Acute, fulminant hepatic and renal failure and subsequent death following Amanita phalloides ingestion in a 4-month-old puppy

2020 ◽  
Vol 8 (2) ◽  
pp. e000997
Author(s):  
Catarina Amorim
Keyword(s):  
Renal Failure ◽  
Alkaline Phosphatase ◽  
Impaired Renal Function ◽  
Clinical Presentation ◽  
Clinical History ◽  
Serum Biochemistry ◽  
Amanita Phalloides ◽  
Presumptive Diagnosis ◽  
Therapeutic Measures ◽  
Diagnostic Investigations

This report documents a case of intoxication and subsequent death following ingestion of Amanita phalloides occurring in a 4-month-old cocker spaniel. The patient presented for investigation of acute vomiting, icterus and progressive obtundation. Clinical history identified exposure and ingestion of mushrooms on the day of presentation. Serum biochemistry revealed marked hypoglycaemia, hyperbilirubinaemia, increased serum alanine transferase and alkaline phosphatase activity. Within 24 hours, the patient’s mentation worsened and anuria was identified. Serial biochemistry analysis revealed worsening of hepatic parameters and impaired renal function. Mushrooms provided by the owner were later identified as A phalloides species by a fungal expert. Based on the patient’s clinical presentation and diagnostic investigations, the presumptive diagnosis was acute hepatic and renal failure following mushroom ingestion. Unfortunately, death occurred within 36 hours despite aggressive therapeutic measures.

scholarly journals Fatal Subacute Hepatic Failure in a Patient with AA-Type Amyloidosis: Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Ibrahim Altraif ◽  
Fayaz A. Handoo ◽  
Khaled O. Alsaad ◽  
Adel Gublan
Keyword(s):  
Alkaline Phosphatase ◽  
Case Report ◽  
Hepatic Failure ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Clinical Findings ◽  
Systemic Amyloidosis ◽  
Hepatic Involvement ◽  
Reactive Amyloidosis ◽  
Hepatic Amyloidosis

Although systemic amyloidosis of amyloid-associated protein (AA) type (secondary or reactive amyloidosis) frequently involves the liver, it rarely causes clinically apparent liver disease. Mild elevation of alkaline phosphatase and hepatomegaly are the most common biochemical and clinical findings, respectively. We report a case of systemic amyloidosis of AA type, which clinically presented as subacute hepatic failure and resulted in a fatal clinical course in a 69-year-old man. To the best of our knowledge, this is the fifth case of hepatic amyloidosis of AA type that clinically presented as fatal subacute hepatic failure, an unusual clinical presentation for hepatic involvement by systemic AA-type amyloid.

scholarly journals Endovascular Revascularization of a Symptomatic Common Carotid Artery Occlusion

2016 ◽  
Vol 44 (1) ◽  
pp. 120-123 ◽  
Author(s):  
Julie Kromm ◽  
Tim E. Darsaut ◽  
Khurshid Khan ◽  
Robert Ashforth ◽  
Esseddeeg Ghrooda
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Clinical Presentation ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Common Site ◽  
Extracranial Carotid Artery ◽  
The Common ◽  
Common Carotid Artery Occlusion ◽  
Diagnostic Investigations

AbstractAlthough the common carotid artery is the second most common site for extracranial carotid artery stenosis, complete symptomatic occlusion in the absence of devastating stroke is rare. We present a case of complete common carotid artery occlusion failing medical management and requiring endovascular intervention. The clinical presentation, diagnostic investigations, and management of complete carotid artery occlusions are discussed.

scholarly journals Rat Bite Fever Resembling Rheumatoid Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ripa Akter ◽  
Paul Boland ◽  
Peter Daley ◽  
Proton Rahman ◽  
Nayef Al Ghanim
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Presentation ◽  
Blood Cultures ◽  
Zoonotic Infection ◽  
Presumptive Diagnosis ◽  
Rat Bite Fever ◽  
Rare Manifestation ◽  
History Of ◽  
High Index Of Suspicion ◽  
Culture Positive

Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

scholarly journals Serum biochemistry of 4-day-old ostriches (Struthio camelus)

2008 ◽  
Vol 28 (9) ◽  
pp. 423-426 ◽  
Author(s):  
Renata L. Miranda ◽  
Antonio V. Mundim ◽  
Álisson S. Costa ◽  
Ruyther V. Guimarães ◽  
Frederico O.C. Silva
Keyword(s):  
Alkaline Phosphatase ◽  
Uric Acid ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Biochemistry ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Total Proteins ◽  
Males And Females

An analysis was made of 30 four-day-old ostriches to evaluate their protein, metabolite, mineral, and serum enzyme profiles, to correlate them with the birds' sex. The values obtained were: Total proteins 3.59±0.72g/dL, albumin 1.04±0.14g/dL, globulins 2.51±0.56g/dL, A:G ratio 0.43± 0.07, total cholesterol 615.10±101.15mg/dL, high density lipoprotein cholesterol (HDL-C) 132.72±20.33mg/dL, low density lipoprotein cholesterol (LDL-C) 454.93±90.81mg/dL, very low density lipoprotein cholesterol (VLDL-C) 27.45±9.96mg/dL, triglycerides 137.23±49.78mg/dL, uric acid 6.24±2.15mg/dL, urea 18.27±12.33mg/dL, creatinine 0.30±0.04mg/dL, total calcium 9.38± 0.76mg/dL, ionized calcium 7.17±0.64mg/dL, phosphorus 6.96±0.91mg/dL, Ca:P ratio 1.37±0.21, iron 24.74±13.02µg/dL, sodium 142.03±6.17mEq/L, chlorides 109.59± 4.99mEq/L, aspartate aminotransferase (AST) 200.67±31.42 U/L, alanine aminotransferase (ALT) 3.90±1.92 U/L, γ-glutamyltransferase (GGT) 1.18±0.73 U/L, alkaline phosphatase (ALP) 597.30± 231.36 U/L, and creatine kinase (CK) 2348.30±755.60 U/L. Males and females showed significant differences in total proteins, globulins, alkaline phosphatase, A:G ratio, and uric acid.

scholarly journals Renal Dysplasia and Progressive Renal Failure in a Newborn with Interstitial Chromosome 4 Deletion 4q25-28.3: A New Phenotype?

2020 ◽  
Author(s):  
Cláudia Teles-Silva ◽  
Francisca Martins ◽  
Sandra Costa ◽  
Paulo Soares ◽  
Gustavo Rocha ◽  
...  
Keyword(s):  
Renal Failure ◽  
Clinical Presentation ◽  
Renal Dysplasia ◽  
Large Deletion ◽  
Comparative Genomic ◽  
Chromosome 4 ◽  
Clinical Progression ◽  
Cystic Kidneys ◽  
Progressive Renal Failure ◽  
Subcutaneous Edema

AbstractThe deletion of the long arm of chromosome 4 is rare, presenting with a variable phenotype depending on the chromosomic area affected. A term newborn with prenatal diagnosis of anhydramnios, dysplastic cystic kidneys, and cardiomegaly was born with generalized subcutaneous edema, several dysmorphic features, and progressive renal failure requiring dialysis. The infant continued to deteriorate and died at 52 days of age. Autopsy confirmed bilateral renal dysplasia with cysts. Array-comparative genomic hybridization (CGH) identified a large deletion on 4q25-q28.3, which is not yet described in association with renal disease. The clinical progression could be expected due to the severity of the perinatal clinical presentation.

scholarly journals Renal failure: unusual clinical presentation of an isolated intrarenal hydatid cyst

2013 ◽  
Vol 2013 (nov15 1) ◽  
pp. bcr2013200616-bcr2013200616 ◽  
Author(s):  
M. Nadeem ◽  
S. R. Biyabani ◽  
S. Pervez
Keyword(s):  
Renal Failure ◽  
Hydatid Cyst ◽  
Clinical Presentation

Renal and hepatic injury with elevated cardiac enzymes in Amanita phalloides poisoning: a case report

2007 ◽  
Vol 26 (9) ◽  
pp. 757-761 ◽  
Author(s):  
Pinar Unverir ◽  
Burak Cem Soner ◽  
Erhan Dedeoglu ◽  
Ozgur Karcioglu ◽  
Kaya Boztok ◽  
...  
Keyword(s):  
Renal Failure ◽  
Troponin I ◽  
Blood Chemistry ◽  
Clinical Findings ◽  
Amanita Phalloides ◽  
Penicillin G ◽  
Mushroom Poisoning ◽  
Cardiac Markers ◽  
Cardiac Enzymes ◽  
Coronary Syndrome

Amatoxins are one of the most potent toxins that cause hepatic and renal failure. However, this is the first report demonstrating an elevation of cardiac enzymes in a patient with Amanita phalloides poisoning. A 56-year-old male was admitted to the emergency department (ED) 42 h after an unknown type of mushroom ingestion. Hepatic, renal function tests, amylase and cardiac enzymes (troponin I, creatine kinase (CK), CK-MB isoenzyme and myoglobin) were found elevated in his blood chemistry. The electrocardiogram disclosed sinus tachycardia. Aggressive treatment with fluids, activated charcoal, penicillin G and silibinin were started. The patient was sent to hemodialysis because of anuria. During follow-up, biochemical parameters and clinical findings improved. The patient was discharged from the hospital following the arrangement of hemodialysis schedule because of the chronic renal failure. False elevations of cardiac markers may confuse the clinicians in differantial diagnosis of myocardial infarction in ED. In our patient, amatoxins that have bound the actin filaments within myocardiocytes or renal cells and/or its effects as circulating anti-troponin antibodies might result in elevation of cardiac markers. Elevated cardiac enzyme levels without any acute coronary syndrome are probable in mushroom poisoning cases involving amatoxin ingestion. Human & Experimental Toxicology (2007) 26, 757— 761

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