scholarly journals Catecholamine-Induced Cardiomyopathy in Pheochromocytoma: How to Manage a Rare Complication in a Rare Disease?

2018 ◽  
Vol 51 (07) ◽  
pp. 458-469 ◽  
Author(s):  
Jenn Rachelle U. Santos ◽  
Alessandra Brofferio ◽  
Bruna Viana ◽  
Karel Pacak
Keyword(s):  
Clinical Presentation ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Cardiovascular Responses ◽  
Adrenergic Stimulation ◽  
Venous Compliance ◽  
Therapeutic Algorithm ◽  
Different Types ◽  
Excessive Secretion

AbstractPheochromocytomas and paragangliomas (PHEOs) are rare neuroendocrine tumors. Clinical manifestations include different cardiovascular signs and symptoms, which are related to excessive secretion of catecholamines. Catecholamine-induced cardiomyopathy in PHEO (CICMPP) is a rare but dreaded complication of PHEO. Once patient is diagnosed with this condition, the prognosis is worse and a surgical risk is much higher than expected. This article focuses on how catecholamines affect the heart and the pathophysiologic mechanism of CICMPP. The cardiovascular responses to catecholamine depend mostly on which catecholamine is released as well as the amount of catecholamine that is released. The acute release of norepinephrine and epinephrine from PHEO increases heart rate, systemic vascular resistance, myocardial contractility, and reduces venous compliance. The excessive adrenergic stimulation by catecholamine results in severe vasoconstriction and coronary vasospasm, myocardial ischemia, and subsequently damage, and necrosis. Chronically elevated catecholamine levels lead to significant desensitization of cardiac β-adrenoceptors. The increased levels of the enzyme β-adrenoceptors kinase (βARK) in the heart seems to mediate these biochemical and physiological changes that are consistently correlated with attenuated responsiveness to catecholamine stimulation. Through these mechanisms different types of cardiomyopathy (CMP) can be formed. This review discusses extensively the 3 types of cardiomyopathies that can be present in a PHEO patient. It also provides the clinical presentation and diagnostic and therapeutic algorithm in managing patients with CICMPP.

scholarly journals Clinical manifestations of chronic subdural hematoma in the elderly: Literature Review

2021 ◽  
Author(s):  
Gabriela Ferreira Kalkmann ◽  
Carlos Umberto Pereira ◽  
Francisco de Assis Pereira ◽  
Débora Moura da Paixão Oliveira ◽  
Nicollas Nunes Rabelo
Keyword(s):  
Early Diagnosis ◽  
Literature Review ◽  
Subdural Hematoma ◽  
Elderly Population ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Chronic Subdural Hematoma ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Study Results

Introduction: The clinical manifestations of chronic subdural hematoma (CSDH) are often confused with other medical entities in the elderly, making their early diagnosis difficult or difficult. Early diagnosis is important, since its prognosis is directly associated with the preoperative neurological state, thus resulting in a worse vital and functional prognosis. Objectives: Report through a literature review the clinical manifestations of CSDH in the elderly population. Methods: Literature review, with the search terms: “Signs and Symptoms”, “Chronic Subdural Hematoma”, Aged, Diagnosis and Prognosis. In which PubMed, Lilacs, Scielo, Cochrane and TripDataBase data platforms were used. The inclusion criteria were: original studies published in any language. Articles in which full reading was prevented were excluded. With the application of the inclusion and exclusion criteria, 110 articles were included in the study. Results: Clinical presentation depends on the location, volume of the hematoma, rapid growth, the location of the CSDH, whether unilateral or bilateral, and the clinical conditions of the patient. Because the forms of clinical presentation of CSDH are variable, it is necessary that health professionals linked to the elderly (geriatrician, psychiatrist, general practitioner) have knowledge of this clinical entity. Conclusions: The recognition of classic forms as well as the identification of risk factors in the elderly favors the timely diagnosis and treatment of CSDH in the elderly population.

Facomatosis tipo Cesioflammea: Reporte de caso de neonato con Manchas Mongólicas y Vino oporto. Una presentación simple de una condición dermatológica compleja.

