scholarly journals Case Report: Management and Outcomes of COVID-19 in a Patient with Cirrhosis of Liver

2021 ◽  
pp. 547-551
Author(s):  
Seema M. Kolhe
Keyword(s):  
Case Report ◽  
Past History ◽  
Significant Proportion ◽  
Total Bilirubin Level ◽  
Pemphigus Vulgaris ◽  
Abdominal Ultrasound ◽  
Skin Lesions ◽  
Chief Complaint ◽  
Main Diagnosis ◽  
Cirrhosis Of Liver

Introduction: The outbreak of coronavirus disease 2019 (COVID-19) has recently become a major problem affecting thousands of individuals around the world. It is understood that a significant proportion of patients infected with COVID-19 have disturbed liver function tests. This is a case report of a patient with liver cirrhosis and COVID-19. Presenting Complaints and Investigations: A 39 year old female patient was admitted in AVBRH on 06/02/2021 with chief complaint of distension of abdomen, breathlessness, shortness of breath, reduced urine output over last 3 months. She had skin lesions over the hand, foot, abdomen and back with itching since 4 months. Physical examination, blood investigations and abdominal ultrasound showed cirrhosis of liver with gross ascites seen clinically. She had mild splenomegaly and gall bladder was enlarged. Laboratory tests showed elevated total bilirubin level. In peripheral blood examination, RBC count was low (3.66m/cu mm), Haemoglobin level was 8.2 gm/dl, Platelets count was low (1.19 lakh per cu. mm). WBC count was 3600 cu mm. Doctor diagnosed this as the case of cirrhosis of liver with pemphigus vulgaris with COVID-19. Past History: 6 months ago, patient was admitted in Aarogyadham hospital Yawatmal with chief complaint of abdominal pain, loss of appetites, fever. On ultrasonography, she had splenomegaly for which she took the treatment. The Main Diagnosis, Therapeutic Intervention and Outcomes: This case was diagnosed as a case of COVID-19 with Cirrhosis of liver. Interferon alpha 2b solution was given for 10 days to help improve the immunity. Tab. Ursoldiolis (ursodeoxycholic acid) was used to dissolve gallstones. Conclusion: Good clinical assessment, appropriate care, good nursing care by trained nurses and appropriate treatment can save lives even in complicated COVID-19 infected cases.

scholarly journals Neonatal Pemphigus Vulgaris: A Case Report

2020 ◽  
Vol 8 (4) ◽  
Author(s):  
Fahimeh Abdollahimajd ◽  
Minoo Fallahi ◽  
Azadeh Rakhshan ◽  
Naeeme Taslimi Taleghani ◽  
Mohammad Kazemian ◽  
...  
Keyword(s):  
Case Report ◽  
Fungal Pathogens ◽  
Neonatal Period ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Antimicrobial Treatment ◽  
Incontinentia Pigmenti ◽  
Maternal History ◽  
Transmembrane Glycoprotein ◽  
History Of

: Pemphigus vulgaris (PV) is an autoimmune blistering disorder of the skin and mucous membranes. The transplacental passage of maternal immunoglobulin G (IgG) autoantibodies to desmoglein-3 (a transmembrane glycoprotein component in the skin) from the mother’s blood to the fetus can cause transient PV in the neonatal period. The duration of PV is short in the neonatal period, and the disease is improved with no prolonged sequelae. The similarity of skin lesions in PV to other skin conditions, such as infectious diseases caused by bacterial, viral, and fungal pathogens, or inherited bullous disorders, such as epidermolysis bullosa and incontinentia pigmenti, leads to misdiagnosis, inappropriate hospital admission, and poor antimicrobial treatment of patients. On the other hand, the maternal history of PV, besides laboratory examination, confirms the exact diagnosis. In this case report, we present a male term neonate with multiple pustules and blisters on the skin, developed within the first hours of life. The patient was admitted to the neonatal ward of our hospital for a sepsis workup and antibiotic treatment. Regarding the positive maternal history of PV in the second trimester of pregnancy and neonatal examinations skin biopsy confirmed the diagnosis of this disease.

scholarly journals Papular-purpuric gloves and socks syndrome: A case report

2006 ◽  
Vol 59 (7-8) ◽  
pp. 380-383
Author(s):  
Zorica Gajinov ◽  
Sonja Prcic ◽  
Milan Matic ◽  
Verica Djuran ◽  
Milana Ivkov-Simic
Keyword(s):  
Case Report ◽  
Parvovirus B19 ◽  
Abdominal Ultrasound ◽  
Skin Lesions ◽  
Dorsal Side ◽  
Moderate Increase ◽  
Left Hand ◽  
Normal Limits ◽  
Rare Manifestation ◽  
Viral Diagnosis

Introduction. Papular-purpuric gloves and socks syndrome is a rare manifestation associated with acute seronegative arthritis and skin lesions. It is triggered by a viral infection, most commonly by Human parvovirus B19 or Coxsackie group of viruses, but precise viral diagnosis is not obtained in all cases. Case report. A 54-year old male patient experienced sudden, intense pain and swelling in the carpal area of his left hand. He also presented with unusual skin lesions, and grouped small purpuric-papules on the dorsal side of the left hand. During the next few days, both feet were similarly affected. In the next four weeks, a transient liver damage occurred, with a moderate increase in liver enzymes. Apart from elevated erythrocyte sedimentation rate and fibrinogen levels, other findings were within normal limits (complete blood and reticulocyte count, parameters of rheumatic and autoimmune diseases, abdominal ultrasound scan, radiographs of the chest and of affected hand and feet joints, urethral smears for isolation of trichomonas, yeasts and chlamydia trachomatis, and Syphilis, Borrelia, Toxoplasmosis, and Mycoplasma pneumoniae serology). Apart from positive tests for HPvB19, other viral serology tests were all negative (Coxsackievirus, Adenovirus, Influenza, Hepatitis B and C virus, HIV). The skin lesions resolved in about three weeks: the intensity of joint pain decreased, but lasted for the next 6 months. Conclusion. The diagnosis of papular-purpuric gloves and socks syndrome was made on the basis of the characteristic clinical picture, and confirmed by virus serology. .

scholarly journals The Role of Atorvastatin in Management of Eruptive Xanthoma on a Boy: A Case Report

2021 ◽  
Vol 9 (C) ◽  
pp. 151-153
Author(s):  
Harapan Parlindungan Ringoringo
Keyword(s):  
Body Weight ◽  
Case Report ◽  
Clinical Presentation ◽  
Skin Lesions ◽  
Chief Complaint ◽  
Laboratory Examination ◽  
Cutaneous Lesions ◽  
Early Therapy ◽  
Intense Pruritus

Background: Eruptive xanthoma is a benign skin lesion caused by the accumulation of cholesterol and triglycerides in the skin's dermis. Xanthoma can be an early clinical manifestation of systemic diseases such as dyslipidemia, cardiovascular disease, diabetes mellitus. Clinical presentation varies from asymptomatic skin lesions to intense pruritus and tenderness. Aim: This study aims that oral atorvastatin is effective in treating a child with eruptive xanthoma. Case report: A three-year-old boy with an 8.4 kg body weight and 82.5 cm height came to the hospital with the chief complaint of small yellowish-white papules and nodes, discrete, 2-5 mm in size, painless on pressing, itchy, scattered, mainly in the lower extremity around the buttocks. On laboratory examination, Hb 11.5 g/dL, leukocyte 9,900/ul, platelet 413,000/uL, blood glucose 66 mg/dL. Further evaluation revealed total cholesterol 814 mg/dL, LDL 970 mg/dL, HDL 341 mg/dl, triglycerides 621 mg/dL; there is no evidence of familial hypercholesterolemia. The diagnosis is eruptive xanthoma.  After starting treatment with atorvastatin 0.2 mg/kg body weight/day in one dose for six months, his cutaneous lesions gradually subsided and significantly decreased cholesterol, LDL, HDL, and triglyceride levels. Conclusion: Early therapy with atorvastatin will reduce the morbidity and mortality of eruptive xanthoma.

scholarly journals Case Report: Autoimmune Pemphigus Vulgaris in a Patient Treated With Cemiplimab for Multiple Locally Advanced Cutaneous Squamous Cell Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Rosalba Buquicchio ◽  
Valentina Mastrandrea ◽  
Sabino Strippoli ◽  
Davide Quaresmini ◽  
Michele Guida ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Oral Prednisone ◽  
Locally Advanced ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Response To Therapy

