Southwestern Educational Society

The gold coral, Savalia savaglia , is generally considered a rare parasitic parazoanthid mainly found in the Mediterranean Sea, with occasional records in the Atlantic Ocean. Recently, more has come to light regarding its distribution patterns, genetic information, and habitat due to the increased research focus. Listed as ‘Near Threatened’ on the IUCN Red List, S. savaglia requires continued monitoring, and updated assessments of its distribution are crucial. Here, we compile recent data and current knowledge on this species, highlighting both confirmed findings and unresolved questions, like the question of possible cryptic species and obligatory parasitism. We also report new records from the eastern Adriatic Sea, helping to fill the existing gaps in the known distribution of the morphotype S. savaglia .

Solitary extramedullary plasmacytomas (SEPs) are rare plasma cell tumors, particularly when located in the gastrointestinal tract. Misdiagnosis may occur due to overlapping histological and immunophenotypic features with other hematologic malignancies, such as mantle cell lymphoma (MCL). We present the case of a 63-year-old female patient initially diagnosed with MCL based on rectal mass biopsy, who underwent lymphoma-directed therapy. Surgical excision and further histopathological evaluation revised the diagnosis to SEP. Over time, the patient developed serum monoclonal gammopathy and progressed to multiple myeloma (MM). This case highlights the diagnostic pitfalls of rectal lymphoid lesions, the value of surgical pathology, and the potential for SEPs to evolve into systemic plasma cell neoplasia.

Pathogenic variants in the BRD4 interacting chromatin remodeling complex associated protein (BICRA) are linked to BICRA-related neurodevelopmental disorders. These disorders are characterized by developmental delay, intellectual disability, and dysmorphic facial features, along with behavioral abnormalities, poor growth, vision abnormalities, and feeding difficulties. We present the case of a three-year-old male diagnosed with autism spectrum disorder (ASD), developmental speech delay, and epilepsy. Whole exome sequencing with copy number variant (CNV) analysis revealed a heterozygous variant of uncertain significance in the BICRA gene (c.1246G>C, p.Ala416Pro). This case report aims to highlight a gene associated with BICRA-related neurodevelopmental disorders that is rarely described in ASD patients. Further research is crucial to explore the role of chromatin remodeling in the etiology and development of ASD.

To evaluate the outcome of Indian children with Guillain-Barré syndrome who received IV immunoglobulin compared with those who did not receive any specific therapy. Single center, prospective cross-sectional study. Tertiary care neurology teaching hospital. Children (≤ 18 yr old) with Guillain-Barré syndrome were included from a prospectively maintained Guillain-Barré syndrome registry from January 2008 to April 2017. Children were classified into acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy, acute motor-sensory axonal neuropathy, and inexcitable motor nerves based on nerve conduction study. Out of 138 pediatric Guillain-Barré syndrome, 50 received IV immunoglobulin and another 50 age and peak disability matched controls (who did not receive IV immunoglobulin or plasmapheresis) were selected from the same registry for comparison. Outcome at 3 and 6 months was defined on the basis of a 0-10 Clinical Grading Scale into complete (Clinical Grading Scale < 3), partial (Clinical Grading Scale 3-5), and poor (Clinical Grading Scale > 5) recovery. The primary outcome was proportion of patients with complete recovery at 3 and 6 months in IV immunoglobulin and non-IV immunoglobulin groups. Secondary outcomes included in-hospital deaths, duration of mechanical ventilation, and hospital stay. Subgroup analysis was done in acute motor axonal neuropathy and acute inflammatory demyelinating polyradiculoneuropathy groups. The baseline characteristics were similar except for shorter duration of illness and higher proportion of facial palsy in IV immunoglobulin group. Hospital deaths, duration of mechanical ventilation, hospital stay, and outcome at 3 and 6 months were not different between the two groups. Children with acute motor axonal neuropathy had better recovery at 6 months on IV immunoglobulin (58.3% vs 11.1%; p = 0.03), but not those with acute inflammatory demyelinating polyradiculoneuropathy (58.3% vs 72.2%; p = 0.22). In nonambulatory Guillain-Barré syndrome children, complete recovery at 6 months was similar in IV immunoglobulin and non-IV immunoglobulin group (57.4% vs 57.1%; p = 0.98). In Indian children with Guillain-Barré syndrome, the outcome at 6 months in IV immunoglobulin treated group was similar to non-IV immunoglobulin group. Children with acute motor axonal neuropathy responded better to IV immunoglobulin.

Division of Neurocritical Care and Emergency Neurology and Center for Neuroepidemiology and Clinical Neurological Research, Department of Neurology, Yale School of Medicine, New Haven, CT *See also p. 784. Dr. Hwang disclosed he is the leader for the upcoming Society of Critical Care Medicine Family Engagement Collaborative.

Paediatric Intensive Care Unit, Department of Pediatrics, Sidra Medicine, Doha, Qatar *See also p. e130. Dr. Branco has disclosed that he does not have any potential conflicts of interest.

Department of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany * See also p. 2177. The authors received grant support from Dräger Medical, B. Braun, Pfizer, German Research Foundation (DFG), and the Federal Ministry of Education and Research (BMBF). Dr. Wrigge lectured for Pfizer, Maquet, Dräger Medical, Heinen-Löwenstein, and B. Braun. Dr. Reske lectured for Draeger Medical AG.

Fonseca, Marcelo MD, MSc; Krebs, Vera Lúcia Jornada MD, PhD; de Carvalho, Werther Brunow PhD Author Information

University Hospitals Leuven Leuven, Belgium *See also p. 1914. The author has not disclosed any potential conflicts of interest.