tion of the metastases should be performed for proper staging of both tumours and to decide on the best therapeutic option.Despite worldwide vaccination campaigns, hepatitis B virus (HBV) infection remains a major public health problem.  https://www.selleckchem.com/products/ox04528.html  The natural history ranges from asymptomatic infection to severe liver injury or failure, chronic complications or reactivation episodes. The effects of HBV on the organism are immunomediated, possibly triggering extrahepatic manifestations. Since 1971, only a few cases of pleural effusion related to HBV infection have been described. We report HBV-associated pleural effusion occurring during a viral reactivation episode. Antiviral treatment directed towards pleural effusion related to HBV infection should be dictated by underlying liver disease severity and not pleural effusion severity.
  In the presence of pleural effusion of unknown origin, especially if with simultaneous acute hepatitis, a viral aetiology should be suspected and pursued.The severity of liver disease and not the pleural effusion should guide antiviral treatment.
 In the presence of pleural effusion of unknown origin, especially if with simultaneous acute hepatitis, a viral aetiology should be suspected and pursued.The severity of liver disease and not the pleural effusion should guide antiviral treatment.Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the GI tract, which is frequently associated with extra-intestinal manifestations. Pulmonary parenchymal disease is very uncommon and usually considered to be debilitating and harder to diagnose. Pulmonary granulomas are rarely described in the literature as a complication of Crohn's disease. Here, we present a patient with Crohn's disease exacerbation who developed granulomatous lung disease under treatment with vedolizumab. Our case may add evidence to the emerging theory that gut-selective biologic agents could lead to upregulation of some pro-inflammatory factors leading to the evolution of pulmonary disease.
  Pulmonary parenchymal diseases are rare in Crohn's disease but they can be debilitating and life-threatening as they are usually tardily diagnosed; awareness of this association is of high value and could potentially shorten the time to a definite diagnosis.Pulmonary manifestations of Crohn's disease could be subclinical without any respiratory complaints and not diagnosed with conventional imaging modalities such as chest x-ray.Gut-selective biologic agents could lead to the emergence of extra-intestinal manifestations due to upregulation of multiple pro-inflammatory cytokines.
 Pulmonary parenchymal diseases are rare in Crohn's disease but they can be debilitating and life-threatening as they are usually tardily diagnosed; awareness of this association is of high value and could potentially shorten the time to a definite diagnosis.Pulmonary manifestations of Crohn's disease could be subclinical without any respiratory complaints and not diagnosed with conventional imaging modalities such as chest x-ray.Gut-selective biologic agents could lead to the emergence of extra-intestinal manifestations due to upregulation of multiple pro-inflammatory cytokines.COVID-19, caused by severe acute respiratory syndrome coronavirus 2 infection, has caused the ongoing global pandemic. Initially considered a respiratory disease, it can manifest with a wide range of complications (gastrointestinal, neurological, thromboembolic and cardiovascular) leading to multiple organ dysfunction. A range of immune complications have also been described. We report the case of a 57-year-old man with a medical history of hypertension, prediabetes and beta thalassemia minor, who was diagnosed with COVID-19 and subsequently developed fatigue and arthralgias, and whose blood work showed hyperferritinemia, elevated liver enzymes (AST/ALT/GGT), hypergammaglobulinemia, anti-smooth muscle antibody, anti-mitochondrial antibody, and anti-double-stranded DNA antibodies. The patient was diagnosed with autoimmune hepatitis-primary biliary cholangitis overlap syndrome triggered by COVID-19. To our knowledge, this is the first such case reported.
  COVID-19 can precipitate a wide range of immune complicaeffects of the novel virus.We report a case of mechanical mitral valve endocarditis associated with miliary disseminated bacillus Calmette-Guerin (BCG) infection following intravesical instillations for minimally invasive bladder cancer in a 65-year-old man. The diagnosis was established by echocardiographic evidence of vegetation on the prosthetic mitral valve, miliary lesions in the lungs and evidence of bloodstream infection sustained by Mycobacterium. We successfully treated the patient with the classical regimen of quadruple antituberculous therapy.
  To consider endocarditis as an extra-pulmonary manifestation of 
  infection, especially in the presence of predisposing heart conditions and risk factors.To be careful of drug interactions among warfarin, rifampin and amiodarone.
 To consider endocarditis as an extra-pulmonary manifestation of Mycobacterium bovis infection, especially in the presence of predisposing heart conditions and risk factors.To be careful of drug interactions among warfarin, rifampin and amiodarone.Giant cell arteritis (GCA), or Horton's arteritis, presenting solely as fever is very rare. Usually, it manifests with typical features such as visual problems, headache and jaw claudication, or it can be associated with polymyalgia rheumatica. We describe the case of a patient with GCA who presented only with prolonged fever, the cause of which was not determined by diagnostic tests.
  Fever may be the only symptom of giant cell arteritis (GCA).It is important to consider GCA in the differential diagnosis of fever of unknown origin as early diagnosis is crucial for prompt treatment and to prevent catastrophic complications such as vision loss or stroke.Temporal artery biopsy remains the gold standard for diagnosing GCA.
 Fever may be the only symptom of giant cell arteritis (GCA).It is important to consider GCA in the differential diagnosis of fever of unknown origin as early diagnosis is crucial for prompt treatment and to prevent catastrophic complications such as vision loss or stroke.Temporal artery biopsy remains the gold standard for diagnosing GCA.