scholarly journals Clinical Report of Probable Catastrophic Antiphospholipid Syndrome in Pregnancy

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Eryk Hakman ◽  
Sasha Mikhael
Keyword(s):  
Early Recognition ◽  
Vital Signs ◽  
Adverse Outcomes ◽  
Laboratory Evaluation ◽  
Clinical Report ◽  
Elevated Liver Enzymes ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
In Pregnancy

Background. Catastrophic APS (CAPS) is a rare but life-threatening form of APS defined as multiorgan thrombosis affecting a minimum of three organs with confirmation by histopathology of small vessel occlusions in at least one organ or tissue. The development of CAPS in pregnancy poses many diagnostic challenges as a result of its broad range of clinical presentations and its overlap with other obstetric complications and microangiopathic diseases. Because of the high associated mortality rate, prompt recognition and treatment are paramount. Case. A twenty-five-year-old G3P0111 with a history of multiple thromboembolisms presented at 21 weeks and 3 days of gestation with complaints of right upper quadrant pain, visual disturbances, headache, and syncopal episodes. Laboratory evaluation demonstrated microangiopathic disease with hemolysis (confirmed on peripheral smear), elevated liver enzymes, and abnormal 24-hour urine protein with vital signs within the normal range. Presence of significantly elevated antiphospholipid antibodies was noted, facilitating the diagnosis of probable CAPS. Proper workup was achieved based on clinical suspicion, allowing immediate and appropriate management. Conclusion. CAPS is a life-threatening condition rarely seen in pregnancy making early recognition difficult. A low threshold to initiate urgent and aggressive treatment should be maintained to minimize the risk of adverse outcomes.

scholarly journals A study of effects of hypothyroidism on antenatal patients

2021 ◽  
Vol 11 (1) ◽  
pp. 169
Author(s):  
Payal Saha ◽  
Tushar Palve ◽  
Pooja R.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Early Recognition ◽  
Adverse Outcomes ◽  
Endocrine Disorders ◽  
Exclusion Criteria ◽  
High Prevalence ◽  
History Of ◽  
Nicu Admission ◽  
In Pregnancy

Background: After diabetes mellitus, thyroid disorders are the most common endocrine disorders in pregnancy. The most common thyroid gland dysfunction in pregnancy is hypothyroidism with estimated prevalence of 1.5-4.4% of pregnant women. Effects of hypothyroidism in pregnancy include anemia, pre-eclampsia, prematurity, IUGR, low birth weight, mental retardation in neonate. The objective of this study is to find the association of hypothyroidism and its adverse outcomes on mother and the fetus that is listed above.Methods: A study was conducted over a period of 6 months over 50 antenatal patients with hypothyroidism from Jan 2021 to August 2021 in the department of obstetrics and gynecology, Cama and Albless hospital, Mumbai with inclusion, exclusion criteria. History of infertility, family history of thyroid disease, menstrual pattern, recurrent abortion and fetal outcomes were the main study variables.Results: In this study, majority of hypothyroidism belonged to the age group of 26-30 years (54%). A high prevalence was found in G2 (26%) and antenatal hypothyroidism with past h/0 abortions were found in 26% patients. Low birth weight is found in 32% cases of hypothyroidism, NICU admissions seen in 32% cases of hypothyroidism, 22% cases were found to have anemia.Conclusions: Hypothyroidism is a common health problem in antenatal patients. We concluded that hypothyroidism is more commonly seen to be associated with low birth weight, anemia, pre-eclampsia, NICU admission in neonate. Early ANC registration and regular ANC checkups help in early recognition and initiating early treatment, thus improving fetomaternal outcome. 

Odontogenic deep neck space infection as life-threatening condition in pregnancy

2014 ◽  
Vol 59 (3) ◽  
pp. 375-378 ◽  
Author(s):  
D Dalla Torre ◽  
D Burtscher ◽  
D Höfer ◽  
FR Kloss
Keyword(s):  
Space Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Deep Neck Space Infection ◽  
In Pregnancy

Coexistence of diabetic ketoacidosis and thyrotoxicosis: a jeopardy of two endocrine emergencies

2021 ◽  
Vol 14 (6) ◽  
pp. e243534
Author(s):  
Soban Ahmad ◽  
Amman Yousaf ◽  
Shoaib Muhammad ◽  
Fariha Ghaffar
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Favourable Outcome ◽  
Adverse Outcomes ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Thyroid Disorders ◽  
History Of

Simultaneous occurrences of diabetic ketoacidosis (DKA) and thyroid storm have long been known, but only a few cases have been reported to date. Both these endocrine emergencies demand timely diagnosis and management to prevent adverse outcomes. Due to the similarities in their clinical presentation, DKA can mask the diagnosis of thyroid storm and vice versa. This case report describes a patient with Graves’ disease who presented to the emergency department with nausea, vomiting and abdominal pain. He was found to have severe DKA without an explicit history of diabetes mellitus. Further evaluation revealed that the patient also had a concomitant thyroid storm that was the likely cause of his DKA. Early recognition and appropriate management of both conditions resulted in a favourable outcome. This paper emphasises that a simultaneous thyroid storm diagnosis should be considered in patients with DKA, especially those with a known history of thyroid disorders.

Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child

2021 ◽  
Vol 14 (3) ◽  
pp. e240759
Author(s):  
Jashan Mittal ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal ◽  
Abhishek Purohit
Keyword(s):  
Haemophagocytic Lymphohistiocytosis ◽  
Appetite Loss ◽  
Specific Therapy ◽  
Adequate Treatment ◽  
Underlying Condition ◽  
Persistent Fever ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positive Brucella serology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.

