Leg Ulcer in Patient with Sickle Cell Disease on Hydroxyurea

Leg ulcers are a painful side-effect commonly seen in patients with long-term use of hydroxyurea. We describe an ulcer in a patient with sickle cell disease (SCD) with an 8-year history of hydroxyurea use. Wound care team used cadexomer-iodine topical and collagenase to aid in healing. There are limited options for the treatment of these ulcers beside the cessation of hydroxyurea, a very effective drug in reducing painful sickle cell episodes. It is imperative to be aware of this complication to prevent expensive tests and further work up. Future study into alternative treatment of hydroxyurea-induced leg ulcers for sickle cell patients is necessary.

Pseudo Metabolic Acidosis in the Setting of Hypertriglyceridemia: A Case Report

Low serum bicarbonate, with or without an elevated anion gap, can indicate metabolic acidosis. High anion gap metabolic acidosis is due to the unmeasured anions. Hypertriglyceridemia can also be associated with spuriously low serum bicarbonate levels due to lab interference. We present a 44-year-old woman who presented with anion gap metabolic acidosis in the presence of severe hypertriglyceridemia

Sodium-Glucose Cotransporter-2 Inhibitors and Cardiovascular Disease: Lessons and the Future

Diabetes mellitus (DM), an epidemic non-communicable disease, is associated with macro- and micro-vascular complications which may result in sudden cardiac death at a young age. Sodium-glucose cotransporter-2 inhibitors (SGLT2-I) emerged as a new therapeutic option for managing DM with cardiovascular complications as well as diabetic patients with multiple risk factors. Three drugs in this class significantly reduced cardiovascular mortality and heart failure events, in both type 2 diabetes mellitus and non-diabetic patients with a reduced ejection fraction, to prevent heart failure-related hospitalisation. Evidence of kidney protection was another major advantage provided in more than one study. We reviewed recent SGLT2-I related literature and discuss the benefits beyond the cardiac system.

Proteinuria: A Guide to Diagnosis and Assessment

Proteinuria is a common incidental finding that physicians face in the inpatient and outpatient setting. Proteinuria may represent a benign pathology in asymptomatic patients, or it can be a sign of significant renal or systemic disease. The latter is usually associated with persistent proteinuria or other clinical findings such as renal failure. This article will focus on the mechanisms, causes and diagnostic approach of proteinuria. Proteinuria is a common incidental finding that physicians face in the inpatient and outpatient setting. Proteinuria may represent a benign pathology in asymptomatic patients, or it can be a sign of significant renal or systemic disease. The latter is usually associated with persistent proteinuria or other clinical findings such as renal failure. This article will focus on the mechanisms, causes and diagnostic approach of proteinuria.