Probable Amlodipine-Induced Angioedema

2009 ◽  
Vol 43 (4) ◽  
pp. 772-776 ◽  
Author(s):  
Jessica Southward ◽  
Elizabeth Irvine ◽  
Marina Rabinovich
Keyword(s):  
Autoimmune Disease ◽  
Hemorrhagic Stroke ◽  
Past History ◽  
Case Reports ◽  
Channel Blockers ◽  
Probability Scale ◽  
Careful Evaluation ◽  
Thyroid Autoimmune Disease ◽  
Case Summary ◽  
History Of

Objective: To report a case of angioedema likely associated with amlodipine administration in a patient with a right thalamic hemorrhagic stroke. Case Summary: A 50-year-old female experienced angioedema during hospitalization for s right thalamic hemorrhagic stroke. She had no past history of angioedema and all of her medications were assessed for risk of angioedema. After careful evaluation, case reports linking calcium channel blockers (CCBs) and angioedema led to further examination of amlodipine as a cause. Amlodipine therapy had been initiated 24 hours prior to the development of angioedema, which then resolved 72 hours after discontinuation of the drug. In total, the patient experienced oropharyngeal swelling for 10 days. Discussion: In determining a cause for the patient's angioedema we eliminated genetic, allergic, physically induced, thyroid autoimmune disease-associated, and medication-induced causes. Three case reports describing 7 patients have linked the CCBs verapamil, diltiazem, and nifedipine with angioedema. The onset and resolution of symptoms in our patient were very similar to those seen in other case reports. Application of the Naranjo probability scale found a probable link between amlodipine and angioedema. Conclusions: Although few reports of CCB-induced angioedema exisi, to our knowledge, this is the first reported case to suggest a link between angioedema and amlodipine therapy. Clinicians should consider amlodipine as a potential cause of angioedema.

scholarly journals Hydatid disease with Aspergilloma: A unique case report

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Sandeep Sharma ◽  
Parikshit Thakare ◽  
Ketaki Utpat ◽  
Unnati Desai
Keyword(s):  
Case Report ◽  
Hydatid Disease ◽  
Past History ◽  
Case Reports ◽  
Unique Case ◽  
Rare Finding ◽  
History Of ◽  
One Year

The coexisting presence of hydatid disease with aspergillus colonization is a rare finding. The 20-year-old presented with symptoms of hemoptysis with past history of tuberculosis. On further evaluation, the patient was diagnosed as a case of aspergilloma and managed conservatively. After one year of presenting with similar complaints, the patient was turned out to be hydatid disease with aspergillus colonization on the basis of clinic-radiological and bronchoscopic evaluation. Till now only a few case reports have been reported. We report a unique case report of a similar presentation.

scholarly journals Mixed cortico-medullary adrenal carcinoma in children: looks are deceptive!!

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Arti Khatri ◽  
Nidhi Mahajan ◽  
Niyaz Ahmed Khan ◽  
Natasha Gupta
Keyword(s):  
Past History ◽  
Case Reports ◽  
Final Diagnosis ◽  
Adrenal Carcinoma ◽  
Case Presentation ◽  
First Case ◽  
Contrast Enhanced ◽  
Paediatric Age ◽  
History Of ◽  
Enhanced Computed Tomography

Abstract Background Mixed cortico-medullary adrenal carcinoma (MCMAC) is an extremely rare entity with scarce literature on its cytomorphology. Case presentation A 2-year-old girl presented with abdominal pain for 3 days and a past history of fever with significant weight loss. On examination, a non-tender left hypochondrial firm mass and an enlarged left supraclavicular node were found. Twenty-four-hour urinary levels of VMA were marginally high. Contrast-enhanced computed tomography of the abdomen showed a suprarenal heterogeneous mass encasing major vessels. Aspiration cytology of both mass and node showed similar features comprising a predominant population of singly scattered large cells with moderate cytoplasm, eccentric nucleus and prominent nucleolus in a necrotic background. Tumour cells expressed Synaptophysin and Melan-A. In view of increasing respiratory distress, debulking surgery was performed, and histopathology of the specimen revealed the presence of both malignant medullary and cortical components supported by immunohistochemistry making a final diagnosis of MCMAC. The patient succumbed to death in the postoperative period. The cytology slides were reviewed and were seen to show a dual cell population. Conclusion Coexistent malignant cortical and medullary tumour of the adrenal gland is the first case reported in the paediatric age group in the literature with only three previous case reports in adults.