Alcohol Related Non-traumatic Rhabdomyolysis and Compartment Syndrome

2007 ◽  
Vol 6 (1) ◽  
pp. 33-34
Author(s):  
JPL Ong ◽  
◽  
LA Thomas ◽  
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Lower Extremity ◽  
Compartment Syndrome ◽  
Early Recognition ◽  
Clinical Entity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Renal Support

Rhabdomyolysis is a serious and life-threatening condition in which skeletal muscle is damaged, commonly resulting in acute renal failure. The causes of this clinical entity can be traumatic and non-traumatic. In the latter group, alcohol is the commonest cause. This report describes the case of a 25 year old man who presented with rhabdomyolysis leading to acute renal failure after an alcohol binge. He presented with painful legs and lower extremity compartment syndrome. The patient recovered with surgical fasciotomy and renal support. This case illustrates the importance of early recognition and treatment of alcohol related non-traumatic rhabdomyolysis and compartment syndrome.

Assessment and care of the patient with sepsis

2020 ◽  
pp. 225-257
Author(s):  
Kevin Barrett
Keyword(s):  
Septic Shock ◽  
Early Recognition ◽  
Scoring Systems ◽  
Cardiovascular Responses ◽  
Physiological Changes ◽  
Assessment Framework ◽  
Threatening Condition ◽  
Life Threatening ◽  
Support Mechanisms ◽  
Sepsis And Septic Shock

There has been considerable recent focus on sepsis in both the clinical arena and within the general public to raise awareness of the importance of early recognition of this potentially life-threatening condition. The early recognition of sepsis by ward nurses can both reduce progression of this lethal disease and improve survival for patients in hospital. This chapter focuses on definitions of sepsis and septic shock, physiological changes associated with inflammatory and cardiovascular responses to sepsis, and a clinical assessment framework to guide practice. There is also a discussion of the use of scoring systems and how to escalate support mechanisms for patients with sepsis and septic shock.

Midgut volvulus secondary to congenital malrotation in pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234664 ◽  
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Vishnupriya Rajagopal ◽  
Neil Strugnell
Keyword(s):  
Perinatal Outcomes ◽  
First Trimester ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Midgut Volvulus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

Legionella infection in pregnancy: imitator of HELLP syndrome, presenting as acute respiratory failure and septic shock

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Moti Gulersen ◽  
Eran Bornstein
Keyword(s):  
Septic Shock ◽  
Hellp Syndrome ◽  
Laboratory Evaluation ◽  
Maternal Complications ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Urinary Antigen Testing ◽  
Legionnaires Disease ◽  
Antigen Testing ◽  
In Pregnancy

Abstract Background Legionnaires’ disease in pregnancy may cause severe maternal complications. Hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome is a disorder associated with significant maternal and fetal morbidity and mortality. Several medical conditions have been described as imitators of this syndrome, presenting with similar laboratory abnormalities. Case presentation A healthy, multiparous woman presented at 26 weeks’ gestation with fever, headache and general malaise, rapidly progressing to septic shock and respiratory collapse. Laboratory evaluation revealed similar abnormalities to those seen with HELLP syndrome. Emergent cesarean delivery was performed for worsening maternal and fetal conditions. Following delivery, infection with Legionella was diagnosed on urinary antigen testing. Supportive care was administered in the intensive care unit. Conclusion Legionnaires’ disease should be considered in gravidas presenting with rapidly deteriorating respiratory status, septic shock and laboratory abnormalities mimicking HELLP syndrome.

scholarly journals Non-occlusive mesenteric ischaemia associated with anorexia nervosa

2019 ◽  
Vol 12 (5) ◽  
pp. e229703
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor ◽  
Tadao Kubota
Keyword(s):  
Anorexia Nervosa ◽  
Distal Ileum ◽  
Interdisciplinary Management ◽  
Emergency Laparotomy ◽  
Diffuse Peritonitis ◽  
Chronic Haemodialysis ◽  
Mesenteric Ischaemia ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Non-occlusive mesenteric ischaemia (NOMI) is a life-threatening condition that requires emergent intervention and anorexia nervosa is a chronic eating disorder that requires careful medical and nutritional management. A 54-year-old woman with a history of anorexia nervosa and undergoing chronic haemodialysis developed abdominal pain and called an ambulance. On arrival, she was in shock and abdominal examination was consistent with diffuse peritonitis. Computed tomography scan suggested ischaemia from the distal ileum to the ascending colon. Emergency laparotomy revealed NOMI from the distal ileum to the transverse colon. The treatment strategy included staged operations and careful medical management to optimise nutritional support and electrolyte management with survival of the patient. NOMI and anorexia nervosa are both difficult to manage. Meticulous interdisciplinary management can result in a good outcome.

Salicylate Intoxication

1997 ◽  
Vol 12 (2) ◽  
pp. 66-78 ◽  
Author(s):  
Luke Yip ◽  
Michael S. Jastremski ◽  
Richard C. Dart
Keyword(s):  
Life Support ◽  
Care Facility ◽  
Health Care Facility ◽  
Poison Control ◽  
Electrolyte Balance ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Salicylate Intoxication ◽  
Base Management

Aspirin (acetylsalicylic acid) is one of the most widely used over-the-counter medications. Because of its availability and widespread use, aspirin has a long history of human toxicity from accidental or intentional overdosing. According to the American Association of Poison Control Centers aspirin was implicated in 19083 exposures in 1995, with 11800 cases treated in a health care facility, and 52 associated deaths. Aspirin toxicity may be a life-threatening condition that produces multiple system organ failure requiring treatment in an intensive care unit. Managing a patient with salicylism will challenge the skills of the critical care team, especially in the areas of life support, fluid and electrolyte balance, and acid-base management. This article reviews the physiology, pathophysiology, acute and chronic salicylism in children and adults, and management of salicylate intoxication.

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