Primary Aldosteronism Complicated by Hypokalemic Rhabdomyolysis. A Clinical Case

2019 ◽  
Vol 2 (3) ◽  
pp. 110-114
Author(s):  
K. Skaletsky ◽  
E. Kosmacheva ◽  
N. Kizhvatova ◽  
V. Porhanov
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Primary Aldosteronism ◽  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Secondary Hypertension ◽  
Acute Cerebrovascular Accident ◽  
Initial Stage ◽  
Common Causes

Abstract Primary aldosteronism (PA) is one of the most common causes of secondary hypertension, which in less than half of cases is manifested by hypokalemia. In cases where hypokalemia becomes significant, it can lead to muscle weakness or even paralysis. Such patients are often unsuccessfully treated by neurologists or rheumatologists. In our clinical case a 61 year old patient had rapidly developing symptoms, which were interpreted by ambulance paramedics as an acute cerebrovascular accident. Since the patient was admitted to a multidisciplinary hospital, he was examined by doctors of different specialties, the diagnostic direction was set correctly and rhabdomyolysis was already detected at the initial stage. We excluded various causes of myopathy, which ultimately led us to the most likely cause of this condition - hypokalemia, and explained muscle symptoms. As a result, it helped us to identify the correct diagnosis - aldosteronism. The patient quickly recovered due to the prescribed therapy and felt good, and therefore refused surgical treatment (adrenalectomy), which, perhaps, would allow him to fully recover. Thus, a rare clinical case of differential diagnosis and successful drug treatment of PA with hypokalemia, which is manifested by rhabdomyolysis, is presented.

CLINICAL CASE OF ACUTE CEREBROVASCULAR ACCIDENT IN A CHILD WITH HEREDITARY THROMBOPHILIA

2020 ◽  
Vol 99 (1) ◽  
pp. 232-236
Author(s):  
P.V. Shumilov ◽  
◽  
A.Ya. Ilyina ◽  
A.L. Mishchenko ◽  
A.S. Barinova ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Acute Cerebrovascular Accident ◽  
Hereditary Thrombophilia

scholarly journals Adrenal vein sampling in differential diagnosis of primary aldosteronism on the example of a clinical case

2019 ◽  
Vol 21 (4) ◽  
pp. 109-113
Author(s):  
Ivan I. Sitkin ◽  
◽  
Natalia Yu. Romanova ◽  
Nadezhda M. Platonova ◽  
Natalya V. Molashenko ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Primary Aldosteronism ◽  
Clinical Case ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling

Primary Aldosteronism: Novel Insights

2020 ◽  
Vol 16 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Konstantinos Stavropoulos ◽  
Konstantinos Imprialos ◽  
Vasilios Papademetriou ◽  
Charles Faselis ◽  
Kostas Tsioufis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Aldosteronism ◽  
Molecular Basis ◽  
Diagnostic Procedure ◽  
Secondary Hypertension ◽  
Future Research ◽  
The Novel ◽  
Future Perspectives ◽  
Common Causes ◽  
Existing Data

Background: Primary aldosteronism is one of the most common causes of secondary hypertension. Patients with this endocrine syndrome are at increased cardiovascular risk, higher than hypertensive individuals with equal blood pressure levels. Objectives: The study aimed to thoroughly present and critically discuss the novel insights into the field of primary aldosteronism, focusing on the clinically meaningful aspects. Method: We meticulously evaluated existing data in the field of primary aldosteronism in order to summarize future perspectives in this narrative review. Results: Novel data suggests that a subclinical form of primary aldosteronism might exist. Interesting findings might simplify the diagnostic procedure of the disease, especially for the localization of primary aldosteronism. The most promising progress has been noted in the field of the molecular basis of the disease, suggesting new potential therapeutic targets. Conclusion: Several significant aspects are at early stages of evaluation. Future research is essential to investigate these well-promising perspectives.

scholarly journals Is it Possible to Extirpate Cardiovascular Events in Primary Aldosteronism after Surgical Treatment

2010 ◽  
Vol 1 ◽  
pp. JCM.S6316 ◽  
Author(s):  
Tetsuo Nishikawa ◽  
Yoko Matsuzawa ◽  
Jun Saito ◽  
Masao Omura
Keyword(s):  
Surgical Treatment ◽  
Primary Aldosteronism ◽  
Secondary Hypertension ◽  
Adrenal Venous Sampling ◽  
Venous Sampling ◽  
Partial Adrenalectomy ◽  
Aldosterone Producing Adenoma ◽  
Idiopathic Hyperaldosteronism ◽  
Micro Catheter ◽  
Indication For Treatment

