Myxedema crisis and ovarian hyperstimulation in a child with Down syndrome

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mariasusan Abraham ◽  
Geethalakshmi Sampathkumar ◽  
Rajeshwari Narayanan ◽  
Prahada Jagannathan
Keyword(s):  
Down Syndrome ◽  
Treatment Guidelines ◽  
Cardiac Risk ◽  
Ovarian Hyperstimulation ◽  
Fatal Complication ◽  
Girl Child ◽  
Case Presentation ◽  
Pituitary Hyperplasia ◽  
Resource Poor ◽  
Annual Screening

Abstract Objectives Myxedema crisis, a fatal complication of severe hypothyroidism, is extremely rare in children and treatment guidelines are lacking. Since availability of intravenous levothyroxine is limited in resource poor settings, myxedema crisis can be treated with oral levothyroxine and/or oral liothyronine (if necessary), in the absence of cardiac risk factors, thus hastening the recovery and significantly decreasing the associated morbidity and mortality. In the background of untreated hypothyroidism, a possible association of ovarian hyperstimulation syndrome (OHSS) and reactive pituitary hyperplasia should be kept in mind, thus preventing unnecessary interventions. Case presentation A 13-year-old girl child with Down syndrome, presented with myxedema crisis, as initial presentation of untreated hypothyroidism. Conclusions Annual screening, timely diagnosis of hypothyroidism, and early initiation of thyroid hormone supplementation will prevent associated physical and neurocognitive morbidity in children, especially those with Down syndrome. Importance of oral liothyronine supplementation in myxedema crisis, has been highlighted in this case report.

Fourth Ventricle Outlet Obstruction and Diverticular Enlargement of Luschka Foramina in a Child with Down Syndrome

2020 ◽  
pp. 1-4
Author(s):  
Valentina Orlando ◽  
Pietro Spennato ◽  
Maria De Liso ◽  
Vincenzo Trischitta ◽  
Alessia Imperato ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Fourth Ventricle ◽  
Endoscopic Third Ventriculostomy ◽  
Obstructive Hydrocephalus ◽  
Radiological Finding ◽  
Outlet Obstruction ◽  
Third Ventriculostomy ◽  
Viable Option ◽  
Case Presentation

<b><i>Introduction:</i></b> Hydrocephalus is not usually part of Down syndrome (DS). Fourth ventricle outlet obstruction is a rare cause of obstructive hydrocephalus, difficult to diagnose, because tetraventricular dilatation may suggest a communicant/nonobstructive hydrocephalus. <b><i>Case Presentation:</i></b> We describe the case of a 6-year-old boy with obstructive tetraventricular hydrocephalus, caused by Luschka and Magen­die foramina obstruction and diverticular enlargement of Luschka foramina (the so-called fourth ventricle outlet obstruction) associated with DS. He was treated with endoscopic third ventriculostomy (ETV) without complications, and a follow-up MRI revealed reduction of the ventricles, disappearance of the diverticula, and patency of the ventriculostomy. <b><i>Conclusion:</i></b> Diverticular enlargement of Luschka foramina is an important radiological finding for obstructive tetraventricular hydrocephalus. ETV is a viable option in tetraventricular obstructive hydrocephalus in DS.

scholarly journals Cerebral venous thrombosis in a patient with Down syndrome and coronavirus disease 2019: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Henry Robayo-Amortegui ◽  
Natalia Valenzuela-Faccini ◽  
Cesar Quecano-Rosas ◽  
Darlyng Zabala-Muñoz ◽  
Michel Perez-Garzon
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Case Report ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Epidemiological Data ◽  
Thromboembolic Disease ◽  
Hispanic Woman ◽  
Case Presentation ◽  
The World

Abstract Background The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. Case presentation We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis. Conclusions Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection.

scholarly journals Treatment Considerations for Obstructive Sleep Apnea in Pediatric Down Syndrome

