scholarly journals Use of acetazolamide in lithium-induced nephrogenic diabetes insipidus: a case report

2018 ◽  
Vol 2018 ◽  
Author(s):  
Ricardo A Macau ◽  
Tiago Nunes da Silva ◽  
Joana Rego Silva ◽  
Ana Gonçalves Ferreira ◽  
Pedro Bravo
Keyword(s):  
Case Report ◽  
Diabetes Insipidus ◽  
Nephrogenic Diabetes Insipidus ◽  
Standard Treatment ◽  
Previous History ◽  
List Type ◽  
Severe Dehydration ◽  
History Of ◽  
Patient Series ◽  
Learning Points

Summary Lithium-induced nephrogenic diabetes insipidus (Li-NDI) is a rare and difficult-to-treat condition. A study in mice and two recent papers describe the use of acetazolamide in Li-NDI in 7 patients (a case report and a 6 patient series). We describe the case of a 63-year-old woman with bipolar disorder treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to a bowel obstruction and developed severe dehydration after surgery when she was water deprived. After desmopressin administration and unsuccessful thiazide and amiloride treatment, acetazolamide was administrated to control polyuria and hydroelectrolytic disorders without significant side effects. To our knowledge, this is the third publication on acetazolamide use in Li-NDI patients. Learning points: Treatment of lithium-induced nephrogenic diabetes insipidus might be challenging. Vasopressin, amiloride and thiazide diuretics have been used in lithium-induced nephrogenic diabetes insipidus treatment. Acetazolamide might be an option to treat lithium-induced nephrogenic diabetes insipidus patients who fail to respond to standard treatment. The use of acetazolamide in lithium-induced nephrogenic diabetes insipidus must be monitored, including its effects on glomerular filtration rate.

scholarly journals Dyslipidemia causes overestimation of plasma mitotane measurements

2016 ◽  
Vol 2016 ◽  
Author(s):  
Angelo Paci ◽  
Ségolène Hescot ◽  
Atmane Seck ◽  
Christel Jublanc ◽  
Lionel Mercier ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Standard Treatment ◽  
Internal Standard ◽  
High Plasma ◽  
Therapeutic Window ◽  
List Type ◽  
Plasma Samples ◽  
Routine Monitoring ◽  
History Of ◽  
Learning Points

Summary Mitotane (o,p′-DDD) is the standard treatment for advanced adrenocortical carcinoma (ACC). Monitoring of plasma mitotane levels is recommended to look for a therapeutic window between 14 and 20mg/L, but its positive predictive value requires optimization. We report the case of an ACC patient with a history of dyslipidemia treated with mitotane in whom several plasma mitotane levels >30mg/L were found together with an excellent neurological tolerance. This observation led us to compare theoretical or measured o,p′-DDD and o,p′-DDE levels in a series of normolipidemic and dyslipidemic plasma samples to explore potential analytical issues responsible for an overestimation of plasma mitotane levels. We demonstrate an overestimation of mitotane measurements in dyslipidemic patients. Mitotane and o,p′-DDE measurements showed a mean 20% overestimation in hypercholesterolemic and hypertriglyceridemic plasma, compared with normolipidemic plasma. The internal standard p,p′-DDE measurements showed a parallel decrease in hypercholesterolemic and hypertriglyceridemic plasma, suggesting a matrix effect. Finally, diluting plasma samples and/or using phospholipid removal cartridges allowed correcting such interference. Learning points Hypercholesterolemia (HCH) and hypertriglyceridemia (HTG) induce an overestimation of plasma mitotane measurements. We propose a routine monitoring of lipidemic status. We propose optimized methodology of measurement before interpreting high plasma mitotane levels.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

The fatal cholera like diarrhoea in coronavirus disease 2019(COVID-19)- a rare case report in toddler

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1894-1897
Author(s):  
Varsha Gajbhiye ◽  
Shubhangi Patil (Ganvir) ◽  
Sarika Gaikwad
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Digestive System ◽  
Gastrointestinal Symptoms ◽  
Female Child ◽  
Multiple Organ ◽  
Mild Case ◽  
Severe Dehydration ◽  
Rare Case Report ◽  
History Of

