scholarly journals IgA nephropathy presenting with pulmonary thromboembolism and renal artery infarct

2018 ◽  
Vol 8 (3) ◽  
pp. 29-29
Author(s):  
Madhav Venkatesan ◽  
Anil Mathew ◽  
Rajesh Nair ◽  
George Kurian ◽  
Seethalekshmy NV ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Iga Nephropathy ◽  
Urine Analysis ◽  
Previous History ◽  
Case Presentation ◽  
Arterial Thromboembolism ◽  
Pulmonary Angiogram ◽  
Cardiology Department ◽  
Ct Pulmonary Angiogram ◽  
The Right

Background: Venous and arterial thromboembolism are frequently seen in nephrotic syndrome. They generally occur during periods of sustained proteinuria in patients who are not responding to treatment and more commonly seen in minimal change disease and membranous nephropathy. Case Presentation: A 28-year-old male presented to cardiology department of our hospital with worsening breathlessness for 1 week. We found pulmonary embolism and an infarct in the lower pole of the right kidney by CT pulmonary angiogram. He had no previous history or features of nephrotic syndrome. Urine analysis showed numerous red blood cells, 3+ proteinuria and granular casts. Urine protein creatinine ratio was 5.2 g/g of creatinine. Serum creatinine was 2.61 mg/dL. Renal biopsy was suggestive of IgA nephropathy and patient was started on steroids and warfarin and responded to treatment. Conclusions: Patients with nephrotic syndrome can rarely present initially with venous and arterial thromboembolism. Rarely even IgA nephropathy can present with such thromboembolic episodes.

scholarly journals Pulmonary Thromboembolism in a Child with Sickle Cell Hemoglobin D Disease in the Setting of Acute Chest Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hazel Villanueva ◽  
Sandeepkumar Kuril ◽  
Jennifer Krajewski ◽  
Aziza Sedrak
Keyword(s):  
Pulmonary Artery ◽  
Sickle Cell ◽  
Pulmonary Thromboembolism ◽  
Acute Chest Syndrome ◽  
Standard Management ◽  
Pulmonary Angiogram ◽  
Right Pulmonary Artery ◽  
Ct Pulmonary Angiogram ◽  
Complete Thrombosis ◽  
The Right

Introduction. Sickle cell hemoglobin D disease (HbSD) is a rare variant of sickle cell disease (SCD). Incidence of pulmonary thromboembolism (PE) and deep venous thrombosis (DVT) in children with HbSD is unknown. PE and DVT are known complications of SCD in adults but have not been reported in the literature in children with HbSD.Case Report. We are reporting a case of a 12-year-old boy with HbSD with acute chest syndrome (ACS) complicated by complete thrombosis of the branch of the right pulmonary artery and multiple small pulmonary artery emboli seen on computed tomography (CT) pulmonary angiogram and thrombosis of the right brachial vein seen on Doppler ultrasound. Our patient responded to treatment with anticoagulant therapy.Conclusion. There are no cases reported in children with HbSD disease presenting as ACS with pulmonary thromboembolism. We suggest that PE should be suspected in patients presenting with ACS who do not show improvement with standard management. CT pulmonary angiogram should be utilized for early diagnosis and appropriate management as there is no current protocol for management of PE/DVT in pediatric patients with SCD.

Primary pulmonary angiosarcoma

2021 ◽  
Vol 14 (11) ◽  
pp. e244578
Author(s):  
Muhammad Kashif Rana ◽  
Owais Rahman ◽  
Aiden O’Brien
Keyword(s):  
Pulmonary Arteries ◽  
Rare Type ◽  
Pulmonary Artery Sarcoma ◽  
Pulmonary Angiogram ◽  
Primary Pulmonary Artery Sarcoma ◽  
History Of ◽  
Ct Pulmonary Angiogram ◽  
The Right ◽  
Specific Symptoms ◽  
Large Primary

Primary pulmonary angiosarcoma is a rare type of malignant vascular tumour with poor prognosis. Diagnosis is often late due to non-specific symptoms and low clinical suspicion for angiosarcoma. A 72-year-old man presented to hospital with a 6-month history of mild progressive dyspnoea, with associated cough, episodes of presyncope and weight loss. CT pulmonary angiogram (CTPA) was reported as a large saddle pulmonary embolism extending into both the right and left pulmonary arteries. Further Multidisciplinary team meeting (MDM) discussion, and review of CTPA and subsequent investigations revealed a large primary pulmonary artery sarcoma which was later confirmed histology. The patient was referred to the cardiothoracic surgeons and underwent left radical pneumonectomy.

