scholarly journals Case Report: Drug induced hyperkalemia presenting as acute flaccid quadriparesis

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 737 ◽  
Author(s):  
Santhosh Narayanan ◽  
Divya Prakash
Keyword(s):  
Case Report ◽  
Cardiac Disease ◽  
Acute Onset ◽  
Flaccid Paralysis ◽  
Dramatic Improvement ◽  
Drug Induced ◽  
Emergency Condition ◽  
Life Threatening

Hyperkalemia is a life-threatening dyselectrolytemia that commonly affects cardiac conductivity and contractility. Ascending paralysis affecting the extremities associated with hyperkalemia is not commonly seen. Here we report a case of flaccid quadriparesis in a patient who was taking potassium sparing diuretic for cardiac disease. An electrocardiogram showed typical signs of hyperkalemia. The patient was administered antihyperkalemic measures, which led to a dramatic improvement in symptoms. Hyperkalemic paralysis is a completely reversible emergency condition and should always be considered when dealing with acute onset flaccid paralysis.

scholarly journals Resolution of Severe Neurologic Signs Following Intravenous Lipid Emulsion Therapy in a Young Dog With a Portosystemic Shunt: Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Amanda M. Spillane ◽  
Jenica L. Haraschak ◽  
Maureen A. McMichael
Keyword(s):  
Hepatic Encephalopathy ◽  
Lipid Emulsion ◽  
Reference Interval ◽  
Ammonia Concentration ◽  
Acute Onset ◽  
Portosystemic Shunt ◽  
Dramatic Improvement ◽  
Intravenous Lipid Emulsion ◽  
Life Threatening ◽  
Patient’S History

A 5-month-old male intact Great Pyrenees was presented for an acute onset of severe neurologic signs (stupor, absent menace, intermittent head turn to the left). The patient's history included possible naproxen ingestion with a maximum ingested dose of 59 mg/kg, exceeding the reported dose of >50 mg/kg known to cause neurologic signs. Blood sampling for baseline bloodwork was performed, and intravenous lipid emulsion (ILE) was subsequently administered, for treatment of the suspected toxicosis. Due to severe and life-threatening neurologic signs, other methods of decontamination were contraindicated and unlikely to be effective; extracorporeal therapy was also unavailable. Complete resolution of neurologic signs occurred 30 min after completion of ILE therapy. At this time, the owners found the missing naproxen tablets after returning home and the bloodwork results returned revealing findings consistent with hepatic encephalopathy. The fasted blood ammonia concentration immediately prior to ILE administration was 702.1 μg/dL (reference interval, RI: 24–36 μg/dL) and decreased to 194.1 μg/dL 24 h later. In the first 24 h, the patient also received three doses of lactulose, N-acetylcysteine, and intravenous fluids. The patient was subsequently diagnosed with a single, large intrahepatic portosystemic shunt via computed tomography and underwent an endovascular coil embolization procedure. Given the rapid and dramatic improvement in severe neurologic signs after ILE therapy alone, it is strongly suspected that this treatment resulted in improvement of hepatic encephalopathy.

scholarly journals Vitamin B12 deficiency masquerading Addison’s disease: a case report of an adolescent male

2020 ◽  
Vol 8 (5) ◽  
pp. 1932
Author(s):  
Sudhaa Mani M. ◽  
Yasmeen Ahamed S. ◽  
Nanitha Lakshmi Kavitha Giri ◽  
Jesudasan A.
Keyword(s):  
Case Report ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
Ultra Violet ◽  
Adolescent Male ◽  
Drug Induced ◽  
Ultra Violet Radiation ◽  
Life Threatening ◽  
B12 Deficiency ◽  
Violet Radiation

Intraoral pigmentations range from innocuous physiologic pigments to life-threatening malignant conditions. It is at the discretion of the observing clinician to identify the abnormal clinical manifestations and provide necessary intervention. There are controversies about delineating the definite etiology of the pigmentation such as race, exposure to ultra-violet radiation, drug-induced pigmentation post-inflammatory pigments of the oral cavity.

Tramadol-induced parkinsonism: a case report of a 75-year-old woman

2018 ◽  
Vol 30 (2) ◽  
pp. 275-278 ◽  
Author(s):  
Ranbir Singh
Keyword(s):  
Case Report ◽  
Female Gender ◽  
Acute Onset ◽  
Negative Consequences ◽  
Probability Scale ◽  
Main Risk Factor ◽  
Drug Induced ◽  
Old Patients ◽  
Medical Practitioners

