scholarly journals Graves hyperthyroidism in pregnancy: a rare presentation

2019 ◽  
Vol 8 (10) ◽  
pp. 4104
Author(s):  
Priyanka Garg ◽  
Romi Bansal ◽  
Roushali .
Keyword(s):  
Sleep Disturbances ◽  
Fetal Loss ◽  
Rare Presentation ◽  
Fetal Demise ◽  
Present Patient ◽  
Male Baby ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
In Pregnancy

Hyperthyroidism in pregnancy is much less common occurring in 0.1-0.2% of women with Grave’s disease being the most common cause accounting for 90% of the cases. It is important to diagnose hyperthyroidism in pregnancy because fetal loss in untreated patients is high and may even be life threatening for the mother. We are presenting a case of 29 years old G3P2L1 who presented to our emergency with amenorrhea of 7 months and history of loose stools for the last 20 days. It was associated with generalized weakness. She also had history of palpitations, weight loss and sleep disturbances. She was a known case of hyperthyroidism for the past 1-2 years and was already taking anti-thyroid drugs. B/L exophthalmos was apparently present. Patient was severly anaemic with haemoglobin of 5.5gms/dl. Ultrasound showed fetal demise at 28weeks. Patient was given 3 units of blood transfusion and was induced with prostaglandins. She delivered a dead male baby weighing 1.2kgs. Her postpartum period was uneventful. Timely diagnosis of graves hyperthyroidism and its optimal treatment throughout pregnancy is vital in reducing maternal, fetal and neonatal complications. 

Stridor: a rare presentation of motor neuron disease

2021 ◽  
Vol 14 (7) ◽  
pp. e241923
Author(s):  
Brian Gordon ◽  
Eimear Joyce ◽  
Timothy J Counihan
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Vocal Cord ◽  
Poor Response ◽  
Vocal Cord Palsy ◽  
Pharmacological Therapy ◽  
Rare Presentation ◽  
Emergency Tracheostomy ◽  
Life Threatening ◽  
History Of

A 74-year-old farmer presented to the emergency department with a subacute history of progressive dyspnoea, wheeze and dysphonia. He was treated for an exacerbation of asthma with poor response to pharmacological therapy. Investigation of dysphonia via laryngoscopy identified a bilateral vocal cord palsy. Subsequently, the patient developed an episode of life-threatening stridor and hypercapnic respiratory failure requiring an emergency tracheostomy. Neurology input identified evidence of widespread muscle fasciculations on clinical examination. MRI of the brain and cervical spine were unremarkable. Electromyogram testing identified changes of acute denervation in several limbs consistent with a diagnosis of motor neuron disease (MND). Bilateral vocal cord palsy has been rarely reported in the literature as the heralding symptom resulting in the diagnosis of MND. In patients with a subacute onset of dysphonia, dyspnoea and stridor, MND should be a differential diagnosis.

scholarly journals Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus

Reumatismo ◽  
2019 ◽  
Vol 71 (2) ◽  
pp. 108-112 ◽  
Author(s):  
G. Tansir ◽  
P. Kumar ◽  
A. Pius ◽  
S.K. Sunny ◽  
M. Soneja
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pleural Effusion ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Abdominal Distension ◽  
Ca 125 ◽  
Systemic Lupus ◽  
Rare Presentation ◽  
The Past ◽  
History Of

Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals Detection of antitrophoblast antibodies in the sera of patients with anticardiolipin antibodies and fetal loss

Blood ◽  
1993 ◽  
Vol 82 (9) ◽  
pp. 2730-2741 ◽  
Author(s):  
KR McCrae ◽  
AM DeMichele ◽  
P Pandhi ◽  
MJ Balsai ◽  
P Samuels ◽  
...  
Keyword(s):  
Fetal Loss ◽  
Thromboxane A2 ◽  
First Trimester ◽  
Anticardiolipin Antibodies ◽  
Trophoblast Cells ◽  
Fetal Demise ◽  
Blood Fluidity ◽  
Increased Risk ◽  
History Of ◽  
Placental Blood

Abstract Women with anticardiolipin antibodies (ACLA) are at increased risk for fetal loss. One potential explanation for this outcome is that sera from these individuals contain antibodies reactive with trophoblast cells, which are involved in the establishment of the uteroplacental vasculature and maintenance of placental blood fluidity. To examine this hypothesis, we compared the incidence of trophoblast-reactive antibodies in 27 patients with ACLA and a history of fetal loss with that in 29 normal pregnant women. Sera from 20 patients, but only one control, contained trophoblast-reactive antibodies (P < .001). These antibodies were not directed against major histocompatibility class I antigens, and reacted with both term and first-trimester trophoblast cells. In most cases, sera from which ACLA were adsorbed by cardiolipin- containing liposomes maintained reactivity against cells. In addition, patient Ig fractions immunoprecipitated an approximately 62-kD protein from the trophoblast cell surface, stimulated the release of arachidonic acid and thromboxane A2 by trophoblasts, and inhibited the binding of prourokinase to trophoblast urokinase receptors. These observations show that sera from women with ACLA and a history of fetal loss contain antitrophoblast antibodies. These antibodies may be serologically distinct from ACLA, and may contribute to the pathogenesis of fetal demise.

