Syndrome of Inappropriate Secretion of Antidiuretic Hormone Cholestasis and Pericardial Effusion Due to Brucellosis Infection: A Case Report

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is an extremely rare complication of infectious diseases. A rare case of brucellosis complicated by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) cholestasis and pericardial involvement is reported. A 27-year-old woman was admitted for fever, abdominal pain, and scleral icterus. Her medical history revealed no recent use of diuretic agents. In addition to cholestasis and elevated liver enzymes, euvolemic hyponatremia, hypouricemia, low plasma osmolality, and high urinary osmolality were also detected. Surrenal and thyroid tests were also within normal range. Echocardiography revealed minimal pericardial effusion with normal cardiac functions. The final diagnosis was SIADH due to Brucellosis. Hyponatremia, cholestasis, and pericardial disease were resolved with effective antibrucellar treatment with streptomycine and doxycycline. After completing treatment of brucellosis, there was not any more evidence of cholestasis and pericardial fluid.

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Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

SAGE Open Medical Case Reports ◽

10.1177/2050313x211036005 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110360

Author(s):

Lardinois Benjamin ◽

Goeminne Jean-Charles ◽

Miller Laurence ◽

Randazzo Adrien ◽

Laurent Terry ◽

...

Keyword(s):

Pericardial Effusion ◽

Cardiac Tamponade ◽

Cardiac Toxicity ◽

Checkpoint Inhibitors ◽

Final Diagnosis ◽

Pericardial Fluid ◽

Malignant Pericardial Effusion ◽

Typical Cell ◽

High Fluorescence ◽

Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

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Syndrome of Inappropriate Secretion of Antidiuretic Hormone due to Selective Serotonin Reuptake Inhibitors After Pancreaticoduodenectomy for Carcinoma of the Ampulla of Vater: Case Report

International Surgery ◽

10.9738/intsurg-d-13-00032.1 ◽

2013 ◽

Vol 98 (4) ◽

pp. 289-291

Author(s):

Ryota Iwase ◽

Hiroaki Shiba ◽

Takeshi Gocho ◽

Yasuro Futagawa ◽

Shigeki Wakiyama ◽

...

Keyword(s):

Antidiuretic Hormone ◽

Serum Sodium ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Plasma Osmolality ◽

Sodium Concentration ◽

Ampulla Of Vater ◽

Serum Sodium Concentration ◽

Selective Serotonin ◽

Inappropriate Secretion

Abstract A 68-year-old man underwent pancreaticoduodenectomy with lymph nodes dissection for carcinoma of the ampulla of Vater. The patient had anxiety neurosis and had been treated with a selective serotonin reuptake inhibitor (SSRI). Postoperatively, SSRI was resumed on postoperative day 2. His serum sodium concentration gradually decreased, and the patient was given a sodium supplement. However, 11 days after the operation, laboratory findings included serum sodium concentration of 117 mEq/L, serum vasopressin of 2.0 pg/mL, plasma osmolality of 238 mOsm/kg, urine osmolality of 645 mOsm/kg, urine sodium concentration of 66 mEq/L, serum creatinine concentration of 0.54 mg/dL, and serum cortisol concentration of 29.1 μg/dL. With a diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH), the antianxiety neurosis medication was changed from the SSRI to another type of drug. After switching the medication, the patient made a satisfactory recovery with normalization of serum sodium by postoperative day 20.

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Cytokines in Pericardial Effusion of Patients with Inflammatory Pericardial Disease

Mediators of Inflammation ◽

10.1155/2012/382082 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Konstantinos Karatolios ◽

Rainer Moosdorf ◽

Bernhard Maisch ◽

Sabine Pankuweit

Keyword(s):

Coronary Artery ◽

Pericardial Effusion ◽

Artery Bypass ◽

Bypass Graft ◽

Serum Levels ◽

Pericardial Fluid ◽

Serum Samples ◽

Viral Origin ◽

Pericardial Disease ◽

Artery Disease

Background. The role of inflammatory and angiogenic cytokines in patients with inflammatory pericardial effusion still remains uncertain.Methods. We assessed pericardial and serum levels of VEGF, bFGF, IL-1βand TNF-αby ELISA in patients with inflammatory pericardial effusion (PE) of autoreactive () and viral () origin, and for control in pericardial fluid (PF) and serum () of patients with coronary artery disease (CAD) undergoing coronary artery bypass graft surgery.Results. VEGF levels were significantly higher in patients with autoreactive and viral PE than in patients with CAD in both PE ( for autoreactive and for viral PE) and serum ( for autoreactive and for viral PE). Pericardial bFGF levels were higher compared to serum levels in patients with inflammatory PE and patients with CAD ( for CAD; for autoreactive PE; for viral PE). Pericardial VEGF levels correlated positively with markers of pericardial inflammation, whereas pericardial bFGF levels showed a negative correlation. IL-1βand TNF-αwere detectable only in few PE and serum samples.Conclusions. VEGF and bFGF levels in pericardial effusion are elevated in patients with inflammatory PE. It is thus possible that VEGF and bFGF participate in the pathogenesis of inflammatory pericardial disease.

