Famotidine-Induced Mixed Hepatocellular Jaundice

1994 ◽  
Vol 28 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Paul W. Ament ◽  
John D. Roth ◽  
Carol J. Fox
Keyword(s):  
Liver Enzyme ◽  
Elevated Liver Enzyme ◽  
Epigastric Pain ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Enzyme Concentration ◽  
Case Summary ◽  
First Case ◽  
History Of ◽  
Hepatocellular Jaundice

OBJECTIVE: To report a case of probable famotidine-induced mixed hepatocellular jaundice. CASE SUMMARY: A 55-year-old man presented with a one-month history of mid-epigastric pain. Initial physical examination and laboratory studies, including liver enzyme concentration tests, were unrevealing. A diagnosis of gastritis was made and ranitidine was prescribed. Following one week of therapy, the patient's symptoms had not improved and therapy was changed to famotidine and sucralfate. Approximately one week later the patient presented with jaundice. Liver enzyme concentrations were elevated and the patient was hospitalized for further evaluation. Five days following discontinuation of famotidine, liver enzyme concentrations were normal and jaundice had resolved. Further tests did not reveal any pathologic etiology. DISCUSSION: Hepatic changes have occurred in patients receiving histamine2-antagonists; ranitidine and cimetidine have been cited most frequently. In general, the elevations are mild, transient, and return to baseline with continued therapy. This is one of the first case reports of probable famotidine-induced mixed hepatocellular jaundice. CONCLUSIONS: There was a temporal relationship between the patient's signs and symptoms and initiation of famotidine. No identifiable factors contributed to the elevated liver enzyme concentrations and jaundice.

Ceftriaxone-Induced Acute Pancreatitis

1993 ◽  
Vol 27 (1) ◽  
pp. 36-37 ◽  
Author(s):  
Anthony E. Zimmermann ◽  
Brian G. Katona ◽  
Joginder S. Jodhka ◽  
Richard B. Williams
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Antibiotic Regimen ◽  
Intravenous Injections ◽  
Case Summary ◽  
Catheter Sepsis ◽  
History Of

OBJECTIVE: To report a case of probable ceftriaxone-induced acute pancreatitis. CASE SUMMARY: A patient with a history of short-bowel syndrome on home total parenteral nutrition developed fever, chills, and right flank pain. She was diagnosed with gram-negative catheter sepsis and prescribed antibiotic therapy to be administered for four weeks. After completion of the first week of therapy, the antibiotic regimen was changed to intravenous injections of ceftriaxone to be given daily at home. Prior to discharge the patient developed acute abdominal pain, leukocytosis, jaundice, and markedly elevated lipase and amylase concentrations consistent with acute pancreatitis. The patient's condition improved upon discontinuation of the ceftriaxone and the remainder of her stay was uneventful. DISCUSSION: There is only one other case report in the literature of probable ceftriaxone-induced pancreatitis. Multiple other medications have been implicated in causing acute pancreatitis. The exact mechanism of this uncommon adverse effect of ceftriaxone is unknown. CONCLUSIONS: There was a temporal relationship between the development of this patient's signs and symptoms and the administration of ceftriaxone. We could not identify any other factors that may have been responsible for the development of her acute pancreatitis. Ceftriaxone should be considered as a possible etiologic agent in patients who present with acute abdominal pain and elevated lipase and amylase concentrations.

scholarly journals Subsequent Development of Desmoid Tumor after a Resected Gastrointestinal Stromal Tumor

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Areen Abdulelah Murshid ◽  
Hatim Q. Al-Maghraby
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Desmoid Tumor ◽  
Case Reports ◽  
Previous History ◽  
Subsequent Development ◽  
Stromal Tumor ◽  
Desmoid Tumors ◽  
Mesenchymal Tumors ◽  
First Case ◽  
History Of

