scholarly journals SARS-CoV-2-induced Multisystem Inflammatory Syndrome in a Young Adult

Author(s):  
haldun bulut ◽  
Alexandra H.E. Herbers ◽  
Ilse M.G. Hageman ◽  
Paetrick M. Netten ◽  
Hendrik J.M. de Jonge ◽  
...  

Abstract We describe a case of a previous healthy 20-year-old male athlete who presented with an atypical clinical profile with multiorgan involvement five weeks after confirmed SARS-CoV-2 infection, suggestive for multisystem inflammatory syndrome (MIS). MIS is a rare, potentially life-threatening complication associated with SARS-CoV-2 and shares several similar clinical features with overlapping hyperinflammatory syndromes that may create a great challenge to distinguish between them. MIS should promptly be considered and treated, as uncontrolled MIS has a high mortality. In MIS cardiac involvement, heart failure may present as an additional problem, especially because volume loading is advised in accordance with proposed therapy. Carefully monitoring of the respiratory and cardiac status in response of resuscitation is therefore warranted.

Author(s):  
Haldun Bulut ◽  
Alexandra H. E. Herbers ◽  
Ilse M. G. Hageman ◽  
Paetrick M. Netten ◽  
Hendrik J. M. de Jonge ◽  
...  

AbstractWe describe a case of a previous healthy 20-year-old male athlete who presented with an atypical clinical profile with multiorgan involvement within five weeks after confirmed SARS-CoV-2 infection, suggestive for multisystem inflammatory syndrome (MIS); MIS is a rare, potentially life-threatening complication associated with SARS-CoV-2. MIS shares similar clinical features compatible with several overlapping lifethreatening hyperinflammatory syndromes, such as incomplete Kawasaki Disease (KD) and toxic shock syndrome (TSS) associated to a cytokine storm suggestive of a macrophage activation syndrome (MAS) without fulfilling the criteria for hemophagocytic lymphohistiocytosis (HLH), that may create a great challenge to distinguish between them. MIS should promptly be considered and treated, as uncontrolled MIS has a high mortality.In MIS cardiac involvement, heart failure may present as an additional problem, especially because volume loading is advised in accordance with proposed therapy. Carefully monitoring of the respiratory and cardiac status in response of resuscitation is therefore warranted.


1990 ◽  
Vol 104 (11) ◽  
pp. 894-895 ◽  
Author(s):  
G. E. Murty ◽  
P. Lamballe ◽  
A. R. Welch

AbstractThe syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a rare but life-threatening complication of trans-sphenoidal pituitary adenomectomy. It has previously only been described as a late phenomenon. We report an early presentation within the first week. The pathophysiology, clinical features and treatment are discussed.


1996 ◽  
Vol 41 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Gb Meterissian

Objectives: 1. To report the case of a 53-year-old patient who developed neuroleptic malignant syndrome (NMS) — a rare but potentially life-threatening complication of neuroleptic therapy — 4 days after treatment with risperidone was initiated. 2. To review previously reported cases of NMS associated with risperidone. Methods: A computerized search of several databases, including MEDLINE, was conducted to find all previously reported cases of NMS with risperidone. Results: Five reported cases of risperidone-induced NMS were found in the literature. All cases including the one reported here displayed typical clinical features of NMS and all 6 patients had a prior history of extrapyramidal side effects and/or NMS. Age and duration of exposure to risperidone did not seem to be of significance. Conclusions: These cases illustrate that clinicians should be on the lookout for risperidone-induced NMS.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Carles Bautista ◽  
Joan Sanchez-de-Toledo ◽  
Clark C Bradley ◽  
Jetrho Herberg ◽  
Fanny Bajolle ◽  
...  

