set of information he can’t process due to missing contextual contents in the long-term memory, he will probably ask for assistance. If an incorrect model is used, he won’t recognize the error as long as there is no additional information such as visible adverse effects. SA II use of incorrect mental model 10 "During TIVA a change of the syringe (remifentanil) was pending. The syringe had been prepared by the nurse (50 ml, clear solution). The label “remifentanil” and the ampoule lied besides the syringe. The nurse told to the anesthesiologist that the remifentanil syringe was prepared. The anesthesiologist changed the syringe; in the following minutes, the patient shows tachycardia and high blood pressure, deepening anaesthesia is without success. When the nurse came back, she asked if the anesthesiologist had added the remifentanil to the prepared syringe. As it turned out, the communication […] was unclear and stated a potential danger for the patient.” The anesthesiologist incorrectly assumed a syringe to be correctly prepared (SA-II). Visible information (the ampoule next to the syringe) was not perceived or not integrated in order to come to the conclusion that the syringe contained purely saline. Additionally, the reporting individual identified a lack of information resulting from unclear communication as the cause. SA II over-reliance on default values 11 “A critically ill patient with complex pains, who was visited by pain physicians for 4-fold analgetic medication. During change of syringe pump, ketamine is administered in wrong dosage, 50 mg/ml instead of 1 mg/ml is administered, as it is usual for sedation. During shift change the error is recognized. […] The patient was awake throughout the case […] but suffered from headache.” The nurse who changed the syringe prepared the dosage as usual (assuming standard values), despite differing information from the medication order as indicated through the fact that this was recognized during shift change. This may have happened through an over-reliance on default values (SA-II) although additional information was available that would have resulted in a different action (preparing the correct dosage). SA II over-reliance on default values 12 “During thoracic surgery (VATS lobectomy) the suction catheter was introduced too deep in the tracheal part of the double-lumen tube. […] Lobectomy is performed using a stapler. The suction catheter could not be removed for checking for leakiness […]. As a cause, the stapler had fixed the suction catheter. An anterior thoracotomy was performed […] and the suction catheter was removed successfully.” The anesthesiologist, assumingly, was aware about the surgical procedure to be performed (use of stapler). Additionally he had the information about the suction catheter as he himself had inserted it. This information has not been integrated properly as he relied on his experience from prior situations where removing the device was always without problems and long-term memory content such as a mental model or prototypical situations suited to successfully integrate the basic data was not used or not present. As a result, also a problem on the level of projection emerges as an anterior thoracotomy had to be performed unexpectedly. SA II lack of or incomplete mental model 13 “A surgeon indicated emergency surgery. There is no written information about patient history and it is impossible to get the information orally [from the patient]. The patient is assessed clinically, an old scar from tracheostomy is visible which indicates possible intubation problems. The anesthesiologist put himself under pressure and induces anaesthesia without investigating the background or consulting the admitting hospital. A rapid sequence induction is performed. Intubation with a 8.0 size tube is not possible, bag mask ventilation works, a 7.0 mm is not introducible as well, and a laryngeal mask (4 and 5) is not tight so that adequate ventilation is impossible. Finally, another physician successfully intubates.” Unexpectedly, the anesthesiologist ran into intubation difficulties, indicating an error on the SA level of projection (SA-III). This is supported by the retrospective statement that he worked under avoidable time pressure and that, as a consequence, search for additional information was omitted (SA-I). Regardless of the fact whether the simple presence of a scar from tracheostomy should prompt the preparation for difficult airway management, a mental model that integrates the basic data (tracheostomy in the past) to SA on the level of projection “expected difficult intubation” was absent (SA-III). SA III lack of or incomplete mental model 14 A patient is scheduled for hip replacement. […] Until the use of palacos bone cement everything went fine. […] Immediately after inserting palacos bone cement, end-tidal CO 2 drops from 37 to 13 mmHg. Oxygen saturation does not provide values. At the beginning, a sinus tachycardia of 140 bpm is noticed, quickly followed by deformed QRS complexes. Heart rate drops to 20 bpm. Cardiopulmonary resuscitation is initiated immediately. The working hypotheses are air embolism, fat embolism and allergic reaction. An unexpected deterioration due to the use of palacos bone cement is described (SA-III). A dramatic change of vital parameters is the basic information (SA-I) that results in a re-evaluation of the situation. As a consequence, the anesthesiologist comprehends that cardiopulmonary resuscitation is required (SA-II). Additionally, based on basic information, possible causes are discussed. SA III over-projection of current trends 15 A geriatric patient with dementia is transported to the emergency department. He has a visible laceration