2020 ◽  
pp. 14-18
Author(s):  
Vonetta A Vallejo Lewis ◽  
Militza Torres Herrera ◽  
Ian Alberto Gonzalez Grajales,
Keyword(s):  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Congenital Glaucoma ◽  
Pigmented Lesion ◽  
Different Types ◽  
The Face ◽  
Systemic Manifestations ◽  
The Right ◽  
Renal Vascular ◽  
Rule Out

La facomatosis pigmentovascular es un conjunto de signos y síntomas caracterizado por la coexistencia de malformaciones vasculares capilares con una lesión pigmentaria cutánea congénita (nevo epidérmico, nevo spilus o melanosis dérmica) asociada o no, a manifestaciones sistémicas. Existen varios grupos de facomatosis pigmentovasculares según el tipo de nevo asociado a la lesión capilar vascular. Puede existir solo la afectación cutánea o tener manifestaciones sistémicas, entre ellas, traumatológicas, neurológicas, oftalmológicas, inmunológicas, renales, vasculares, linfáticas, entre otras.Exponemos el caso de un neonato masculino, quien presenta manchas vino oporto facial bilateral, cuello y tórax anterior y posterior, junto a melanocitosis dérmicas en espalda y ambos miembros inferiores, asociado a glaucoma congénito del ojo derecho. Debido a las manifestaciones clínicas cutáneas y sistémicas, se diagnostica facomatosis pigmentovascular, realizándose evaluación multidisciplinaria por radiología, dermatología, oftalmología, genética y neurología, para descartar afectación extracutánea.Los estudios complementarios son de vital importancia para detectar alteraciones extracutáneas, como se presentaron en el paciente. Abstract Phakomatosis pigmentovascularis is set of signs and symptoms characterized by the association of a vascular nevus with a congenital pigmented lesion (epidermal nevus, nevus spilus, and dermal melanocytosis) associated or not to systemic malformations. There are different types of phakomatosis pigmentovascularis according to the pigmentary nevus associated with the vascular malformation. There may be only the cutaneous condition or have systemic manifestations such as, trauma, neurological, ophthalmological, inmunological, renal, vascular, lymphatic, among others disorders.We present the case of a male newborn who had a port wine stain located bilaterally on the face, anterior and posterior thorax and neck, together with dermal melanocitosis in the back and lower extremities, associated with congenital glaucoma of the right eye. Due the clinical manifestations, the diagnosis of phakomatosis pigmentovascularis was made and multidisciplinary evaluation is requested by radiology, dermatology, ophthalmology, genetics and neurology to rule out extracutaneous involvement.Complementary studies are essential to detect extracutaneous alterations as presented in the patient.  

scholarly journals Significant Clinical Manifestations in Ballantyne Syndrome, after a Case Report and Literature Review: Recognizing Preeclampsia as a Differential Diagnosis

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Silvia F. Navarro-Perez ◽  
Karen Corona-Fernandez ◽  
José L. Rodriguez-Chavez ◽  
A. Bañuelos-Franco ◽  
María G. Zavala-Cerna
Keyword(s):  
Literature Review ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Fetal Loss ◽  
Signs And Symptoms ◽  
Sacrococcygeal Teratoma ◽  
Fetal Hydrops ◽  
Early Management ◽  
Fetal Survival ◽  
Clinical Triad

Ballantyne syndrome (BS) also called mirror syndrome is defined by the presence of a clinical triad that includes fetal hydrops and placental and maternal edema. Here we present a clinical case of a 34-year-old woman with a 29 weeks’ pregnancy, who developed BS and fetal loss probably due to failure in prompt recognition of a rapidly growing sacrococcygeal teratoma (SCT). Due to similarities in clinical presentation with preeclampsia and the importance in early identification of the source for BS, we underwent a literature review in order to identify significant signs and symptoms, as well as sonographic changes, in order to help clinicians to make this prompt recognition, identification of the cause, and early management of BS, which will have an important impact in maternal and fetal survival.

scholarly journals A gyermekkori koronavírus-fertőzést követő sokszervi gyulladás diagnosztikája és kezelése

2021 ◽  
Vol 162 (17) ◽  
pp. 652-667
Author(s):  
Tamás Constantin ◽  
Noémi Andrási ◽  
Andrea Ponyi ◽  
Ádám Goschler ◽  
László Ablonczy ◽  
...  
Keyword(s):  
Intensive Care ◽  
Toxic Shock Syndrome ◽  
Macrophage Activation ◽  
Specific Immunotherapy ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Toxic Shock ◽  
Severe Condition ◽  
Organ Systems ◽  
Therapeutic Algorithm

