scholarly journals Systemic Inflammatory Reaction to Intravitreal Bevacizumab: A Case Report

2021 ◽  
Author(s):  
Samuel Burridge ◽  
Richard Stratton ◽  
Riaz Asaria
Keyword(s):  
Adverse Effects ◽  
Inflammatory Reaction ◽  
Intravitreal Bevacizumab ◽  
Case Presentation ◽  
Blood Tests ◽  
Bevacizumab Treatment ◽  
Systemic Inflammatory Reaction ◽  
Life Threatening ◽  
History Of ◽  
Systemic Side Effects

Abstract IntroductionTo present a case of systemic inflammatory reaction, with associated pleural and pericardial effusions, following intravitreal bevacizumab for retinal macroaneurysm. Case presentationA 73 year old female was commenced on monthly intravitreal bevacizumab injections for right eye macroaneurysm and associated macular oedema. Eight days following her third injection, the patient was admitted to hospital with a history of fever, rigors, arthralgia and vomiting. Admission blood tests demonstrated mild thrombocytopaenia and raised inflammatory markers. A CT chest revealed small pericardial and pleural effusions. The patient improved without treatment and was later discharged from hospital. As intravitreal bevacizumab treatment continued, the patient developed two further episodes of fever and vomiting, with both episodes occurring approximately nine days following each injection. The patient then underwent outpatient medical review by infectious disease and rheumatology specialists, at which time the recurrent episodes of systemic inflammation were diagnosed as secondary to intravitreal bevacizumab.ConclusionsThough rare, patients can develop serious and potentially life-threatening systemic adverse effects from intravitreal anti-VEGF treatment. Ophthalmologists should always enquire about systemic side effects; in this way, adverse effects may be recognised sooner and a change or cessation of therapy considered.

Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

2019 ◽  
Vol 64 (3) ◽  
pp. 116-118
Author(s):  
Özant Helvacı ◽  
Seyma Yıldız ◽  
Berfu Korucu ◽  
Ulver Derici ◽  
Turgay Arinsoy
Keyword(s):  
Nephrotic Syndrome ◽  
Coeliac Disease ◽  
Post Partum ◽  
Lower Extremity Weakness ◽  
Case Presentation ◽  
Multisystem Involvement ◽  
Life Threatening ◽  
History Of ◽  
Rare Occasion

Background Coeliac crisis is a life-threatening presentation of coeliac disease. Severe diarrhoea, weight loss, electrolyte imbalances and malnutrition are prominent features. Although mainly a disease of childhood, it can on the rare occasion be diagnosed in adults. Case presentation A 25-year-old female with severe generalised oedema, lower extremity weakness, hypokalemia and profound hypoalbuminemia was referred with an initial diagnosis of nephrotic syndrome. Three months previously she had given birth to a healthy child following an uneventful pregnancy. She did not have proteinuria. She had a history of diarrhoea with gluten-containing food since childhood but lacked a formal diagnosis of coeliac disease. A duodenal biopsy confirmed the suspected diagnosis. Coeliac crisis was diagnosed with life-threatening multisystem involvement. Introduction of a gluten-free diet abolished all disease symptoms and ameliorated laboratory parameters at six months’ follow-up. Conclusion Coeliac crisis is a rare, yet dangerous presentation of coeliac disease in adults. As this case suggests, it can present with generalised oedema and hypoalbuminemia mimicking nephrotic syndrome. Rapid diagnosis is the key to successful treatment.

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 Microcornea and Thickened Lens in Angle Closure following Nonsurgical Treatment of Retinopathy of Prematurity

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Ta C. Chang ◽  
Kimberly D. Tran ◽  
Linda A. Cernichiaro-Espinosa ◽  
Ella H. Leung ◽  
Alana L. Grajewski ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Anterior Segment ◽  
Young Patients ◽  
Intravitreal Bevacizumab ◽  
Full Term ◽  
Angle Closure ◽  
Retrospective Case ◽  
Control Series ◽  
Bevacizumab Treatment ◽  
History Of

Purpose. To characterize the clinical features in young patients with angle closure and to determine the characteristics associated with acquired anterior segment abnormality following retinopathy of prematurity (ROP) treatment. Methods. We performed two retrospective case-control series. In the first series, we identified consecutive young angle closure patients without prior surgeries, with and without a history of ROP treatment; in the second series we identified consecutive patients who underwent ROP treatment, without and without anterior segment changes. Results. In the first series, 25 eyes of 14 consecutive angle closure patients were included: 19 eyes (11 patients, 78.6%) had a history of treated ROP, while 6 eyes (3 patients) belonged to full-term patients. The treated ROP eyes had significantly shallower anterior chambers (1.77 ± 0.17 mm vs 2.72 ± 0.18 mm, P<0.0001) and thicker lenses (5.20 ± 0.54 mm vs 3.98 ± 0.20 mm, P=0.0002) compared to the full-term controls. In the second series, 79 eyes of 40 patients were included, with median gestational age of 24.6 weeks. Acquired iridocorneal adhesion was noted in the eight eyes (10.1%) at a mean age of 4.7 years and was associated with prior zone 1 and plus disease (P=0.0013), a history of initial intravitreal bevacizumab treatment (IVB, P=0.0477) and a history of requiring additional IVB after initial treatment (P=0.0337). Conclusions. Many young angle closure patients may have a history of treated ROP and may present with the triad of increased lens thickness, microcornea, and angle closure.

