scholarly journals A rare case of pulmonary cement embolism in a lung transplant patient

2018 ◽  
Vol 24 ◽  
pp. 63-64 ◽  
Author(s):  
Atif S. Siddiqui ◽  
Ahmad Goodarzi ◽  
Tilottama Majumdar ◽  
Thomas Kaleekal
2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
David Joseph Tansey ◽  
Mensud Hatunic ◽  
John Conneely ◽  
Michelle Murray

Abstract Background: Pheochromocytoma is a rare catecholamine-producing tumor with an estimated incidence of less than 0.1% in the global population. We present the case of a pheochromocytoma in a 25-year-old man with a background history of a double-lung transplant for Cystic Fibrosis, carried out 5 years earlier. Clinical Case: A 25 year old, with a background history of Cystic Fibrosis and a Double Lung transplant in 2012 presented to the emergency department with crampy abdominal pain, nausea and vomiting. He was diagnosed with Distal Intestinal Obstruction syndrome (DIOS) for which he was admitted for rehydration and laxatives. Contrast-enhanced computed tomography (CT) imaging of the abdomen and pelvis which showed a 3.4 cm right adrenal lesion, which was confirmed by a subsequent MRI Adrenals and an Endocrinology review was requested. On review, the patient was noted to be hypertensive with a blood pressure averaging 170/90 despite treatment with 3 different anti-hypertensive medications - namely amlodipine, telmisartan and doxazosin. On review of his medical notes, it was clear that he had been persistently hypertensive over the last 3 years. On further questioning, he noted increasingly frequent sweating episodes over the last number of months but denied any palpitations, headache or back pain. Laboratory analysis showed an elevated plasma normetanephrines (NMN) of 3167 pmol/L (182-867) as well as elevated metanephrines (MN) of 793 pmol/L (61-377) and high 3-MT of 257 pmol/L (<185). His MIBG scan showed only a mild increase in the uptake of tracer to the right adrenal gland compared to the left. The case was discussed at a multidisciplinary meeting and given the suggestive laboratory and radiologic findings, a presumptive diagnosis of pheochromocytoma was made. After controlling blood pressure with an alpha-blocker and beta-blocker for a week, the patient was hydrated and scheduled for an elective right adrenalectomy. The histopathology of the excised adrenal gland was consistent with a 3cm pheochromocytoma with none of the adverse features associated with malignant potential. The patient recovered well post-op, his blood pressure normalised and he was discharged home well for follow-up at the Endocrine and Transplant clinics. Conclusion: We describe a rare case of a right adrenal pheochromocytoma in a young man with multiple co-morbidities, who completely recovered after tumor resection. This case highlights the crucial importance of investigating secondary causes of hypertension, especially in younger patients. This is the first documented case in the literature of a case of pheochromocytoma in a post-transplant patient with Cystic Fibrosis. References: 1. Farrugia FA, Marikos G et al. Pheochromocytoma, diagnosis and treatment: Review of the literature. Endocrine Regulation, Volume 51, Issue 3, 30th August 2017.


2021 ◽  
Vol 40 (4) ◽  
pp. S509-S510
Author(s):  
M. Barraza ◽  
J. Rosenheck ◽  
B.C. Keller ◽  
I. Livshitz ◽  
M.M. Howsare

2021 ◽  
Vol 21 (3) ◽  
pp. 1340-1342
Author(s):  
Abbas Shahmohammadi ◽  
Martin Rosenthal ◽  
Mauricio Pipkin ◽  
Tiago N. Machuca

2021 ◽  
Vol 36 (1) ◽  
pp. 34-41
Author(s):  
Lia Argevani ◽  
Michael J. Schuh ◽  
Sheena Crosby

Objective: To report pharmacogenomics post-related bradykinesia secondary to phenoconversion in an elderly post-bilateral lung transplant patient. Summary: The patient was a 68-year-old double lung transplant patient taking the immunosuppressant and CYP3A4/5 substrate tacrolimus concomitantly with 2 CYP3A4/5 inhibitor medications, fluconazole and diltiazem. This drug combination post-dosing resulted in debilitating bradykinesia 1-2 hours after dosing, increasing the risk of falls and possible increased mortality and morbidity risk. Conclusion: Taking tacrolimus in combination with CYP3A4/5 inhibitors may increase neurologic adverse effects resulting in increased fall and associated increased mortality and morbidity risk.


2005 ◽  
Vol 129 (8) ◽  
pp. 976-976
Author(s):  
Amir Kazory ◽  
Didier Ducloux

2001 ◽  
Vol 20 (3) ◽  
pp. 288-296 ◽  
Author(s):  
Janet Madill ◽  
Carlos Gutierrez ◽  
Jennifer Grossman ◽  
Johanne Allard ◽  
Charlie Chan ◽  
...  

2006 ◽  
Vol 54 (4) ◽  
pp. 657-663 ◽  
Author(s):  
Eun Ji Kwon ◽  
Kenneth A. Katz ◽  
Karla S. Draft ◽  
John T. Seykora ◽  
Alain H. Rook ◽  
...  

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