scholarly journals 780 Appearing and disappearing right-heart thrombus: a case reporto in COVID-19 patient

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giacomo Campi ◽  
Martina Finocchi ◽  
Nicolas Palagano ◽  
Emanuela Calcagno ◽  
Alessandra Pesci ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Right Ventricle ◽  
Thrombus Formation ◽  
Nasopharyngeal Swab ◽  
Cardiac Ultrasound ◽  
Free Wall ◽  
Pulmonary Angiogram ◽  
Right Ventricle Free Wall ◽  
Ct Pulmonary Angiogram ◽  
The Right

Abstract Aims Venous thromboembolism represents frequent complication of patients with severe COVID-19 disease. Several reports about atypical thrombosis are described, rarely it has been described a right venticular thrombus during the course of infection. We report a case of right endoventricular thrombosis in a patient with SARS-Cov-2 pneumonia. Methods and results A 58-year-old man was admitted to our ward for severe respiratory failure in interstitial pneumonia. The nasopharyngeal swab for COVID-19 resulted positive. Steroids and prophylaxis with LMWH were started, associated to CPAP to maintain good gas exchange. During hospitalization a venous ECD was performed with evidence of left popliteal thrombosis despite the therapy. d-Dimer was 4463  ng/ml. A new onset AF was documented at the telemetry, without troponin elevation. A cardiac ultrasound was performed showing a right endoventricular lesion of 1.8  cm adhering to the free wall of the right ventricle. A CT-pulmonary angiogram (CTPA) resulted negative for pulmonary embolism and confirmed suspected right ventricular thrombus. Treatment with fondaparinux 7.5 mg was started. After 10 days, cardiac ultrasound shown complete resolution of thrombosis, and CT confirmed the disappearing of the mass. Dabigatran 150  mg twice/day was started. Patient clinically improved and he was discharged after 20 days of hospitalization. Conclusions SARS-CoV-2 infection may cause inflammation with cytokine storm and hypercoagulability leading to venous thromboembolism. Atypical thrombus formation was reported, including right-ventricle free wall. Early caridac ultrasound was critical to make diagnosis and starting prompt treatment, therefore routine cardiac ultrasound is mandatory in severe COVID-19 patients.

Optic Disc Drusenoid Deposits with Hemifield Defects in a Patient with IgA Nephropathy - New Findings

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Visual Field ◽  
Iga Nephropathy ◽  
Optic Disc ◽  
Urine Analysis ◽  
Leukocytoclastic Vasculitis ◽  
Visual Field Defects ◽  
Total Leucocyte Count ◽  
Cell Hyperplasia ◽  
New Findings ◽  
The Right

To describe emerging new OCT and Humphrey visual field findings is the objective of the study. A previously treated 20-year old female patient for skin rashes, hematuria, and pain abdomen 8 months ago reported with visual disruption in the right eye for the last one week. Features of leukocytoclastic vasculitis on skin biopsy and glomerular mesangial cell hyperplasia on renal biopsy inferred a clinical diagnosis of IgA nephropathy. Consequently, proteinuria manifested one month after administration of prednisolone 50 mg/day tapered for 8 months, Visual acuity of 6/9 in the right eye and 6/6 in the left eye with normal color vision recorded in addition to early signs of papilledema. Classically, on OCT, hyperreflective intense echoes discovered in the optic disc, and accordingly inferior hemifield defects established predominantly in the right eye on HFA. Total leucocyte count at11720 cells/cu mm and ESR 60 mm/hr by the Wintrobe method with the presence of albumin, RBCs, and pus cells on urine analysis in addition to positive occult stool blood detection. C3, C4, and ANCA panel revealed negative results and the USG abdomen disclosed fatty liver with mesenteric nodes. In conclusion, Optic disc drusenoid deposits corresponding with hemifield visual field defects detected in the current case study is possibly the associated early fundus manifestation of IgA nephropathy.

