Incidence and natural history of intravenous immunoglobulin-induced aseptic meningitis: a retrospective review at a single tertiary care center

Transfusion ◽  
2015 ◽  
Vol 55 (11) ◽  
pp. 2597-2605 ◽  
Author(s):  
Vighnesh Bharath ◽  
Kathleen Eckert ◽  
Matthew Kang ◽  
Ian H. Chin-Yee ◽  
Cyrus C. Hsia
Keyword(s):  
Natural History ◽  
Intravenous Immunoglobulin ◽  
Aseptic Meningitis ◽  
Retrospective Review ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
History Of

scholarly journals Self-reported natural history of recurrent prolapse among women presenting to a tertiary care center

2012 ◽  
Vol 120 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Payton Johnson ◽  
Kindra A. Larson ◽  
Yvonne Hsu ◽  
Dee E. Fenner ◽  
Daniel Morgan ◽  
...  
Keyword(s):  
Natural History ◽  
Care Center ◽  
Tertiary Care ◽  
Recurrent Prolapse ◽  
Tertiary Care Center ◽  
History Of

scholarly journals Incidence and Natural History of Ivig-Induced Aseptic Meningitis: A Retrospective Review at a Single Tertiary Care Centre

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2884-2884 ◽  
Author(s):  
Vighnesh Bharath ◽  
Kathleen Eckert ◽  
Matthew Kang ◽  
Ian Chin-Yee ◽  
Cyrus C. Hsia
Keyword(s):  
Natural History ◽  
Aseptic Meningitis ◽  
Retrospective Review ◽  
Tertiary Care ◽  
Case Series ◽  
Primary Immune Deficiency ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
True Incidence ◽  
History Of

Abstract Background: Aseptic meningitis is a rare and significant complication of intravenous immunoglobulin (IVIg) therapy. The true incidence is unknown as there are a number of case reports and few thorough reviews. Some have suggested the incidence being 0-1% with one reported exception of 11% in the literature. It is important to recognize this condition clinically, as it often mimics infectious meningitis. To determine the true incidence and natural history of IVIg-induced aseptic meningitis, we conducted a retrospective review and case series at a single tertiary care centre by two separate methods. For this study, IVIg-induced aseptic meningitis was defined as: headache with meningismus or a deterioration in mental status after receiving IVIg, with or without accompanying fever, nausea, vomiting, pharyngitis, photophobia, and/or diarrhea (as per the Transfusion Transmitted Injuries Surveillance System of the Public Health Agency of Canada). IVIg headaches alone were not included in our review. Method: We performed a retrospective review of all cases of IVIg-induced aseptic meningitis at London Health Sciences Centre (LHSC) from January 1, 2008 to December 31, 2013. During the study period, the initial method was to evaluate all reported transfusion reactions (as per the Transfusion Reaction Course [TRAC] system for reporting) to identify possible or probable aseptic meningitis due to IVIg. Subsequently, in our second method, we reviewed and cross-referenced all documented IVIg infusions and all lumbar punctures performed at LHSC during the study period. All patients with both IVIg infusions and lumber punctures were identified and further chart review was performed to determine if these patients had aseptic meningitis due to IVIg. We report on our identified cases of IVIg-induced aseptic meningitis, identify the true incidence, and speculate on the natural history of this condition. Results: During our study period, a total of 1921 IVIg infusions (554,566 g) were administered, with major indications being: chronic inflammatory demyelinating polyneuropathy (25.7%), primary immune deficiency (14.1%), other (primarily rheumatologic indications – 13.9%), multifocal motor neuropathy (10.4%), and adult immune thrombocytopenia (7.4%). 8 cases of aseptic meningitis were reported to the transfusion laboratory by the first method, with no additional cases identified by the second method, which gave us an overall incidence of 0.42%. Indications included: aplastic anemia (1/8), immune thrombocytopenia (3/8), chronic inflammatory demyelinating polyneuropathy (1/8), autoimmune hemolytic anemia (1/8), primary immune deficiency (1/8), and myasthenia gravis (1/8). As per our case series, IVIg-induced aseptic meningitis is an uncommon complication of unknown etiology that seems to affect all ages, with no relation to the underlying indication for IVIg. The only predisposing factor seen in our cohort may be a prior exposure to blood products, but other risk factors such as migraines, immune dysregulation, and dose and rate of infusion have been reported in the literature. In this study, patients presented with symptoms within 24-48 hours of IVIg infusion, and were treated with antibiotics initially due to the clinical resemblance and suspicion of bacterial meningitis. However, symptoms self-resolved within 5-7 days. This condition appears to be non-fatal; therefore, treatment is purely supportive, with subsequent IVIg infusions likely requiring premedication or possibly a switch in formulation. Conclusion: In this review of IVIg-induced aseptic meningitis over a 6 year period in a tertiary care centre, we identify a more robust incidence of 0.42% for this condition (consistent with most previous reports). Though this condition can be under-recognized, all possible cases were identified with a rigorous TRAC system for reporting reactions and by using two different methods. Furthermore, we speculate on the natural history of this condition based on our 8 identified cases. Given that this complication can mimic infectious meningitis and cause considerable morbidity, we hope that physicians will be aware of, and recognize, this rare but important complication of IVIg therapy. Disclosures No relevant conflicts of interest to declare.