Statin-Associated Bilateral Foot Myopathy

2019 ◽  
Vol 33 (6) ◽  
pp. 899-902 ◽  
Author(s):  
Mary Caitlin Baggett ◽  
Diane Nykamp
Keyword(s):  
Cardiovascular Risk ◽  
Lipid Lowering ◽  
Common Side Effect ◽  
Probability Scale ◽  
Case Summary ◽  
History Of ◽  
Muscle Groups ◽  
Artery Disease ◽  
Alternative Lipid ◽  
Statin Use

Objective: To report a case of statin-induced bilateral foot myopathy that resulted from 2 different statins. Case Summary: A 44-year-old Caucasian male with a history of ventricular fibrillation cardiac arrest, hyperlipidemia, and coronary artery disease experienced bilateral foot pain, weakness, and soreness while taking atorvastatin 20 mg daily. The pain subsided within weeks of discontinuing atorvastatin but returned years later after the initiation of rosuvastatin. The Naranjo probability scale indicates that this is a definite association between bilateral foot myopathy and statin use. Discussion: There is an association with statin use and lowering cardiovascular risk in patients with dyslipidemia and cardiovascular disease. However, statin metabolites can accumulate in the myocytes of muscle groups to cause a common side effect of myopathy. Statin myopathy typically occurs in large, bilateral, or proximal muscle groups, such as the thighs, back, calves, or buttocks. This patient was unusual in that his muscle symptoms only occurred in his feet and was severe enough to affect his ambulation. Conclusion: Stain-associated muscle symptoms have been reported to lessen medication adherence. There is also a risk with muscle symptoms that the patient could develop rhabdomyolysis, a rare but serious condition. Recognizing statin-associated muscle symptoms even in uncommon locations is important, so that alternative lipid-lowering strategies can be implemented to lower cardiovascular risk.

Successful Treatment of Corynebacterium striatum Endocarditis with Daptomycin plus Rifampin

2005 ◽  
Vol 39 (10) ◽  
pp. 1741-1744 ◽  
Author(s):  
Monica Shah ◽  
Jeremias L Murillo
Keyword(s):  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Reports ◽  
Unsuccessful Attempt ◽  
Case Summary ◽  
Corynebacterium Striatum ◽  
History Of ◽  
Linezolid Therapy ◽  
Lipopeptide Antibiotic ◽  
Viable Treatment

OBJECTIVE: To report a case of Corynebacterium striatum endocarditis that was treated successfully with daptomycin plus rifampin following an unsuccessful attempt at vancomycin desensitization and failure of linezolid therapy. CASE SUMMARY: A 46-year-old woman with hemodialysis-dependent chronic renal failure was admitted for a graft-related infection. She presented with C. striatum endocarditis that was treated with daptomycin plus rifampin due to a history of allergies to vancomycin and β-lactam antibiotics and failure of linezolid therapy. The patient received daptomycin and rifampin for a total of 6 weeks. Three months after completion of treatment, no recurrence of endocarditis was evident. DISCUSSION: Daptomycin is a lipopeptide antibiotic, with rapid bactericidal activity. It has demonstrated efficacy in animal models of staphylococcal, streptococcal, and enterococcal endocarditis. Case reports of its activity in methicillin-resistant Staphylococcus aureus endocarditis have also been documented. CONCLUSIONS: Daptomycin, which has shown in vitro activity against C. striatum, may be a viable treatment option for patients with C. striatum endocarditis who are either allergic or refractory to traditional antibiotics.

Fulminant Hepatic Failure Associated with Propylthiouracil

2003 ◽  
Vol 37 (2) ◽  
pp. 224-228 ◽  
Author(s):  
Jorge K Ruiz ◽  
Giorgio V Rossi ◽  
Humberto A Vallejos ◽  
Rosemarie W Brenet ◽  
Isabel B Lopez ◽  
...  
Keyword(s):  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Adverse Reactions ◽  
Medical Sciences ◽  
Probability Scale ◽  
Histologic Study ◽  
Case Summary ◽  
Severe Liver Dysfunction ◽  
History Of ◽  
Therapeutic Measures

