scholarly journals Systemic-Lupus-Erythematosus-Related Acute Pancreatitis: A Cohort from South China

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Yanlong Yang ◽  
Yujin Ye ◽  
Liuqin Liang ◽  
Tianfu Wu ◽  
Zhongping Zhan ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
South China ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
Multiple Organ ◽  
Chinese People ◽  
Favorable Prognosis ◽  
Organ Systems ◽  
Life Threatening ◽  
Life Threatening Complication

Acute pancreatitis (AP) is a rare but life-threatening complication of SLE. The current study evaluated the clinical characteristics and risk factors for the mortality of patients with SLE-related AP in a cohort of South China.Methods. Inpatient medical records of SLE-related AP were retrospectively reviewed.Results. 27 out of 4053 SLE patients were diagnosed as SLE-related AP, with an overall prevalence of 0.67%, annual incidence of 0.56‰ and mortality of 37.04%. SLE patients with AP presented with higher SLEDAI score (21.70±10.32versus16.17±7.51,P=0.03), more organ systems involvement (5.70±1.56versus3.96±1.15,P=0.001), and higher mortality (37.04% versus 0,P=0.001), compared to patients without AP. Severe AP (SAP) patients had a significant higher mortality rate compared to mild AP (MAP) (75% versus 21.05%,P=0.014). 16 SLE-related AP patients received intensive GC treatment, 75% of them exhibited favorable prognosis.Conclusion. SLE-related AP is rare but concomitant with high mortality in South Chinese people, especially in those SAP patients. Activity of SLE, multiple-organ systems involvement may attribute to the severity and mortality of AP. Appropriate glucocorticosteroid (GC) treatment leads to better prognosis in majority of SLE patients with AP.

scholarly journals Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Kaitlyn Vennard ◽  
Matthew P. Gilbert
Keyword(s):  
Heart Block ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Complete Heart Block ◽  
Multiple Organ ◽  
Thyroid Storm ◽  
Metabolic Abnormalities ◽  
Organ Systems ◽  
Life Threatening ◽  
Life Threatening Complication

Thyroid storm is a rare endocrine emergency characterized by dysfunction of multiple organ systems. Thyroid storm is more common in Graves’ disease and can be precipitated by surgery, trauma, infection, metabolic abnormalities, iodine load, and parturition. We present a diagnostically challenging case of thyroid storm precipitated by radioiodine therapy and accompanied by bradycardia, a rare but life-threatening complication related to treatment for hyperthyroidism.

scholarly journals Complement-Mediated Thrombotic Microangiopathy Associated with Lupus Nephritis Treated with Eculizumab: A Case Report

2021 ◽  
pp. 95-102
Author(s):  
Everardo Arias Torres ◽  
Yongen Chang ◽  
Sheetal Desai ◽  
Ian Chang ◽  
Jonathan E. Zuckerman ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Alternative Pathway ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Homozygous Deletion ◽  
Multiple Organ ◽  
Thrombotic Microangiopathies ◽  
Clinical Criteria ◽  
Organ Systems ◽  
Oral Steroids ◽  
Uremic Syndrome

Thrombotic microangiopathies (TMAs) involve multiple organ systems due to the presence of microangiopathic hemolysis. One such condition, atypical hemolytic uremic syndrome (aHUS), is a complement-mediated process that is part of a spectrum of disorders that have underlying complement dysfunction of the alternative pathway due to overactivity or decreased self-nonself discrimination by innate immunity. Complement-amplifying conditions such as pregnancy may unmask a diagnosis of aHUS. We present an important case of a pregnant 23-year-old Hispanic female who presented in mid-gestation (21 weeks) with an initial diagnosis of systemic lupus erythematosus (SLE) complicated by aHUS. She met clinical criteria for aHUS on presentation and was found to have a pathogenic CFHR1–3 homozygous deletion. She has been treated with intravenous and oral steroids, cyclophosphamide, subsequently also with plasma exchange, and finally with eculizumab with partial improvement in renal function. This case adds to the emerging literature showing that SLE and aHUS (or complement-mediated TMA) can be successfully treated with C5 blockade.

URIC ACID LEVEL AS A PREDICTOR OF SEVERITY IN PREGNANT WOMEN WITH SEVERE PREECLAMPSIA

2021 ◽  
pp. 327-331
Author(s):  
Natasya Natasya ◽  
Fidel Ganis Siregar ◽  
Ratna Akbari Ganie
Keyword(s):  
Developing Countries ◽  
Uric Acid ◽  
Pregnant Women ◽  
Acid Level ◽  
Developed Countries ◽  
Multiple Organ ◽  
Live Births ◽  
Obstetric Emergency ◽  
Organ Systems ◽  
Life Threatening

Preeclampsia is a pregnancy syndrome affecting multiple organ systems, characterized by hypertension and proteinuria after 20 weeks of gestation. The incidence of preeclampsia is estimated to be 3-10% of pregnancies worldwide and is the leading cause of death for pregnant women. Preeclampsia is a life-threatening obstetric emergency, so it needs prompt and precise treatment to prevent morbidity and mortality. WHO estimates that the incidence of preeclampsia is seven times higher in developing countries (2.8% of live births) than in developed countries 1,2 (0.4%).

scholarly journals Leukoencephalopathy and cerebral edema as the presenting manifestations of SLE in an ANA-negative adolescent female: A case report and review of literature.

2020 ◽  
Author(s):  
Alexandra Theisen ◽  
Paroma Bose ◽  
Christina Knight ◽  
Melissa Oliver
Keyword(s):  
Cerebral Edema ◽  
Lupus Erythematosus ◽  
Primary Care Physicians ◽  
Neuropsychiatric Symptoms ◽  
Clinical Manifestations ◽  
Central Nervous System Involvement ◽  
Multiple Organ ◽  
Small Subset ◽  
Adolescent Female ◽  
Organ Systems

Abstract Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with various clinical manifestations involving multiple organ systems. Neuropsychiatric manifestations of SLE has been associated with increased morbidity and mortality, thus it is important to recognize and diagnosis the disease entity and treat early. When neuropsychiatric symptoms are involved, typically there are many other systemic features to aid in the diagnosis of SLE. Many autoantibodies have been discovered and are used to help diagnose SLE. The antibody present in most cases of pediatric SLE, as well as in many other rheumatic diseases, is the nonspecific antinuclear antibody (ANA), making it a commonly used screening tool by primary care physicians when evaluating a patient with a possible rheumatic disorder. However, a small subset of SLE patients, 1-5%, present with a negative ANA, and it is important to keep SLE on the differential diagnosis in specific instances when a thorough infectious and neurological workup has been completed and proven to be inconclusive. Case Presentation: This case involves a Hispanic adolescent female with a negative ANA who presented with diffuse cerebral edema secondary to leukoencephalopathy due to SLE with central nervous system involvement. She had an extensive workup while inpatient involving metabolism, infectious disease, rheumatology, and neurology prior to obtaining the diagnosis of SLE. She was treated with both cyclophosphamide and rituximab and showed improvement. Conclusions: A review of the literature revealed 8 cases with SLE presenting with or developing diffuse cerebral edema and/or leukoencephalopathy. Our patient’s case differs in that she was also ANA negative despite other autoantibody positivity. While she did have low complements and transient leukopenia, she did not present with other signs of organ involvement, which made the diagnosis of SLE with neuropsychiatric involvement quite challenging. We discuss the importance of keeping SLE on the differential despite a negative ANA in complex cases without any other cause and to consider initial screening with not only the ANA but also dsDNA and complements to avoid missed diagnoses.

scholarly journals The Indirect Implication of SARS-CoV-2 Resulting in Kayexalate Toxicity in a Patient with Acute Kidney Injury

2021 ◽  
Vol 5 (1) ◽  
pp. 6-13
Author(s):  
Charles E. Middleton IV ◽  
William Daley ◽  
Neha Varshney
Keyword(s):  
Acute Kidney Injury ◽  
Virus Disease ◽  
Severe Disease ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Subsequent Treatment ◽  
Gastrointestinal Complications ◽  
Treatment Regimens ◽  
Organ Systems ◽  
Life Threatening

