scholarly journals Loss of vision secondary to toxic optic neuropathy due to gutka overdose: A Case Report

2021 ◽  
Vol 11 (5) ◽  
pp. 139-140
Author(s):  
Irfan Kabiruddin Jeeva ◽  
 Sidra Masud ◽  
Syed Hasan Raza Abidi, ◽  
Tazeen Saeed Ali ◽  
Ayesha Akbar Waheed, ◽  
...  
Keyword(s):  
Case Report ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Liver Function Tests ◽  
Nerve Fibers ◽  
Central Scotoma ◽  
Case Presentation ◽  
Toxic Optic Neuropathy ◽  
Oral Form ◽  
History Of

Introduction: Toxic optic neuropathy is defined as the damage caused by a toxin to the optic nerve fibers. There is a vast list of toxins that may lead to optic neuropathies. One of the toxins among this list is tobacco. Gutka being an oral form of tobacco, however, has not been previously related to optic neuropathy. Case presentation: We present a case of a 22-year-old male who presented with decreased far vision and gradually increasing photophobia. He had a history of gutka usage, a form of smokeless tobacco. Investigations revealed a central scotoma on FOV, a swollen optic disc on OCT and deranged Liver function tests. A diagnosis of RIGHT + LEFT optic neuropathy secondary to a chemical toxic was made, which in this case, was gutka. Conclusion: Consumption of gutka can lead to irreversible toxic optic neuropathy.

scholarly journals RESEARCH OF REPARATIVE MECHANISMS IN THE OPTIC NERVE IN TOXIC NEUROPATHY CAUSED BY Cr (VI)

ScienceRise ◽  
2020 ◽  
pp. 31-39
Author(s):  
Olena Kuzenko ◽  
Yuri Demin ◽  
Yevhen Kuzenko
Keyword(s):  
Endothelial Cells ◽  
Optic Nerve ◽  
Heat Shock ◽  
Heat Shock Proteins ◽  
Optic Neuropathy ◽  
Nerve Fibers ◽  
Male Rats ◽  
Neurotoxic Effect ◽  
Toxic Optic Neuropathy ◽  
Shock Proteins

Intoxication lesions of the optic nerve (toxic optic neuropathy, TON) most often occur under the influence of exogenous factors, including heavy metals. Сell survival under stress have involves heat shock proteins (HSPs). The aim of the research. To assess the optic nerve’s immunoreactivity to heat shock proteins of the HSP70 and HSP90α families and reveal its relationship with the severity of morphological changes in toxic optic neuropathy caused by Cr (VI). Materials and methods. The study was conducted on 48 mature male rats. The experimental groups were given to drink water with Cr(VI) for 20, 40 and 60 days. This type of water is typical for the water basins in the northern districts of the Sumy region. Optic nerves сhanges under the influence of Cr(VI) have investigated by the morphometric method. Neuroglial cells and capillary endothelial cells were assessed by immunohistochemistry by HSP70α and HSP90 expression for intensity and spatial distribution. Results. The data analysis revealed that Cr (VI) has a neurotoxic effect on the optic nerve with the development of edema, which is manifested by the thickening of nerve fibers. The dynamics of HSP70 immunoexpression in the endothelium of the optic nerve capillaries of rats on 20 and 40 experimental days was characterized by stable values and was 1.5 times higher than the control. The maximum number of positively stained cells for the HSP70 marker was detected in endothelial cells of the microvasculature for 60 days – 82.44±12.42 %. HSP70 levels in neuroglia cells of optic nerve have decreased on day 40 (55.66±11.56% p=0.05) and lower than the control (70.44±4.81 %.) group. Optic nerve capillaries was highest immunoactivity on HSP90 in group II endothelial cells – 51.22±14.57% (p=0.05). The activity of HSP90α protein in optic neuroglia cells was characterized by a gradual increase in the duration of the experiment and was higher by 12, 4 % in experimental group III (81.77±21.67 %) compared with control (71.66±4.95 %). Conclusions. Our study provides an insight into the significant difference in the immunoreactivity of heat shock proteins of the HSP70 and HSP90α families in neuroglia and endothelial cells of the optic nerve capillaries under the influence of Cr(VI). The results obtained suggest that Cr (VI) has a neurotoxic effect on the optic nerve with the development of edema, which is manifested by the thickening of nerve fibers. A comparison of the dynamics of the development of the dystrophic process in the optic nerve with the results of the immunohistochemical analysis showed, that an increase in the thickness of nerve fibers is accompanied by an increase in immunoreactive neuroglial cells (HSP90α) and endothelial cells (HSP70).