scholarly journals Anemia That Presented with Desaturation: A Focus on Core Concepts

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lakshmi Shobhavat ◽  
Antonio D’Costa ◽  
Karthik Shroff
Keyword(s):  
Blood Smear ◽  
Intensive Care Admission ◽  
Case Presentation ◽  
Threatening Condition ◽  
Core Concepts ◽  
Life Threatening ◽  
History Of ◽  
The Common ◽  
Treatable Condition ◽  
Prompt Diagnosis

Background. Methemoglobinemia is a potentially life-threatening condition which presents with cyanosis and characteristic “chocolate-coloured blood.” Although a co-oximetry would give a prompt diagnosis, there have been multiple reports of misdiagnosing this treatable condition—from being diagnosed as sepsis to asthma and even being operated for “ruptured ectopic pregnancy.” Here, we report a case which presented without the classical signs of poisoning and methemoglobinemia—without vomiting, cyanosis, or chocolate-coloured blood. We also discuss the common misconceptions regarding anemia physiology and the pitfalls in diagnosing this condition and warn the reader regarding the reflexive use of antidotes like methylene blue. Case Presentation. A well-grown 3-year old boy presented with an acute history of irritability, cola-coloured urine, and desaturation on examination. The child was pale, with tachypnoea and in failure. Blood smear was suggestive of severe hemolytic anemia. Methemoglobinemia was diagnosed on co-oximetry. By focussing on physiologic principles of management rather than a specific antidote, the child was discharged home, well and active within 3 days of intensive care admission.

scholarly journals Evaluation of the influence of genetic variants in Cereblon gene on the response to the treatment of ENL with thalidomide

2021 ◽  
Author(s):  
Perpétua Socorro Silva Costa ◽  
Miriãn Ferrão ◽  
Thayne Woycinck Kowalski ◽  
Lucas Rosa Fraga ◽  
Mariléa Furtado Feira ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Adverse Effects ◽  
Inflammatory Reaction ◽  
Genetic Variants ◽  
Erythema Nodosum ◽  
Primary Target ◽  
Gene Encoding ◽  
Inflammatory Drug ◽  
Erythema Nodosum Leprosum ◽  
Systemic Inflammatory Reaction

Abstract Erythema Nodosum Leprosum (ENL) is an acute and systemic inflammatory reaction of leprosy characterized by painful nodules and involvement of various organs. Thalidomide is an immunomodulatory and anti-inflammatory drug currently used to treat conditions such as ENL and multiple myeloma (MM). Cereblon protein was described as the primary target of thalidomide teratogenicity. Moreover, it was postulated that CRBN is necessary for the efficacy of thalidomide and its analogs in the treatment of MM. In this study, we evaluate the influence of CRBN genetic variants on the dose of thalidomide used in the treatment of ENL and on the manifestation of adverse effects during treatment for ENL. Polymorphisms rs1620675, rs1672770 and rs4183 located in regions flanking the part of the gene encoding the portion of the protein that binds to thalidomide were evaluated. An association with adverse ocular and gastrointestinal effects was observed. These results show that CRBN polymorphisms could alter the expression or activity of the protein and influence the development of adverse effects in response to thalidomide in ENL.

scholarly journals RECURRENT SYNCOPE AS A SYMPTOM OF ELECTRICAL STORM – CASE PRESENTATION

2021 ◽  
Vol 8 (4) ◽  
pp. 271-273
Author(s):  
Przemysław Skoczyński ◽  
Paweł Pochciał
Keyword(s):  
Ventricular Arrhythmias ◽  
Electrical Storm ◽  
Monitoring Equipment ◽  
Case Presentation ◽  
Diffi Cult ◽  
Patient Reported ◽  
Cardiology Clinic ◽  
Life Threatening ◽  
History Of