The clinical features of corona virus disease 2019 (COVID-19) are variable, but the majority of patients experience mild flu-like symptoms. The cases of severe disease include complications such as progressive pneumonia, acute kidney injury, multi-organ failure, and even death. This paper explores the association between COVID-19 and its effect on multiple organ systems and how the subsequent treatment of this disease can itself lead to morbidity and mortality. We present a case which emphasizes the life threatening gastrointestinal complications associated with treatment of acute kidney injury (AKI) in a patient with COVID-19. We conclude that the patients whose treatment regimens utilize medical resins should be closely monitored for gastrointestinal complications so as to mitigate the known adverse effects associated with these drugs, such as colonic mucosal ulceration, perforation, or even death.

scholarly journals Biologics in the Treatment of Lupus Erythematosus: A Critical Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Dominik Samotij ◽  
Adam Reich
Keyword(s):  
Clinical Trials ◽  
Lupus Erythematosus ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
Immunosuppressive Drugs ◽  
Multiple Organ ◽  
Biologic Agents ◽  
Drug Induced ◽  
Treatment Regimes ◽  
Organ Systems

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting multiple organ systems that runs an unpredictable course and may present with a wide variety of clinical manifestations. Advances in treatment over the last decades, such as use of corticosteroids and conventional immunosuppressive drugs, have improved life expectancy of SLE sufferers. Unfortunately, in many cases effective management of SLE is still related to severe drug-induced toxicity and contributes to organ function deterioration and infective complications, particularly among patients with refractory disease and/or lupus nephritis. Consequently, there is an unmet need for drugs with a better efficacy and safety profile. A range of different biologic agents have been proposed and subjected to clinical trials, particularly dedicated to this subset of patients whose disease is inadequately controlled by conventional treatment regimes. Unfortunately, most of these trials have given unsatisfactory results, with belimumab being the only targeted therapy approved for the treatment of SLE so far. Despite these pitfalls, several novel biologic agents targeting B cells, T cells, or cytokines are constantly being evaluated in clinical trials. It seems that they may enhance the therapeutic efficacy when combined with standard therapies. These efforts raise the hope that novel drugs for patients with refractory SLE may be available in the near future. This article reviews the current biological therapies being tested in the treatment of SLE.

Rare problems associated with the Fontan circulation

2010 ◽  
Vol 20 (S3) ◽  
pp. 113-119 ◽  
Author(s):  
David J. Goldberg ◽  
Kathryn Dodds ◽  
Jack Rychik
Keyword(s):  
Fontan Operation ◽  
Venous Pressure ◽  
Multiple Organ ◽  
Univentricular Heart ◽  
Protein Losing Enteropathy ◽  
Congenital Cardiac Disease ◽  
Organ Systems ◽  
Coagulation Protein ◽  
Life Threatening ◽  
Fontan Physiology

AbstractThe Fontan operation, originally described for the surgical management of tricuspid atresia, is now the final surgery in the strategy of staged palliation for a number of different forms of congenital cardiac disease with a functionally univentricular heart. Despite the improved technical outcomes of the Fontan operation, staged palliation does not recreate a normal physiology. Without a pumping chamber delivering blood to the lungs, the cardiovascular system is less efficient; cardiac output is generally diminished, and the systemic venous pressure is increased. As a result, patients with “Fontan physiology” may face a number of rare but potentially life-threatening complications including hepatic dysfunction, abnormalities of coagulation, protein-losing enteropathy, and plastic bronchitis. Despite the staged palliation resulting in remarkable survival, the possible complications for this group of patients are complex, involve multiple organ systems, and can be life threatening. Identifying the mechanisms associated with each of the rare complications, and developing strategies to treat them, requires the work of many people at many institutions. Continued collaboration between sub-specialists and between institutions will be required to optimise the care for this group of survivors with functionally univentricular hearts.

scholarly journals A study of etiological clinical biochemical and radiological profile of patients with acute pancreatitis in rural population

2021 ◽  
Vol 8 (9) ◽  
pp. 2624
Author(s):  
Shilpashree Channasandra Shekar ◽  
Suhas Narayana Swamy Gowda ◽  
Naveen Narayan ◽  
Ajay Nagraj ◽  
Vishnu Venugopal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Ct Scan ◽  
Enzyme Level ◽  
Remote Organ ◽  
Organ Systems ◽  
Life Threatening ◽  
Systemic Manifestations ◽  
Common Sign ◽  
A Prospective Study ◽  
High Degree