scholarly journals Refractive, sensory, and biometric outcome among retinopathy of prematurity children with a history of laser therapy: A retrospective review from a tertiary care center in South India

2019 ◽  
Vol 67 (6) ◽  
pp. 871 ◽  
Author(s):  
SasikalaE Anilkumar ◽  
Vinut Anandi ◽  
ParagK Shah ◽  
Sandra Ganesh ◽  
Kalpana Narendran
Keyword(s):  
Laser Therapy ◽  
Retinopathy Of Prematurity ◽  
Retrospective Review ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
History Of

The Natural History of Chronic Urticaria: A Cross-sectional Retrospective Study at a Tertiary Care Center, Bangkok, Thailand

2009 ◽  
Vol 123 (2) ◽  
pp. S107-S107
Author(s):  
S. Chantbuddhiwet ◽  
K. Ruxrungtham ◽  
W. Korkij ◽  
N. Noppakun
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Chronic Urticaria ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Cross Sectional ◽  
History Of

ANALYSIS AND INTERPRETATION OF SPIROMETRY OF PATIENTS ATTENDING RESPIRATORY MEDICINE OPD IN A TERTIARY CARE CENTER: A RETROSPECTIVE STUDY

2021 ◽  
pp. 39-41
Author(s):  
Vidhi Jobanputra ◽  
Hafiz Deshmukh ◽  
Ashish Deshmukh ◽  
Sunil Jadhav ◽  
Shivprasad Kasat ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bronchial Asthma ◽  
Lung Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Respiratory Medicine ◽  
Smoking History ◽  
Tertiary Care Center ◽  
Operative Evaluation ◽  
History Of

OBJECTIVE: To study the various spirometry ndings and look for its association with smoking history and use of biomass fuels. METHODS: Spirometry ndings of 375 patients who attend Respiratory medicine OPD from year 2017- 2019 were studied. RESULTS: Out of 375 patients, 95 patients were diagnosed as COPD, 62 as bronchial asthma, 149 had normal spirometry and 69 had restriction. CONCLUSION: In this study we concluded that spirometry plays an intergral role in the diagnosis of bronchial asthma, COPD and restrictive lung diseases. It gives an overview of the decline of lung function with increasing age, smokers, occupational lung exposures, family history of bronchial asthma. Restrictive patterns were most commonly seen in patients who came for pre operative evaluation.

Management of Retrosternal Goiter without Sternotomy: A Retrospective Review in a Tertiary Care Center

2020 ◽  
Vol 11 (3) ◽  
pp. 47-49
Author(s):  
Prashanth Veerabhadraiah ◽  
Pruthvi R Shivalingaiah ◽  
Chandni R Pillai ◽  
Sachin S Nair ◽  
Kiran C Hanumanthappa
Keyword(s):  
Retrospective Review ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Retrosternal Goiter

scholarly journals Case report on fatal human rabies infection in central India

2021 ◽  
Vol 9 (1) ◽  
pp. 324
Author(s):  
Pratik Kumar ◽  
Vijay Domple ◽  
Gautam Khakse
Keyword(s):  
Public Awareness ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Human Rabies ◽  
Tertiary Care Center ◽  
Unusual Behavior ◽  
Probable Case ◽  
Health Care Center ◽  
History Of