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1074
Author(s):  
Erica Gastelum ◽  
Marcus Cummins ◽  
Amitoj Singh ◽  
Michael Montoya ◽  
Gino Luis Urbano ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Treatment Guidelines ◽  
Negative Impact ◽  
Pediatric Population ◽  
Healthy Children ◽  
Obstructive Sleep ◽  
Treatment Considerations ◽  
Additional Therapy

Children with Down syndrome (DS) are at high risk for developing obstructive sleep apnea (OSA) compared to children without DS. The negative impact of OSA on health, behavior, and cognitive development in children with DS highlights the importance of timely and effective treatment. Due to the higher prevalence of craniofacial and airway abnormalities, obesity, and hypotonia in patients with DS, residual OSA can still occur after exhausting first-line options. While treatment commonly includes adenotonsillectomy (AT) and continuous positive airway pressure (CPAP) therapy, additional therapy such as medical management and/or adjuvant surgical procedures need to be considered in refractory OSA. Given the significant comorbidities secondary to untreated OSA in children with DS, such as cardiovascular and neurobehavioral consequences, more robust randomized trials in this patient population are needed to produce treatment guidelines separate from those for the general pediatric population of otherwise healthy children with OSA. Further studies are also needed to look at desensitization and optimization of CPAP use in patients with DS and OSA.

scholarly journals Lobar torsion after thoracoscopic esophagectomy, and prevention method to detect its incidence during the operation

2016 ◽  
Author(s):  
Yutaka Miyawaki ◽  
Yasuaki Nakajima ◽  
Yutaka Tokairin ◽  
Kenro Kawada ◽  
Taichi Ogo ◽  
...  
Keyword(s):  
Pulmonary Resection ◽  
Middle Lobe ◽  
Thoracoscopic Esophagectomy ◽  
Fatal Complication ◽  
Case Presentation ◽  
Urgent Surgery ◽  
Right Middle Lobe ◽  
Prevention Method ◽  
Pulmonary Torsion ◽  
The Right

Abstract Introduction: Lobar torsion is a rare but fatal complication, with such cases being mostly treated with pulmonary resection. Only a few cases of pulmonary torsion following esophagectomy have thus far been reported, and all cases occurred subsequent to transthoracic esophagectomy. Case presentation: We herein present the case of a patient with the right middle lobe torsion after thoracoscopic esophagectomy in a 64-year-old male.As the patient exhibited a hemodynamically unstable condition immediately after surgery and bronchoscopy and computed tomography revealed right middle lobe torsion, urgent surgery was performed.As torsion of right middle lobe was confirmed during a second operation, repositioning for torsion was performed. Fortunately, right middle lobe was aerated and exhibited a good complexion immediately after repositioning; therefore, pneumonectomy was not performed. Conclusion: Because it is difficult to observe the process of reinflation of a collapsed lung under direct vision in order to prevent lobar torsion when performing thoracoscopic esophagectomy, it is imperative to confirm the patency of the proximal bronchi during the operation using bronchoscopy.

Ovarian Hyperstimulation Syndrome in Newborns – A Case Presentation and Literature Review

2008 ◽  
Vol 71 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Jerzy Starzyk ◽  
Małgorzata Wójcik ◽  
Joanna Wojtyś ◽  
Przemysław Tomasik ◽  
Zofia Mitkowska ◽  
...  
Keyword(s):  
Literature Review ◽  
Ovarian Hyperstimulation Syndrome ◽  
Ovarian Hyperstimulation ◽  
Case Presentation

scholarly journals A Early Development of Severe Ovarian Hyperstimulation Syndrome following Ovulation Induction

JMS SKIMS ◽  
2011 ◽  
Vol 14 (1) ◽  
pp. 30-32
Author(s):  
Fayaz A Sofi ◽  
Wasim Ahmed ◽  
Ghulam Nabi Dhobi ◽  
Showkat Ali Mufti ◽  
Rafi Ahmed Jan ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Ovulation Induction ◽  
Ovarian Hyperstimulation Syndrome ◽  
Capillary Permeability ◽  
Ovarian Hyperstimulation ◽  
Fatal Complication ◽  
Vitro Fertilization ◽  
Severe Ovarian Hyperstimulation Syndrome

