COVID-19-associated orthostatic hypotension syndrome: direct and indirect mechanisms of development

2021 ◽  
Vol LIII (3) ◽  
pp. 64-70
Author(s):  
Elena G. Mendelevich ◽  
Alsu A. Saifeeva ◽  
Artur I. Kurbanov
Keyword(s):  
Nervous System ◽  
Orthostatic Hypotension ◽  
Clinical Case ◽  
Clinical Observation ◽  
Thrombus Formation ◽  
Correct Diagnosis ◽  
Aim Analysis ◽  
Angiotensin Converting Enzyme 2 ◽  
Mechanisms Of Development ◽  
Near Future

Background. The article presents an observation of the clinical case of orthostatic hypotension that developed after an infection caused by the SARS-CoV-2 virus. The issues of etiology, pathogenesis, diagnosis are outlined. The complexity of diagnosis at the stage of clinical observation is due to the comorbidity of possible mechanisms and the difficulty of determining the primary factor. Taking into account the study of variants of direct and indirect action of this 2019-nCoV, the description of the clinical observation of orthostatic hypotension supplements the data on the spectrum of manifestations of this disease. Aim. Analysis of the clinical case of the development of orthostatic hypotension in the post-acute period of COVID-19. Material. When conducting a literature review on the selected topic, various sources were considered. The search depth was over 7 years. For the recruitment of literature, Internet platforms UpToDate, PubMed, Medscape were used. Russian and foreign sources were studied. Methods. Anamnesis collection, objective research, specialized tests, laboratory and instrumental research methods, study of disease history, literature sources on orthostatic hypotension and the effect of COVID-19 on the autonomic nervous system. Results. The analysis of this case with the determination of the leading mechanism of orthostatic hypotension is extremely difficult. Probably, there is a combination of factors: direct and indirect effects on the nervous system at COVID-19. The direct effect is associated with the interaction of the virus with the angiotensin converting enzyme 2 receptors in the nervous system, which causes a significant increase in the concentration of bradykinin and the development of hypotension. An indirect effect is due to both increased thrombus formation with the development of PE, and autonomic dysfunction, within the framework of secondary polyneuropathy of fine fibers. Conclusion. It is likely that in the near future the number of such patients in the practice of doctors will increase, therefore, timely and correct diagnosis of these conditions, with their careful management, will be the fundamental postulates in the recovery of patients. Drawing attention to this topic will possibly expand our understanding of the spectrum of complications of COVID-19 and will greatly complement the information available today.

Acute intermittent porphyria: familial disease cases (clinical observation)

2021 ◽  
pp. 28-39
Author(s):  
Nadezhda Viktorovna Kurkina ◽  
Vsevolod Vladimirovich Skvortsov ◽  
Ella Ivanovna Polozova ◽  
Valeriya Aleksandrovna Vyshinskaya
Keyword(s):  
Nervous System ◽  
Targeted Therapy ◽  
Clinical Response ◽  
Clinical Case ◽  
Clinical Observation ◽  
Autosomal Dominant ◽  
Acute Intermittent Porphyria ◽  
Autosomal Dominant Disorder ◽  
Mental Symptoms ◽  
Excessive Accumulation

Acute intermittent porphyria is a rare autosomal dominant disorder characterized by excessive accumulation and excretion of porphyrins and their precursors, repeated attacks of neurological and mental symptoms. Due to the rarity of this pathology and the atypical course in the onset, certain difficulties often arise during the initial diagnosis. The main pathogenetic drug is gemin (Normosang), which allows obtaining a stable clinical response and preventing the development of severe changes in the nervous system. This article presents an analysis of a clinical case of acute intermittent porphyria among blood relatives and discusses the effectiveness of targeted therapy.

scholarly journals Neglected cause of recurrent syncope: a case report of neurogenic orthostatic hypotension