on the head after having fallen out of the bed. The laceration was sutured and a CT scan ordered in face of increasing somnolence. “ A medical student saw that nobody had placed a cervical collar and that the patient complaint about pain when the head was positioned for suturing. He did not communicate his observation […]. The scan showed a facture of atlas and axis.” There are relevant cues that indicate the possibility of a lesion of the cervical spine (fall, laceration on head, increasing somnolence, pain during movement of the head). The reporting individual emphasizes that the team did not comprehend the possibility of a spine lesion that is, they either did not possess over the mental model that allowed for meaningful integration of the information mentioned above (SA-II) or they simply did not perceive some piece of information, e.g., pain during movement of the neck (SA-I). SA I failure to observe SA II Another point refers to a lack of communication as the medical student did not speak up (Team SA). Communication can refer to the SA level of comprehension (e.g., “we cannot rule out a spinal lesion, therefore cervical collar makes sense”) or to the level of perception (e.g., “every time the patients head/spine is moved, the patient complaints about pain”). missing mental model TEAM SA Fifteen cases during which SA errors led to errors or near misses. SA-I refers to the level of perception, SA-II to the level of comprehension, SA-III to the level of projection, respectively
| 3.974609
| 0.783691
|
sec[2]/sec[1]/p[0]
|
en
| 0.999998
|
26772179
|
https://doi.org/10.1186/s12871-016-0172-7
|
[
"that",
"information",
"syringe",
"model",
"mental",
"anesthesiologist",
"remifentanil",
"this",
"time",
"pump"
] |
[
{
"code": "8A80.Z",
"title": "Migraine, unspecified"
},
{
"code": "QA76",
"title": "Medication or substance that is known to be an allergen without injury or harm"
},
{
"code": "PL13.6",
"title": "Medication or substance that is known to be an allergen, as mode of injury or harm"
},
{
"code": "9C40.A0",
"title": "Papilloedema"
},
{
"code": "PA6Z",
"title": "Unintentional fall from unspecified height"
},
{
"code": "NA07.09",
"title": "Concussion with loss of consciousness, duration unspecified or unknown due to lack of information"
},
{
"code": "PK90.0",
"title": "Anaesthesiology devices associated with injury or harm, diagnostic or monitoring devices"
},
{
"code": "6E8Z",
"title": "Mental, behavioural or neurodevelopmental disorders, unspecified"
},
{
"code": "6A00.Z",
"title": "Disorders of intellectual development, unspecified"
},
{
"code": "6E6Z",
"title": "Secondary mental or behavioural syndrome, unspecified"
}
] |
=== ICD-11 CODES FOUND ===
[8A80.Z] Migraine, unspecified
Also known as: Migraine, unspecified | Migraine
[QA76] Medication or substance that is known to be an allergen without injury or harm
Definition: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm.
Also known as: Medication or substance that is known to be an allergen without injury or harm
Excludes: Medication or substance that is known to be an allergen, as mode of injury or harm
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
Also known as: Medication or substance that is known to be an allergen, as mode of injury or harm | medication error relating to known allergy to drug or substance | adverse drug event relating to known allergy to drug or substance
[9C40.A0] Papilloedema
Definition: Optic disc swelling that results from increased intracranial pressure
Also known as: Papilloedema | Optic disc swelling that results from increased intracranial pressure
Includes: Optic disc swelling that results from increased intracranial pressure
[PA6Z] Unintentional fall from unspecified height
Also known as: Unintentional fall from unspecified height | fall NOS | accidental fall | fall causing injury that resulted in death | fell NOS
[NA07.09] Concussion with loss of consciousness, duration unspecified or unknown due to lack of information
Also known as: Concussion with loss of consciousness, duration unspecified or unknown due to lack of information
[PK90.0] Anaesthesiology devices associated with injury or harm, diagnostic or monitoring devices
Definition: An anaesthesiology device was involved in an incident that occurred in a diagnostic or monitoring task
Also known as: Anaesthesiology devices associated with injury or harm, diagnostic or monitoring devices | Anaesthesiology devices associated with injury or harm, arterial pressure monitoring catheter | Anaesthesiology devices associated with injury or harm, pulse oxymeter giving faulty information
Excludes: Circumstances associated with a surgical or other medical device influencing the episode of care without injury or harm
[6E8Z] Mental, behavioural or neurodevelopmental disorders, unspecified
Also known as: Mental, behavioural or neurodevelopmental disorders, unspecified | Psychiatric disorder | mental disease NOS | mental disorder NOS | mental illness
[6A00.Z] Disorders of intellectual development, unspecified
Also known as: Disorders of intellectual development, unspecified | Disorders of intellectual development | Mental retardation | Intellectual developmental disorder | Intellectual disability
[6E6Z] Secondary mental or behavioural syndrome, unspecified
Also known as: Secondary mental or behavioural syndrome, unspecified | organic mental disorders | Secondary mental and behavioural disorders | Mental or behavioural syndromes due to health conditions not classified under mental or behavioural disorders
=== GRAPH WALKS ===
--- Walk 1 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--EXCLUDES--> [?] Headache, not elsewhere classified
Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....