OBJECTIVE: To report 2 fatal cases of fulminant hepatic failure associated with propylthiouracil treatment against hyperthyroidism. CASE SUMMARY: Two women, 30 and 32 years old with no previous liver disease, were treated with propylthiouracil against Graves' disease. Both patients developed jaundice after a 4- and 5-month treatment period, respectively. The disease was similar to viral hepatitis, with a progressive course to severe liver dysfunction and death, along with multisystem organ failure despite extensive therapeutic measures. One of the patients was pregnant and subsequently miscarried. Neither patient had a history of alcoholism, drug abuse, blood transfusion, or exposure to hepatitis A, B, or C. Extrahepatic obstruction was ruled out with an abdominal ultrasonogram. Serologic studies and immunologic tests were negative. A submassive necrosis was shown in a postmortem histologic study. DISCUSSION: Naranjo probability scale criteria applied to both cases confirm the adverse reactions as probable. These cases fit the requirements of drug hepatotoxicity proposed by Hanson and the Council of the International Organization of Medical Sciences. Eight deaths associated to propylthiouracil were found in our review of the medical literature up to December 2000. CONCLUSIONS: Despite the widespread use of propylthiouracil, fulminant hepatitis with death is exceptionally rare; these 2 cases could be added to the fatal outcomes published to date.

Famotidine-Induced Mixed Hepatocellular Jaundice

1994 ◽  
Vol 28 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Paul W. Ament ◽  
John D. Roth ◽  
Carol J. Fox
Keyword(s):  
Liver Enzyme ◽  
Elevated Liver Enzyme ◽  
Epigastric Pain ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Enzyme Concentration ◽  
Case Summary ◽  
First Case ◽  
History Of ◽  
Hepatocellular Jaundice

OBJECTIVE: To report a case of probable famotidine-induced mixed hepatocellular jaundice. CASE SUMMARY: A 55-year-old man presented with a one-month history of mid-epigastric pain. Initial physical examination and laboratory studies, including liver enzyme concentration tests, were unrevealing. A diagnosis of gastritis was made and ranitidine was prescribed. Following one week of therapy, the patient's symptoms had not improved and therapy was changed to famotidine and sucralfate. Approximately one week later the patient presented with jaundice. Liver enzyme concentrations were elevated and the patient was hospitalized for further evaluation. Five days following discontinuation of famotidine, liver enzyme concentrations were normal and jaundice had resolved. Further tests did not reveal any pathologic etiology. DISCUSSION: Hepatic changes have occurred in patients receiving histamine2-antagonists; ranitidine and cimetidine have been cited most frequently. In general, the elevations are mild, transient, and return to baseline with continued therapy. This is one of the first case reports of probable famotidine-induced mixed hepatocellular jaundice. CONCLUSIONS: There was a temporal relationship between the patient's signs and symptoms and initiation of famotidine. No identifiable factors contributed to the elevated liver enzyme concentrations and jaundice.

Bevacizumab-Induced Oral Mucositis in Background of Cutaneous Plaque-Type Psoriasis

2012 ◽  
Vol 46 (11) ◽  
pp. e32-e32 ◽  
Author(s):  
Andra M Popa ◽  
Kelly Valla ◽  
Latha Radhakrishnan ◽  
Sandra Cuellar ◽  
J Lee Villano
Keyword(s):  
Oral Mucositis ◽  
Mucosal Damage ◽  
Glioneuronal Tumor ◽  
Probability Scale ◽  
Imaging Studies ◽  
Continuous Therapy ◽  
Psoriatic Disease ◽  
Plaque Type ◽  
Case Summary ◽  
History Of

OBJECTIVE: To report the serial development of oral mucositis following infusion of bevacizumab in a young woman with a malignant brain tumor and history of cutaneous psoriasis. CASE SUMMARY: A 29-year-old woman with a history of active cutaneous psoriasis and a malignant glioneuronal tumor was treated with bevacizumab for 2.5 years. With each infusion of bevacizumab, she developed oral mucositis within 36 hours. She received temozolomide as part of concurrent therapy with radiation and as maintenance therapy; it was discontinued after continuous therapy for 1.5 years. Bevacizumab 10 mg/kg was added after 7 cycles of maintenance temozolomide, as the tumor had minimal response and evidence of increased perfusion with angiogenesis on imaging studies. All medication, including temozolomide, was evaluated and eventually discontinued, with the exception of bevacizumab, which remained the drug suspected of causing the mucositis. DISCUSSION: Oral mucositis is a frequent adverse effect of cytotoxic chemotherapy, but has not been reported with bevacizumab. The Naranjo probability scale indicated a probable adverse drug reaction. This likely indicates that bevacizumab is one of many drugs known to induce exacerbation of psoriatic disease. We speculate that oral mucositis developed as bevacizumab-induced generation of proinflammatory cytokines within the vascular endothelium, leading to mucosal damage and ulceration. In addition, interruption of reparative angiogenic pathways with bevacizumab likely contributed to the severity of mucositis. CONCLUSIONS: Clinicians should be aware that bevacizumab can potentially exacerbate psoriatic disease.

scholarly journals Thrombocytopaenia and thyroiditis: coincidence?

