scholarly journals Life threatening hypokalaemia during treatment of severe diltiazem overdose with high dose insulin euglycemic therapy: a case report

2021 ◽  
Vol 5 (1) ◽  
pp. 140-142
Author(s):  
Andrew Kozman ◽  
Kerry Hoggett ◽  
Jessamine Soderstrom
Keyword(s):  
Case Report ◽  
High Dose ◽  
Diltiazem Overdose ◽  
Life Threatening

scholarly journals Fulminant necrotizing fasciitis to the hand in a patient on high-dose steroids: A case report of successful limb salvage

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Miguel Johnson ◽  
Juan Berner ◽  
George Christopoulos ◽  
Preci Hamilton ◽  
Robert Pearl
Keyword(s):  
Case Report ◽  
Early Detection ◽  
Necrotizing Fasciitis ◽  
Limb Salvage ◽  
Vasogenic Edema ◽  
High Dose ◽  
Steroid Use ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Early Features

Abstract Glucocorticoids are commonly used in the management of patients with brain Tumour for reducing peritumoral and vasogenic edema. However, they may lead to development of limb and life-threatening conditions such as necrotizing fasciitis (NF). NF is a rare but potentially lethal condition. Early detection and aggressive treatment may lead to decreased mortality and limb salvage. The diagnosis is predominately clinical but may be supported by laboratory and radiological investigations. Chronic steroid use not only predisposes to the development of NF but also may mask early features delaying presentation and diagnosis. Clinicians should have a high index of suspicion especially in patients on chronic steroid therapy as this may aid in early detection and treatment. We present a case report of a successful limb salvage that exemplifies these points.

Very high-dose methylprednisolone for treatment of nivolumab-induced limbic encephalitis: A case report

2020 ◽  
Vol 26 (6) ◽  
pp. 1538-1543 ◽  
Author(s):  
Vincent-Thierry Taillefer ◽  
Marjorie Pigeon ◽  
Michelle Chen ◽  
Catherine Larochelle ◽  
Marie Florescu ◽  
...  
Keyword(s):  
Case Report ◽  
Limbic Encephalitis ◽  
Oral Prednisone ◽  
Neurological Impairment ◽  
Immune Checkpoint Blockade ◽  
High Dose ◽  
Life Threatening ◽  
Autoimmune Limbic Encephalitis ◽  
High Doses ◽  
Very High

Introduction Nivolumab is a programmed death 1 (PD-1) inhibitor approved by the Food and Drug Administration (FDA) for the treatment of eight different cancers including metastatic melanoma. Immune checkpoint blockade may lead to a range of neurologic immune-related adverse events (irAEs) with severity varying from mild to life-threatening, including encephalitis. Case report We describe a case of a 68-year-old man who developed alteration in mental status, physical weakness and fatigue after nine cycles of nivolumab 3 mg/kg every two weeks. These symptoms were compatible with a clinical diagnosis of autoimmune limbic encephalitis, although no specific antibodies were detected and the initial MRI was normal. Management and outcome The patient received intravenous methylprednisolone 1 g daily for 5 days, which was then converted to a maintenance dose of oral prednisone. The patient made a full clinical recovery but relapsed clinically upon steroid tapering, while hypersignal in the left mesial temporal suggestive of limbic encephalitis was observed on repeated MRI. Discussion Because of the prevailing usage of nivolumab in many cancer protocols, this case highlights the importance of rapidly recognising neurological impairment in patients treated with nivolumab and of initiating very high doses of corticosteroids.

scholarly journals Malignant Catatonia Requiring High Dose Bromocriptine: Case Report

2021 ◽  
Author(s):  
Edwin Meresh ◽  
◽  
Clinton Korneffel ◽  
Bavani Rajah ◽  
Ryan Bergren
Keyword(s):  
Case Report ◽  
Extended Release ◽  
Medical Emergency ◽  
High Dose ◽  
Anti Psychotic ◽  
Prompt Treatment ◽  
Life Threatening ◽  
History Of ◽  
Long Acting ◽  
Malignant Catatonia

Catatonia can occur in patients diagnosed with schizophrenia and bipolar disorder and malignant catatonia is life threatening. Anti-psychotic medications should be discontinued during acute phase of catatonia. Anti-psychotic discontinuation in catatonia is a challenge in patients maintained on long-acting injectable antipsychotics because of the extended release. Case report: We present a case of malignant catatonia developed in a patient with history of schizophrenia and developmental delay. Symptoms lasted several weeks as he was recently administered long acting injectable antipsychotic medication, requiring high dose Bromocriptine treatment. Patient required several days of bromocriptine treatment. Because of the shorter half-life, frequent and higher dosing of bromocriptine led to resolution of malignant catatonia. Malignant catatonia is a medical emergency and prompt treatment including high dose bromocriptine could lead to resolution of catatonia.

scholarly journals Management of Autoimmune Hemolytic Anemia in the Midst of Coronavirus Disease 2019 Pandemic: A Case Report

Medicinus ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. 223
Author(s):  
Andree Kurniawan ◽  
Devina Adella Halim
Keyword(s):  
Body Weight ◽  
Case Report ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Immunosuppressive Drugs ◽  
High Dose ◽  
Cell Surface Antigens ◽  
Indirect Bilirubin ◽  
Life Threatening ◽  
Novel Coronavirus

<p><strong>Introduction : </strong>The novel coronavirus disease 2019 (COVID-19) has become a pandemic involving all people and can be severe and life-threatening in a certain population such as those with comorbidity. Autoimmune hemolytic anemia (AIHA) is an autoimmune hematologic disease characterized with antibodies production that binds to red cell surface antigens. In this pandemic, several concerns have been raised by autoimmune disease clinicians and patients regarding the use of immunosuppressive drugs. In this case report, we illustrate the problems of autoimmune hemolytic anemia patient when she got active case.</p><p><strong>Case Illustration : </strong>A 28 years old lady was admitted to the hospital owing to fatigue and tiredness during exercise for two weeks. She had been diagnosed with autoimmune hemolytic anemia before and did not comply with the treatment. This patient has been reevaluated of having AIHA from the symptoms of fatigue, enlarged spleen, low hemoglobin, increased reticulocytes, signs of hemolytic in blood smear examination, increased indirect bilirubin, LDH and the Combs’ test result was given positive. She received methylprednisolone 2 mg/kg of body weight intravenously, washed packed red cells (PRC), calcium and proton pump inhibitor. She was discharged at the seventh day since admission and she was prescribed oral methylprednisolone equal to 1 mg/kg body weight.</p><p><strong>Conclusion : </strong>This is an educated case of non-compliance of AIHA that should be given high dose steroid and blood transfusion during hospitalization amid the COVID-19 pandemic. The recommendation of treatment for AIHA was still the same as before the pandemic occured.</p>

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report

2021 ◽  
Vol 42 (4) ◽  
pp. 102977
Author(s):  
Alexander N. Goel ◽  
Andrey Filimonov ◽  
Julie Teruya-Feldstein ◽  
Christian Salib ◽  
Joseph J. Rousso ◽  
...  
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Burkitt Lymphoma ◽  
Life Threatening

scholarly journals Thermal burns in electroconvulsive therapy

2021 ◽  
pp. 201010582110310
Author(s):  
Ernest Weisheng Ho ◽  
Eng Leonard ◽  
Lee Tih-Shih ◽  
Gregory James Meredith
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Ignition Source ◽  
Thermal Burns ◽  
High Impedance ◽  
Temporal Placement ◽  
Close Proximity ◽  
Life Threatening

Electroconvulsive therapy (ECT) is effective for mood disorders and schizophrenia. Thermal burns, while rare, are potentially sight and life threatening. The three elements necessary for a fire are often in close proximity during a session: an oxidiser (oxygen), an ignition source (faulty electrodes, poor contact with skin producing a spark) and fuel (hair, residual alcohol cleanser). This case report describes one such incident when a patient sustained a burn during ECT, with poor contact of electrode pad with skin, high impedance and an oxygen-rich environment possibly contributing. Given that ECT is conducted relatively frequently (once every 2–3 days) in a usual regimen, we make recommendations for safe application of electrode pads for temporal placement ECT.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

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