Desmoid tumors (deep fibromatosis) of the mesentery are rare mesenchymal tumors. They are often misdiagnosed, especially with a previous history of resection for gastrointestinal stromal tumor (GIST). Immunohistochemistry can help differentiate between these two tumors. In this article, we present a case we had encountered: a Desmoid tumor developing in a patient with a history of GIST 3 years ago. It is the first case of GIST with subsequent development of Desmoid tumor to be reported in Saudi Arabia. We discuss the two entities of Desmoid tumor and GIST by comparing their definitions, clinical presentations, histological features, immunohistochemistry stains, molecular pathogenesis, prognosis, and treatment. We also discuss the relationship between GIST and the subsequent development of Desmoid tumors and compare our case with case reports in literature.

scholarly journals Metastatic Pancreatic Cancer with BRAF and P53 Mutations: Case Report of Therapeutic Response to Doublet Targeted Therapy

2020 ◽  
Vol 13 (3) ◽  
pp. 1239-1243
Author(s):  
Shenthol Sasankan ◽  
Lorraine Rebuck ◽  
Gloria Darrah ◽  
Moises Harari Turquie ◽  
Ian Rabinowitz
Keyword(s):  
Pancreatic Cancer ◽  
Case Report ◽  
Targeted Therapy ◽  
Therapeutic Response ◽  
Case Reports ◽  
Clinical History ◽  
P53 Mutation ◽  
Metastatic Pancreatic Cancer ◽  
First Case ◽  
History Of

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.

scholarly journals Lichen Planus Pemphigoides Induced by Enalapril: A Case Report and a Review of Literature

2017 ◽  
Vol 9 (3) ◽  
pp. 217-224 ◽  
Author(s):  
Woranit Onprasert ◽  
Kumutnart Chanprapaph
Keyword(s):  
Lichen Planus ◽  
Early Recognition ◽  
Case Reports ◽  
Direct Immunofluorescence ◽  
Drug Induced ◽  
First Case ◽  
Bullous Dermatosis ◽  
Culprit Drug ◽  
History Of ◽  
Hands And Feet

Lichen planus pemphigoides (LPP) is a rare autoimmune bullous dermatosis. The clinical presentation of LPP may mimic bullous pemphigoid making the diagnosis difficult. A thorough clinical, histopathological, and immunological evaluation is essential for the diagnosis of LPP. The etiology is largely idiopathic; however, there are several case reports of drug-induced LPP. We report an 81-year-old Thai woman with underlying hypertension and type 2 diabetes mellitus who presented with a 4-week history of multiple tense bullae initially on the hands and feet that subsequently expanded to the trunk and face. Enalapril was commenced to control hypertension. The histopathology and direct immunofluorescence were compatible with LPP. Circulating anti-basement antibodies BP180 was also positive. The patient was treated with topical corticosteroid with a modest effect. Enalapril was discontinued and complete resolution of LPP occurred within 12 weeks. There was no recurrence after a 1-year follow-up period. To the best of our knowledge, we present the first case of enalapril-induced LPP. Early recognition and prompt discontinuation of the culprit drug allow resolution of the disease. Medication given for LPP alone, without cessation of the offending drug, may not change the course of this condition.

scholarly journals Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

2020 ◽  
Author(s):  
Abdolali MOSHFE ◽  
Arash ARIA ◽  
Najme ERFANI ◽  
Ali JAMSHIDI ◽  
Bahador SARKARI ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Serological Test ◽  
Demographic Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diagnosis And Management ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran.    Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

scholarly journals Pseudomyxoma peritonei presenting with port site hernia

2021 ◽  
pp. 89-92
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Case Reports ◽  
Abdominal Distension ◽  
Right Hemicolectomy ◽  
Port Site ◽  
Mucinous Tumor ◽  
Ovarian Mass ◽  
First Case ◽  
Port Site Hernia ◽  
History Of

Pseudomyxoma peritonei (PMP) is a rare disease with an incidence of two per million. Acute appendicitis, ovarian mass, and abdominal distension are the most common presentations. A 72-year-old male patient with a history of laparoscopic cholecystectomy was admitted to the hospital with abdominal pain and increased supraumbilical port site swelling. Radiological examination revealed a mass in the terminal ileum and severe intraabdominal mucinous fluid. Intraabdominal gelatinous fluid protruding from the port site defect and a mass in the distal ap-pendix were observed during operation. He underwent a right hemicolectomy, ileocolic anasto-mosis and peritoneal debridement; cytoreductive surgery was administered two months later due to mucinous tumor of the appendix. There are only a few case reports describing PMP presen-ting with an incisional hernia after open surgical procedures. To the best of our knowledge, this report describes the first case of PMP presenting with a port site hernia after a laparoscopic in-tervention.