2019 ◽  
Vol 12 (7) ◽  
pp. e228411 ◽  
Author(s):  
Sara Fonseca ◽  
Catarina Lacerda ◽  
Ines Ganhão ◽  
Sofia Castro
Keyword(s):  
Autoimmune Disease ◽  
Laboratory Investigation ◽  
Platelet Glycoprotein ◽  
Thyroid Autoantibodies ◽  
Autoimmune Mechanism ◽  
Thyroid Autoimmune Disease ◽  
History Of

Thrombocytopaenia can be associated with an autoimmune mechanism. Immune thrombocytopaenia can be associated with thyroid autoimmune disease. The authors present a case of a teenager with a history of thrombocytopaenia who complained of tiredness. Laboratory investigation showed thyroid autoantibodies. The co-existence of thrombocytopaenia and thyroiditis lead to further investigation and antibodies against platelet glycoprotein IIbIIIa were found. This case illustrates the association of the overlap aspects between thyroid and platelet autoimmunity.

Thyroid-Induced Mania in Hypothyroid Patients

1980 ◽  
Vol 137 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Allan M. Josephson ◽  
Thomas B. Mackenzie
Keyword(s):  
Past History ◽  
Case Reports ◽  
Manic State ◽  
Affective Disturbance ◽  
Patients At Risk ◽  
History Of ◽  
The Relationship ◽  
Hypothyroid Patients ◽  
Insight Into ◽  
High Range

SummaryThis retrospective study, based on 18 case reports, describes an organic affective syndrome, manic type, occurring shortly after the initiation of thyroid replacement in hypothyroid patients. The symptomatology and homogeneity of the syndrome offers insight into the relationship between thyroid activity and affective disturbance. The patients experiencing mania showed concurrent psychopathology at the time of replacement therapy, frequently had a past history of personal or familial psychiatric disorder and were given dosages in the high range of normal. The potential morbidity of the manic state was considerable. These findings suggest that a group of hypothyroid patients at risk can be identified. In such a group, lower initial dosages and gradual increases in dosage may be indicated.

scholarly journals Aneurysmal Subarachnoid Hemorrhage in a 68-Year-old Hyperglycemic Female Patient: Case Report and Literature Review

2019 ◽  
Vol 7 (2) ◽  
pp. 45-49
Author(s):  
Paul Marcel Morgan
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Hemorrhagic Stroke ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Previous History ◽  
Channel Blockers ◽  
Small Areas ◽  
Glucose Levels ◽  
History Of ◽  
Western Regional ◽  
Acute Hemorrhagic Stroke

Background: While hyperglycemia is intimately associated with uncontrolled diabetes mellitus (DM), recent clinical studies have demonstrated that hyperglycemia is also present in the early acute phase of stroke and is associated with poor prognosis and increased long-term mortality. About half of patients with acute hemorrhagic stroke also present with hyperglycemia upon admission. But more than 50% of patients with acute hemorrhagic stroke develop hyperglycemia even without a previous history of DM. This sheds new light on the relationship between DM, hyperglycemia, and hemorrhagic stroke, with a pathophysiology that is perhaps more profound than is conventionally understood. The Case: We report a case of a 68-year-old female, with a history of DM Type 2 and stage 3 hypertension who presents to the emergency room (ER) at the Western Regional Hospital in Belmopan City, Belize, with hemorrhagic stroke and hyperglycemia. Diffuse subarachnoid hemorrhage was found in the frontal, temporal, and parietal regions. Mild intraventricular hemorrhage was also observed in the frontal horns and basal cisterns. And small areas of intraparenchymal hemorrhage were present in the frontal lobes. The patient was stabilized and treated conservatively with calcium channel blockers, and diuretics. Conclusion: Despite a unifying consensus that is still pending, maintaining glucose levels between 110-120 mg/dl by using continuous insulin infusions after traumatic brain injury or aneurysmal subarachnoid hemorrhage may carry some clinical benefit with slightly improved outcome.

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