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Inappropriate Secretion of Antidiuretic Hormone: A Rare Complication after Carotid Endarterectomy

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2006.05.015 ◽

2006 ◽

Vol 32 (5) ◽

pp. 568-569 ◽

Cited By ~ 2

Author(s):

J. Cordobès-Gual ◽

P. Lozano-Vilardell ◽

N. Torrreguitart-Mirada ◽

E. M-Rimbau

Keyword(s):

Carotid Endarterectomy ◽

Antidiuretic Hormone ◽

Rare Complication ◽

Inappropriate Secretion

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Cancerous pericarditis presenting as cardiac tamponade in a 68-year-old man with pancreatic adenocarcinoma: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02546-y ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Sachie Kiryu ◽

Zensho Ito ◽

Masashi Ishikawa ◽

Takafumi Akasu ◽

Yoshihiro Matsumoto ◽

...

Keyword(s):

Pancreatic Cancer ◽

Pericardial Effusion ◽

Cardiac Tamponade ◽

Progressive Disease ◽

Rare Complication ◽

Pericardial Fluid ◽

Case Presentation ◽

Old Japanese ◽

Atypical Cells ◽

Circulatory Dynamics

Abstract Introduction Pericardial effusion is a rare complication of pancreatic cancer. We report a case of cardiac tamponade secondary to pancreatic cancer. Case presentation A 68-year-old Japanese man was diagnosed as having pancreatic cancer during surgery and received chemotherapy for 28 months after the diagnosis. He was admitted to the emergency room with severe dyspnea. Echocardiography revealed pericardial effusion with severe hypofunction. Emergency pericardial drainage was performed to maintain hemodynamics, which resulted in the elimination of 450 mL of blood and the maintenance of circulatory dynamics. Cytological examination of the pericardial fluid revealed atypical cells and tumor cells suggesting adenocarcinoma. Conclusions To our knowledge, pancreatic cancer complicated with cancerous pericarditis has not been previously documented. This case highlights the extreme severity of pericardial effusion, a sign of progressive disease, secondary to pancreatic cancer. In the case of neoplastic pericardial effusion, an extremely poor prognosis must be considered.

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Pericardial disease as a rare complication of pediatric appendicitis: a systematic literature search

JA Clinical Reports ◽

10.1186/s40981-020-00395-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Bibek Saha ◽

Kazuyoshi Aoyama ◽

Maria-Alexandra Petre ◽

Marina Englesakis ◽

James Robertson ◽

...

Keyword(s):

Prognostic Value ◽

Literature Search ◽

Pediatric Patients ◽

Case Reports ◽

Rare Complication ◽

Pericardial Fluid ◽

Systematic Literature Search ◽

Inclusion Criteria ◽

Pericardial Disease ◽

Abdominal Abscesses

Abstract Background Classic symptoms of acute appendicitis are well known but are uncommon and often misinterpreted in pediatric patients, potentially delaying diagnosis and resulting in rare sequelae. Methods We conducted a comprehensive systematic literature search of case reports detailing pericardial disease as a rare complication of pediatric appendicitis through MEDLINE, Embase, and Cochrane Databases. Inclusion criteria was that the patient must be < 18 years old and present with both pericardial disease and appendicitis. Results Our search yielded 7 cases with an average age of 10.3 ± 3.9 years old. The cases involved cardiac tamponade, pericarditis, and/or pericardial effusion. Five cases were diagnosed with appendicitis before complicated by pericardial disease. Most cases had an infectious component, but a majority had negative pericardial fluid cultures. Pleural effusion and abdominal abscesses were other common complications of pediatric appendicitis. Conclusion Awareness of this uncommon relationship may have prognostic value as this may facilitate appropriate management of pericardial effusions, tamponade, and/or appendicitis.

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Pericardial disease

10.1093/med/9780199568741.003.0109 ◽

2018 ◽

Author(s):

David Adlam

Keyword(s):

Pericardial Effusion ◽

Constrictive Pericarditis ◽

Acute Inflammation ◽

Small Volume ◽

Pericardial Fluid ◽

Clinical Spectrum ◽

Fluid Accumulation ◽

Pericardial Disease ◽

Pericardial Space ◽

Pericardial Diseases

The pericardium forms a continuous sac around the heart, analogous to the pleura surrounding the lungs, and the peritoneum surrounding the abdominal viscera. Between the parietal and visceral layers of the serous pericardium is the pericardial space, which normally contains a small volume of pericardial fluid. The clinical spectrum of pericardial diseases can be divided into: pericarditis, caused by acute inflammation; pericardial effusion, or fluid accumulation in the pericardial space, leading to tamponade; and constrictive pericarditis, caused by chronic infiltration or inflammation leading to pericardial constriction.

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