Összefoglaló. A SARS-CoV-2-fertőzés ritka gyermekkori szövődménye a sokszervi gyulladás, angol terminológiával paediatric inflammatory multisystem syndrome (PIMS). Két vagy több szerv érintettségével járó, súlyos tünetekkel induló betegségről van szó, amelynek tünetei átfedést mutatnak a Kawasaki-betegséggel, a toxikus sokk szindrómával és a makrofágaktivációs szindrómával. A PIMS-betegek intenzív terápiás osztályon vagy intenzív terápiás háttérrel rendelkező intézményben kezelendők, ahol biztosítottak a kardiológiai ellátás feltételei is. A szükséges immunterápia a klinikai prezentációtól függ. A jelen közleményben a szerzők a releváns nemzetközi irodalom áttekintését követően ajánlást tesznek a PIMS diagnosztikai és terápiás algoritmusára. Orv Hetil. 2021; 162(17): 652–667. Summary. Pediatric inflammatory multisystem syndrome (PIMS) is a rare complication of SARS-CoV-2 infection in children. PIMS is a severe condition, involving two or more organ systems. The symptoms overlap with Kawasaki disease, toxic shock syndrome and macrophage activation syndrome. PIMS patients should be treated in an intensive care unit or in an institution with an intensive care background, where cardiological care is also provided. The required specific immunotherapy depends on the clinical presentation. In this paper, after reviewing the relevant international literature, the authors make a recommendation for the diagnostic and therapeutic algorithm for PIMS. Orv Hetil. 2021; 162(17): 652–667.

scholarly journals Clinico- etiological profile of acute poisoning and intoxication in children in western Nepal

2021 ◽  
Vol 8 (10) ◽  
pp. 1643
Author(s):  
Love K. Sah ◽  
Munu Mahat ◽  
Prince Pareek ◽  
Ram P. Pokhrel ◽  
Reema Garegrat
Keyword(s):  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Acute Poisoning ◽  
Acute Onset ◽  
Accidental Poisoning ◽  
Emergency Physicians ◽  
Medical College ◽  
Different Types ◽  
Common Clinical Presentation ◽  
History Of

Background: Pediatric poisoning is a common emergency. The present study was done to assess the incidence, clinico-etiological profile of acute poisoning and intoxication in children.Methods: This study was conducted in the Department of Pediatrics, Lumbini Medical College and Teaching Hospital, Nepal in which children aged less than 18 years, with history of consumption of poison accompanied or unaccompanied by container or poison or with doubtful history of consumption of poison but with definite signs and symptoms of acute poisoning we included. We also included children with history of bites by poisonous creatures like snakes, scorpions, bees and insects or with doubtful history of bites due to poisonous creatures but with definite acute onset of signs and symptoms locally or systemically.Results: In the present study, during the study duration, 68 children were included. The most common age group of included children was 1 to 5 years (59%). Accidental poisoning was reported in 93% of the cases, while the rest had suicidal poisonings. The most common type of poison used were different types of pesticides (46%). We observed that vomiting was the most common clinical presentation (79%). In our study sample, arrival of 46% of the children was delayed by 30 minutes to 2 hours. Majority of the patients arrived in the afternoon to the hospital (51%).Conclusions: The findings of the present study would enable emergency physicians to identify clinical features of common poisonings among children, which would enable manage the cases better.

scholarly journals A Reappraisal of Clinical Characteristics of Typhoid Fever

2012 ◽  
Vol 34 (3) ◽  
pp. 80-85 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Sanjana Zaman ◽  
Farhana Chaiti ◽  
Naveen Sheikh ◽  
Gopen Kumar Kundu
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Health Resources ◽  
Signs And Symptoms ◽  
Salmonella Typhi ◽  
Widal Test ◽  
Missed Diagnosis ◽  
The Mean

