scholarly journals Liver Failure, Renal Failure, and a Rash: An Unusually Severe Case of Multi-Organ Failure Due to Murine Typhus

Cureus ◽  
2021 ◽  
Author(s):  
Stephanie Wachs ◽  
Brandon Kuiper
Keyword(s):  
Renal Failure ◽  
Liver Failure ◽  
Organ Failure ◽  
Severe Case ◽  
Murine Typhus ◽  
Multi Organ Failure

scholarly journals Convalescent plasma successfully treats a severe COVID-19 patient with multi-organ failure

2020 ◽  
Vol 7 (10) ◽  
pp. 4022-4025
Author(s):  
Behnam Bajelan ◽  
Pejman Salehifar ◽  
Afshin Karami ◽  
Mehdi Salimi ◽  
Alireza Janbakhsh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Organ Failure ◽  
Clinical Status ◽  
Specific Treatment ◽  
Severe Case ◽  
Present Case Report ◽  
Pulmonary Lesions ◽  
Multi Organ Failure ◽  
Therapeutic Measures

Due to the high mortality rate of coronavirus disease 2019 (COVID-19) and the lack of specific treatment for the disease, it is essential to find new therapies. The present case report aimed to assess the efficiency of convalescent plasma in patients with severe acute respiratory syndrome coronavirus 2. We reported a severe case of COVID-19 with multi-organ failure, who had reduced oxygen saturation after several courses of antiviral therapy. Moreover, computed tomography (CT) scan results showed patchy lesions in the base of lungs. Therapeutic measures, including endotracheal intubation and plasmapheresis with convalescent plasma, were performed for the patient; subsequently, good responses to the treatments were observed. Our findings demonstrate that convalescent plasma improves pulmonary lesions and the patient's clinical status.

scholarly journals Successful Use of Plasma Exchange Preceding RBC Exchange in Sickle Cell Disease Hyperhemolytic Crisis with Hepatic Sequestration: A Case Report

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4279-4279
Author(s):  
Samir Atiya ◽  
Rosalyn I Marar ◽  
Aleh Bobr
Keyword(s):  
Case Report ◽  
Liver Failure ◽  
Organ Failure ◽  
Plasma Exchange ◽  
Sickle Cell ◽  
Case Reports ◽  
Multiorgan Failure ◽  
Multi Organ Failure ◽  
Free Heme ◽  
Pain Crisis

Abstract Introduction Hyperhemolytic crisis is an uncommon complication of SCD that may cause multiorgan failure and lead to significant mortality. There are no current national or international guidelines for management of hyperhemolytic crisis and associated complications. There have been limited number of case reports and series that demonstrated utility of plasma exchange in the patients with multiorgan failure resulting from hemolysis complications (Zaidi GZ et al.,2020). We are presenting the case where hyperhemolytic crisis was complicated by hepatic sequestration and acute liver failure, that was dramatically reversed by 2 plasma exchange treatments followed by RBC exchange. Case report We present a case of a 35-year-old African American male with SCD and beta thalassemia trait with frequent hospitalizations for sickle cell pain crisis. He presented with pain typical for his acute pain crises and was admitted for intravenous hydration and pain control. The next morning, lab work showed bicytopenia with a drop in hemoglobin from 10.5 to 5.8 g/dL and platelets (PLT) from 100 to 22 X10E3/uL. Lactate dehydrogenase (LDH) increased from 434 to 2848 U/L, haptoglobin was 36 mg/dL, but disseminated intravascular coagulation (DIC) and Heparin-induced Thrombocytopenia (HIT) antibody panel were negative. The blood urea nitrogen (BUN) creatinine (Cr) ratio was also elevated (30.6) suggesting renal damage as well. He was transferred to the intensive care unit and started on Intravenous Immunoglobulin (IVIG) 0.4 grams/kilogram daily for 5 days and methylprednisolone 500 mg daily for 2 days followed by a prednisone taper. Liver enzymes continued to trend upward with AST of 19,866 U/L and ALT of 3,675 U/L on day 3 of hospitalization. Ultrasound of abdomen demonstrated mild splenomegaly with a spleen measuring 13.3 cm. The clinical presentation and hepatocellular pattern of injury was consistent with hepatic sequestration crisis. Despite receiving 1 unit of platelet 3 units of pRBC, there was little improvement and apheresis service was consulted. Plasma exchange was initiated for 2 procedures on consecutive days followed by RBC exchange with rapid improvement in clinical status and laboratory findings with a reduction of LDH (1304), AST (129), ALT (204), Hgb (8.0), PLT (41), BUN/Cr (20.0). He was discharged on day 7 at baseline status. Discussion Although the mechanism of development of hyperhemolysis in SCD is not fully understood, the hemolysis leads to release of free hemoglobin (Hb) and free heme that activate neutrophils, and vascular endothelial cells via TLR-4. This ultimately leads to inflammatory, coagulative, and cytotoxic damages and decreased nitric oxide (NO) bioavailability which further contributes to SCD complications such as pulmonary and systemic vasculopathy, pain crisis and acute chest syndrome and multi organ failure (Louie JE et al., 2018). This provides a rationale for plasma exchange - removal of free heme from the patient plasma and replenishing exhausted haptoglobin and hemopexin reserves from donor plasma. Hemolytic crisis causing visceral organ damage is relatively rare. There are no current guidelines for management of such patients. In 1996 Betrosian et al. discussed the first case of liver failure in a SCD with vasa-occlusive crisis treated with RBC and plasma transfusions (Betrosian A et al., 1996). Since then, there have been case reports/series of plasma exchange/plasma transfusions in SCD with multi organ failure (Geigel EJ et al., 1997, Louie JE et al., 2018) but reports about use of plasma exchange in SCD patients with hepatic sequestration have not been identified by our literature review. Our case demonstrates that plasma exchange in hyperhemolysis and hepatic sequestration is: Safe Leads to quick and significant improvement in hemolysis laboratory values. Results in quick and durable reversal of hepatic sequestration and associated liver failure. Adds plasma exchange as therapeutic apheresis modality in addition to previously accepted RBC exchange. Provides data about priority of plasma exchange over RBC exchange in this clinical situation. Disclosures No relevant conflicts of interest to declare.

Thirty-eight-negative-kinase-1 is a major mediator of trauma-induced intestinal injury and multi-organ failure

2018 ◽  
Vol 56 (08) ◽  
pp. e205-e206
Author(s):  
M Armacki ◽  
AK Trugenberger ◽  
A Ellwanger ◽  
T Eiseler ◽  
L Bettac ◽  
...  
Keyword(s):  
Organ Failure ◽  
Intestinal Injury ◽  
Multi Organ Failure ◽  
Major Mediator

scholarly journals High-dose diquat poisoning: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110261
Author(s):  
Yanxia Huang ◽  
Renjing Zhang ◽  
Mei Meng ◽  
Dechang Chen ◽  
Yunxin Deng
Keyword(s):  
Renal Failure ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
High Dose ