scholarly journals Hypercalcemia, Anemia, and Acute Kidney Injury: A Rare Presentation of Sarcoidosis

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Neeraj Sharma ◽  
Hassan Tariq ◽  
Kalpana Uday ◽  
Yevgeniy Skaradinskiy ◽  
Masooma Niazi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hematologic Malignancy ◽  
Granulomatous Inflammation ◽  
Kidney Injury ◽  
Transbronchial Biopsy ◽  
Rare Presentation ◽  
X Ray ◽  
Initial Impression ◽  
Chest X Ray ◽  
Noncontrast Computed Tomography

We discuss a case of a 61-year-old woman who presented with substernal chest pain. She was found to have elevated calcium levels, anemia, and acute kidney injury. The hypercalcemia persisted despite therapy with fluids and bisphosphonates. She was found to have nonparathyroid hormone (PTH) mediated hypercalcemia. The chest X-ray did not reveal any pathology. Our Initial impression was likely underlying hematologic malignancy such as lymphoma or multiple myeloma. A bone marrow biopsy was performed that revealed nonnecrotizing granulomatous inflammation. Further workup revealed elevated vitamin 1,25 dihydroxy level, beta-two microglobulin level, and ACE levels. Noncontrast computed tomography (CT) scan of chest showed bilateral apical bronchiectasis, but did not show any lymphadenopathy or evidence of malignancy. Subsequently, a fiber optic bronchoscopy with transbronchial biopsy showed nonnecrotizing granulomatous inflammation consistent with sarcoidosis. After initiating glucocorticoid therapy, the patient’s hypercalcemia improved and her kidney function returned to baseline.

scholarly journals Acute Kidney Injury in ADPKD Patients with Pneumonia

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Carlos Franco Palacios ◽  
Mira T. Keddis ◽  
Dingxin Qin ◽  
Ladan Zand ◽  
Guangxi Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Autosomal Dominant ◽  
Kidney Injury ◽  
Polycystic Kidney ◽  
X Ray ◽  
Lower Baseline ◽  
Acute Pneumonia ◽  
Chest X Ray ◽  
Hospital Stays ◽  
Autosomal Dominant Polycystic Kidney

Background. In animal models, polycystic kidneys are susceptible to acute kidney injury (AKI). We examined the occurrence of AKI in a cohort of autosomal dominant polycystic kidney disease (ADPKD) and non-ADPKD patients with acute pneumonia.Design. All ADPKD patients admitted to Mayo Clinic Rochester for pneumonia from January 1990 to April 2010 were examined. Sixty-three patients had lobar infiltration and consolidation on chest X-ray. After excluding patients on dialysis, with organ transplantation, and on chronic immunosuppression, 24 remaining ADPKD patients were enrolled. Twenty-three of the 24 were matched with 92 (1 : 4 ratio) non-ADPKD pneumonia patients based on their baseline eGFR. AKI was defined as serum creatinine elevation ≥0.3 mg/dL.Results. Sixteen of the 23 ADPKD patients (69.6%) and 36 of the 92 (39.1%) non-ADPKD patients developed AKI,P=0.008. In both groups, those who developed AKI had a lower baseline eGFR (41.1±5.00versus58.7±11.8in ADPKD and40.2±3.65versus51.8±2.24 mL/min/1.73 m2in the non-ADPKD group), more intensive care unit admissions, and longer hospital stays. AKI was associated with a reduced survival in both groups.Conclusions. Patients with ADPKD admitted for acute pneumonia had more frequent episodes of AKI than non-ADPKD patients with comparable kidney function.

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

scholarly journals A Rare Presentation of Hypermagnesemia Associated with Acute Kidney Injury due to Hypercalcemia

2019 ◽  
Vol 58 (8) ◽  
pp. 1123-1126 ◽  
Author(s):  
Taro Horino ◽  
Osamu Ichii ◽  
Yoshio Terada
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Rare Presentation

scholarly journals Chronic Granulomatous Disease: A Rare Hereditary Immuno-deficiency Disorder in a Young Boy with Its Adverse Consequences

2016 ◽  
Vol 33 (3) ◽  
pp. 156-160
Author(s):  
Mamunur Rashid ◽  
Asfia Nigar ◽  
Md Rashidul Hassan
Keyword(s):  
Chronic Granulomatous Disease ◽  
Granulomatous Inflammation ◽  
Primary Immunodeficiency Disease ◽  
Granulomatous Disease ◽  
Phagocytic Cells ◽  
X Ray ◽  
Chest X Ray ◽  
Immunodeficiency Disease ◽  
Bacteria And Fungi ◽  
Long Acting

