Bilateral adrenal haemorrhage with renal infarction after ChAdOx1 nCoV-19 AstraZeneca vaccination

Vaccine-induced thrombotic thrombocytopaenia (VITT) is a rare syndrome associated with the ChAdOx1 nCoV-19 (AstraZeneca) vaccine. We detail a case of vaccine-induced thrombotic thrombocytopaenia in a 47-year-old female who was found to have bilateral adrenal haemorrhage, renal vein thrombosis, renal infarction and pulmonary embolism 13 days post-vaccination with ChAdOx1 nCoV-19.

Occam’s Razor and Managing Acute Thrombosis in the COVID-19 Era

The COVID-19 pandemic has profoundly influenced the practice of medicine in Australia over the last 24 months. Recently, the development of several vaccines to COVID-19 has been accompanied by reports of an associated rare syndrome of thrombosis and thrombocytopaenia (VITTS). The possibility of this rare disorder confronts all clinicians who deal with acute thrombosis, particularly given the prevalence of patients who have recently been immunised. However, VITTS remains rare, and we believe unnecessary focus on its potential diagnosis may distract from other more common causes of acute thrombosis. We discuss this with reference to a recent case at our institution.

MMR-Rare Can Be There

We report a case of a 10-year-old male who had megalocornea with mental retardation(Neuhauser syndrome). It is a rare syndrome with a few cases reported in literature. These patients also require a thorough systemic examination as many diseases are often associated with megalocornea.

Paroxysmal Hypothermia With Prominent Parkinsonian Features After Suprachiasmatic Tumor Resection

Paroxysmal hypothermia (PH) is a rare syndrome of stereotyped episodes of hypothermia, bradycardia, and altered mental status occurring in patients with hypothalamic lesions. Prior cases have mentioned bradykinesia, ataxia, and dysarthria, but parkinsonism has not been described as a specific feature of PH. We report two patients, an adult and a child, who developed PH after suprachiasmatic tumor resection, both with clinical presentations notable for prominent parkinsonian features despite no evidence of parkinsonism during the intervening months and years. We propose a diagnostic algorithm and scoring tool to aid in the clinical diagnosis of PH presenting as parkinsonism.