It is well known that primary aldosteronism (PA) due to aldosterone-producing adenoma (APA) is a surgically curable secondary hypertension. Thus, the differential diagnosis between unilateral hyperaldosteronemia due to APA and bilateral hyperaldosteronemia due to idiopathic hyperaldosteronism (IHA) is crucial to decide surgical indication for treatment in PA patients. Adrenal venous sampling (AVS) can diagnose the laterality of hypersecretion of aldosterone in those patients, while it is still impossible to differentiate bilateral hypersecretion of bilateral aldosterone-producing adenomas (Blt-APAs) from that of bilateral hyperplasia of IHA. To solve the problem, we try to develop a new method of supper-selective ACTH-stimulated adrenal venous sampling (SS-ACTH-AVS). We performed SS-ACTH-AVS by using a strip-tip type 2.2 Fr micro-catheter (Koshin Medical Inc. Japan). Adrenal effluents were sampled super-selectively at the central veins and at one or two tributaries of adrenal veins in each gland. We would like to emphasize that SS-ACTH-AVS can precisely analyze the situation of hyperfunction of steroidogenesis in each side of adrenals as well as in some tiny lesions inside the adrenal cortex which are not visible in the CT images. Moreover, we can differentiate Blt-APAs from IHA, and postulate the decision of surgical treatment, such as partial adrenalectomy. Thus, we should perform SS-ACTH-AVS especially in the case demonstrating the existence of bilateral adrenal lesions such as unilateral and bilateral tumors, or even no tumor in both sides in the patients with PA.

scholarly journals Pulmonary lesions in visceral toxocariasis in children in the phthisiatric practice (clinical case)

2021 ◽  
Vol 16 (3) ◽  
pp. 245-250
Author(s):  
O.M. Raznatovska ◽  
Yu.V. Mironchuk
Keyword(s):  
Differential Diagnosis ◽  
Blood Test ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
White Blood Cells ◽  
Left Lung ◽  
Lung Lesion ◽  
Pediatric Tuberculosis ◽  
Tuberculin Tests

Background. The clinical and radiological picture of pulmonary tuberculosis has many common features with a large number of diseases. Therefore, differential diagnosis is very important when detecting tuberculosis. The purpose of the work: on the example of a clinical case to present the complexity of the differential diagnosis between pulmonary lesion in visceral toxocariasis and tuberculosis in children. Results. The child was diagnosed with an infiltrate in the third segment of the left lung with lesions of the intrathoracic lymph nodes, which is characteristic of the primary tuberculosis. The volatility of the infiltrate was not determined. All general blood test hadn’t shown an increase in eosinophils and white blood cells. According to the literature data, the appearance of persistent and prolonged eosinophilia with the development of eosinophilic leukemoid reactions of the blood, an increase in the level of leukocytes are the main and one of the constant manifestations of toxocariasis. The child was diagnosed with moderate hepatomegaly, which is cha­racteristic for both diseases. The patient was registered at a pediatric tuberculosis clinic due to a shift in tuberculin tests. At the time of hospitalization, there were not reasons to suspect visceral toxocariasis. Due to the examination data, first of all the absence of bacterial excretion and negative tuberculin tests, and the pre­sence in the child’s house of the dogs and cats, it was decided to recommend the consultation of the infectionist to exclude any parasitic disease. At the end, the correct diagnosis was established in this child at time and the necessary treatment was prescribed. Conclusions. This clinical case demonstrates the difficulties of differential diagnosis of visceral toxocariasis in lung lesion and tuberculosis. First of all, this is due to the asymptomatic clinical picture of toxocariasis, the diagnosis of which was established by X-ray data, blood test for IgG antibodies to Toxocara and epidemiological history. Given the fact that toxocariasis includes a large spectrum of masks of various diseases, and children who are infected by Toxocara do not have specific clinical symptoms, doctors should remember to prescribe the additional examination for the presence of parasitic diseases, including toxocariasis, especially if pets live in the child’s home.

Upper Extremity Anomalies

2019 ◽  
pp. 203-210
Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry
Keyword(s):  
Valproic Acid ◽  
Differential Diagnosis ◽  
Upper Extremity ◽  
Clinical Case ◽  
Background Information ◽  
Amniotic Band ◽  
Case Presentation ◽  
Vascular Disruption ◽  
Common Causes ◽  
Malformation Syndromes

This chapter reviews background information about the incidence, epidemiology, genetics, and other anomalies associated with common congenital anomalies of the upper extremity. The discussion reviews the differential diagnosis of transverse, longitudinal (amelia, radial, ulnar), intercalary (phocomelia), and central (split hand/foot) defects of the radius and ulna and combined upper and lower extremity defects. The chapter summarizes common causes of upper extremity anomalies, including amniotic band disruption sequence, teratogenic agents (misoprostol, thalidomide, valproic acid), vascular disruption, chromosome anomalies, and Mendelian congenital malformation syndromes, and it gives recommendations for evaluation and management. A clinical case presentation features an infant with Holt–Oram syndrome.

scholarly journals A Case Report of Bullous Emphysema in an Adolescent: Congenital Malformation or Outcome of Bronchopulmonary Dysplasia?