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

The Coexistence of Olfactory Groove with Optic Nerve Sheath Meningioma Presenting with Anosmia: Case Report

2020 ◽  
Vol 16 ◽  
Author(s):  
Hatice Ferhan Kömürcü ◽  
Gıyas Ayberk ◽  
Ömer Anlar
Keyword(s):  
Case Report ◽  
Optic Nerve ◽  
Visual Impairment ◽  
Optic Nerve Sheath ◽  
Olfactory Groove ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma ◽  
History Of ◽  
Olfactory Groove Meningioma ◽  
Memory Disturbance

Introduction: Meningiomas are the third most common intracranial tumors in adults after glial tumors and metastases. Olfactory groove meningiomas often grow without symptoms due to their slow growth rates and location in the frontal lobe. Optic nerve sheath meningiomas are benign neoplasms of the meninges surrounding the optic nerve. The coexistence of olfactory groove and optic nerve sheath meningiomas without any history of neurofibromatosis or radiotherapy has never been reported in the literature. Case Report: A 36-year-old female patient presenting with anosmia, headache, memory disturbance, and visual impairment and operated with the diagnosis of olfactory groove meningioma was reported. In the postoperative period, optic nerve sheath meningioma was detected in the imaging performed due to the persistence of visual impairment. Conclusion: Olfactory groove and optic nerve sheath meningiomas are rare tumors and can be diagnosed late because they progress slowly. Early diagnosis and treatment may affect the prognosis and morbidity of these patients favorably.

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

scholarly journals Acute Iodine Toxicity from a Suspected Oral Methamphetamine Ingestion

2014 ◽  
Vol 7 ◽  
pp. CCRep.S20086 ◽  
Author(s):  
Marilyn N. Bulloch
Keyword(s):  
Case Report ◽  
Gastrointestinal Symptoms ◽  
Liver Function Tests ◽  
Oral Ingestion ◽  
Methamphetamine Abuse ◽  
Normal Limits ◽  
Naturally Occurring ◽  
History Of ◽  
Systemic Symptoms ◽  
Iodine Toxicity

Background Iodine is a naturally occurring element commercially available alone or in a multitude of products. Iodine crystals and iodine tincture are used in the production of methamphetamine. Although rarely fatal, iodine toxicity from oral ingestion can produce distressing gastrointestinal symptoms and systemic symptoms, such as hypotension and tachycardia, from subsequent hypovolemia. Objective The objective of this case report is to describe a case of iodine toxicity from suspected oral methamphetamine ingestion. Case Report A male in his early 20′s presented with gastrointestinal symptoms, chills, fever, tachycardia, and tachypnea after orally ingesting a substance suspected to be methamphetamine. The patient had elevated levels of serum creatinine, liver function tests, and bands on arrival, which returned to within normal limits by day 4 of admission. Based on the patient's narrow anion gap, halogen levels were ordered on day 3 and indicated iodine toxicity. This is thought to be the first documented case of iodine toxicity secondary to suspected oral methamphetamine abuse. Conclusion Considering that the incidence of methamphetamine abuse is expected to continue to rise, clinicians should be aware of potential iodine toxicity in a patient with a history of methamphetamine abuse.

scholarly journals Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Thomas-Michael Schneider ◽  
Friederike Klenner ◽  
Franz Brettner
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
High Dose ◽  
Great Success ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Rehabilitation Hospital ◽  
Membrane Oxygenation ◽  
History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

scholarly journals Tacrolimus-induced bilateral optic neuropathy: A case report

2021 ◽  
pp. 4-4
Author(s):  
Lepsa Zoric ◽  
Aleksandra Ilic ◽  
Emina Colak ◽  
Milos Mirkovic ◽  
Jelica Pantelic ◽  
...  
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
White Male ◽  
Immunosuppressive Drug ◽  
Organ Rejection ◽  
Toxic Optic Neuropathy ◽  
Tacrolimus Therapy ◽  
Male Patients

Intrduction. Tacrolimus (fujimycin or FK506) is a potent immunosuppressive drug with growing usage. It is usually used in prevention of transplanted organ rejection. Its use is highly valuable, but like other immunosupressants, it has adverse effects. One of them is optic neuropathy. Case report. A 47-year-old white male patients who had received tacrolimus therapy for nine years, after kidney transplantation, developed a subacute, painless vision loss on both eyes. He was thoroughly examined on different possible optic neuropathies and other causes of vision loss. After exclusion of other possible causes, the diagnosis of toxic optic neuropathy was established. His therapy was converted to cyclosporine, by his nephrologist, but his vision had improved only slightly. Conclusion. Toxic optic neuropathies are presented in everyday ophthalmological practice, but they are underestimated. Diagnosis can be demanding, especially when it comes to drugs and substances whose possible toxic effect on the optic nerve is not widely known. Unlike other adverse effects of tacrolimus therapy on nervous system, optic neuropathy can causes great and permanent functional impairment.

scholarly journals An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Zhao ◽  
Zhichao Lai ◽  
Xiaojun Song ◽  
Rong Zeng ◽  
Changwei Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Carotid Endarterectomy ◽  
Early Stage ◽  
Prostatic Hyperplasia ◽  
Surgical Patients ◽  
Blood Products ◽  
Case Presentation ◽  
Life Threatening ◽  
History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

scholarly journals Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Naoko Yuzawa-Tsukada ◽  
Toshikazu D. Tanaka ◽  
Satoshi Morimoto ◽  
Michihiro Yoshimura
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Insufficiency ◽  
Infectious Endocarditis ◽  
Cardiac Abnormality ◽  
Case Presentation ◽  
Old Japanese ◽  
History Of ◽  
Nonbacterial Thrombotic Endocarditis ◽  
High Turbulence

Abstract Background A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve. Case presentation We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve. Conclusions Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.

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