Rabies is a zoonotic disease that affects the central nervous system of mammals and has a high mortality rate. It is a viral disease that can be prevented by vaccination. Dogs are the leading cause of human rabies deaths, accounting for up to 99% of all human rabies transmissions. On 15th December 2019 an 8 years old male child was bitten by a stray dog outside of his house. The patient visited with his parents to a nearby primary health care center on same day where his wound was washed with water. He received first dose of anti-rabies vaccine and was referred to a tertiary care center for immunoglobulin because of a history of wound bleeding. They did not visit tertiary care center for immunoglobulin as advised. 15 days after exposure on 1st January 2021 the patient presented with unusual behavior like fear of water and tremor. On examination his pupils were found dilated and he was referred to isolation ward of tertiary care center. Based on the history of animal bites and clinical signs, the patient was diagnosed as probable case of rabies. The patient eventually died within 24 hours of admission. Such kind of incident shows that there is lack of awareness regarding rabies in community. In this case, if the patient had completed the anti-rabies vaccination schedule and visited a higher centre on time for immunoglobulin, death could have been avoided. Mortality due to rabies can be prevented by raising public awareness about immunization.

scholarly journals Prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center

2017 ◽  
Vol 6 (3) ◽  
pp. 797 ◽  
Author(s):  
Renji S. R. ◽  
Sujatha Thankappan Lekshmi ◽  
Nirmala Chellamma
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Statistical Tests ◽  
Care Center ◽  
Tertiary Care ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Tertiary Care Center ◽  
Family History Of Diabetes ◽  
History Of

Background: Number of pregnant women with preexisting diabetes is increasing. Hence the detection and management of diabetes from the beginning of pregnancy itself will help to improve the fetal and maternal outcome. Aim of the study was to determine the prevalence of pre-gestational diabetes among the antenatal women attending a tertiary care center and to study the associated factors.Methods: This was a cross sectional study conducted in SAT hospital, Government Medical College, Trivandrum, Kerala, India for one year. HbA1C was the test used to diagnose diabetes. 400 women attending the OP in their first trimester were selected after informed consent. Socio demographic factors assessed by a structured questionnaire.  Blood samples were taken for HbA1C. Diagnosis of diabetes was made at levels of HbA1C ≥6.5%. Statistical tests used were mean, standard deviation, chi-square and odds ratio.Results: Prevalence of pre-gestational diabetes was 3.8%.in our study. Main associations were age more than 25 years, body mass index, family history of diabetes, history of intra uterine death, gestational diabetes in previous pregnancy, candidiasis and thyroid disease.Conclusions: Screening of all pregnant women in first trimester itself for diabetes will help in early detection of pre-gestational diabetes, so that anticipation of adverse outcomes and proper management can be done in such cases.

scholarly journals Epidemiological and clinical profile of various plant poisons in a tertiary care center in South Tamilnadu, India

2019 ◽  
Vol 7 (9) ◽  
pp. 3517
Author(s):  
Meena Kumari ◽  
Pattu Swarna Latha ◽  
Kalyanasundaram .
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Tertiary Care Center ◽  
Active Components ◽  
Medical College ◽  
Suicidal Intention ◽  
History Of ◽  
Plant Constituents ◽  
Plant Poisoning

Background: Plant poisoning is a common scenario in a toxicology unit . Some of the plants contain active components used as medicines. However, some of the plant constituents are poisonous with wide variety of clinical manifestations. Authors aimed to study the pattern of various types of plant poisons and clinical presentations and complications of various plant poisons admitted in our toxicological unit.Methods: A total of 87 patients admitted with history of plant poison ingestion, in toxicological unit of Tirunelveli medical college were studied . It was a retrospective observational study and was done over a period of one year.Results:  Out of 87 cases studied, 92%were due to consumption with suicidal intention. Plant poisoning ranks second only to pesticide poisoning . among the plant poisons encountered 66.6% were due to Oleander poison, followed by Datura (8%) and Glory lily(5.7%). Common parts of plant consumed by patients include seeds and plant oils . Vomiting and abdominal pain were the commonest presentations. Encephalopathy, dyselectrolytemia and arrhythmias were the notable complications in our study.Conclusions: Early admission and prompt first aid and monitoring at tertiary care center are key to the reduced mortality. The study throws light on various manifestations, toxic parts and complications of plant poisons.

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