scholarly journals Benign Subcutaneous Nodules and Hypereosinophilic Syndrome: A Rare Presentation of an Uncommon Entity

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Rimesh Pal ◽  
Uday Yanamandra ◽  
Prasanna Kumar ◽  
Nirmalya Banerjee
Keyword(s):  
Eosinophil Count ◽  
Index Case ◽  
Hypereosinophilic Syndrome ◽  
Low Grade ◽  
Rare Presentation ◽  
Angiolymphoid Hyperplasia ◽  
The Past ◽  
Absolute Eosinophil Count ◽  
Oral Corticosteroids ◽  
History Of

A 40-year-old gentleman presented with a history of multiple swellings involving his face, scalp, left axilla, back, and right thigh for the past 8 years. For the last 6 months, he developed intermittent low-grade fever, anorexia, weight loss, and gradually worsening breathlessness. On evaluation, the patient was found to have abnormally elevated absolute eosinophil count. Workup for the etiology of eosinophilia was unrewarding. All investigations related to an underlying myeloproliferative disorder were negative. Hence, a clinical possibility of angiolymphoid hyperplasia with eosinophilia (ALHE) was kept which was confirmed on histopathology. In the absence of other causes of hypereosinophilia, a clinical diagnosis of “associated hypereosinophilic syndrome” secondary to ALHE was made. He was managed with oral corticosteroids. The absolute eosinophil count reduced markedly, while the swellings showed a more gradual response, shrinking in size by about 50% following two months of therapy. The index case thus highlights a rather unusual presentation of ALHE.

scholarly journals Rare presentation of the great imitator: a rare case report

2017 ◽  
Vol 3 (3) ◽  
pp. 453
Author(s):  
Ravindranath Brahmadeo Chavan ◽  
Vasudha Abhijit Belgaumkar ◽  
Aarti Sudam Salunke ◽  
Sharada Shivaji Chirame
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Rare Case ◽  
Signs And Symptoms ◽  
Rare Presentation ◽  
The Past ◽  
Modern Health Care ◽  
Rare Case Report ◽  
Life Threatening ◽  
Primary Care Clinicians

<span>Syphilis is often thought to be a disease of the past, largely eradicated in modern health care; however, the rates are still extremely high in certain populations. The diagnosis of syphilis may be overlooked by primary-care clinicians due to the presence of nonspecific signs and symptoms that may be indistinguishable from other diseases. Left undiagnosed and untreated, life-threatening complications, including hepatitis, stroke, and nervous system damage, may occur particularly in immuno-compromised individuals. We present a case of lues maligna an extremely rare presentation of syphilis.</span>

scholarly journals Role of low dose ecosprin and heparin in achieving live births in pregnancy with thrombophilia

2017 ◽  
Vol 6 (12) ◽  
pp. 5261
Author(s):  
Shilpa Asthana ◽  
Bandana Sodhi ◽  
Satish Kumar
Keyword(s):  
Low Dose ◽  
Previous History ◽  
Fetal Loss ◽  
Obstetric Outcomes ◽  
Obstetric Outcome ◽  
Live Births ◽  
History Of ◽  
Chi Square Analysis ◽  
In Pregnancy

Background: Thrombophilia is a disorder of haemostatic system that results in increased tendency of thrombus formation in both venous and arterial vascular system. The thrombotic events are not only restricted to venous thromboembolism but also can cause fetal loss (abortions or recurrent abortions and fetal demise), placental abruption, intrauterine growth restriction and severe pre-eclampsia. This study evaluates the role of administering thromboprophylaxis with heparin and ecosprin to patients with thrombophilia in pregnancy with previous history of adverse obstetric outcomes.Methods: This prospective study was conducted in 60 patients diagnosed with thrombophilia during pregnancy. The objective of the study was to determine the role of administering low dose ecosprin and heparin as thromboprophylaxis in achieving live births in these patients with thrombophilia. All patients included in this study were prophylactically administered low dose ecosprin with either unfractionated heparin (5000 IU s.c, BD) or low molecular weight heparin (40 mg s.c, OD) during pregnancy. Patients were followed up in the antenatal period and the obstetric outcome noted. Comparisons were made between the obstetric outcomes of these patients receiving the aforesaid thromboprophylaxis with those of previous untreated pregnancies during which no ecosprin or heparin had been administered. The data obtained were subjected to statistical analysis using Students ‘t’ test and Chi square analysis. P value <0.05 was considered statistically significant.Results: Fifty nine of the sixty patients with thrombophilia and previous adverse pregnancy outcome who received prophylaxis with ecosprin and heparin during the present pregnancy had live births (98.33%; p <0.0001). Fifty-eight (96.66%) of these patients progressed to term delivery and one (1.67%) pregnancy resulted in a pre-term birth.Conclusions: Present study reveals that prophylaxis with low dose ecosprin and heparin administered to patients with thrombophilia (acquired or inherited) with history of previous adverse obstetric outcome resulted in a positive outcome in terms of a significantly higher number of live births. However, larger studies are needed to further elaborate on the role of thromboprophylaxis in pregnancies with inherited thrombophilia.