Abstract Adverse drug reaction (ADR) is a form of unwanted reaction and is the crucial reason for illness and death. Tramadol-induced parkinsonism is a kind of ADR that occurs after the repeated intake of tramadol. Long-term exposure to tramadol has been known to induce tremor and alter the functioning of dopamine. This case report introduces a 75-year-old woman diagnosed with tramadol-induced parkinsonism due to the administration of tramadol for the treatment of post-operated (breast cancer) acute onset of severe pain on the left side of the chest. The assessment of the offending drug was carried out via Naranjo probability scale. A score of 6 was reported for this patient, defining tramadol as a probable cause of this reaction. For the management of the drug-induced parkinsonism, levodopa/carbidopa was prescribed and the symptoms related to parkinsonism resolved within a week. The age of the patient and the female gender is considered to be the main risk factor for the occurrence of such reaction. This case report is an attempt to spread awareness about the negative consequences of long-term use of tramadol in old patients. Thus, the medical practitioners must be very careful while administering tramadol to the old aged population.

scholarly journals Quincke’s disease: a case report

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Rakshita R. Kamath ◽  
S. Juthika Rai
Keyword(s):  
Case Report ◽  
Chronic Pancreatitis ◽  
Medical Personnel ◽  
Acute Onset ◽  
Unknown Etiology ◽  
Angioneurotic Edema ◽  
Case Presentation ◽  
Clinical Disorder ◽  
Life Threatening ◽  
Acute Condition

Abstract Background Isolated angioneurotic edema of the uvula is termed Quincke’s disease. It is a rare clinical disorder of acute onset with few known causes. It may be encountered in any emergency setup and must be dealt with rapidly and with utmost vigilance for prevention of progression and complications. Case presentation A young adult, 3 months post Frey’s procedure for chronic pancreatitis, presented with acute onset throat discomfort and gagging progressive over 8 h. Examination showed isolated edematous hyperemic uvula with normal oropharyngeal structures and adequate airway. Prompt antihistaminic and corticosteroid therapy caused relief of symptoms over 2 h with no recurrences. Conclusion Any symptom suggesting orofacial edema must not be trivialized. Awareness about this rare but acute condition, even in the background of unknown etiology, in all medical personnel is essential. Early diagnosis with appropriate management can prevent life-threatening airway obstruction and hypoxemia.

scholarly journals Drug-Induced Methemoglobinemia: a Case Report and Review of Literature

2014 ◽  
Vol 2 (5) ◽  
pp. 34 ◽  
Author(s):  
Ahmed Zedan ◽  
Sabry Omar ◽  
Mahmoud Fenire
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Diagnostic Procedures ◽  
Blood Levels ◽  
Review Of Literature ◽  
Drug Induced ◽  
Upper Gi ◽  
Life Threatening ◽  
Upper Gi Endoscopy ◽  
Life Threatening Event

Drugs, including those used during diagnostic procedures, can have adverse effects and potentially serious side-effects, especially in complicated patients with significant comorbidity. Benzocaine is frequently used as an oropharyngeal anesthetic agent during bronchoscopy, transesophageal echocardiography, and upper GI endoscopy and can cause methemoglobinemia, a potentially life-threatening event if not diagnosed and treated quickly. Co-oximetry is the gold standard for the diagnosis of methemoglobinemia and can quantitate blood levels, which in turn correlate with the clinical presentation and the urgency for treatment. Methylene blue is the treatment of choice for methemoglobinemia. In this case report we discuss the pathophysiology, the clinical presentation, the diagnosis, and the treatment of benzocaine-induced methemoglobinemia.

scholarly journals SARS-CoV-2 as a Trigger in the Development of Tourette’s-Like Symptoms: A Case Report

2021 ◽  
Author(s):  
Sabine Hazan ◽  
John Nowicki ◽  
Sheldon Jordan
Keyword(s):  
Case Report ◽  
Gut Microbiota ◽  
Gut Microbiome ◽  
Neuropsychiatric Symptoms ◽  
Acute Onset ◽  
Dramatic Improvement ◽  
Rt Pcr ◽  
Gastrointestinal Microbiota ◽  
Blood Brain Barrier Disruption ◽  
The Impact

Abstract Background: Reports have been surfacing surrounding CNS-associated symptoms in individuals affected by coronavirus disease 19 (COVID-19). Tourette syndrome is a neuropsychiatric disorder with usual onset in childhood. Gut microbiota can affect central physiology and function via the microbiota-gut-brain axis. The authors of this case report describe Tourette’s-like symptoms in a patient resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disrupting gut microbiota. Case Presentation: This case involves a 16-year-old female that developed acute onset Tourette’s-like symptoms along with neuropsychiatric symptoms after exposure to and infection from SARS-CoV-2. The patient had negative nasopharyngeal (NP) real-time reverse transcription-PCR (RT-PCR) tests for SARS-CoV-2 on five occasions from August of 2020 through June of 2021. The patient’s symptoms continued to worsen over the next six months until next-generation sequencing (NGS) revealed SARS-CoV-2 in her stool. Repair of the gastrointestinal microbiota, treatment with nutraceutical and pharmaceutical agents, as well as alterations in her surroundings resulted in dramatic improvement in the microbiome and a significant reduction of symptoms.Discussion: The use of RT-PCR testing to determine the presence or absence of SARS-CoV-2 may be inadequate and inaccurate for individuals that have been exposed to the virus. In addition, the impact of SARS-CoV-2 infection to the GI tract may cause significant havoc in the gut microbiota which may lead to disruption of the blood brain barrier, disruption to the gut- microbiome-brain axis, and neurological symptoms. Additional testing, eradication of infectious agents, as well as restoration of the gut microbiome are needed to effectively manage and treat this condition.