Background: Pancreatitis has been recognized since antiquity. Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other tissues or remote organ systems, presenting with variable clinical and systemic manifestations, presenting with mild self-limiting disease to severe life-threatening multi-organ failure.Methods: This was a prospective study of 60 patients, who were admitted with the diagnosis of acute pancreatitis (AP) during the period from December 2017 to June 2019. The data was collected from the all the patients who met the inclusion criteria, and recorded in the proforma prepared for the study.Results: Out of 60 patients 86.7% were male and 13.3% were female. The highest incidence was noted in 40-51 years age group (35%). Alcohol was the most common cause (75% patients). Abdominal pain was the most common mode of presentation (100%), and epigastric tenderness was the most common sign (100%). More than 3-fold elevation of serum amylase and lipase was seen in 26.7% and 33.3% of patients respectively. USG and CT scan was diagnostic only in 58.5% and 76.7% of patients respectively. All patients were managed conservatively. There was no mortality.Conclusions: In AP patients one should not only rely on enzyme level elevations for diagnosing AP. Patients with only a small increase in amylase and/or lipase levels or even with normal levels may also have or develop acute pancreatitis. High degree of suspicion is required; USG, CT scan and enzyme levels study are complimentary to the clinical suspicion.

scholarly journals A Pediatric Diabetic Ketoacidosis Patient with Multisystem Complications and a Prolonged Course

2019 ◽  
Vol 12 (3) ◽  
pp. 89-90
Author(s):  
John Henry Carson ◽  
Lindall E. Smith ◽  
Poornima Pandiyan ◽  
Priyank J Yagnik
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Unique Case ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Deep Vein

The prevalence of diabetic ketoacidosis (DKA) in children with type 1 diabetes mellitus (T1DM) is 30% at the time of diagnosis.1 Cerebral edema is a rare, but life-threatening complication of DKA, occurring in only 0.3 - 1% of cases.2 Deep vein thrombosis and acute pancreatitis are other rare complications of DKA. Supraventricular tachycardia (SVT) as a complication of pediatric DKA has been reported.3 A unique case of a pediatric patient who had multiple rare complications of DKA including cerebral edema, venous thrombosis, and hypertriglyceridemia associated acute pancreatitis is presented.The SVT episode encountered during the admission was due to complications arising from a procedure and not due to DKA itself.

scholarly journals Hemophagocytic Lymphohistiocytosis: A Life Threatening Cytopenic Condition

2021 ◽  
Vol 15 (2) ◽  
pp. 98-102
Author(s):  
Suranjit Kumar Saha ◽  
MM Shahin Ul Islam ◽  
Nasir Uddin Ahmed ◽  
Prativa Saha
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Gene Mutations ◽  
Multiple Organ ◽  
Treatment Modalities ◽  
Hematopoietic Stem ◽  
Organ Systems ◽  
Life Threatening ◽  
Poor Outcomes

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that occurs in many underlying conditions in all age. This is characterized by unbridled activation of cytotoxic T lymphocytes, natural killer (NK) cells and macrophages resulting in raised cytokine level. Those cytokines and immune mediated injury occur in multiple organ systems. It may be primary and secondary. Primary HLH is familial, childhood presentation and associated with gene mutations. Secondary HLH is acquired, adulthood presentation that occurs in infections, malignancies inflammatory and autoimmune diseases etc. Clinical manifestations include fever, splenomegaly, lymphadenopathy, neurologic dysfunction, coagulopathy, features of sepsis etc. Laboratory investigation includes cytopenias, hypertriglyceridemia, hyperferritinemia, abnormal liver function, hemophagocytosis, and diminished NKcell activity. Treatment modalities include immunosuppressive, immunomodulatory agents, cytostatic drugs, T-cell antibodies, anticytokine agents and hematopoietic stem cell transplantation (HSCT). Besides those, aggressive supportive care combined with specific treatment of the precipitating factor can produce better outcome. With treatment more than 50% of children who undergo transplant survive, but adults have quite poor outcomes even with aggressive management. Faridpur Med. Coll. J. 2020;15(2): 98-102

Sign in / Sign up

Export Citation Format

Share Document