Not a Usual Suspect; Rabeprazole Therapy Presenting as a Severe Neuropsychiatric Illness: Case Report

2003 ◽  
Vol 33 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Christopher A. Alfonzo ◽  
William V. Bobo ◽  
Myron D. Almond
Keyword(s):  
Psychological Distress ◽  
Case Report ◽  
Neuropsychiatric Symptoms ◽  
Tolerability Profile ◽  
Side Effect Profile ◽  
Symptom Presentation ◽  
Healthcare Resources ◽  
Usual Suspect ◽  
Neuropsychiatric Illness ◽  
Progressive Course

We report the case of a patient who, as a result of exposure to the proton pump inhibitor rabeprazole, developed a severe and disabling admixture of neuropsychiatric symptoms. Because of its widely appreciated placebo-like side effect profile, rabeprazole was never suspected as being the cause of his symptoms. Instead, a somatoform spectrum disorder was assigned based on the patient's atypical symptom presentation, progressive course, subjective psychological distress, intemperate consumption of healthcare resources over a relatively brief period of time and lack of any medical explanation for his symptoms at that time, despite exhaustive laboratory and radiologic work-ups. This case report reinforces the notion that even a medication such as rabeprazole, with an established safety and tolerability profile, may be associated with side effects severe enough to mimic disabling neuropsychiatric illness.

Neuropsychiatric Derangement by Polycythemia Vera: A Case Report of an Unexpected Disease Presentation and Review of the Literature

2021 ◽  
pp. 1-6
Author(s):  
Heleen De Lil ◽  
Michelle van Beek ◽  
Alexandra Herbers ◽  
Ellen van der Holst ◽  
Karen Keijsers
Keyword(s):  
Case Report ◽  
Chronic Disease ◽  
Cerebral Infarction ◽  
Polycythemia Vera ◽  
Neuropsychiatric Symptoms ◽  
Unusual Presentation ◽  
Review Of The Literature ◽  
Remarkable Recovery ◽  
Visual Complaints ◽  
Underlying Pathophysiology

Cerebral infarction as well as other thromboses, headaches, and visual complaints are well-known symptoms of polycythemia vera. However, chorea and neuropsychiatric disturbances are less recognized consequences of this chronic disease. Whereas chorea is a rare but acknowledged symptom of polycythemia vera, neuropsychiatric symptoms have only sporadically been reported. We depict 2 patients with an unusual presentation of polycythemia vera. Our first patient presented with right-sided hemiballism and psychosis, and the second patient had a long diagnostic trajectory of unexplained chorea. In both cases diagnosis of JAK2 positive polycythemia vera was established, and in both cases remarkable recovery occurred after the initiation of phlebotomies. The underlying pathophysiology of these symptoms has not been clearly elucidated. Because of the unfamiliarity of the link between especially neuropsychiatric symptoms and polycythemia, current reported numbers are probably an underestimation. Benefit of treatment appears to be large. We seek to create more awareness among physicians about this phenomenon.

scholarly journals Neuropsychological profile of a male psychiatric patient with a Morgagni-Stewart-Morel syndrome

2014 ◽  
Vol 27 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Aksel Hansen ◽  
Liliana Engelhardt ◽  
Wolfgang Pleschutznig ◽  
Gerhard Dammann ◽  
Stephanie Vietze
Keyword(s):  
Case Report ◽  
Psychiatric Patient ◽  
Neuropsychological Tests ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Pain Syndrome ◽  
Admission Diagnosis ◽  
Neuropsychological Profile ◽  
Definition Of

In 1765 Giovanni Morgagni described a syndrome consisting of hyperostosis frontalis interna (HFI), obesity and hirsutism. In 1928 Stewart and in 1930 Morel added neuropsychiatric symptoms, e.g. depression and dementia, which led to the definition of the Morgagni-Stewart-Morel Syndrome (MSM). Although mostly women were characterized in literature no gender specifity is demanded. This case report presents the rare case of a 66 year old male psychiatric patient with Morgagni-Stewart-Morel Syndrome. The patient complained of loss of concentration and difficulties with activities of daily living. Admission diagnosis was an opioid misuse on the basis of a chronic pain syndrome. In this case report we are describing clinical features, the patient history and technical (MRI) and neuropsychological tests. Although severe psychiatric symptoms and neuropsychological deficits are commonly seen in these patients, our patient showed only mild symptoms. This case reports shows the possibility of a male patient with MSM. If MSM is a separate entity or just an epiphenomena of hormone dysregulation should be investigated in further studies.