scholarly journals A case report of Aceclofenac induced Drug induced Hypersensitivity syndrome

2021 ◽  
Vol 8 (1) ◽  
pp. 128
Author(s):  
Divyanshu Srivastava ◽  
Arvind Krishna ◽  
Robin Chugh ◽  
Abhinav David
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Report ◽  
Maculopapular Rash ◽  
Hypersensitivity Syndrome ◽  
Drug Induced ◽  
Successful Resolution ◽  
Life Threatening

<p>Drug-induced hypersensitivity syndrome (DIHS) is an unusual, potentially life-threatening, multi-organ adverse drug reaction. DIHS usually develops 2-6 weeks after drug initiation. We report a case of 21 years old female with maculopapular rash associated with fever and generalised lymphadenopathy, 15 days after intake of aceclofenac. Treatment with intravenous corticosteroids, antibiotics and fluids along with cessation of the offending drug resulted in successful resolution.</p>

Severe Drug-Induced Liver Injury as an Adverse Drug Event of Antibiotics: A Case Report and Review of the Literature

Chemotherapy ◽  
2017 ◽  
Vol 62 (6) ◽  
pp. 367-373 ◽  
Author(s):  
Martin Munz ◽  
Hans Grummich ◽  
Josef Birkmann ◽  
Martin Wilhelm ◽  
Ulrike Holzgrabe ◽  
...  
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Adverse Drug Event ◽  
Drug Event ◽  
Review Of The Literature ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Life Threatening

Drug-induced liver injury is one of the main reasons for acute liver failure. We report the case of a young patient who experienced a drug-induced liver injury resulting in life-threatening acute liver failure after treatment with different antibiotics (amoxicillin, ciprofloxacin, cefazolin, clindamycin) and acetaminophen, or a combination of these drugs. Moreover, we provide an overview of the hepatotoxic potential of these drugs.

scholarly journals Acute thrombocytopenia due to meropenem: a case report

2019 ◽  
Vol 8 (12) ◽  
pp. 2766
Author(s):  
Priti Dhande ◽  
Shreyas Deshmukh
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Broad Spectrum ◽  
Antibacterial Drug ◽  
Immune Mechanism ◽  
Drug Induced ◽  
Threatening Condition ◽  
Life Threatening ◽  
Severe Infections ◽  
Abdominal Infections

Meropenem is a broad spectrum antibacterial drug from the carbapenem family. It is commonly used as an empirical antimicrobial in severe infections like pneumonia, intra-abdominal infections, septicaemia, meningitis etc. Severe adverse effects with meropenem are rare (<1 %) which include hypersensitivity and hematologic adverse effects. In the literature, few cases have been reported of meropenem induced thrombocytopenia that has shown the immune mechanism by which thrombocytopenia occurs. Drug induced thrombocytopenia (DITP) can be a life threatening condition if not diagnosed and managed properly. As meropenem is being widely used in hospitals nowadays, it is important to be aware of the rare but serious adverse effects it causes.

scholarly journals Anticancer Drug-Induced Cardiotoxicity: Insights and Pharmacogenetics

2021 ◽  
Vol 14 (10) ◽  
pp. 970
Author(s):  
Archana Adhikari ◽  
Syed Mohammed Basheeruddin Asdaq ◽  
Maitham A. Al Hawaj ◽  
Manodeep Chakraborty ◽  
Gayatri Thapa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Anticancer Drug ◽  
Protective Role ◽  
Dramatic Improvement ◽  
Future Perspectives ◽  
Drug Induced ◽  
Chemotherapy Drugs ◽  
Life Threatening ◽  
Rate Of Recovery

The advancement in therapy has provided a dramatic improvement in the rate of recovery among cancer patients. However, this improved survival is also associated with enhanced risks for cardiovascular manifestations, including hypertension, arrhythmias, and heart failure. The cardiotoxicity induced by chemotherapy is a life-threatening consequence that restricts the use of several chemotherapy drugs in clinical practice. This article addresses the prevalence of cardiotoxicity mediated by commonly used chemotherapeutic and immunotherapeutic agents. The role of susceptible genes and radiation therapy in the occurrence of cardiotoxicity is also reviewed. This review also emphasizes the protective role of antioxidants and future perspectives in anticancer drug-induced cardiotoxicities.

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