Background: Recent reports from developing countries show that the clinical presentation, diagnosis and treatment of typhoid have significantly altered often leading to missed diagnosis. The incidence of complications is also reported to be variable. The consequence of missed diagnosis is immense in terms of burden on limited health resources and patients’ suffering. Therefore, its clinical spectrum requires constant reappraisal to update our physicians with current knowledge. This study was carried out to determine the changes in clinical pattern of typhoid fever. Patients & Methods: A total of 106 children, aged up to 14 years, diagnosed primarily as typhoid fever, were included as study population. The diagnostic criteria were either positive blood culture for Salmonella typhi or Salmonella paratyphi or at least a four-fold rise in antibody titre on Widal test. The study included mode of clinical presentations, treatment received before admission, Widal test findings and culture and sensitivity to antibiotics. Results: The mean age of the patients was 5.2 years and males were a little than the females. The mean duration of illness was 11.2±3.3 days. Majority of the patients presented with classical signs and symptoms like step ladder pattern of fever (nearly 70%) coated tongue (69.8%), diarrhoea (49.1%), toxemia (68.9%), relative leucopenia (71.7%), hepatomegaly (55.7%), pain in the right hypochondrium (41.5%) and splennomegaly (18.9%). Very few cases had a typical manifestations. Over 85% of the patients had raised SGPT (>40 IU/L) and 13.8% had detectable jaundice (serum billirubin >3 mg/dl). Widal test demonstrated that about 45% of the patients’ ‘O’ antibody titer increased to 4-fold, 27.4% to 8-fold or more. In case of antibody ‘H’, 35.8% exhibited 4-fold and 39.7% 8-fold or more increase. Of the 103 cases, 68(66%) were positive for Salmonella typhi. Majority of the isolated organisms was sensitive to cefixime, ceftriaxone and gentamycin (83%, 84% and 82% respectively). The second line of sensitivity was obtained to amikacin (64.2%), meropenem (50%), ciprofloxacin (46.2%), imepenem (46.2%) and azithromycin (43.4%). The least sensitive drugs were amoxicillin (28.3%), cotrimoxazole (27.4%) and chloramphenicol (22.6%). Onethird (33.8%) of the patients had multidrug resistant (MDR) strains. However, No significant association was found between multi-drug resistant (MDR) strains and atypical clinical manifestations. Conclusion: Clinical presentation of most typhoid fever still conforms with the classic pattern. High fever, anorexia, coated tongue, diarrhoea, relative leucopenia and hepatosplenomegaly are still common manifestations of typhoid fever. So, majority of the patients could be treated blindly based on clinical diagnosis. However, treatment should be given with first line of drugs like cefexime or ceftriaxone. DOI: http://dx.doi.org/10.3357/bjch.v34i3.10357 BJCH 2010; 34(3): 80-85

scholarly journals The frequency and clinical presentation of Zika virus coinfections: a systematic review

2020 ◽  
Vol 5 (5) ◽  
pp. e002350
Author(s):  
Ludmila Lobkowicz ◽  
Anna Ramond ◽  
Nuria Sanchez Clemente ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Demócrito de Barros Miranda-Filho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Zika Virus ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Case Series ◽  
Signs And Symptoms ◽  
Cross Sectional ◽  
Epstein Barr

BackgroundThere is limited knowledge on the influence of concurrent coinfections on the clinical presentation of Zika virus (ZIKV) disease.MethodsTo better understand the types, frequencies and clinical manifestations of ZIKV coinfections, we did a systematic review of four databases (PubMed, Embase, Web of Science, LILACS) without restrictions for studies on ZIKV coinfections confirmed by nucleic acid (quantitative real-time-PCR) testing of ZIKV and coinfecting pathogens. The review aimed to identify cohort, cross-sectional, case series and case report studies that described frequencies and/or clinical signs and symptoms of ZIKV coinfections. Conference abstracts, reviews, commentaries and studies with imprecise pathogen diagnoses and/or no clinical evaluations were excluded.ResultsThe search identified 34 articles from 10 countries, comprising 2 cohort, 10 cross-sectional, 8 case series and 14 case report studies. Coinfections were most frequently reported to have occurred with other arthropod-borne viruses (arboviruses); out of the 213 coinfections described, ZIKV infections co-occurred with chikungunya in 115 cases, with dengue in 68 cases and with both viruses in 19 cases. Other coinfecting agents included human immunodeficiency, Epstein-Barr, human herpes and Mayaro viruses, Leptospira spp, Toxoplasma gondii and Schistosoma mansoni. ZIKV-coinfected cases primarily presented with mild clinical features, typical of ZIKV monoinfection; however, 9% of cases in cohort and cross-sectional studies were reported to experience complications.ConclusionBased on the evidence collated in this review, coinfections do not appear to strongly influence the clinical manifestations of uncomplicated ZIKV infections. Further research is needed to confirm whether risk of severe complications is altered when ZIKV infection co-occurs with other infections.PROSPERO registration numberCRD42018111023.