--- Walk 2 ---
[8A80.Z] Migraine, unspecified
--PARENT--> [8A80] Migraine
Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...
--EXCLUDES--> [?] Headache, not elsewhere classified
Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....
--- Walk 3 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--- Walk 4 ---
[QA76] Medication or substance that is known to be an allergen without injury or harm
Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....
--PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm
--CHILD--> [QA71] Underdosing without injury or harm
Def: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccur...
--- Walk 5 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
--- Walk 6 ---
[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm
--PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance
--CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm
Def: Incorrect dose - too high...
|
[
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --EXCLUDES--> [?] Headache, not elsewhere classified\n Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....",
"[8A80.Z] Migraine, unspecified\n --PARENT--> [8A80] Migraine\n Def: A primary headache disorder, in most cases episodic. Disabling attacks lasting 4-72 hours are characterised by moderate or severe headache, usually accompanied by nausea, vomiting and/or photophobia a...\n --EXCLUDES--> [?] Headache, not elsewhere classified\n Def: Headache with characteristic features suggesting that it is a unique diagnostic entity, a finding or complaint, but not fulfilling criteria for any of the headache disorders described above....",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --EXCLUDES--> [?] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [?] Mode of injury or harm associated with exposure to a drug, medicament or biological substance",
"[QA76] Medication or substance that is known to be an allergen without injury or harm\n Def: Medication that has previously been identified as an allergen to the patient is administered, but does not result in injury or harm....\n --PARENT--> [?] Circumstances associated with exposure to a drug, medicament or biological substance influencing the episode of care without injury or harm\n --CHILD--> [QA71] Underdosing without injury or harm\n Def: Under-dosing occurs when a patient takes less of a medication than is prescribed by the provider or the manufacturer's instructions without documented injury or harm. This can be the result of inaccur...",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high...",
"[PL13.6] Medication or substance that is known to be an allergen, as mode of injury or harm\n --PARENT--> [PL13] Mode of injury or harm associated with exposure to a drug, medicament or biological substance\n --CHILD--> [PL13.0] Overdose of substance, as mode of injury or harm\n Def: Incorrect dose - too high..."
] |
8A80.Z
|
Migraine, unspecified
|
[
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B0",
"icd10_title": "Ophthalmoplegic migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43409",
"icd10_title": "Hemiplegic migraine, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A0",
"icd10_title": "Cyclical vomiting, in migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D0",
"icd10_title": "Abdominal migraine, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43709",
"icd10_title": "Chronic migraine without aura, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43A1",
"icd10_title": "Cyclical vomiting, in migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43509",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43719",
"icd10_title": "Chronic migraine without aura, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43501",
"icd10_title": "Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C0",
"icd10_title": "Periodic headache syndromes in child or adult, not intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43401",
"icd10_title": "Hemiplegic migraine, not intractable, with status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43419",