2020 ◽  
Vol 2 ◽  
pp. 2-6
Author(s):  
Svitlana Ilchenko ◽  
Anastasiia Fialkovska ◽  
Oleksii Makoveychuk
Keyword(s):  
Differential Diagnosis ◽  
Clinical Case ◽  
Diagnostic Method ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Detailed Examination ◽  
Pathological Process ◽  
Pulmonary Diseases ◽  
Chronic Obstructive ◽  
Chronic Obstructive Pulmonary Diseases

Pulmonary emphysema belongs to the group of chronic obstructive pulmonary diseases, and inpediatric pulmonology is one of the complex diagnoses that require a careful differential diagnosis. Thearticle describes the possible causes of the formation and clinical manifestations of pulmonaryemphysema in children. We present a clinical case of bullous emphysema in a teenager. This case showsthat a detailed examination using such a modern diagnostic method as high-resolution computedtomography played a crucial role in establishing the patient's correct diagnosis. However, establishing thenature of this pathological process in the child was very difficult. Perhaps an earlier diagnosis couldprevent severe irreversible changes in a teenager's lungs would avoid developing the diffusebronchopulmonary process.

scholarly journals The case of detection and differential diagnosis of Hypell-Lindau disease in a patient as a result of a comprehensive examination of a patient in a chronic critical condition

2020 ◽  
Author(s):  
A Yakovleva
Keyword(s):  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Family History ◽  
Critical Condition ◽  
Clinical Case ◽  
Multidisciplinary Approach ◽  
Von Hippel Lindau ◽  
Live Births ◽  
Comprehensive Examination ◽  
Von Hippel Lindau Syndrome

According to evidence in the literature occurrence of the Hippel Lindau disease changes from 1: 33000 - 1: 36000 (population frequency) to 1 in 39000 live births. Up to 20% of them have not family history. Hereditary predisposition of most patients with systemic angioreticulomatosis has patterns and attributes. Diversity of forms and infrequent cases of the Hippel Lindau disease complicate timely diagnosis. Untimely control of condition of patient with the Hippel Lindau disease increases the probability of complications in surgical treatment. It can be the reason of early disability too. The presented clinical case reflects the need for a multidisciplinary approach to the management of patients with von Hippel-Lindau syndrome.

Rare clinical case of the diagnosis of idiopathic pulmonary artery hypertension

2021 ◽  
Vol 29 (2) ◽  
pp. 299-304
Author(s):  
Grigory A. Ignatenko ◽  
Ilya S. Grekov ◽  
Marina V. Grushina ◽  
Anna V. Dubovyk
Keyword(s):  
Pulmonary Artery ◽  
Clinical Case ◽  
Adult Population ◽  
Correct Diagnosis ◽  
Life Quality ◽  
Pulmonary Artery Hypertension ◽  
Right Ventricular Failure ◽  
Ventricular Failure ◽  
Initial Stage

In this work, a rather rare (morbidity of about 12 cases per 1 million of adult population per year) and interesting clinical case of the diagnosis of idiopathic pulmonary artery hypertension (IPAH) was described. This case was also known as Ayerza disease or AyerzaArilago syndrome. At the initial stage, this pathology was characterized by an asymptomatic course that caused certain difficulties in making a correct diagnosis. In general, this disease had a poor prognosis. The main cause of death was decompensated right ventricular failure. The occurrence of complications could be significantly reduced and the life quality of such patients could be improved by the timely diagnosis and correct approach.

Alopecia in Children: The Most Common Causes

1990 ◽  
Vol 12 (1) ◽  
pp. 25-30
Author(s):  
Andrew V. Atton ◽  
Walter W. Tunnessen
Keyword(s):  
Differential Diagnosis ◽  
Tinea Capitis ◽  
Scalp Hair ◽  
Correct Diagnosis ◽  
Careful Examination ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Common Causes ◽  
Historical Pattern

The differential diagnosis of alopecia in the pediatric age group is simplified by the fact that 90% to 95% of the cases are caused by four major entities: alopecia areata, telogen effluvium, tinea capitis, and trichotillomania. Careful examination of the scalp, hair, and historical pattern of the loss will usually be rewarded by the correct diagnosis.

Sign in / Sign up

Export Citation Format

Share Document