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Myocarditis is a rare but severe adverse event associated with immune checkpoint inhibitors, its diagnosis depending on a high index of suspicion and appropriate investigations. Our objective was to systematically review the diagnostic approaches to myocarditis associated with immune checkpoint inhibitors. The systematic review was conducted according to the PRISMA guidelines (PROSPERO Registration: CRD42018097247). We searched Medline and Embase for case reports, case series, and observational studies published in journal articles or presented as conference abstracts that describe patients who developed myocarditis after immune checkpoint inhibitor therapy. After a review of 2326 citations, we included 88 cases (53 case reports/series published in journal articles and 35 cases in the observational study). Serum troponin was elevated in 98% of the case reports and 94% of participants in the observational study. ST changes including ST elevation were present in almost a third of case reports. Echocardiography revealed preserved left ventricular ejection fraction in 32% of case reports and 51% of cases in the observational study; however, preserved systolic function did not predict greater survival. Patients who suffered poorer prognosis tended to have major conduction defects or ventricular arrhythmias more frequently than patients who did not. Acute myocardial ischemia was ruled out in all cases (n = 31) when the diagnostic workup included coronary angiography. Immune checkpoint inhibitor-associated myocarditis is characterized by elevation of cardiac troponin levels and non-specific electrocardiographic changes. Early coronary angiography may distinguish it from myocardial ischemia or myocardial infarction. • Largest systematic review of immune checkpoint inhibitor-induced myocarditis cases • Cases show elevated cardiac biomarkers, nonspecific electrocardiographic changes. • Cases with poor prognosis reported conduction defects and arrhythmias. • High negative predictive value of coronary angiography may help in prompt diagnosis. [ABSTRACT FROM AUTHOR]

Excessive skeletal radioisotope uptake in relation to soft tissues along with absent or faint activity in the genitourinary tract on skeletal scintigraphy is known as a "superscan." Prostate cancer is the most common cause of superscan in skeletal scintigraphy due to diffuse skeletal metastases. However, prostate cancer may cause secondary renal osteodystrophy leading to metabolic superscan also. Differentiating between these two entities are important as treatment options are different. We, hereby, describe a case of prostatic adenocarcinoma presented with metabolic superscan on methylene diphosphonate skeletal scintigraphy and demonstrate the utility of single emission computed tomography-computed tomography in differentiating between two entities. [ABSTRACT FROM AUTHOR]

The article discusses the prognosis of Purtscher retinopathy which causes sudden loss of vision. It mentions that the said disease has caused the 53 year old woman loss her vision. A bone marrow biopsy was performed on the patient that showed her plasma cells inflicted with multiple myeloma. It stresses that hyperviscosity from multiple myeloma has played a role in the patient's visual loss.