Ovarian Hyperstimulation is a rare but potentially fatal complication of ovarian stimulation during treatment of infertility. Worldwide the incidence of this syndrome is increasing due to liberal use of invitro fertilization for management of infertility. The syndrome is characterized by cystic ovarian enlargement and abnormal capillary permeability due to secretion of vasogenic substances by ovaries. The syndrome is classified into early and late variants with early variants usually mild to moderate in severity. We present a case of severe ovarian hyperstimulation syndrome (OHSS) developing early in a 25-year female while undergoing In-vitro fertilization (IVF). Six days after ovulation induction, the woman developed ascites, bilateral pleural effusion and acute renal failure with ultrasound abdomen revealing bilateral cystic enlargement of ovaries. JMS 2011;14(1):30-32

scholarly journals Successful Management of Cryptococcal Meningitis and Bone Marrow Infiltration in a Young HIV/AIDS Patient: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Sonika Patel ◽  
Marla Jalbut ◽  
Kimberly S. Esham ◽  
David Stone
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Treatment Guidelines ◽  
Newly Diagnosed ◽  
Review Of The Literature ◽  
Successful Management ◽  
Related Complication ◽  
Case Presentation ◽  
Recommended Treatment ◽  
Established Treatment

Bone marrow cryptococcosis has been rarely reported in the literature, and there are no established treatment guidelines specific to this AIDS-related complication. The recommended treatment for AIDS-related invasive fungal treatments include amphotericin B and flucytosine which are associated with an array of complications making optimal treatment recommendations difficult. This case presentation represents an example of a patient with newly diagnosed AIDS and bone marrow cryptococcosis, which was successfully managed with an antifungal regimen adjusted to her comorbidities.

scholarly journals Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation

2020 ◽  
Vol 4 (4) ◽  
pp. 634-635
Author(s):  
Taofiq Oyedokun ◽  
Kevin Durr
Keyword(s):  
Upper Airway ◽  
Mass Effect ◽  
Endoscopic Examination ◽  
Past Medical History ◽  
Fatal Complication ◽  
Case Presentation ◽  
History Of ◽  
Retropharyngeal Hematoma ◽  
Significant Mass Effect ◽  
Significant Mass

Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway. Discussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.

scholarly journals Treatment of Iatrogenic Cervical Esophageal Transection following Thyroidectomy: A Case Report and Review of Literature

2021 ◽  
Author(s):  
Kai-Yun Hsueh ◽  
En-Kuei Tang
Keyword(s):  
Surgical Intervention ◽  
Primary Repair ◽  
Rare Condition ◽  
Review Of Literature ◽  
Fatal Complication ◽  
Case Presentation ◽  
T Tube ◽  
Mediastinal Abscess ◽  
Prompt Diagnosis ◽  
Gastric Pull Up

Abstract Background: iatrogenic cervical esophageal transection after thyroidectomy is an extremely rare condition that requires prompt diagnosis and surgical intervention.Case presentation: we reported a rare case of iatrogenic cervical esophageal transection following thyroidectomy for thyroid carcinoma in a 54-year-old woman. Primary repair was not achievable because of loss of a long segment of the cervical esophagus. A modified diversion was performed by inserting a T-tube into the remnant esophagus, followed by gastrostomy and jejunostomy. The next day, mediastinal abscess was detected on chest computed tomography; therefore, thoracoscopic mediastinotomy was performed, with placement of two drains. After 6 months, thoracoscopic esophagectomy, alimentary reconstruction with gastric pull-up, and cervical esophagogastrostomy anastomosis were performed. The patient was discharged on postoperative day 18, without complications.Conclusions: iatrogenic cervical esophageal transection following thyroidectomy is a rare but fatal complication. It can be successfully managed with a series of treatments, including modified diversion procedure, prompt drainage of mediastinitis, alimentary reconstruction with gastric pull-up, and cervical esophagogastrostomy anastomosis.

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