scholarly journals Clozapine-induced liver injury and pleural effusion

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Joseph P.M. Kane ◽  
Francis A. O’Neill
Keyword(s):  
Pleural Effusion ◽  
Liver Injury ◽  
Liver Enzymes ◽  
Clinical Symptoms ◽  
Acute Liver Injury ◽  
Case Reports ◽  
High Index ◽  
Documented Case ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Clozapine, whilst associated commonly with a transient and benign increase in liver enzymes, has also been associated with varying presentations of hepatitis in existing case reports. This report describes what we believe to be the first documented case of acute liver injury and pleural effusion associated with clozapine, resolving after cessation of the agent. The case supports existing literature in advocating a high index of suspicion, particularly in the 4-5 weeks following clozapine initiation, when considering nonspecific clinical symptoms and signs.

scholarly journals Clozapine-induced liver injury and pleural effusion

2014 ◽  
Vol 6 (2) ◽  
pp. 36-37
Author(s):  
Joseph P.M. Kane ◽  
Francis A. O'Neill
Keyword(s):  
Pleural Effusion ◽  
Liver Injury ◽  
Liver Enzymes ◽  
Clinical Symptoms ◽  
Acute Liver Injury ◽  
Case Reports ◽  
High Index ◽  
Documented Case ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Clozapine, whilst associated commonly with a transient and benign increase in liver enzymes, has also been associated with varying presentations of hepatitis in existing case reports. This report describes what we believe to be the first documented case of acute liver injury and pleural effusion associated with clozapine, resolving after cessation of the agent. The case supports existing literature in advocating a high index of suspicion, particularly in the 4-5 weeks following clozapine initiation, when considering nonspecific clinical symptoms and signs.

scholarly journals Liver Dysfunction associated with Hyperthyroidism: Lessons from 2 Case Reports

2020 ◽  
Author(s):  
Nana Akua Opoku-Akyeampong ◽  
Adwoa Adjei-Nkansah ◽  
Ernest Yorke
Keyword(s):  
Liver Dysfunction ◽  
Liver Enzymes ◽  
Case Reports ◽  
High Index ◽  
Response To Treatment ◽  
Liver Pathology ◽  
High Index Of Suspicion ◽  
The Impact

Deranged liver enzymes due to hyperthyroidism rather than intrinsic liver pathology are not uncommon. We present two cases that highlight the impact of hyperthyroidism on liver biochemistry tests and good response to treatment. A high index of suspicion is paramount in patients presenting with unexplained deranged liver enzymes or jaundice.

scholarly journals Disulfiram-Induced Acute Liver Injury

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Lucas Ramer ◽  
Matthieu Tihy ◽  
Nicolas Goossens ◽  
Jean-Louis Frossard ◽  
Laura Rubbia-Brandt ◽  
...  
Keyword(s):  
Liver Injury ◽  
Acute Hepatitis ◽  
Fulminant Hepatitis ◽  
Liver Enzymes ◽  
Drug Withdrawal ◽  
Acute Liver Injury ◽  
True Incidence ◽  
Elevated Liver Enzymes ◽  
Severity Of Injury ◽  
Hepatocyte Necrosis

Disulfiram is a drug used to treat alcohol dependence since many years. It interferes with the metabolism of alcohol, may be associated with neurological and dermatological symptoms, and can be hepatotoxic. Due to the frequent coexistent liver test alterations due to alcohol, the true incidence of disulfiram-associated liver injury is unclear and severity of injury may vary from mildly elevated liver enzymes to fulminant hepatitis leading to death. There are several reported cases of disulfiram hepatitis in the literature. Liver histology, when available, demonstrates some degree of portal inflammation with eosinophils and hepatocyte necrosis. We present here a well-documented case of acute hepatitis due to disulfiram with typical histological lesions, favorable outcome following drug withdrawal, and a brief steroid course. The risk of hepatotoxicity should be kept in mind when prescribing disulfiram.

scholarly journals Clinical spectrum and radiographic features of the syndrome of the trephined

2015 ◽  
Vol 6 (03) ◽  
pp. 438-441 ◽  
Author(s):  
Cara L. Sedney ◽  
William Dillen ◽  
Terrence Julien
Keyword(s):  
Clinical Symptoms ◽  
Case Reports ◽  
Statistical Significance ◽  
Skin Flap ◽  
Surgical Care ◽  
Medical Providers ◽  
Demographic Information ◽  
Neurosurgical Procedure ◽  
High Index Of Suspicion ◽  
Syndrome Of The Trephined

ABSTRACT Object: Craniectomy is a common neurosurgical procedure. Syndrome of the trephined (ST) occurring after craniectomy results in neurologic symptoms that are reversible with cranioplasty. While well-documented, previous literature consisted of case reports, symptom spectrum and risk factors have not been well characterized. Materials and Methods: A retrospective review of 29 consecutive cases who underwent decompressive craniectomy within a 30-month period was performed. Patients were considered affected by ST if a previously stable neurological deficit improved within 3 weeks after cranioplasty. Prevalence of ST was measured and association with demographic information, clinical symptoms patterns, indication for and size of craniectomy, as well as radiological signs were tested. Results: Seven patients (24%) developed ST. Chronic rehabilitation arrest was more common than acute neurologic decline. Factors such as craniectomy size and patient age did not reach statistical significance in development of ST. Radiographic factors were predictive, with a sunken skin flap contour being most sensitive, while ventricular effacement was most specific.Conclusion: ST may have a higher incidence than previously thought, with a chronic rehabilitation arrest being a more common presentation than an acute decline. Medical providers involved in the post surgical care and rehabilitation of these patients should maintain a high index of suspicion for ST.