Chronic granulomatous disease (CGD) is a primary immunodeficiency disease which results from absence of the NADPH oxidase in the professional phagocytic cells neutrophils, monocytes, macrophages and eosinophils. Deficiency of this oxidase renders the patient liable to infection by bacteria and fungi, and, as the name of the disease suggests, to chronic granulomatous inflammation. Here, a young boy presented with increasing breathlessness and productive cough had recurrent episode of pulmonary infection since his childhood. Repeated Chest X-ray and CT scan showed homogenous opacities at different places of lung in different occasions with bilateral reticulo-nodular opacities. Mulipleoraganisms were isolated from sputum at different times. A nitroblu-tetrazolium test (NBT) was done abroad which was positive and confirmed his diagnosis. Since then, He had prophylactic fluconazol and sulphamethoxazoltrimethoprime daily and pneumocaccal and influenza vaccination regularly and proper treatment of acute infective episodes accordingly. In spite all these measures, repeated infection caused grievous harm to his lung leading to irreversible pulmonary fibrosis and bronchiectasis. As a consequence, he became home bound, oxygen dependant and dependant on regular use of long acting bronchodilators in different form. Hematopoeitic stem cell transplantation was advised which was not affordable for his parents. Now, this young boy is waiting for further assaults to his lungs and further deterioration and ultimate hopeless outcomes.J Bangladesh Coll Phys Surg 2015; 33(3): 156-160

scholarly journals Acute Kidney Injury, Immune Thrombocytopenic Purpura, and the Infection That Binds Them Together: Disseminated Histoplasmosis

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774619
Author(s):  
Pooja Sethi ◽  
Jennifer Treece ◽  
Chidinma Onweni ◽  
Vandana Pai ◽  
Sowminya Arikapudi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Immune Thrombocytopenic Purpura ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Kidney Injury ◽  
The United States ◽  
Rare Presentation ◽  
Thrombocytopenic Purpura ◽  
Disseminated Histoplasmosis ◽  
Immunodeficiency Virus

Untreated human immunodeficiency virus (HIV) can be complicated by opportunistic infections, including disseminated histoplasmosis (DH). Although endemic to portions of the United States and usually benign, DH can rarely act as an opportunistic infection in immunocompromised patients presenting with uncommon complications such as acute kidney injury and idiopathic thrombocytopenic purpura. We report a rare presentation of DH presenting with acute kidney injury and immune thrombocytopenic purpura in an immunocompromised patient with HIV.

scholarly journals Re-expansion pulmonary edema following a pneumothorax drainage in a patient with COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kosaku Komiya ◽  
Ryosuke Hamanaka ◽  
Hisayuki Shuto ◽  
Hiroki Yoshikawa ◽  
Atsushi Yokoyama ◽  
...  
Keyword(s):  
Chest Pain ◽  
Pulmonary Edema ◽  
Left Lung ◽  
Viral Pneumonia ◽  
Smoking History ◽  
Lung Field ◽  
Rare Presentation ◽  
X Ray ◽  
Chest X Ray ◽  
Oxygenation Status

Abstract Background Re-expansion pulmonary edema is an uncommon complication following drainage of a pneumothorax or pleural effusion. While pneumothorax is noted to complicate COVID-19 patients, no case of COVID-19 developing re-expansion pulmonary edema has been reported. Case representation A man in his early 40 s without a smoking history and underlying pulmonary diseases suddenly complained of left chest pain with dyspnea 1 day after being diagnosed with COVID-19. Chest X-ray revealed pneumothorax in the left lung field, and a chest tube was inserted into the intrathoracic space without negative pressure 9 h after the onset of chest pain, resulting in the disappearance of respiratory symptoms; however, 2 h thereafter, dyspnea recurred with lower oxygenation status. Chest X-ray revealed improvement of collapse but extensive infiltration in the expanded lung. Therefore, the patient was diagnosed with re-expansion pulmonary edema, and his dyspnea and oxygenation status gradually improved without any intervention, such as steroid administration. Abnormal lung images also gradually improved within several days. Conclusions This case highlights the rare presentation of re-expansion pulmonary edema following pneumothorax drainage in a patient with COVID-19, which recovered without requiring treatment for viral pneumonia. Differentiating re-expansion pulmonary edema from viral pneumonia is crucial to prevent unnecessary medication for COVID-19 pneumonia and pneumothorax.

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