"icd10_title": "Hemiplegic migraine, intractable, without status migrainosus"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43B1",
"icd10_title": "Ophthalmoplegic migraine, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43C1",
"icd10_title": "Periodic headache syndromes in child or adult, intractable"
},
{
"from_icd11": "8A80.Z",
"icd10_code": "G43D1",
"icd10_title": "Abdominal migraine, intractable"
}
] |
G43B0
|
Ophthalmoplegic migraine, not intractable
|
"Fetal death was identified on admission during training in the use of the sonicaid in one mother (s(...TRUNCATED)
| 3.871094
| 0.873047
|
sec[2]/sec[4]/p[2]
|
en
| 0.999997
|
32536345
|
https://doi.org/10.1186/s12884-020-02921-z
|
[
"mother",
"baby",
"meconium",
"tilt",
"contraction",
"heart",
"present",
"because",
"delivery",
"mask"
] | [{"code":"QA48.1","title":"Care or examination of lactating mother"},{"code":"KB60.1","title":"Syndr(...TRUNCATED)
| "=== ICD-11 CODES FOUND ===\n\n[QA48.1] Care or examination of lactating mother\n Also known as: Ca(...TRUNCATED)
| ["[QA48.1] Care or examination of lactating mother\n --EXCLUDES--> [?] Certain specified disorders (...TRUNCATED)
|
QA48.1
|
Care or examination of lactating mother
| [{"from_icd11":"QA48.1","icd10_code":"Z391","icd10_title":"Encounter for care and examination of lac(...TRUNCATED)
|
Z391
|
Encounter for care and examination of lactating mother
|
"In the following, the 5 fictional case vignettes are presented, together with the respective soluti(...TRUNCATED)
| 3.841797
| 0.964844
|
sec[2]/p[0]
|
en
| 0.999996
|
33593428
|
https://doi.org/10.1186/s13102-021-00243-x
|
[
"pain",
"this",
"people",
"these",
"emergency",
"seek",
"while",
"knee",
"fictional",
"muscles"
] | [{"code":"MG3Z","title":"Pain, unspecified"},{"code":"8E43.Z","title":"Pain disorders, unspecified"}(...TRUNCATED)
| "=== ICD-11 CODES FOUND ===\n\n[MG3Z] Pain, unspecified\n Also known as: Pain, unspecified | pain o(...TRUNCATED)
| ["[MG3Z] Pain, unspecified\n --PARENT--> [?] Pain\n --PARENT--> [?] General symptoms","[MG3Z] Pain(...TRUNCATED)
|
MG3Z
|
Pain, unspecified
| [{"from_icd11":"MG3Z","icd10_code":"R52","icd10_title":"Pain, unspecified"},{"from_icd11":"MG3Z","ic(...TRUNCATED)
|
R52
|
Pain, unspecified
|
"A 46-year-old Japanese man without a remarkable medical history visited our hospital with chief com(...TRUNCATED)
| 4.039063
| 0.974121
|
sec[1]/p[0]
|
en
| 0.999998
|
34171004
|
https://doi.org/10.1186/s41100-018-0157-8
|
[
"blood",
"anti",
"ascites",
"serum",
"protein",
"lymph",
"staining",
"platelet",
"renal",
"antibody"
] | [{"code":"3C0Z","title":"Diseases of the blood or blood-forming organs, unspecified"},{"code":"MF50.(...TRUNCATED)
| "=== ICD-11 CODES FOUND ===\n\n[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n (...TRUNCATED)
| ["[3C0Z] Diseases of the blood or blood-forming organs, unspecified\n --PARENT--> [03] Diseases of (...TRUNCATED)
|
3C0Z
|
Diseases of the blood or blood-forming organs, unspecified
| [{"from_icd11":"3C0Z","icd10_code":"D75A","icd10_title":"Glucose-6-phosphate dehydrogenase (G6PD) de(...TRUNCATED)
|
D75A
|
Glucose-6-phosphate dehydrogenase (G6PD) deficiency without anemia
|
"Following the CARE Guidelines, a six-year-old Sudanese female child presented to the emergency depa(...TRUNCATED)
| 3.925781
| 0.981445
|
sec[1]/sec[0]/p[1]
|
en
| 0.999997
|
PMC10622857
|
https://doi.org/10.12688/f1000research.122349.1
|
[
"range",
"reference",
"four",
"axial",
"mother",
"ventricular",
"however",
"keppra",
"ventricle",
"likes"
] | [{"code":"QA00.6Y","title":"Other specified examination of eyes or vision"},{"code":"4B00.0Z","title(...TRUNCATED)
| "=== ICD-11 CODES FOUND ===\n\n[QA00.6Y] Other specified examination of eyes or vision\n Also known(...TRUNCATED)
| ["[QA00.6Y] Other specified examination of eyes or vision\n --PARENT--> [QA00.6] Examination of eye(...TRUNCATED)
|
QA00.6Y
|
Other specified examination of eyes or vision
| [{"from_icd11":"3B63.1Z","icd10_code":"D473","icd10_title":"Essential (hemorrhagic) thrombocythemia"(...TRUNCATED)
|
D473
|
Essential (hemorrhagic) thrombocythemia
|
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