scholarly journals Symptomatic sinus bradycardia due to electrolyte imbalances in syndrome of inappropriate antidiuretic hormone (SIADH) related covid-19: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muzakkir Amir ◽  
Andi Renata ◽  
Levina Tri Ratana
Keyword(s):  
Case Report ◽  
Antidiuretic Hormone ◽  
Broad Spectrum ◽  
Sinus Bradycardia ◽  
Clinical Manifestations ◽  
Electrolyte Imbalance ◽  
Case Presentation ◽  
Global Pandemic ◽  
Possible Cause ◽  
Atypical Manifestation

Abstract Background Coronavirus Disease-2019 (COVID-19) has been declared a global pandemic since March 11th, 2020. Despite emerging reports and literature covering a broad spectrum of COVID-19 clinical manifestations, facets of COVID-19 have not been fully elucidated. To the authors’ concern, sinus bradycardia as a manifestation of COVID-19-induced syndrome of inappropriate antidiuretic hormone (SIADH) has never been reported before. Case presentation In this paper, we report a case of a 59-year-old male patient with confirmed COVID-19 initially presented with presyncope. Further investigations reveal sinus bradycardia related to COVID-19-induced SIADH. This case highlights the possibility of immuno-neuroendocrino-cardiovascular crosstalk resulting in an atypical manifestation of COVID-19: near syncope due to sinus bradycardia. Conclusions Another possible cause of sinus bradycardia in COVID-19 is electrolyte imbalance due to COVID-19-related SIADH.

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

Disorders of Water and Sodium Balance: Hyponatremia

2019 ◽  
Author(s):  
Danilea M. Carmona Matos ◽  
Herbert Chen
Keyword(s):  
Antidiuretic Hormone ◽  
Sodium Transport ◽  
Clinical Manifestations ◽  
Electrolyte Imbalance ◽  
Renal Physiology ◽  
Sodium Balance ◽  
Electrolyte Balance ◽  
Clear Understanding ◽  
Drug Induced ◽  
Clinical Scenarios

Disorders of water and sodium balance are common in clinical practice. To better assess them, we must have a clear understanding of water-electrolyte homeostasis and renal function. The following review goes over practical equations necessary for electrolyte balance analysis as well as the foundations of renal physiology. Emphasis is placed on the understanding of sodium transport and its physiologic and pharmacologic regulation. In addition, we explore the most common electrolyte imbalance affecting up to 28% of hospitalized patients: hyponatremia (ie, low sodium concentration). Hyponatremia has been found in several acute and chronic clinical scenarios including postoperative, drug-induced, and exercise-associated hyponatremia. However, it is not uncommon to find this disorder coexisting with other diseases such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), acquired immunodeficiency syndrome (AIDS), cancer, and in rare cases, hypothyroidism. To better understand this disorder, the etiology, diagnosis with clinical manifestations and laboratory values, and treatment options are explored. This review contains 9 figures, 6 tables, and 52 references. Key Words: aldosterone, antidiuretic hormone, body fluids, electrolyte balance, hyponatremia, hypovolemia, osmolality, sodium transport, vasopressin

Disorders of Water and Sodium Balance: Hyponatremia

2019 ◽  
Author(s):  
Danilea M. Carmona Matos ◽  
Herbert Chen
Keyword(s):  
Antidiuretic Hormone ◽  
Sodium Transport ◽  
Clinical Manifestations ◽  
Electrolyte Imbalance ◽  
Renal Physiology ◽  
Sodium Balance ◽  
Electrolyte Balance ◽  
Clear Understanding ◽  
Drug Induced ◽  
Clinical Scenarios

Disorders of water and sodium balance are common in clinical practice. To better assess them, we must have a clear understanding of water-electrolyte homeostasis and renal function. The following review goes over practical equations necessary for electrolyte balance analysis as well as the foundations of renal physiology. Emphasis is placed on the understanding of sodium transport and its physiologic and pharmacologic regulation. In addition, we explore the most common electrolyte imbalance affecting up to 28% of hospitalized patients: hyponatremia (ie, low sodium concentration). Hyponatremia has been found in several acute and chronic clinical scenarios including postoperative, drug-induced, and exercise-associated hyponatremia. However, it is not uncommon to find this disorder coexisting with other diseases such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), acquired immunodeficiency syndrome (AIDS), cancer, and in rare cases, hypothyroidism. To better understand this disorder, the etiology, diagnosis with clinical manifestations and laboratory values, and treatment options are explored. This review contains 9 figures, 6 tables, and 52 references. Key Words: aldosterone, antidiuretic hormone, body fluids, electrolyte balance, hyponatremia, hypovolemia, osmolality, sodium transport, vasopressin