Introduction: Following the SARS-CoV-2 pandemic peak, children suffering from a multiorgan inflammatory disease that often leads to shock have been reported. This condition shares features with Kawasaki disease, but its etiopathogenesis is unknown. Hypothesis: We aimed to describe presentation and hospital course for this pediatric inflammatory multisystemic syndrome associated with COVID-19 (PIMS-TS). Methods: Data were collected from a retrospective review of children from 33 participating European, Asian and American sites. Results: We included 183 patients (109 males, 59·6%) with PIMS-TS, at a mean age of 7·0 (±4·7) years. Fifty-six (30·6%) had black ethnicity and obesity was present in 48 (26·2%) cases. Overall, 114/183 (62·3%) had biological evidence of current or recent SARS-CoV-2 infection. At admission, all presented with fever, 117/183 (63·9%) with gastrointestinal symptoms and 79/183 (43·2%) with shock, that was associated with more frequent black ethnicity, higher inflammatory markers and more cardiac involvement. Twenty-seven patients (14·7%) fulfilled criteria for Kawasaki disease. They were younger with no shock, fewer gastrointestinal, cardio-respiratory and neurological symptoms. Among the remaining PIMS-TS patients, 77 (49·3%) had mainly fever and inflammation with less cardiac involvement. For the entire cohort of 183 patients, the mean duration of admission was 8·6 (±5·6) days. Inotropic support, mechanical ventilation and ECMO were indicated in 72 (39·3%), 43 (23·5%) and 4 (2·2%) patients, respectively. Three patients (1·6%) died. A shorter duration of symptoms before admission was a risk factor for worse outcome and for ECMO/death, with 63% increased risk per day reduction (95%CI 0·39-0·93, p=0·03) and with 51·4% increased risk per day reduction (95%CI 0·36-0·9, p=0·03), respectively. Conclusions: We describe the first largest international series of children with PIMS-TS. Life-threatening shock is a common presentation. A shorter duration of symptoms prior to admission characterizes the fulminant form of the disease with potentially worse outcome.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Panagiotis Andriopoulos ◽  
Christos Antoniou ◽  
Panagiota Manolakou ◽  
Athanassios Vasilopoulos ◽  
George Assimakopoulos ◽  
...  

Brucellaendocarditis (BE) is a rare but life threatening complication ofbrucellosis. We present a case report of a patient with relapsing brucellosis complicated with aortic valve endocarditis. The patient underwent valve replacement and required prolonged antibiotic treatment because of rupture of the noncoronary leaflet and development of congestive heart failure. Since the onset of endocarditis in patients with brucellosis is not known, proper follow-up is required in order to identify any late onset complications, especially in endemic areas.


1995 ◽  
Vol 109 (2) ◽  
pp. 159-160 ◽  
Author(s):  
Yaron Bar-Lavie ◽  
Albert Gatot ◽  
Ferit Tovi

AbstractA case of intraoperative tracheostomy tube obstruction is reported. The clinical features and the chain of events leading to the diagnosis of cuff herniation are presented. The different mechanisms of herniation are discussed. In the present case we speculate that a manufacturing defect together with nitrous oxide diffusion into the cuff caused dilatation and herniation of the latter which led to obstruction of the distal tube lumen. We draw attention to this rare but life-threatening complication.


2018 ◽  
Vol 64 (9) ◽  
pp. 787-790
Author(s):  
Kevin Domingues ◽  
Mariana Saraiva ◽  
Liliana Marta ◽  
Isabel Monteiro ◽  
Margarida Leal

SUMMARY Cardiac amyloidosis is an infiltrative cardiomyopathy, resulting from amyloid deposition within the myocardium. In primary systemic (AL-type) amyloidosis, the amyloid protein is composed of light chains resulting from plasma-cell dyscrasia, and cardiac involvement occurs in up to 50% of the patients We present a case of a 43-year-old man, with complaints of periodical swollen tongue and xerostomia, bleeding gums and haematuria for two months. His blood results showed normocytic anaemia, thrombocytopenia and a high spontaneous INR, therefore he was referred to the Internal Medicine clinic. In the first visit, he showed signs and symptoms of overt congestive heart failure and was referred to the emergency department. The electrocardiogram showed sinus tachycardia and low voltage criteria. Echocardiography showed biventricular hypertrophy with preserved ejection fraction, restrictive physiology with elevated filling pressures, thickened interatrial septum and atrioventricular valves, small pericardial effusion and relative “apical sparing” on 2D longitudinal strain. Cardiac MRI showed diffuse subendocardial late enhancement. Serum protein electrophoresis was inconclusive, however urine analysis revealed nephrotic range proteinuria, positive Bence Jones protein and an immunofixation test with a monoclonal lambda protein band. Abdominal fat biopsy was negative for Congo red stain, nevertheless a bone marrow biopsy was performed, revealing lambda protein monoclonal plasmocytosis, confirming the diagnosis of primary systemic amyloidosis. This case represents a rare cause of heart failure in a young adult. Low-voltage QRS complexes and typical echocardiography features should raise the suspicion for cardiac amyloidosis. Prognosis is dictated by the level of cardiac involvement; therefore, early diagnosis and treatment are crucial.


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