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Robert J H Miller ◽  
Derek S Chew ◽  
Satish R Raj
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Orthostatic Hypotension ◽  
Correct Diagnosis ◽  
Valsalva Manoeuvre ◽  
System Failure ◽  
Neurogenic Orthostatic Hypotension ◽  
Physician Visits ◽  
Autonomic Nervous ◽  
History Of

Abstract Background Syncope commonly results in emergency room and physician visits, leading to hospitalization and invasive investigations. Up to 24% of these presentations may be caused by neurogenic orthostatic hypotension (nOH), which continues to be an under-recognized clinical entity. We review an approach to diagnosing nOH. Case summary An 85-year-old man with a history of Parkinson’s disease was referred for a history of recurrent syncope, which had resulted in extensive cardiac investigation. Collateral history revealed that the events were orthostatic in nature, but with variable time to onset of symptoms. The patient was found to have significant postural drop in blood pressure without compensatory tachycardia. Cardiovascular autonomic function testing was performed, which confirmed significant autonomic nervous system failure, including a marked hypotensive response on tilt-table testing and a lack of vasoconstriction during Valsalva manoeuvre. The patient was diagnosed with nOH and initiated on midodrine with subjective improvement in the frequency of syncope. Discussion Autonomic nervous system failure, with nOH, is a common cause of recurrent syncope, particularly in older patients. Attention to detail during the medical history, including precipitating factors and the presence of prodromal symptoms prior to syncope, is critical for making the correct diagnosis. Measuring orthostatic vital signs correctly in patients with syncope provides valuable information, is cost-effective, and critical to diagnose nOH.

scholarly journals Contemporary views on disorders of neuromiyelitis optica spectrum. Clinical case from personal practice

2021 ◽  
pp. 90-94
Author(s):  
Svitlana Shkrobot ◽  
Olena Budarna ◽  
Khrystyna Duve ◽  
Nataliya Tkachuk ◽  
Lyubov Milevska-Vovchyk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Clinical Observation ◽  
Demyelinating Disease ◽  
Survey Methods ◽  
Demyelinating Diseases ◽  
Research Issue ◽  
Scientific Report

Neuromyelitis optica (Devic’s disease) is a demyelinating disease of central nervous system. This disease is progressive and might be fatal. The authors have analyzed data of domestic and foreign literature on research issue. The idea of modern laboratory and instrumental survey methods was summarized, because clinical manifestation of the disease may be non-specific and differential searching might be extremely wide. The modern schemes of treatment of described syndrome are represented. As an illustration we used own clinical observation confirmed by the results of neuroimaging. The practical orientation of the represented scientific report is proved. Key words neuromiyelitis optica, differential diagnosis, antibodies to aquaporin-4, demyelinating diseases

scholarly journals Magnetic Susceptibility MRI in Differential Diagnostics of Primary CNS Lymphoma and Anaplastic Astrocytoma Clinical Observation

2020 ◽  
Vol 3 (4) ◽  
pp. 94-100
Author(s):  
D. V. Sashin ◽  
M. B. Dolgushin ◽  
E. A. Kobyakova ◽  
E. A. Nechipay ◽  
T. G. Gasparyan
Keyword(s):  
Clinical Case ◽  
Clinical Observation ◽  
Correct Diagnosis ◽  
Malignant Gliomas ◽  
Primary Cns Lymphoma ◽  
Differential Diagnostics ◽  
Cns Lymphoma ◽  
Rapid Progression ◽  
The Central Nervous System ◽  
The Brain

Primary lymphomas of the central nervous system (PCLCS) are relatively rare tumors, usually having a multifocal manifestation in the brain and rapid progression. It is not always possible to make a correct diagnosis for MRI, since similar radiological manifestations (markers) of this disease, when using routine protocols, MRI can occur, for example, in malignant gliomas. This article presents a clinical case of a refinement diagnosis — PLCNS when using MRI in sequence (SWI), which was confirmed by the data of histological examination of surgical material.

scholarly journals Сardiovascular autonomic neuropathy as a diabetes complication