Disorders of Water and Sodium Balance: Hyponatremia

2019 ◽  
Author(s):  
Danilea M. Carmona Matos ◽  
Herbert Chen
Keyword(s):  
Antidiuretic Hormone ◽  
Sodium Transport ◽  
Clinical Manifestations ◽  
Electrolyte Imbalance ◽  
Renal Physiology ◽  
Sodium Balance ◽  
Electrolyte Balance ◽  
Clear Understanding ◽  
Drug Induced ◽  
Clinical Scenarios

Disorders of water and sodium balance are common in clinical practice. To better assess them, we must have a clear understanding of water-electrolyte homeostasis and renal function. The following review goes over practical equations necessary for electrolyte balance analysis as well as the foundations of renal physiology. Emphasis is placed on the understanding of sodium transport and its physiologic and pharmacologic regulation. In addition, we explore the most common electrolyte imbalance affecting up to 28% of hospitalized patients: hyponatremia (ie, low sodium concentration). Hyponatremia has been found in several acute and chronic clinical scenarios including postoperative, drug-induced, and exercise-associated hyponatremia. However, it is not uncommon to find this disorder coexisting with other diseases such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), acquired immunodeficiency syndrome (AIDS), cancer, and in rare cases, hypothyroidism. To better understand this disorder, the etiology, diagnosis with clinical manifestations and laboratory values, and treatment options are explored. This review contains 9 figures, 6 tables, and 52 references. Key Words: aldosterone, antidiuretic hormone, body fluids, electrolyte balance, hyponatremia, hypovolemia, osmolality, sodium transport, vasopressin

scholarly journals Effects of Histobulin on Depression and Anxiety in Chronic Urticaria: Psychiatric Manifestations or Psychiatric Comorbidities of Chronic Urticaria?: A Case Report

2020 ◽  
Author(s):  
G Noh ◽  
Sungjin Cho
Keyword(s):  
Case Report ◽  
Chronic Urticaria ◽  
Clinical Manifestations ◽  
Severe Depression ◽  
Depression And Anxiety ◽  
Psychiatric Comorbidities ◽  
Case Presentation ◽  
Clinical Changes ◽  
Psychiatric Manifestations ◽  
Allergic Manifestations

Abstract Background: Psychiatric comorbidities of chronic urticaria (CU) have been reported and examined recently. The prevalence of mental disorders and emotional distress is high in patients with chronic urticaria. Histobulin is well known to be effective in chronic urticaria. Case Presentation: Three cases of CU accompanying psychiatric manifestations (PMs) were treated with Histobulin. One patient with CU with severe depression showed clinical changes in depressive symptoms in parallel to changes in allergic symptoms. Histobulin improved not only chronic urticaria but also the accompanying PMs in two other patients with CU. The PMs were not improved by an antihistamine (H1 blocker) in all 3 cases. Histobulin is effective not only for allergic manifestations (AMs) but also for PMs of chronic urticaria. Conclusions: PMs seem to be clinical manifestations of chronic urticaria through histamine-mediated mechanisms. PMs as well as AMs of chronic urticaria were effectively and causatively treated with Histobulin. These conditions were suggested to be ‘allergic psychiatric manifestations (APM)’ or ‘histamine-mediated psychiatric manifestations (HmPM). Further study of PMs based on histamine-mediated mechanisms, including allergies, is necessary. Accordingly, it should be clarified whether the PMs of CU are actual PMs of CU or are psychiatric comorbidities of CU.

scholarly journals Left Renal Vein Thrombus and Pulmonary Thromboembolism Caused by Nutcracker Syndrome: a Case Report