Drug Rash With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Probably Related to Cefpodoxime: A Case Report

2019 ◽  
pp. 089719001986609 ◽  
Author(s):  
Tirin Babu ◽  
George Mathew Panachiyil ◽  
Juny Sebastian ◽  
Veeranna Shastry
Keyword(s):  
Case Report ◽  
Signs And Symptoms ◽  
Side Effect Profile ◽  
Drug Reactions ◽  
Dress Syndrome ◽  
First Case ◽  
Drug History ◽  
Drug Rash ◽  
Systemic Symptoms ◽  
Favorable Side Effect Profile

Cefpodoxime is a common antibiotic with a favorable side effect profile. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome has been described with several cephalosporins but not cefpodoxime. We report the probable first case of cefpodoxime-induced DRESS syndrome in a 52-year-old female patient. In our case, the patient presented with symptoms of DRESS syndrome 16 days after initiation of cefpodoxime. This case highlights the necessity of consideration of an iatrogenic reason for presenting signs and symptoms at all times. Reinforcing the importance of taking a thorough drug history and considering drug reactions even if onset of symptoms are delayed.

scholarly journals Advanced Mucinous Adenocarcinoma Arising from a Mature Cystic Teratoma: A Case Report and Literature Review

2016 ◽  
Vol 9 (2) ◽  
pp. 331-337
Author(s):  
Aki Miyasaka ◽  
Tadaaki Nishikawa ◽  
Eito Kozawa ◽  
Masanori Yasuda ◽  
Keiichi Fujiwara ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Literature Search ◽  
Abdominal Mass ◽  
Cystic Teratoma ◽  
Figo Stage ◽  
Mature Cystic Teratoma ◽  
Advanced Stage ◽  
Review Of The Literature ◽  
Progressive Course

Purpose: To describe the postoperative progressive course of advanced-stage adenocarcinoma arising from a mature cystic teratoma (MCT) and review the literature regarding this disease. Methods: A 59-year-old woman visited our hospital with an abdominal mass. Laparotomy showed enlargement of the left ovary and dissemination throughout the abdominal and pelvic cavities. The diagnosis was FIGO stage IIIB adenocarcinoma arising from a MCT. We report this case in detail with a review of the literature. Results: A literature search yielded 9 cases of stage III adenocarcinoma with malignant transformation. Six of these 9 patients died within 12 months after diagnosis. Of the 8 patients who underwent postoperative chemotherapy, 3 survived for over 39 months. The review indicates that prognosis of adenocarcinoma is as poor as that for squamous cell carcinoma arising from a MCT. Conclusions: In general, as with this case, prognosis of advanced adenocarcinoma associated with a MCT is poor. However, we should be aware that not all patients are resistant to chemotherapy.

scholarly journals The Impact of the COVID-19 Pandemic on Psychological Distress, Physical Activity, and Symptom Severity in Parkinson’s Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1355-1364 ◽  
Author(s):  
Anouk van der Heide ◽  
Marjan J. Meinders ◽  
Bastiaan R. Bloem ◽  
Rick C. Helmich
Keyword(s):  
Physical Activity ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Distress ◽  
Symptom Severity ◽  
Neuropsychiatric Symptoms ◽  
Lifestyle Changes ◽  
Personality Factors ◽  
Reduced Physical Activity ◽  
The Impact

Background: The ongoing COVID-19 pandemic has many consequences for people with Parkinson’s disease (PD). Social distancing measures complicate regular care and result in lifestyle changes, which may indirectly cause psychological stress and worsening of PD symptoms. Objective: To assess whether the COVID-19 pandemic was associated with increased psychological distress and decreased physical activity in PD, how these changes related to PD motor and non-motor symptom severity, and what frequency and burden of COVID-related stressors were. Methods: We sent an online survey to the Personalized Parkinson Project (PPP) cohort (n = 498 PD patients) in the Netherlands. In the survey, we distinguished between COVID-related stressor load, psychological distress, PD symptom severity, and physical activity. We related inter-individual differences to personality factors and clinical factors collected before the pandemic occurred. Results: 358 PD patients completed the survey between April 21 and May 25, 2020 (response rate 71.9%). Patients with higher COVID-related stressor load experienced more PD symptoms, and this effect was mediated by the degree of psychological distress. 46.6% of PD patients were less physically active since the COVID-19 pandemic, and reduced physical activity correlated with worse PD symptoms. Symptoms that worsened most were rigidity, fatigue, tremor, pain and concentration. Presence of neuropsychiatric symptoms (anxiety, depression) before the pandemic, as well as cognitive dysfunction and several personality traits predicted increased psychological distress during the COVID-19 pandemic. Conclusion: Our findings show how an external stressor (the COVID-19 pandemic) leads to a worsening of PD symptoms by evoking psychological distress as well as lifestyle changes (reduced physical activity).

scholarly journals Ten‐year‐old boy with atypical COVID‐19 symptom presentation: A case report