scholarly journals Spontaneous Gastric Necrosis: A Rare Presentation of Invasive Mucormycosis in an Immunocompetent Adult

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tariq Hameed ◽  
Sudhir Kumar Jain ◽  
Faiz Manzar Ansari ◽  
Adiba Nizam ◽  
Amrita Dua
Keyword(s):  
Surgical Excision ◽  
Young Female ◽  
Immunocompetent Adult ◽  
Rare Presentation ◽  
Ulcer Disease ◽  
Pain Abdomen ◽  
Life Threatening ◽  
History Of ◽  
Intravenous Amphotericin ◽  
Immunocompetent Adults

Spontaneous gastric perforations are usually seen in patients with untreated peptic ulcer disease. Mucormycosis, an uncommon, opportunistic, life-threatening fungal infection, rarely causes gastric perforation in immunocompetent adults. Here, we present a case of young female who was admitted to hospital for acute pain abdomen and distension with 5 days history of fever. She was operated and was found to have multiple perforations in the stomach with transmural necrosis. Despite adequate surgical excision and intravenous amphotericin B, patient succumbed to sequelae of infection.

A Prospective and Retrospective View of Pediatric Hematology/Oncology

2006 ◽  
Author(s):  
Momcilo Jankovic ◽  
Giuseppe Masera
Keyword(s):  
Health Care Professionals ◽  
Pediatric Hematology ◽  
The Past ◽  
Life Threatening Illness ◽  
Retrospective View ◽  
Simple Question ◽  
Life Threatening ◽  
Working Together ◽  
History Of ◽  
The Moment

How does one help a family whose child has been diagnosed with a life-threatening illness? It is a deceptively simple question with complicated answers. This brief chapter is not meant to be a history of biopsychosocial pediatric oncology, and it does not cover every theme. The explosion of studies on children with cancer over these past decades (Pizzo & Poplack, 2001) renders a retrospective look formidable and subjective. The sole purpose of this retrospective examination into the earliest beginnings is to place into context some of the main themes that have appeared over the past years, so that they can serve as a foundation for our recommendations for future intervention and research in the field. That is our assigned task. Much of the review reflects personal respective experiences beginning in the late 1960s. The chapters that form this volume, written by many of the most experienced psychosocial researchers who have brought the field so far forward over these many years, are the state of the art, tell us where we have been most recently, and tell us in greater detail where we are at the moment. Where does our psychosocial history begin? What have we done these past many years to help the children and their families cope with the illness and its treatment? With due awareness of the subjectivity and inevitable unfairness of our venture, we undertake the task with due apologies for any omissions that may occur in this retrospective review. As we begin to look in some detail at the main themes formed over the past four decades, we place our review into the context of four preambles: a multidisciplinary and international effort; an alliance between physicians and parents; research and service; and a sharing of the research wealth with economically struggling countries. From the earliest years, the effort to care for the child with cancer has been multidisciplinary, multi-institutional, and international, involving a highly cooperative and collaborative effort of physicians, nurses, psychologists, social workers, and allied health care professionals working together across national borders.

Pott's puffy tumour and intracranial complications of frontal sinusitis in pregnancy

2012 ◽  
Vol 127 (S1) ◽  
pp. S35-S38 ◽  
Author(s):  
C Domville-Lewis ◽  
P L Friedland ◽  
P L Santa Maria
Keyword(s):  
Multidisciplinary Care ◽  
Frontal Sinusitis ◽  
Subperiosteal Abscess ◽  
Periorbital Oedema ◽  
Intravenous Antibiotics ◽  
Intracranial Complications ◽  
Life Threatening ◽  
History Of ◽  
Sinus Drainage ◽  
In Pregnancy

AbstractIntroduction:A Pott's puffy tumour is a subperiosteal abscess and osteomyelitis of the frontal bone secondary to frontal sinusitis. Intracranial complications are seen in approximately 40 per cent of cases and are potentially life-threatening; such complications have not previously been reported in pregnancy.Case report:A 21-year-old woman at 35 weeks' gestation presented with a history of frontal headaches and swelling, periorbital oedema, pain and chemosis. Imaging confirmed Pott's puffy tumour with right-sided epidural empyema and periorbital cellulitis. A multidisciplinary team was involved in the patient's management. Intravenous antibiotics were commenced and initial percutaneous drainage through the frontal sinus skin was performed, followed by endoscopic sinus drainage. A caesarean section was performed 3 days later. Complete resolution of the sinus and intracranial collections was noted on imaging performed six weeks later.Conclusion:This case highlights the challenges of managing rare intracranial complications of sinusitis in pregnancy, and the importance of multidisciplinary care.

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