2021 ◽  
Author(s):  
Kanta Hori ◽  
Shota Yamamoto ◽  
Maki Kosukegawa ◽  
Noboru Yamashita ◽  
Yuichiro Shinno
Keyword(s):  
Case Report ◽  
Renal Vein ◽  
Pulmonary Thromboembolism ◽  
Case Reports ◽  
Left Renal Vein ◽  
Clinical Manifestations ◽  
Venous Hypertension ◽  
Nutcracker Syndrome ◽  
Case Presentation ◽  
Renal Venous Hypertension

Abstract Background: Nutcracker syndrome (NCS) refers to compression of the left renal vein (LRV) between the aorta and superior mesenteric artery (SMA), which results in renal venous hypertension and its resultant clinical manifestations. Left renal vein thrombus (LRVT) complicating NCS is relatively rare. To the best of our knowledge, there are only four case reports of LRVT complicating NCS. Furthermore, there are no reports of pulmonary thromboembolism (PTE) caused by NCS. Herein, we describe a rare case of NCS causing LRVT and PTE and its clinical management. Case Presentation: A 40-year-old man was admitted to our hospital with acute left flank pain. Computed tomography angiography (CTA) revealed compression of the LRV between the aorta and the SMA with an LRVT. Furthermore, CTA revealed bilateral PTE. Rivaroxaban was administered as an anticoagulant. Twenty days after initiation, CTA revealed complete resolution of PTE and LRVT, and repeat CTA at 3 and 6 months showed no recurrence. Conclusions: This case report demonstrates that NSC may be a possible cause of LRVT and PTE. We review the reported cases of NCS complicated by LRVT and discuss the imaging modalities for NCS.

Bradycardia and Hypotension from Improper Use of Aconite Root: A Case Report and Brief Review

2018 ◽  
Vol 25 (5) ◽  
pp. 338-343 ◽  
Author(s):  
Pei-Ying Chou ◽  
Ching-Chiung Wang ◽  
Chen-Jei Tai ◽  
Tsung-Lin Yang ◽  
You-Jen Tang
Keyword(s):  
Case Report ◽  
Sinus Bradycardia ◽  
Clinical Manifestations ◽  
Herbal Medicines ◽  
Good Health ◽  
Active Components ◽  
P Waves ◽  
Processing Methods ◽  
Health Maintenance ◽  
Improper Use

Background: Adverse reactions associated with Chinese herbal medicines (CHMs) are usually the result of unpredictable active/toxic ingredients, inaccurate or mistaken beliefs, or poor supervision. The herb that most commonly induces severe adverse effects in Hong Kong and China is aconite root. More than 200 species of Aconitum plants are used for medicinal purposes, with aconite roots producing analgesic, anti-inflammatory, cardiotonic, and anti-tumor effects. The active components are alkaloids; these can be toxic, but CHM processing methods lower their toxicity and increase the pharmacological efficacy. However, aconite poisoning can result from inadequate decoction time or exceeding the recommended dose. Case Report: Here we report the case of a 92-year-old woman who presented with life-threatening bradycardia and hypotension. This started 1 h after she inappropriately consumed a herbal decoction containing Fuzi for mood fluctuation and health maintenance; Fuzi, an aconite root, has known cardiotoxicity. Electrocardiography showed supraventricular abnormalities, including sinus bradycardia and low-amplitude P waves. After an infusion of normal saline and inotropic agents for 25 h, the clinical manifestations subsided, her sinus rhythm returned to normal, and she was discharged. At follow-up 2 weeks later, she was in good health and had ceased taking any CHM. Conclusions: Standardized processing methods, stringent regulations, and cooperation between health professions can ensure medication safety and establish a fully-fledged operating process for these valuable drugs. We hope this report will help establish correct attitudes toward CHM and will assist Traditional Chinese Medicine practitioners to become more familiar with Aconitum plants.

scholarly journals Palmo-plantar hyperkeratosis associated with HTLV-1 infection: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elías Quintero-Muñoz ◽  
Daniel Martin Arsanios ◽  
María Fernanda Estupiñán Beltrán ◽  
Juan David Vera ◽  
Catalina Palacio Giraldo ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Manifestation ◽  
Seborrheic Dermatitis ◽  
Clinical Manifestations ◽  
Strongyloides Stercoralis ◽  
Palmoplantar Keratoderma ◽  
Case Presentation ◽  
Skin Manifestation ◽  
Human T Cell ◽  
Palmoplantar Hyperkeratosis

