P72 Riluzole causing pancytopenia: a clinically important rarity

2019 ◽  
Vol 90 (3) ◽  
pp. e41.1-e41
Author(s):  
M Islam
Keyword(s):  
Case Report ◽  
Past History ◽  
Individual Case ◽  
Medication History ◽  
Significant Drop ◽  
History Of ◽  
Swallowing Difficulty ◽  
Anterior Horn Cell Disease ◽  
Peg Tube ◽  
Risk And Benefit

DesignCase Report: An 83-year-old lady, was admitted with progressive speech and swallowing difficulty and wasting of small muscles of hand for 3 months. EMG revealed widespread anterior horn cell disease. With a diagnosis of MND, She was started on Riluzole 50 mg, LFT and FBC were normal before and 2 days after 1 st dose and the dose increased to a recommended dose of 50 mg twice a day. While waiting for PEG tube insertion, within 7 days, FBC showed a significant drop in Hb of 23 g/L ( from 125 to 102 g/L), Platelet dropped to 150×x10^9/L from 208 × 10^9/L, leucopenica ( 2.4 × 10^9/L) without any significant neutropenia. Her follow up haemogram showed persistent pancytopenia with more evident leucopenia and thrombocytopenia over next 7 days. She had no symptoms and signs of infection with normal infection screen. Her medication history was unremarkable apart from riluzole and thyroxine. No past history of liver disease or haematological conditions. Serum electrophoresis, Vitamin B12 and Folate were completely normal. A diagnosis of riluzole induced pancytopenia was made. A study by FDA suggests out of 861 patients, 3 patients (0.35%) developed Pancytopenia and 100% of them had it in the 1 st month. The aim of this case report to highlight the importance of considering Pancytopenia as an adverse reaction of riluzole. Patient may develop overt sepsis as a part of the spectrum. In that case, risk and benefit of riluzole prescription needs to addressed as an individual case basis.

scholarly journals P35.06: Intramural Pregnancy with a past history of artificial abortion - A case report

2008 ◽  
Vol 32 (3) ◽  
pp. 434-434
Author(s):  
H. Abe ◽  
D. Doi ◽  
M. Kakisu ◽  
T. Fukami ◽  
H. Asakura ◽  
...  
Keyword(s):  
Case Report ◽  
Past History ◽  
History Of ◽  
Artificial Abortion

scholarly journals Case Report: A rare association between SLE and Acute Lymphatic Leukemia

2018 ◽  
Vol 1 (3) ◽  
pp. 01-02
Author(s):  
P.K. Sasidharan
Keyword(s):  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
Past History ◽  
Lymphoblastic Leukemia ◽  
Acute Lymphatic Leukemia ◽  
Rare Association ◽  
Lymphatic Leukemia ◽  
History Of

A 30-year-old housewife with past history of acute lymphoblastic leukemia 12 years back, still in remission, was admitted with polyarthritis of 2 months duration. She was evaluated and found to have SLE with positive ANA and Anti ds DNA which were strongly positive.

scholarly journals Hydatid disease with Aspergilloma: A unique case report

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Sandeep Sharma ◽  
Parikshit Thakare ◽  
Ketaki Utpat ◽  
Unnati Desai
Keyword(s):  
Case Report ◽  
Hydatid Disease ◽  
Past History ◽  
Case Reports ◽  
Unique Case ◽  
Rare Finding ◽  
History Of ◽  
One Year

The coexisting presence of hydatid disease with aspergillus colonization is a rare finding. The 20-year-old presented with symptoms of hemoptysis with past history of tuberculosis. On further evaluation, the patient was diagnosed as a case of aspergilloma and managed conservatively. After one year of presenting with similar complaints, the patient was turned out to be hydatid disease with aspergillus colonization on the basis of clinic-radiological and bronchoscopic evaluation. Till now only a few case reports have been reported. We report a unique case report of a similar presentation.

scholarly journals Mycobacterium Other Than Tuberculosis (MOTT) – A Case Report: الجرثومة الفطرية غير الدرنية - تقرير حالة

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Hosam Abdullah Alsulami, Sonia Mezghani Ben Salah
Keyword(s):  
Case Report ◽  
Lung Disease ◽  
Past History ◽  
Thick Wall ◽  
Heavy Smoker ◽  
Chronic Obstructive ◽  
Left Thoracotomy ◽  
Breath Sounds ◽  
Two Samples ◽  
History Of

Patients with chronic obstructive pulmonary disease (COPD) and bronchiectasis are considered at risk of non-tuberculous mycobacterial lung disease especially those on inhaled corticosteroids. We described a case of a 69-year-old male, Ex. a heavy smoker with past history of pulmonary tuberculosis, COPD with diffuse centro lobular emphysema; status post left thoracotomy for hydropneumothorax, left-sided bullectomy done 8 months back. Patient admitted in our hospital " King Fahad General Hospital, Jeddah " with a history of chronic productive cough with an increased SOB, on/ off fever, night sweats and loss of weight in the last 3 months. No hemoptysis. On examination, he was conscious, oriented, afebrile, positive clubbing. Vitally stable. Chest examination showed a scare of left thoracotomy clean with small chest wall bulge; decreased breath sounds with bilateral ronchi and dullness in the left lower chest. Laboratory investigations showed hyperleukocytosis of 14.6 and serology for HIV was negative. CT scan chest showed left lobulated pleural effusion with empyema necessities, a diffuse emphysematous lung disease with bilateral thick wall cavities and pulmonary nodules as well as left bronchiectasis changes with underlying consolidation collapse. US-guided left pleural aspiration done showed exudative polymorph inflammation. Pleural fluid AFB and PCR was negative and two samples of AFB sputum were positive (2+), PCR was negative, 2 Bactec cultures were positives with the rapid growth of MOTT. Mycobacterial Avium Complex has been identified (Mayoclinic lab. in USA) which is sensitive to Rifampicin*, Clarithromycin* and Ethambutol* but resistant to Moxifloxacin and to Linozelid*. Patient treated with a combination of Rifampicin + Ethambutol* +Clarithromycin* for 18 months with clinical and radiologic improvement and good tolerance. This Study is a "case report study" aimed to report a very rare case, to report a new case of MOTT in Saudi Arabia for the purpose of statistics and for scientific benefit.

scholarly journals Gossypiboma and Total Hip Arthroplasty – A Rare Accidental Finding Following a Periprosthetic Infection

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Gabriel Pina ◽  
David Pereira ◽  
Nuno Borralho ◽  
Manuel Sousa
Keyword(s):  
Case Report ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Past History ◽  
Surgical Complication ◽  
Soft Tissue Tumors ◽  
The Body ◽  
Total Hip ◽  
Reactive Protein ◽  
History Of

Introduction: Gossypiboma or textiloma is the technical term used to describe a surgical complication related to accidental retention of surgical material within the body, most often surgical swabs. Since it is rare in orthopedic surgery, its diagnostis is less common and often initially mistaken with soft-tissue tumors. The aim of this study is to point out the importance of this differential diagnosis in the event of clinical swelling or accidental intraoperative finding associated with previous surgery. Case Report: Female patient presenting with 3 weeks hip pain and inflammatory signs, with a past history of a total hip arthroplasty 15 years before. Analytically presented C-reactive protein CRP of 13.67 mg/dl. Ultrasound and computed tomography CT scan revealed a solid lesion in the anterior thigh root and a liquid lesion in the lateral region of the hip. Discussion: Gossypibomas can be classified into two types: The aseptic fibrous type, which produces adhesions and a fibrotic capsule, and the exudative type, which is characterized by abscess formation. This case report refers to an aseptic fibrous type, given an asymptomatic evolution over 15 years and histopathological findings. However, this diagnosis occurred following a periprosthetic hip infection. Keywords: Gossypiboma, muslinoma, textiloma, total hip arthroplasty. Gossypiboma, Textiloma, Muslinoma, Total hip arthroplasty

Bilateral, spontaneous cerebrospinal fluid rhinorrhoea: endoscopic, uninasal, trans-septal approach for simultaneous closure

2011 ◽  
Vol 125 (11) ◽  
pp. 1185-1188
Author(s):  
M Kurien ◽  
G A Mathew ◽  
S L Abraham ◽  
A Irodi
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
English Language ◽  
Past History ◽  
Cerebrospinal Fluid Leakage ◽  
Endoscopic Repair ◽  
Recent Onset ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Fluid Leakage ◽  
History Of

AbstractBackground:Bilateral, spontaneous cerebrospinal fluid rhinorrhoea is extremely rare, with only one previous case report (this patient developed contralateral cerebrospinal fluid leakage four years after successful endoscopic repair). We present the first English-language report of simultaneous, bilateral, spontaneous cerebrospinal fluid rhinorrhoea.Objective:To recommend a simple alternative endoscopic technique for simultaneous closure of bilateral, spontaneous cerebrospinal fluid rhinorrhoea.Case report:A 47-year-old woman presented with recent onset of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, a recent history suggestive of meningitis, and a past history of pneumococcal meningitis. Bony defects on both sides of the cribriform plate were closed endoscopically in the same anaesthetic session, via a uninasal, trans-septal approach, enabling both leakage sites to be sealed simultaneously.Conclusion:In cases of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, uninasal, trans-septal endoscopic repair is a simple and effective technique for simultaneous closure of cerebrospinal fluid leakage.

scholarly journals An Unusual Case of Migraine Preconception and Severe Postpartum Headache and Intracranial Hemorrhage

2020 ◽  
pp. 1-4
Author(s):  
Nighat Fatima ◽  
Ayesha Salman ◽  
Lama Khalid Hamza ◽  
Tooba Shakeel
Keyword(s):  
Case Report ◽  
Past History ◽  
Cerebrovascular Disorders ◽  
Fluid Pressure ◽  
Reproductive Hormones ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Secondary Headache Disorders ◽  
Common Causes ◽  
History Of

Migraine affects many women in their childbearing years and gets worse during pregnancy, probably due to fluctuations in reproductive hormones. Similar changes in maternal physiology due to pregnancy increase the susceptibility toward secondary headache disorders and can cause the return of migraines in the postpartum period. Increased occurrence of headaches is also associated with the administration of epidural anesthesia, which decreases cerebrospinal fluid pressure. However, the less common causes such as secondary headache disorders related to cerebrovascular disorders and hypertension should be considered for differential diagnosis in this group of patients. In this case report, we discuss the case history of a 36-year-old woman, with a past history of migraine without aura, who presented at 1 week postpartum with headache, confusion, dizziness, right-sided weakness, and urinary incontinence. Brain imaging studies revealed global hypoxic ischemic injury to the brain. This case report discusses her presentation, investigations, management, and etiology of migraine, leading to stroke and death postpartum.

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