A 14-month female child came with complain of cholera like watery loose stool 10-12 times and vomiting 6-7 times, 24 hrs before admission. She was in severe dehydration, hypotension, unconscious with no recorded fever during her stay in hospital and no history of contact with COVID-19. Patient was COVID-19 positive Dehydration and hypotension was corrected, metabolic acidosis continued and eventually patient succumb due to multiple organ failure. This case report should arouse us to suspect COVID infection in every acute Gastroenteritis child who may not have any common symptoms as seen in COVID patient, also who have no history of significant contact with COVID positive patient in family. Some people with COVID-19 develop gastrointestinal symptoms either alone or with respiratory symptoms. Recently, researchers at Stanford University found that a third of patients they studied with a mild case of COVID-19 had symptoms affecting the digestive system. Another recent study Trusted Source published by researchers in Beijing found that anywhere from 3 to 79 percent of people with COVID-19 develop gastrointestinal symptoms.

scholarly journals Mild SARS-CoV-2 Infection After Gene Therapy in a Child With Wiskott-Aldrich Syndrome: A Case Report

2020 ◽  
Vol 11 ◽  
Author(s):  
Sabina Cenciarelli ◽  
Valeria Calbi ◽  
Federica Barzaghi ◽  
Maria Ester Bernardo ◽  
Chiara Oltolini ◽  
...  
Keyword(s):  
Gene Therapy ◽  
Case Report ◽  
Immune Reconstitution ◽  
Autoinflammatory Disease ◽  
Clinical Phenotype ◽  
High Titer ◽  
Previous History ◽  
Wiskott Aldrich Syndrome ◽  
Neutralizing Capacity ◽  
History Of

In this work we present the case of SARS-CoV-2 infection in a 1.5-year-old boy affected by severe Wiskott-Aldrich Syndrome with previous history of autoinflammatory disease, occurring 5 months after treatment with gene therapy. Before SARS-CoV-2 infection, the patient had obtained engraftment of gene corrected cells, resulting in WASP expression restoration and early immune reconstitution. The patient produced specific immunoglobulins to SARS-CoV-2 at high titer with neutralizing capacity and experienced a mild course of infection, with limited inflammatory complications, despite pre-gene therapy clinical phenotype.

scholarly journals Adolescent Catatonia Successfully Treated with Lorazepam and Aripiprazole

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Aaron J. Roberto ◽  
Subhash Pinnaka ◽  
Abhishek Mohan ◽  
Hiejin Yoon ◽  
Kyle A. B. Lapidus
Keyword(s):  
Case Report ◽  
Children And Adolescents ◽  
Emotional Distress ◽  
Successful Treatment ◽  
Previous History ◽  
Treatment Modalities ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Significant Impairment ◽  
History Of

Catatonia is especially concerning in children and adolescents. It leads to significant impairment, including emotional distress, difficulty communicating, and other debilitating symptoms. In this case report, we discuss a patient with no previous history of neuroleptic medication or psychotic symptoms, presenting with first-episode catatonia in the presence of disorganized, psychotic thoughts. We then review the catatonia syndrome, citing examples in the literature supporting its underdiagnosis in children and adolescents, and discuss successful treatment modalities. It is important to diagnose and treat catatonia as efficiently as possible, to limit functional and emotional distress to the patient.

scholarly journals Rituximab: a novel treatment for refractory Riedel’s thyroiditis

2018 ◽  
Vol 2018 ◽  
Author(s):  
Leanne Hunt ◽  
Barney Harrison ◽  
Matthew Bull ◽  
Tim Stephenson ◽  
Amit Allahabadia
Keyword(s):  
Monoclonal Antibody ◽  
Case Report ◽  
Rare Condition ◽  
List Type ◽  
Patient Case ◽  
Riedel’S Thyroiditis ◽  
Novel Treatment ◽  
Tender Mass ◽  
Learning Points ◽  
Riedel's Thyroiditis

Summary This case report reviews the rare condition of Riedel’s thyroiditis via a patient case. The report highlights the difficulties that one may encounter when managing such a case in regards to patient symptoms, side effects of medications and the relapsing nature of the condition. The case report also highlights novel treatment in the treatment of Riedel’s thyroiditis, rituximab, how this works and the resolution of symptoms that we have achieved with our patient on this treatment. Learning points: Riedel’s thyroiditis is characterised by chronic inflammation, which causes dense fibrosis in the thyroid gland. Riedel’s thyroiditis can present with neck pain, dysphagia and dyspnoea with a firm, non-tender mass found on examination. Riedel’s thyroiditis is part of the IgG4-related systemic disorders. Rituximab is a monoclonal antibody that works against the protein CD20.

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