Abstract Background Palmoplantar hyperkeratosis is a cutaneous manifestation that had not been clearly associated with infection by the human T-cell lymphotropic virus, which is a retrovirus that in most cases does not develop clinical pathologies and its symptoms may be undetected. The skin is one of the most affected organs, however until now only seborrheic dermatitis, xerosis/ichthyosis and infective dermatitis associated with HTLV-1 have been described as cutaneous clinical manifestations of this disease. Case presentation We present the case of a 36-year-old male patient with serologically documented HTLV-1 infection, who presented symptoms of diarrhea, malabsorption due to Strongyloides stercoralis, and in whom a physical examination revealed an association with generalized xerosis and palmoplantar keratoderma confirmed by skin biopsy. Other infectious etiologies and malignancy were ruled out. This clinical manifestation was managed with dermal hydration, and skin care which improved the thickened skin and make it less noticeable. Conclusions According to our experience, this is the first reported case of palmoplantar keratoderma associated with a human lymphotropic virus infection. This is a skin manifestation that has not been confirmed in conjunction with HTLV-I before. This implies that palmoplantar keratoderma is a new clinical manifestation of this infection, that should be considered in the initial approach of patients in endemic areas with these dermatological characteristics.

scholarly journals Two case reports of COVID-19: A 6-year-old boy and his 66-year-old grandmother

2020 ◽  
Author(s):  
Wanwan Yi ◽  
Hengwei Fan ◽  
Zhong Wei Lv ◽  
Xuan Long ◽  
hengmei zhu
Keyword(s):  
Clinical Manifestations ◽  
The Elderly ◽  
Imaging Features ◽  
Test Results ◽  
Imaging Diagnosis ◽  
Case Presentation ◽  
Global Pandemic ◽  
Family Aggregation ◽  
Multiple Detection ◽  
Acid Test

Abstract Background: Currently, COVID-19 is a global pandemic disease that has caused a large number of infections worldwide. Reports of COVID-19 cases are not uncommon, but there is no report that SAMS-CoV-2 RNA test results for grandma and grandchildren in family aggregation infections are completely different.Case presentation: A 6-year-old boy's chest CT indicated lung infection, but SAMS-CoV-2 RNA test was negative. His grandmother's imaging showed lung inflammation absorption, and nucleic acid test was positive. Conclusions: Children and the elderly people have different clinical manifestations during the course of SAMS-CoV-2 infection, it is challenging to identify whether they are infectious. Therefore, the diagnosis of COVID-19 requires a combination of multiple detection measures, including clinical features, imaging features, and SAMS-CoV-2 RNA test results.Keywords: COVID-19; SAMS-CoV-2 RNA test; Imaging diagnosis; Case report

scholarly journals First description of immune complex vasculitis after COVID-19 vaccination with BNT162b2: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Victoria Therese Mücke ◽  
Viola Knop ◽  
Marcus Maximilian Mücke ◽  
Falk Ochsendorf ◽  
Stefan Zeuzem
Keyword(s):  
Case Report ◽  
Immune Complex ◽  
Clinical Manifestations ◽  
Lower Abdomen ◽  
Short Treatment ◽  
Laboratory Findings ◽  
Case Presentation ◽  
Immune Complex Vasculitis ◽  
Oral Steroids ◽  
Hands And Feet

Abstract Background Cases of immune complex vasculitis have been reported following COVID-19 infections; so far none in association with novel mRNA-based COVID-19 vaccination. This case report describes a cutaneous immune complex vasculitis after vaccination with BNT162b2. Case presentation A 76-year old male with liver cirrhosis developed an immune complex vasculitis 12 days after the second injection of BNT162b2. On physical examination, the patient presented with pruritic purpuric macules on hands and feet, flexor and extensor parts of both legs and thighs and lower abdomen, and bloody diarrhoea. Laboratory testing showed elevated inflammatory markers. After short treatment with oral steroids all clinical manifestations and laboratory findings resolved. Conclusions An increasing number of clinical manifestations have been attributed to COVID-19 infection and vaccination. This is the first written report of immune complex vasculitis after vaccination with BNT162b2. We present our case report and a discussion in the light of type three hypersensitivity reaction.

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