The clinical diagnostic aspects of acute pancreatic encephalopathy

2016 ◽  
Vol 22 (3) ◽  
pp. 153-156
Author(s):  
A. A Strutsenko ◽  
I. V Damulin ◽  
N. V Mazurtchik ◽  
P. P Ogurtsov
Keyword(s):  
Acute Pancreatitis ◽  
Neurological Disorders ◽  
Rare Complication ◽  
Clinical Stage ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Course Of Disease ◽  
Therapeutic Algorithm ◽  
Fast Development ◽  
Pancreatic Encephalopathy

The pancreatic encephalopathy is characterized by various focal neurological symptomatic and sporadic fast development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy that significantly makes severer course of disease and increases lethality. The review article considers particular aspects of clinical manifestations and probable diagnostic algorithm of neurological disorders observed in patients with acute pancreatitis. The actuality of development of diagnostic algorithm of pancreatic encephalopathy is emphasized. This algorithm will permit ultimately early, probably at pre-clinical stage, discover the mentioned complication of acute pancreatitis with the purpose of not only ultimate early detection of pancreatic encephalopathy but also development of pathogenically conditioned therapeutic algorithm considering all chains of pathogenesis.

Different clinical features of amitraz poisoning in children

2002 ◽  
Vol 21 (1) ◽  
pp. 13-16 ◽  
Author(s):  
M Emre Atabek ◽  
K Aydin ◽  
I Erkul
Keyword(s):  
Cardiopulmonary Arrest ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Hepatic Function ◽  
Adrenergic Stimulation ◽  
Laboratory Features ◽  
Function Test ◽  
Important Sign ◽  
Poisoning In Children ◽  
Cns Depression

Objective: To evaluate clinical experience of amitraz poisoning in children. Methods: In this study, the clinical and laboratory features of amitraz poisoning in 14 children are presented and compared with previous studies. Results: This study revealed that clinical manifestations of poisoning by oral and dermal routes appeared within 30–150 min, and that central nervous system (CNS) depression, which is the most important sign, improved within 6–24 hours and other signs within 24–72 hours. Unlike the findings in other studies, three severe cases in our study had reversible mydriasis and one of them required resuscitation because of cardiopulmonary arrest occurring as a result of serious respiratory depression. In addition, hepatic function test levels had increased in these three cases, and aspiration pneumonitis existed because of emesis in two of them. Conclusion: There is little information in the literature about dermal poisoning. The signs and symptoms of dermal poisoning were relatively mild compared with oral poisoning, and there were no topical signs. The classical signs of¬small2small-adrenergic stimulation such as marked sinusal bradycardia and mydriasis as reported in many poisoning cases of animals have not been reported before our three severe cases among children.

Traumatic Leptomeningeal Cyst in a 24-Year-Old Man: Case Report

Neurosurgery ◽  
2006 ◽  
Vol 58 (1) ◽  
pp. E201-E201 ◽  
Author(s):  
Karlo Houra ◽  
Vili Beros ◽  
Tomislav Sajko ◽  
Hrvoje Cupic
Keyword(s):  
Case Report ◽  
Childhood Trauma ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Bone Lesions ◽  
Leptomeningeal Cyst ◽  
Progressive Neurological Deficit ◽  
History Of ◽  
Subcutaneous Mass

Abstract OBJECTIVE AND IMPORTANCE: Traumatic leptomeningeal cysts represent a rare complication of a childhood cranial fracture, and occur in only 0.05 to 0.6% of all cranial fractures. In adults, clinical manifestations of a childhood trauma are very rare and usually appear in the form of nontender, nonpulsatile, subcutaneous mass, accompanied by a progressive neurological deficit and seizures, as shown in our case. CLINICAL PRESENTATION: We present the case of a 24-year-old man with seizures caused by a traumatic leptomeningeal cyst resulting from the head injury he suffered at the age of 9 months. INTERVENTION: Right-sided craniotomy was performed with consequent microsurgical removal of the leptomeningeal cyst. The dura was reconstructed in a watertight manner and a cranioplasty was performed with Palacos (Howmedica International, Limerick, Ireland). CONCLUSION: It is important to consider traumatic leptomeningeal cysts when treating adult patients with erosive bone lesions who have a history of head trauma.

Sign in / Sign up

Export Citation Format

Share Document