Pulmonary Aspiration Presenting with Generalised Convulsions

1983 ◽  
Vol 28 (4) ◽  
pp. 368-370 ◽  
Author(s):  
R. J. Northcote
Keyword(s):  
Foreign Body ◽  
Respiratory Distress ◽  
Case History ◽  
Pulmonary Aspiration ◽  
High Index ◽  
Grand Mal ◽  
High Index Of Suspicion ◽  
Epileptiform Seizures ◽  
Symptoms And Signs

Foreign body in the tracheobroncial tree is a relatively infrequent, but, potentially fatal event, requiring rapid and expert intervention. The symptoms and signs may be mistaken for asthma and pneumonia, — or, as in the case described, with grand mal epileptiform seizures. This emphasises the need to take a thorough case history, and to have a high index of suspicion in a case presenting with convulsion associated with cough, wheezing or respiratory distress.

scholarly journals Appendicitis in pregnancy mimicking haemolysis, elevated liver enzymes and low platelets syndrome

2011 ◽  
Vol 4 (1) ◽  
pp. 35-36
Author(s):  
Pooja Sikka ◽  
Neelam Aggarwal ◽  
Seema Chopra ◽  
Vanita Suri
Keyword(s):  
Abdominal Pain ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
High Index ◽  
Biochemical Evidence ◽  
Elevated Liver Enzymes ◽  
High Index Of Suspicion ◽  
In Pregnancy

We report a patient with pregnancy at term in whom appendicitis mimicked haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. A high index of suspicion of appendicitis should be kept in patients with abdominal pain and biochemical evidence of HELLP.

scholarly journals The Hepatoprotection by Oleanolic Acid Preconditioning: Focusing on PPARαActivation

PPAR Research ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Wenwen Wang ◽  
Kan Chen ◽  
Yujing Xia ◽  
Wenhui Mo ◽  
Fan Wang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Oleanolic Acid ◽  
Molecular Mechanisms ◽  
Liver Enzymes ◽  
Acute Liver Injury ◽  
Inflammatory Factors ◽  
Peroxisome Proliferator ◽  
Peroxisome Proliferator Activated Receptor ◽  
Anti Inflammatory ◽  
Major Factors

Objective. Previous studies have characterized the hepatoprotective and anti-inflammatory properties of oleanolic acid (OA). This study aimed to investigate the molecular mechanisms of OA hepatoprotection in concanavalin A- (ConA-) induced acute liver injury.Materials and Methods. ConA (20 mg/kg) was intravenously injected to induce acute liver injury in Balb/C mice. OA pretreatment (20, 40, and 80 mg/kg) was administered subcutaneously once daily for 3 consecutive days prior to treatment with ConA; 2, 8, and 24 h after ConA injection, the levels of serum liver enzymes and the histopathology of major factors and inflammatory cytokines were determined.Results. OA reduced the release of serum liver enzymes and inflammatory factors and prevented ConA mediated damage to the liver. OA elevated the expression levels of peroxisome proliferator-activated receptor alpha (PPARα) and decreased the phosphorylation of c-Jun NH2-terminal kinase (JNK).Conclusion. OA exhibits anti-inflammatory properties during ConA-induced acute liver injury by attenuating apoptosis and autophagy through activation of PPARαand downregulation of JNK signaling.

Acute liver failure after changing oral anticoagulant from apixaban to rivaroxaban

2021 ◽  
Vol 14 (4) ◽  
pp. e240719
Author(s):  
Vikram Rao ◽  
Anna Munasinghe
Keyword(s):  
Adverse Reaction ◽  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Injury ◽  
Case Reports ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Treatment And Prevention ◽  
Elevated Bilirubin ◽  
Liver Transaminases

Rivaroxaban is a commonly used anticoagulant agent for treatment and prevention of thromboembolism. There are case reports demonstrating an association between its use and drug-induced liver injury. However, this has not been reported in a patient who previously tolerated apixaban. An 88-year-old man presented to hospital with worsening lethargy, jaundice and vomiting. He had severely elevated liver transaminases, an abnormal coagulation profile and elevated bilirubin in keeping with acute liver injury. This is in the context of having had his anticoagulation medication switched from apixaban to rivaroxaban 2 weeks prior. The patient recovered well after cessation of rivaroxaban, suggesting that it was the likely offending agent. The mechanism of rivaroxaban-induced liver injury remains to be investigated. Drug-induced liver injury should be discussed and monitored for as a potential adverse reaction when commencing rivaroxaban, even if a patient has previously tolerated a drug of the same class.

scholarly journals Acute liver injury following turmeric use in Tuscany: An analysis of the Italian Phytovigilance database and systematic review of case reports

2020 ◽  
Author(s):  
Niccolò Lombardi ◽  
Giada Crescioli ◽  
Valentina Maggini ◽  
Ilaria Ippoliti ◽  
Francesca Menniti‐Ippolito ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Injury ◽  
Acute Liver Injury ◽  
Case Reports

Palmar Dislocations of the 5th Carpometacarpal Joint: Case Report of a Rare Injury and Review of Published Cases

2020 ◽  
Vol 25 (03) ◽  
pp. 368-372
Author(s):  
Zhixue Lim ◽  
Sandeep Jacob Sebastin
Keyword(s):  
Case Report ◽  
Closed Reduction ◽  
Case Reports ◽  
High Index ◽  
Carpometacarpal Joint ◽  
Rare Injury ◽  
Delay In Diagnosis ◽  
High Index Of Suspicion

Isolated palmar dislocation of the 5th carpometacarpal joint (CMCJ) is a rare injury that can be easily missed and requires a high index of suspicion to detect. We report a case of an initially missed isolated ulnopalmar dislocation of the 5th CMCJ and a summary of other published case reports comparing methods of fixation and outcomes. We conclude that a delay in diagnosis will significantly reduce the chances of successfully managing this injury via closed reduction.

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