scholarly journals Laparoskopinė urachus cistų ir sinuso šalinimo operacija: du klinikiniai atvejai ir literatūros apžvalga

2012 ◽  
Vol 11 (3-4) ◽  
pp. 93-100
Author(s):  
Algirdas Žalimas ◽  
Audrius Gradauskas ◽  
Deividas Narmontas ◽  
Edmundas Štarolis ◽  
Sandra Selickaja
Keyword(s):  
Female Patient ◽  
Case Reports ◽  
Laparoscopic Approach ◽  
Invasive Technique ◽  
Attractive Alternative ◽  
Urachal Cyst ◽  
Abdominal Ultrasonography ◽  
Urachal Remnant ◽  
First Case ◽  
History Of

ĮžangaEmbrioninio šlapimo latako (urachus) anomalijos yra retos. Infekcija yra dažniausia jų komplikacija ir simptomų pasireiškimo priežastis. Simptomines urachus anomalijas reikia šalinti. Mes aprašome du klinikinius atvejus, kai sėkmingai pašalinta urachus cista ir sinusas laparoskopinės operacijos būdu. Mūsų turimais duomenimis, Lietuvoje atliktos pirmosios tokio pobūdžio operacijos.Atvejų pristatymasPirmas atvejis yra 55 metų amžiaus moters, kuri paguldyta į ligoninę dėl du mėnesius trunkančio padažnėjusio šlapinimosi. Atlikus pilvo echoskopiją, klaidingai nustatyta dešinės kiaušidės cistadenoma. Urachus cista buvo aptikta atlikus diagnostinę laparoskopiją, pilvo ir dubens kompiuterinę tomografiją. Antras atvejis yra 22 metų moters, kuri paguldyta į ligoninę dėl 10 dienų trunkančio pilvo skausmo ir bambos šlapiavimo. Pilvo echoskopijos metu žemiau bambos po pilvo siena buvo rastos dvi cistos – viena iš jų netoli šlapimo pūslės, kita atsiverianti į bambą. Remiantis atliktais tyrimais diagnozuota urachus cista ir sinusas. Abiem atvejais buvo atliktos laparoskopinės urachus cistų ir sinuso ekscizijos.IšvadosDaugelį metų urachus anomalijos buvo operuojamos atviruoju būdu, tačiau laparoskopinė operacija tapo gera alternatyva atvirosioms dėl silpnesnio pooperacinio skausmo, mažesnių randų, greitesnio sveikimo.Reikšminiai žodžiai: urachus cista, urachus sinusas, ekscizija, laparoskopinė operacija.Laparoscopic excision of urachal cysts and sinus: report of two cases and review of the literature IntroductionUrachal abnormalities are rare. Usually, they are incidental findings and remain asymptomatic unless a complication (most commonly infection) occurs. A complicated urachal anomaly needs to be removed. We introduce two successful case reports, according to our data the first laparoscopic urachal remnant excision in Lithuania.Cases presentationIn the first case, 55-year-old female patient presented with a two-month history of dysuria. Abdominal ultrasonography misdiagnosed the right ovarian cyst. Diagnostic laparoscopy and pelvic computer tomography showed an urachal cyst. In the second case, a 22-year-old female patient presented with a ten-day history of abdominal pain and umbilical discharge. Abdominal ultrasonography showed two cysts (the first cyst was found near the urinary bladder and the second cyst was connected with the umbilicus) under the anterior abdominal wall. According to clinical symptoms and ultrasound findings, urachus sinus and cyst were diagnosed. Laparoscopic urachal anomaly excision operations were performed to both patients.ConclusionsLaparoscopy is an effective and safe minimally invasive technique in the management of urachal anomalies. Open surgical excision has been the treatment of choice for many years, but the laparoscopic approach has become an attractive alternative because of less postoperative pain, better cosmetics, and rapid convalescence.Key words: urachal cyst, urachal sinus, excision, laparoscopic surgery.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

scholarly journals A Case Report of Metronidazole-Induced Pancreatitis

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Alcohol Intake ◽  
Viral Infections ◽  
Clinical Course ◽  
Epigastric Pain ◽  
Case Reports ◽  
Sudden Onset ◽  
African American Female ◽  
Case Summary ◽  
Biochemical Evaluation ◽  
Knowledge Identification