2020 ◽  
Author(s):  
Hamidreza Houshmand ◽  
Mahdi Abounoori ◽  
Reza Ghaemi ◽  
Sara Bayat ◽  
Gholamreza Houshmand
Keyword(s):  
Case Report ◽  
Symptom Presentation

scholarly journals A 7-Year History of Necrobiotic Xanthogranuloma following Asymptomatic Multiple Myeloma: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Siriluk Inthasotti ◽  
Rungsima Wanitphakdeedecha ◽  
Jane Manonukul
Keyword(s):  
Multiple Myeloma ◽  
Case Report ◽  
Monoclonal Gammopathy ◽  
Early Recognition ◽  
Strong Association ◽  
Hematologic Malignancies ◽  
Morbidity And Mortality ◽  
Wound Complications ◽  
History Of ◽  
Progressive Course

Necrobiotic xanthogranuloma (NXG) is a rare destructive xanthomatous granuloma with chronic, indolent, and progressive course. The morbidity and mortality are the results from wound complications and associated disorders. Because of its strong association with monoclonal gammopathy and multiple myeloma, early recognition of disease is mandatory to monitor and prevent systemic involvements of hematologic malignancies.

Dementia in Parkinson's disease: Case report

2011 ◽  
Vol 26 (S2) ◽  
pp. 846-846
Author(s):  
S.G. Oliveira ◽  
S.M. Pereira ◽  
J. Mendes
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Report ◽  
Psychiatric Hospitalization ◽  
Psychological Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Diagnostic Testing ◽  
Visual Hallucinations ◽  
Psychomotor Agitation ◽  
Disease Case

IntroductionParkinson's disease (PD) dementia is a rapidly growing global health problem. Dementia in PD is often accompanied with neuropsychiatric manifestations, such as depression, insomnia, visual hallucinations and psychomotor agitation, which need psychiatric attention.ObjectivesThe authors’ aim is to report a case of a 76-year-old female suffering from PD who was admitted to the psychiatric yard exhibiting neuropsychiatric symptoms. A literature's review about PD dementia was also made.Case reportPatient had one psychiatric hospitalization at age 41, due to depressive symptoms. PD diagnose was made at age 65 and initially responded well to levodopa. Over the subsequent years, motor fluctuations and dyskinesias as well as autonomic, cognitive and psychological symptoms gradually developed. At 75 years, patient's family stated that she had been more forgetful, impulsive, showing signs of anxiety and dysphoria. She was hospitalized exhibiting psychomotor agitation, disorientation, insomnia and mainly nocturnal visual hallucinations with persons. Diagnostic testing included: cranial tomography which showed mild generalized atrophy but no other structural cause of her symptoms; laboratory tests with B12, folic acid, thyroid function; syphilis detection test and examinations of serum and urine were normal. The MMSE scored 19. Attention deficits and constructional apraxia were present in clock drawing test. Treatment was initiated with memantine and a low dose of quetiapine. She was discharged after 20 days with improvement of neuropsychiatric symptoms.ConclusionsEarly diagnosis and treatment of dementia in PD may prevent psychiatric hospitalization and avoid patient's and family's distress.

scholarly journals COVID-19 and Dengue Co-infection in a Young Girl: A Case Report

2021 ◽  
Vol 33 (1) ◽  
pp. 104-108
Author(s):  
Homayra Tahseen Hossain ◽  
Refaya Tasnim ◽  
Halima Khatun ◽  
Nawsabah Noor ◽  
Mahbub Mayukh Rishad ◽  
...  
Keyword(s):  
Case Report ◽  
Oxygen Therapy ◽  
Private Hospital ◽  
Monsoon Season ◽  
Rt Pcr ◽  
Happy Face ◽  
Healthcare Resources ◽  
Great Satisfaction ◽  
Course Of Illness ◽  
Plasma Leakage

During COVID-19 pandemic, the increasing incidence of dengue in Monsoon season has become a further threat especially in the dengue endemic countries of Southeast Asia like Bangladesh. Co-infection of dengue with COVID-19 has created a number of practical challenges to combat the diseases simultaneously, especially at a time when healthcare resources are already exhausted tackling the COVID pandemic. We are presenting the case report of a 14 year old girl who suffered from both RT-PCR positive COVID -19 infection & NS1 positive Dengue. She was managed in a Private Hospital of Dhaka as Dengue fever Group C (due to severe plasma leakage) with severe COVID-19 infection (as required oxygen therapy). She had a critical course of illness, having continued fever, cough, breathlessness, desaturation along with thrombocytopenia & plasma leakage. However, to our great satisfaction, the patient was ultimately improved & could be discharged in a happy face. Bangladesh J Medicine July 2022; 33(1) : 104-108

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