2016 ◽  
Vol 97 (6) ◽  
pp. 1000-1002
Author(s):  
I A Latfullin ◽  
Z F Kim ◽  
M A Mingazetdinov
Keyword(s):  
Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Clinical Case ◽  
Clinical Observation ◽  
Clinical Manifestations ◽  
Diabetes Complication ◽  
Treatment And Prevention ◽  
Biventricular Failure ◽  
Mechanisms Of Development ◽  
Work Up

The article deals with one of the possible complications of diabetes mellitus - cardiovascular autonomic neuropathy as a variant of diabetic neuropathy. The basic pathogenic mechanisms of development of this condition and clinical manifestations depending on the patient’s age, duration and degree of diabetes compensation, are described. Diagnostic criteria for heart involvement in diabetes mellitus are discussed in detail, from asymptomatic course to sudden patient’s death, from instrumental findings to acute biventricular failure development. The main findings from patient’s work-up (ECG, echocardiography) are named. The principles of prevention and treatment of heart disease in diabetes mellitus are provided. Theory is accompanied by our own clinical observation and is illustrated with ECG. In the clinical case tactics of treatment and prevention of diabetic cardiopathy are suggested.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

Middle ear tuberculosis - clinical case

ORL ro ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 12-14
Author(s):  
A. Sandul ◽  
M. Buracovschi ◽  
N. Buracovschi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Human Population ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Tuberculous Otitis Media ◽  
Type V

Tuberculosis is one of the oldest pathologies that affect human population, being a significant cause of morbidity/mortality in several countries. Middleear tuberculosis is a rare pathology, often misdiagnosed because of an atipic evolution, as a result leading to severe complications. This paper presents a case of tuberculous otitis media complicated with facial nerveparalysis House Brackmann type V in a patient who underwent multiple middleear surgeries before correct diagnosis was established.  

Detergent properties as the basis of the dimexide therapeutic effect in AA-amyloidosis infectious nature (clinical case analysis)

2020 ◽  
Vol 24 (2) ◽  
pp. 60-71
Author(s):  
V. Rameev ◽  
L. Kozlovskaya ◽  
A. Rameeva ◽  
P. Tao
Keyword(s):  
Therapeutic Effect ◽  
Medical Practice ◽  
Clinical Case ◽  
Clinical Observation ◽  
Case Analysis ◽  
Systemic Amyloidosis ◽  
Aa Amyloidosis ◽  
Functional Amyloid ◽  
History Of

The article discusses the current possibilities of postinfectious AA-amyloidosis treatment with dimexide on the example of clinical observation, discribes in detail the problem of functional amyloid and debates the prospects of the principle of amyloid resorption in the treatment of systemic amyloidosis. The history of the use of dimexide in medical practice is given, thenecessary dataon the pharmacology of dimexide are presented.

Neural Stem Cells to Glial Cells an Important Factor for Brain Injury

2020 ◽  
Author(s):  
Prithiv K R Kumar
Keyword(s):  
Stem Cells ◽  
Central Nervous System ◽  
Nervous System ◽  
Neural Stem Cells ◽  
Glial Cells ◽  
Brain Injuries ◽  
The Body ◽  
The Central Nervous System ◽  
Near Future

Stem cells have the capacity to differentiate into any type of cell or organ. Stems cell originate from any part of the body, including the brain. Brain cells or rather neural stem cells have the capacitive advantage of differentiating into the central nervous system leading to the formation of neurons and glial cells. Neural stem cells should have a source by editing DNA, or by mixings chemical enzymes of iPSCs. By this method, a limitless number of neuron stem cells can be obtained. Increase in supply of NSCs help in repairing glial cells which in-turn heal the central nervous system. Generally, brain injuries cause motor and sensory deficits leading to stroke. With all trials from novel therapeutic methods to enhanced rehabilitation time, the economy and quality of life is suppressed. Only PSCs have proven effective for grafting cells into NSCs. Neurons derived from stem cells is the only challenge that limits in-vitro usage in the near future.

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