BackgroundPemphigus vulgaris (PV) is a rare and severe autoimmune blistering disorder affecting the skin and mucous membranes, characterized by the production of autoantibodies against two desmosomal adhesion proteins, desmoglein 1 and 3. In patients with advanced squamous cell carcinoma of the skin unfit for surgery and radiotherapy, immune check-point inhibitors, including the anti-Programmed Death-1 (PD-1) agent cemiplimab have been successfully employed proving relevant clinical outcomes. Cemiplimab is a monoclonal antibody capable of inhibiting PD-1 signalling that has recently been approved for the treatment of patients with metastatic or locally advanced cutaneous squamous cell carcinoma. Although the peculiar setting of advanced CSCC involving elderly patients, rare and unusual skin immune-related adverse events such as PV could be observed in cemiplimab treated patients.Case ReportA 95-year-old man without a history of autoimmune disease was treated with cemiplimab for multiple and advanced squamous cell carcinomas of the head obtaining a complete response to therapy. After seven cycles of cemiplimab administered every 21 days, the patient developed a mucocutaneous blistering eruption. Clinical diagnosis of PV was suspected on the basis of the diffuse involvement of trunk and extremities with large blisters and necrotic eschar. It was carried out an ELISA test, that showed high level of circulating antibodies against desmoglein 1, thus confirming the diagnosis of PV. For this reason, cemiplimab infusion was discontinued and complete resolution of skin lesions was obtained using oral prednisone 0,8 mg/kg/daily for four weeks. Once remission was achieved, a maintenance dose of 10 mg/day was administered, observing a good control of bullous disease and low value of desmoglein 1. Response to CSCC persisted also during cemiplimab discontinuation, until obtaining a complete remission still persisting at 9 months after the last cycle of therapy.ConclusionThe case we observed is the first description of PV revealed from cemiplimab therapy, thus suggesting that cemiplimab could allow the arise of underlying autoimmune PV, through a mechanism both T and B-cell-mediated.

Childhood pemphigus vulgaris treated with dapsone: a case report.

1998 ◽  
Vol 15 (5) ◽  
pp. 381-383 ◽  
Author(s):  
B Bjarnason ◽  
C Skoglund ◽  
E Flosadottir
Keyword(s):  
Case Report ◽  
Pemphigus Vulgaris

Chronic Pemphigus Vulgaris of the Gingiva: A Case Report With a 6-Year Follow-up

1983 ◽  
Vol 54 (11) ◽  
pp. 685-689 ◽  
Author(s):  
Walter A. Orlowski ◽  
Edward Bressman ◽  
John L. Doyle ◽  
Abram I. Chasens
Keyword(s):  
Case Report ◽  
Pemphigus Vulgaris

Paroxysmal localized Hyperhidrosis, a case-report: When excessive sweating occurs in combination with severe headaches

Cephalalgia ◽  
2021 ◽  
pp. 033310242110068
Author(s):  
Marleen H van Coevorden ◽  
Mariëtte WCJ Schoofs ◽  
Jeroen Venhovens
Keyword(s):  
Nervous System ◽  
Case Report ◽  
Autonomic Nervous System ◽  
Diagnostic Testing ◽  
Abdominal Ultrasound ◽  
Severe Headache ◽  
Excessive Sweating ◽  
Autonomic Nervous ◽  
Underlying Disorder ◽  
System Disorder

Background Paroxysmal localized hyperhidrosis is a rare disorder of the central autonomic nervous system. No association between paroxysmal hyperhidrosis and severe headache has been previously described in literature. Case description: A 65-year-old woman with idiopathic paroxysmal localized hyperhidrosis combined with severe holocranial headache attacks is described in this case report. Extensive diagnostic testing by means of laboratory examinations, 24-hour urinalyses, chest X-ray, abdominal ultrasound and computed tomography scans, and brain and spinal cord magnetic resonance imaging could not identify an underlying disorder. A diagnosis of idiopathic paroxysmal localized hyperhidrosis was made, and the patient was successfully treated with clonidine 0.075 mg three times a day, without any side effects. Conclusion Paroxysmal localized hyperhidrosis is a rare central autonomic nervous system disorder that can occur in combination with severe headache. Both the headache and paroxysmal hyperhidrosis complaints were treated effectively with clonidine in the patient described in this case-report.

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