Pulmonary mucormycosis causing a mycotic pulmonary artery aneurysm

2021 ◽  
pp. 021849232199849
Author(s):  
Richard Saldanha ◽  
Ravi Ghatanatti ◽  
Mohan D Gan ◽  
Kiran Kurkure ◽  
Gautam Suresh ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Artery Aneurysm ◽  
High Morbidity ◽  
Pulmonary Artery Aneurysm ◽  
Pulmonary Mucormycosis ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Pulmonary Artery Aneurysms ◽  
The Right ◽  
Very High

Mycotic pulmonary artery aneurysms requiring pneumonectomy are extremely rare. We present a severely breathless immunocompromised diabetic middle-aged female patient. CT pulmonary angiogram revealed a giant pulmonary artery aneurysm with impending rupture in the right lung. We did an emergency right pneumonectomy under cardiopulmonary bypass support. Histopathology report of the lung specimen confirmed mucormycosis. She received amphotericin B after the procedure. The patient had a prolonged postoperative hospital stay and succumbed to sepsis. Mycotic pulmonary artery aneurysm portends very high morbidity and mortality in immunocompromised patients.

scholarly journals Feasibility of Detecting Pulmonary Embolism Using Noncontrast MRI

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
C. S. Mudge ◽  
T. T. Healey ◽  
M. K. Atalay ◽  
J. A. Pezzullo
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Mri ◽  
Imaging Techniques ◽  
Pulmonary Arteries ◽  
Pulmonary Emboli ◽  
Pulmonary Angiogram ◽  
Mri Protocol ◽  
Ct Pulmonary Angiogram ◽  
Magnetic Resonance Imaging Techniques ◽  
The Right

Purpose. The purpose of this study was to evaluate the feasibility of detecting pulmonary emboli utilizing noncontrast magnetic resonance imaging techniques in patients with known pulmonary embolism. Materials and Methods. Eleven patients were enrolled in a study to evaluate right ventricular function by cardiac MRI in patients diagnosed with acute pulmonary embolism on CT pulmonary angiogram. Cardiac MRI was performed as soon as possible following pulmonary embolism detection. Two independent observers reviewed the precontrast portion of each MRI, scoring right, left, and lobar arteries as positive or negative for PE. The CTs were reviewed and interpreted in the same manner. Results. MRI was obtained on average of 40 hours after the CT. Forty-eight vessels were affected by PE on CT, 69% of which were identified on MRI. All eight pulmonary emboli located in the right or left pulmonary arteries were detected on MRI. Of the 15 pulmonary emboli that were not detected on MRI, 7 were subsegmental, 6 were segmental, and 2 were located in a branch not included in the MRI field of view. Conclusions. Most pulmonary emboli detected on CT were identified on noncontrast MRI, even though our MRI protocol was not optimized for pulmonary artery visualization.

Pulmonary embolism with coexistent incidental pulmonary cement embolism post vertebroplasty

2021 ◽  
Vol 14 (3) ◽  
pp. e237449
Author(s):  
James Ross ◽  
Robin Bhatia ◽  
Tom Hyde ◽  
Giles Dixon
Keyword(s):  
Thrombus Formation ◽  
Main Pulmonary Artery ◽  
Sudden Onset ◽  
Incidence Rates ◽  
Lytic Lesion ◽  
Pleuritic Chest Pain ◽  
Pulmonary Angiogram ◽  
Cement Embolism ◽  
Ct Pulmonary Angiogram ◽  
The Right

A 46-year-old woman presented with sudden onset of shortness of breath and pleuritic chest pain. A CT pulmonary angiogram identified a 5 cm cement pulmonary embolus within the right main pulmonary artery with a surrounding thrombus. She had undergone an L4 vertebroplasty 3 years prior to presentation for a benign lytic lesion. Cement embolus is a known complication of cement vertebroplasty with incidence rates of approximately 0.9%. Management is usually conservative and associated morbidity and mortality rates are low. It is not known whether a previous cement embolus could provide a nidus for thrombus formation.