Dangerous ventricular arrhythmias leading to sudden cardiac death (SCD) are some of the most diffi-cult diagnostic challenges. They are often mildly symptomatic. Their often self-limiting nature means that they are difficult to capture on ECG. A 75-year old woman with chronic heart failure due to nonis-chemic cardiomyopathy reported to the cardiology clinic for a scheduled routine follow-up of the ICD, implanted three years prior as primary prevention of SCD. The patient reported recent episodes of sud-den weakness and described the episodes as hypotension. The patient associated it with too aggressive treatment of arterial hypertension. During the visit the patient experienced one of these episodes that she had previously described. The monitoring equipment in the clinic revealed ventricular tachycardia (VT). The history of the implanted ICD revealed many similar previous episodes including 5 episodes in the last 24 hours which led to a diagnosis of electrical storm. Dangerous ventricular arrhythmias may be mildly symptomatic and they are often underestimated by the patient. Fainting, especially in situa-tions unusual for the vasovagal reflex or orthostatic hypotension, should always arouse vigilance to-wards life-threatening ventricular arrhythmia.

scholarly journals Acute Respiratory Infection in Co-Infection Form of Bacteria and Virus, Human Bocavirus with Streptococcus pneumoniae: A Case Report

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Mehrdad Mohammadi
Keyword(s):  
Respiratory Infection ◽  
Respiratory Infections ◽  
Causative Organism ◽  
Human Bocavirus ◽  
Gastrointestinal Infections ◽  
Case Presentation ◽  
Microbiological Methods ◽  
Life Threatening ◽  
History Of ◽  
Tract Infections

Introduction: Human bocavirus (HBoV) belongs to the Parvoviridae family, which has been revealed to be associated with respiratory and gastrointestinal infections in children. There are many reports worldwide on respiratory infection or gastroenteritis caused by this virus. Case Presentation: In a twin case (a girl and a boy), we demonstrated that HBoV infection in combination with Streptococcus pneumonia as co-infection caused the death of a 14-month-old girl with a history of high fever and wheezing. A week later, her brother presented with almost the same symptoms, but only HBoV was found in a nasopharyngeal aspirate sample. Discussion: This case suggests that lower respiratory tract infections due to HBoV may cause severe and life-threatening diseases, resulting in death in combination with a bacterial infection, such as S. pneumonia. The study suggests replacing multiplex PCR as a fast and meticulous method instead of conventional and time-consuming microbiological methods for determining the causative organism for respiratory infections.

scholarly journals A Single Drop in the Eye – Effects on the Whole Body?

2017 ◽  
Vol 11 (1) ◽  
pp. 305-314 ◽  
Author(s):  
Anu Vaajanen ◽  
Heikki Vapaatalo
Keyword(s):  
Adverse Effects ◽  
Whole Body ◽  
Systemic Absorption ◽  
Eye Drops ◽  
Allergic Reactions ◽  
Single Drop ◽  
Active Components ◽  
Life Threatening ◽  
Systemic Side Effects ◽  
Kinetics Of

Introduction: Although the local adverse effects of ophthalmic drugs, including allergic reactions, are well recognized, less is known about the systemic side- effects of eye drops, especially during pregnancy, breast-feeding and early childhood. Ophthalmologists should also be aware of unusual, in some cases even life-threatening, effects of commonly used eye drops. Conclusion: This brief review outlines the routes of systemic absorption and the kinetics of active components present in eye drops, and identifies the clinically relevant systemic adverse effects.

scholarly journals Case Report: Magic Mushroom (Psilocybe Cubensis) Intoxication

2021 ◽  
Vol 1 (2) ◽  
pp. 31-34
Author(s):  
Andrian Fajar Kusumadewi
Keyword(s):  
Auditory Hallucination ◽  
Symptomatic Treatment ◽  
Acute Renal Injury ◽  
Case Presentation ◽  
Comprehensive Management ◽  
Precise Diagnosis ◽  
Life Threatening ◽  
History Of ◽  
Threatening Situation ◽  
Direct Management

Introduction. Psilocybe mushroom, or wi dely known as the magic mushroom is a variety of mushroom commonly consumed because of hallucinogenic traits it causes toward its consumer. This hallucinogenic effect is caused by Psilocybin, a hallucinogenic substance often found within Psilocybe mushroom. This substance affects mental state of the consumer and has similar effect to those of LSD and Mescaline. Aside from its effect to cause mental disturbance, consumption of this mushroom may cause acute renal injury which leads to a fatal and life -threatening situation. Case presentation. A case of Psilocybe intoxication had been reported in a 22 years old male with a confirmed history of consuming Psilocybe mushroom. Patient first came with a symptom of disorientation and restlessness. Patient also often shook his head off, laughed out, screamed, and continuously making bizarre movements. Psychiatric examination confirmed a sign of auditory hallucination, unstable mood, and stereotypical behavior experienced by the patient. Conclusion. An approach is needed in the form of a ph ysical examination and support that supports a prompt and precise diagnosis, as well as comprehensive management that focuses on the direct management of life-threatening symptoms and symptomatic treatment, taking into account the si gns and symptoms of life-threateningnephrotoxicity

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