Case Summary: A 23-year-old African-American female came to the emergency department with sudden onset epigastric pain associated with nausea having begun one day before presentation. Her symptoms started after the third dose of Metronidazole therapy for treatment of bacterial vaginosis. Clinical examination showed moderate epigastric tenderness. Lipase was 771 IU/L on admission. CT abdomen showed mild haziness of peripancreatic fat, which was suggestive of inflammation and diagnosis of acute pancreatitis was made. A detailed history and biochemical evaluation excluded pancreatitis-gallstones, recent increased alcohol intake, ERCP, hypercholesterolemia, hypercalcemia or viral infections. Symptoms resolved quickly upon discontinuation of metronidazole. We conclude therefore that Metronidazole was thought the most probable etiological factor. Discussion: The proportion of cases of Metronidazole-induced pancreatitis occurs in less than 1% in the general population, and the mechanism of action is not well known. Overall has a benign clinical course when assessed and treated appropriately. Conclusion: There are only 15 previous case reports of Metronidazole-induced pancreatitis in the literature to our best knowledge. Identification of Metronidazole as the causative agent is the key to recovery, and physicians should discontinue metronidazole in patients with pancreatitis of no identifiable source to ensure proper healing.

scholarly journals No Bull: A Case of Alpha-Gal Syndrome Associated With Buffalo Meat Sensitivity

2019 ◽  
Vol 10 ◽  
pp. 215265671989336
Author(s):  
Marija Rowane ◽  
Reimus Valencia ◽  
Benjamin Stewart-Bates ◽  
Jason Casselman ◽  
Robert Hostoffer
Keyword(s):  
Case Report ◽  
Immunoglobulin E ◽  
Case Reports ◽  
The United States ◽  
Tick Saliva ◽  
Buffalo Meat ◽  
The Past ◽  
First Case ◽  
Delayed Anaphylaxis ◽  
History Of

Introduction Alpha (⍺)-gal syndrome (AGS) is an immunoglobulin E (IgE) antibody response against the glycoprotein carbohydrate galactose-⍺-1,3-galactose-β-1-(3)4-N-acetylglucosamine-R (Gal⍺-1,3Galβ1-(3)4GlcNAc-R or ⍺-gal) that is present in Ixodida (tick) saliva and noncatarrhine mammals as well as cetuximab, antivenom, and the zoster vaccine. The most frequently observed anaphylactic reactions in AGS are observed after beef, pork, lamb, and deer meat consumption. We present the first case of anaphylaxis to buffalo meat. Case Report A 55-year-old man presented with a history of recurrent urticaria that only developed approximately 7 hours after buffalo consumption. The patient denied history of Ixodidae bites but admitted to frequent hiking outdoors. Anti-⍺-1,3-gal IgE was positive (30.80 kU/L). The patient was advised to strictly avoid red meat. Discussion The prevalence of AGS has been increased in all continents in the past decade, and several Ixodidae species have been associated with this hypersensitivity. The list of IgE-mediated reactions to various types of meat has expanded to kangaroo, whale, seal, and crocodile, although these have not been associated with AGS. van Nunen only cautioned against consumption of exotic meats, such as buffalo, but no published case report describes AGS associated with anaphylaxis to this type of meat. Conclusion AGS is a mammalian meat allergy that has been increasingly prevalent worldwide, especially in Ixodidae endemic regions of Australia and the United States. Multiple AGS case reports published in the past decade demonstrate rapidly increasing understanding of underlying mechanisms provoking ongoing sensitization to help devise management strategies and dietary information. We offer the first case report of delayed anaphylaxis to buffalo meat.

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