scholarly journals Adrenal haemorrhage as a complication of COVID-19 infection

2020 ◽  
Vol 13 (11) ◽  
pp. e239643
Author(s):  
Noor Sharrack ◽  
Conal Thomas Baxter ◽  
Michael Paddock ◽  
Elizabeth Uchegbu
Keyword(s):  
Unusual Complication ◽  
Adrenal Haemorrhage ◽  
Heparin Infusion ◽  
Pulmonary Angiogram ◽  
Intravenous Heparin ◽  
Ct Pulmonary Angiogram ◽  
Synacthen Test ◽  
The Right ◽  
Short Synacthen Test

We report an unusual complication of COVID-19 infection in a 53-year-old Caucasian man. He presented with shortness of breath, fever and pleuritic chest pain. A CT pulmonary angiogram (CTPA) demonstrated acute bilateral pulmonary embolism and bilateral multifocal parenchymal ground glass change consistent with COVID-19 (SARS-CoV-2) infection. Right adrenal haemorrhage was suspected on the CTPA which was confirmed on triple-phase abdominal CT imaging. A short Synacthen test revealed normal adrenal function. He was treated initially with an intravenous heparin infusion, which was changed to apixaban with a planned outpatient review in 3 months’ time. He made an uncomplicated recovery and was discharged. Follow-up imaging nearly 5 months later showed near complete resolution of the right adrenal haemorrhage with no CT evidence of an underlying adrenal lesion.

Shrinking Lung Syndrome – A rare cause of recurrent dyspnoea in SLE

2017 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Hazlyna Baharuddin ◽  
Mohd Arif Mohd Zim ◽  
Azmillah Rosman ◽  
Mollyza Mohd Zain
Keyword(s):  
High Resolution ◽  
Lupus Erythematosus ◽  
Chest Radiographs ◽  
Lung Volumes ◽  
High Resolution Ct ◽  
Pulmonary Angiogram ◽  
Breath Sounds ◽  
Dsdna Antibody ◽  
Ct Pulmonary Angiogram ◽  
The Right

Here we present a 24-year-old lady with systemic lupus erythematosus (SLE) whom we diagnosed with shrinking lung syndrome (SLS), a rare manifestation of SLE. The initial SLE manifestation was alopecia, thrombocytopenia, serositis and vasculitis. Anti-nuclear antibody (ANA), anti-double stranded DNA (dsDNA) antibody, anti-ribonucleic (RNP) and anti-Ro antibody were positive. A year after diagnosis, she started to develop intermittent dyspnea and was hospitalised on three occasions. Lung examinations revealed reduced breath sounds at both bases and dullness at the right base. Multiple chest radiographs showed bilateral raised hemi-diaphragms. Other investigations including CT pulmonary angiogram, high resolution CT of the thorax, ventilation-perfusion scan and echocardiogram were not significant. On the third hospital admission, we noticed bilateral small lung volumes in the previous high resolution CT scan. Inspiratory and expiratory chest radiographs were performed and showed minimal change in lung volumes and a diagnosis of shrinking lung syndrome (SLS) was made. Her SLE remained active with lupus nephritis despite multiple immunosuppression and she passed away two years later due to sepsis with multi-organ failure.

scholarly journals Intravenous leiomyomatosis manifesting as saddle embolism

2019 ◽  
Vol 12 (3) ◽  
pp. e228267
Author(s):  
Alexandra N Murphy ◽  
Danielle Byrne ◽  
Umer Salati ◽  
Leo Lawler
Keyword(s):  
Main Pulmonary Artery ◽  
Benign Neoplasm ◽  
Filling Defect ◽  
Intravenous Leiomyomatosis ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Surgical Thrombectomy ◽  
Vascular Structures ◽  
The Right ◽  
Severe Dyspnoea

A 51-year-old, otherwise well woman, presented with progressive severe dyspnoea. CT pulmonary angiogram (CTPA) demonstrated a large filling defect within the right main pulmonary artery with evidence of right heart strain. She was anticoagulated and discharged home; however, was readmitted with progression of symptoms and hypotension within 1 month. Repeat CTPA demonstrated progression of the filling defect. Formal surgical thrombectomy was performed with removal of an unusual cream-coloured, rubber-like material. Histological analysis revealed intravenous leiomyomatosis (IVL). IVL is a rare benign neoplasm, characterised by smooth muscle cell proliferation in vascular structures that can act aggressively. This case describes the workup, recognition and management of IVL.

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