scholarly journals Clinical feature of severe fever with thrombocytopenia syndrome (SFTS)-associated encephalitis/encephalopathy: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Xu ◽  
Mingran Shao ◽  
Ning Liu ◽  
Danjiang Dong ◽  
Jian Tang ◽  
...  

Abstract Background/objective Severe fever with thrombocytopenia syndrome (SFTS) cause encephalitis/encephalopathy, but few reports were available. We aimed to investigate the incidence of encephalitis/encephalopathy in SFTS patients and to summarize clinical characteristics, laboratory findings and imaging features. Methods We conducted a retrospective review of all patients with confirmed SFTS admitted to Nanjing Drum Tower Hospital, a tertiary hospital in Nanjing City, China, between January 2016 and July 2020. The patients were divided into two groups according to whether they had encephalitis/encephalopathy: encephalitis/encephalopathy group and non- encephalitis/encephalopathy group. Clinical data, laboratory findings, imaging characteristics, treatments and outcomes of these patients were collected and analyzed. Results A total of 109 SFTS patients with were included, of whom 30 (27.5 %) developed encephalitis/encephalopathy. In-hospital mortality (43.3 %) was higher in encephalitis/encephalopathy group than non-encephalitis/encephalopathy group (12.7 %). Univariate logistic regression showed that cough, wheezing, dyspnoea, respiratory failure, vasopressors use, bacteremia, invasive pulmonary aspergillosis (IPA) diagnoses, PCT > 0.5 ug/L, CRP > 8 mg/L, AST > 200 U/L and serum amylase level > 80 U/L were the risk factors for the development of encephalitis/encephalopathy for SFTS patients. Multivariate logistic regression analysis identified bacteremia, PCT > 0.5 mg/L and serum amylase level > 80 U/L as independent predictors of encephalitis/ encephalopathy development for SFTS patients. Conclusions SFTS-associated encephalitis/encephalopathy has high morbidity and mortality. it was necessary to strengthen the screening of CSF testing and brain imaging after admission for SFTS patients who had symptoms of encephalitis/encephalopathy. SFTS patients with bacteremia, PCT > 0.5 ug/L or serum amylase level > 80 U/L should be warned to progress to encephalopathy.

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Masayuki Obatake ◽  
Yusuke Yamane ◽  
Takayuki Tokunaga ◽  
Yasuaki Taura ◽  
Yukio Inamura ◽  
...  

A case of traumatic pancreatitis with subsequent joint pain and osteolytic lesions is presented. A 10-year-old girl was admitted to our hospital with abdominal pain caused by blunt epigastric injury. She was diagnosed with traumatic pancreatitis, and multiple pancreatic pseudocysts subsequently developed. Two weeks after admission, she complained of joint pain, and MR revealed osteolytic lesions of both knee joints. On the 58th day, endoscopic transgastric pseudocyst drainage was performed. Joint pain and osteolytic lesions resolved rapidly, in parallel with the decrease in serum amylase level and pseudocyst size.


2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.


2016 ◽  
Vol 4 (2) ◽  
pp. 115-121
Author(s):  
Arezu Nejabatian ◽  
Farzad Rahmani ◽  
Rozbeh Rajaei Ghafori ◽  
Samad Shams Vahdati ◽  
Parizad Varghayi ◽  
...  

Author(s):  
Anita Verma ◽  
Prerna Harsh

Background: Gallstone disease (GSD) is one of the most common gastrointestinal diseases. Gallstones represent a significant burden for health care systems worldwide and are one of the most common disorders presenting to emergency room. Methods: Hospital based case control study conducted at Department of Biochemistry with close collaboration of Department of General Surgery, S. P. Medical College and associated group of PBM Hospital, Bikaner, Rajasthan. Results: The insignificant serum amylase level difference in case group (47.80± 21.24) as compares to control group (45.97± 16.38). Conclusion: In this study comparison of amylase between case and controls group showed that the levels of amylase in cholelithiasis patients were higher than that of the control group, but there was no significant variation in amylase. Keywords: Amylase, cholelithiasis, Gallstone disease (GSD).


2020 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo

Abstract Background: To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP was analysed. The patients with PEP were recorded. ROC curves were used to statistically analyze the data. Results: PEP occurred in 21 patients (10.19%). The 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot ROC curve. The area under the curve (AUC) was 0.816 , and was statistically significant (P<0.001). The standard error (SE) was 0.0507, the 95% confidence interval (CI) was 0.756-0.866, and the optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). The ROC curves were plotted for both serum amylase and lipase respectively. The areas under the ROC curves were statistically significant(P<0.001). The area under the ROC curve for the 3-hour post-ERCP lipase was 0.778, the 95% confidence interval was 0.673-0.862, and optimal cut-off value was 1834 U/L. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to predict PEP. For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .


Author(s):  
Melda F. Flora ◽  
Budiono Raharjo ◽  
Maimun Z. Arthamin

Kanker pankreas adalah keganasan sel di jaringan pankreas. kejadiannya meningkat pada usia di atas 60 tahun. Namun, sekitar20% dapat terjadi di usia muda. Patogenesis terjadinya masih belum jelas, dikemukakan bahwa mutasi genetik dan faktor eksogen sepertimerokok berhubungan dengan terjadinya keganasan sel pankreas. Kasus adalah seorang laki-laki perokok berusia 31 tahun dengankeluhan utama nyeri ulu hati menjalar ke punggung, disertai mual, muntah, nafsu makan turun. Pada pemeriksaan fisik didapatkansklera ikterik, perkusi redup dan ronkhi di paru, distensi abdomen dan asites. Pada pemeriksaan laboratorik didapatkan leukositosis,trombositopenia, peningkatan aspartate aminotransaminase (AST) lebih dari 10 kali Upper Range Limit (URL), hiperbilirubinemiadirek, peningkatan alkaline phosphatase (ALP), Gamma Glutamyl Transferase (GGT) dan lipase serum, sedangkan amilase serumnormal. Terdapat juga peningkatan kadar CA19-9. Pada computed tomography scan (CT scan) dan Magnetic Resonance Imaging (MRI)didapatkan gambaran kanker pankreas primer yang telah bermetastasis ke pleura dan hati. Kadar amilase normal di pasien dapatdisebabkan karena awal peningkatan dan penurunan kadar amilase terjadi lebih cepat dan pada saat diperiksa telah turun mencapaikadar normal. Simpulan, kanker pankreas dapat terjadi di usia muda. Amilase yang normal dapat terjadi di kanker pankreas.


2020 ◽  
Author(s):  
Yanjiao Lu ◽  
Zhenli Huang ◽  
Meijia Wang ◽  
Kun Tang ◽  
Shanshan Wang ◽  
...  

Abstract Background and objective: Little is yet known whether pathogenesis of COVID-19 is different between young and elder patients. Our study aimed to investigate the clinical characteristics and provide predictors of mortality for young adults with severe COVID-19.Methods: A total of 77 young adults with confirmed severe COVID-19 were recruited retrospectively at Tongji Hospital. Clinical characteristics, laboratory findings, treatment and outcomes were obtained from electronic medical records. The prognostic effects of variables were analyzed using logistic regression model.Results: In this retrospective cohort, non-survivors showed higher incidence of dyspnea and co-existing laboratory abnormalities, compared with young survivals in severe COVID-19. Multivariate logistic regression analysis showed that lymphopenia, elevated level of d-dimer, hypersensitive cardiac troponin I (hs-CTnI) and high sensitivity C-reactive protein (hs-CRP) were independent predictors of mortality in young adults with severe COVID-19. Further analysis showed that severely young adults with two or more factors abnormalities above would be more prone to death. The similar predictive effect of above four factors had been observed in all-age patients with severe COVID-19.Conclusion: Lymphopenia, elevated level of d-dimer, hs-CTnI and hs-CRP predicted clinical outcomes of young adults with severe COVID-19.


2021 ◽  
Author(s):  
Yanjiao Lu ◽  
Zhenli Huang ◽  
Meijia Wang ◽  
Kun Tang ◽  
Shanshan Wang ◽  
...  

Abstract Background and objective: Little is yet known whether pathogenesis of COVID-19 is different between young and elder patients. Our study aimed to investigate the clinical characteristics and provide predictors of mortality for young adults with severe COVID-19.Methods: A total of 77 young adults with confirmed severe COVID-19 were recruited retrospectively at Tongji Hospital. Clinical characteristics, laboratory findings, treatment and outcomes were obtained from electronic medical records. The prognostic effects of variables were analyzed using logistic regression model.Results: In this retrospective cohort, non-survivors showed higher incidence of dyspnea and co-existing laboratory abnormalities, compared with young survivals in severe COVID-19. Multivariate logistic regression analysis showed that lymphopenia, elevated level of d-dimer, hypersensitive cardiac troponin I (hs-CTnI) and high sensitivity C-reactive protein (hs-CRP) were independent predictors of mortality in young adults with severe COVID-19. Further analysis showed that severely young adults with two or more factors abnormalities above would be more prone to death. The similar predictive effect of above four factors had been observed in all-age patients with severe COVID-19.Conclusion: Lymphopenia, elevated level of d-dimer, hs-CTnI and hs-CRP predicted clinical outcomes of young adults with severe COVID-19.


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