Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature

1993 ◽  
Vol 27 (9) ◽  
pp. 1040-1043 ◽  
Author(s):  
Jerry W. Taylor ◽  
Angela J. Bell
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Lithium Carbonate ◽  
Suspected Drug ◽  
Current Management ◽  
Therapy Discontinuation ◽  
Drug Induced ◽  
Parathyroid Dysfunction ◽  
Management Recommendations

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.

scholarly journals A Case Report of Severe Delirium after Amantadine Withdrawal

2017 ◽  
Vol 9 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Franz Marxreiter ◽  
Jürgen Winkler ◽  
Martin Uhl ◽  
Dominik Madžar
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Withdrawal Syndrome ◽  
Dopamine Agonists ◽  
Psychotic Symptoms ◽  
Drug Induced ◽  
Comt Inhibitors ◽  
Mao B ◽  
Psychotropic Substance

Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors). Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome.

scholarly journals Drug Liver Injury Induced by Olmesartan Mediated by Autoimmune-Like Mechanism: A Case Report

2020 ◽  
Author(s):  
Manuel de la Torre-Aláez ◽  
Mercedes Iñarrairaegui
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Drug Exposure ◽  
Interesting Case ◽  
Suspected Drug ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Difficult Diagnosis ◽  
Histological Confirmation ◽  
The Relationship

Autoimmune hepatitis (AIH) was the first liver disease for which an effective therapeutic intervention was carried out, using prednisolone; its usefulness was demonstrated in several clinical trials. Nevertheless, AIH still remains a difficult diagnosis in some cases, because it is necessary to dismiss other possible diagnoses, and perhaps due to it being a heterogeneous disease. The relationship between drug-induced liver injury (DILI) and AIH is complex and not fully understood. There are three possible scenarios: (1) DILI with a strong immunoallergic component mimicking AIH; (2) AIH mimicking a DILI due to drug exposure and (3) AIH triggered by exposure to an offending drug (drug-induced AIH). Drug-induced AIH is well described and documented for some drugs such as nitrofurantoin and minocycline. Histologically distinguishing DILI from AIH remains a challenge. We present an interesting case report which met serologic criteria and histological confirmation to establish AIH, but discontinuation of a suspected drug resolved hypertransaminasaemia.

scholarly journals Rosai-Dorfman disease of cranial and spinal origin - A case series

2020 ◽  
Vol 11 ◽  
pp. 298
Author(s):  
Saleh Salah Safi ◽  
Khaled Murshed ◽  
Arshad Ali ◽  
Surjith Vattoth ◽  
Abdulrazzaq Haider ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Management Strategies ◽  
Case Series ◽  
Current Management ◽  
Rosai Dorfman Disease ◽  
Lymph Node Enlargement ◽  
Long Term Follow Up

Background: Rosai-Dorfman disease (RDD) is an idiopathic nonneoplastic lymphadenopathy disorder which is characterized by lymph node enlargement, but it may also presents primarily involving a variety of extranodal sites, including central nerves system and craniospinal axis. This study reports five cases of craniospinal RDD, with review of epidemiology, clinical presentation, imaging, and histopathological features with current management strategies. Case Description: Five cases of RDD are diagnosed at Hamad General Hospital, Qatar, during 2013–2018. Two cases had dural-based cranial lesions with overlying cranial involvement while three cases were having extradural thoracic spine lesions. All cases underwent surgical intervention and confirmed by histopathology. Conclusion: Craniospinal RDD is a rare clinical presentation and poses significant diagnostic challenges preoperatively due to its similarity with other neoplastic or inflammatory diseases. Surgical option to remove compressive neural pathology provides a good clinical outcome with no recurrence in long-term follow-up.

scholarly journals A clinical presentation of drug-induced cardiotoxicity event in an oncohematology patient: A case report

2020 ◽  
Author(s):  
Ainur Bilmakhanbetova ◽  
Meruyert Beisenbay ◽  
Daulet Marat ◽  
Gulnur Zhakhina
Keyword(s):  
Case Report ◽  
Acute Leukemia ◽  
Inpatient Treatment ◽  
Clinical Case ◽  
Clinical Presentation ◽  
Underlying Disease ◽  
Clinical Death ◽  
Qtc Prolongation ◽  
Drug Induced ◽  
Selection Of

This case report deals with a clinical case of a patient who underwent inpatient treatment of the underlying disease acute leukemia. In the selection of treatment for complications, medications of various groups were prescribed. This therapy led to the clinical death of the patient, caused by drug-induced QT/QTc prolongation.

scholarly journals Hyperparathyroidism Secondary to Long-Term Use of Lithium Carbonate

2020 ◽  
Vol 5 (6) ◽  
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Nephrogenic Diabetes Insipidus ◽  
Thyroid Dysfunction ◽  
Lithium Carbonate ◽  
Self Mutilation ◽  
Persistent Depression ◽  
Interstitial Disease ◽  
Psychiatric Conditions

Lithium carbonate has been used for over half a century in the management of many psychiatric conditions like persistent depression, self-mutilation behaviors and bipolar disorder, where it has been proven to have benefit in suicide prevention [1]. Nevertheless, many side effects have been linked to its use, some of which include chronic tubule-interstitial disease, nephrogenic diabetes insipidus, thyroid dysfunction and, the focus of this case report, hypercalcemia and hyperparathyroidism [2].

scholarly journals Atypical clinical presentation and long-term survival in a patient with optic nerve medulloepithelioma: a case report

2012 ◽  
Vol 6 (1) ◽  
Author(s):  
Natalia Pastora-Salvador ◽  
José Abelairas-Gómez ◽  
Jesús Peralta-Calvo ◽  
Eugenia García-Fernández ◽  
Carmen Morales-Bastos ◽  
...  
Keyword(s):  
Case Report ◽  
Optic Nerve ◽  
Clinical Presentation ◽  
Term Survival ◽  
Long Term Survival ◽  
Atypical Clinical Presentation

scholarly journals Pravastatin-Induced Eczematous Eruption Mimicking Psoriasis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Michael P. Salna ◽  
Hannah M. Singer ◽  
Ali N. Dana
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
The Elderly ◽  
Case Presentation ◽  
Dermatology Clinic ◽  
Systemic Treatments ◽  
Eczematous Dermatitis ◽  
Erythematous Plaques ◽  
New Onset

Background. Statins, an example of the most commonly prescribed medications to the elderly, are not without side effects. Dermatologic events are often overlooked as arising from medications, particularly those which are taken chronically. Moreover, elderly patients are prone to pharmacologic interactions due to multiple medications. In this report, we describe a case of a statin-induced eczematous dermatitis with a psoriasis-like clinical presentation and review the skin manifestations that may arise from statin therapy.Case Presentation. An 82-year-old man with gout and hypercholesterolemia presented to dermatology clinic with new onset of pruritic, scaly erythematous plaques bilaterally on the extensor surfaces of his arms. He had never had similar lesions before. Despite various topical and systemic treatments over several months, the rash continued to evolve. The patient was then advised to discontinue his long-term statin, which led to gradual resolution of his symptoms. He was subsequently diagnosed with statin-induced eczematous dermatitis.Conclusions. This case report describes an adverse cutaneous reaction to statins that is rarely reported in the literature. Medications, including longstanding therapies, should be suspected in cases of refractory dermatologic lesions.

scholarly journals Prepubic urethrostomy opening within a prepuce in a dog: a case report

2014 ◽  
Vol 59 (No. 2) ◽  
pp. 107-111 ◽  
Author(s):  
D. Vnuk ◽  
N. Brkljaca Bottegaro ◽  
L. Slunjski ◽  
B. Skrlin ◽  
A. Musulin ◽  
...  
Keyword(s):  
Case Report ◽  
Urethral Stricture ◽  
Clinical Presentation ◽  
Inguinal Canal ◽  
Skin Irritation ◽  
Standard Technique ◽  
Postoperative Recovery ◽  
Urethrocutaneous Fistula ◽  
Peristomal Skin

The prepubic urethrostomy procedure has been shown to be a long-term diversion technique in dogs with intrapelvic urethral damage. This case report describes the clinical presentation and successful surgical management of an intrapelvic urethral stricture in a four month old male intact Labrador Retriever with hypospadias. The dog was presented for assessment of dysuria, stranguria, urinary incontinence, and urethrocutaneous fistula. After the diagnosis of perineal hypospadias with intrapelvic urethral stricture was made, surgery was performed to relieve the urethral obstruction and repair the urethrocutaneous fistula. A prepubic urethrostomy was made and the transected urethra was pulled through the inguinal canal into the prepuce. The postoperative recovery was uneventful. This technique can reduce postoperative peristomal skin irritation and leads to better cosmetic appearance than the standard technique.  

scholarly journals Successful clozapine rechallenge in a patient with suspected drug induced lupus

2019 ◽  
Vol 12 (4) ◽  
pp. e228574 ◽  
Author(s):  
Suraj Pathak ◽  
Scott Cherry ◽  
Samreen Samad ◽  
Ambreen Aftab
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Effective Treatment ◽  
Case Reports ◽  
Suspected Drug ◽  
Drug Induced

Clozapine is the most effective treatment for patients with refractory schizophrenia. Clozapine is also associated with serious and potentially lethal side effects including drug induced lupus (DIL). There have been four previous published case reports describing clozapine inducing a lupus-like syndrome including one previous case where a clozapine rechallenge was attempted without success. This case report describes a successful clozapine rechallenge in a patient with suspected DIL.

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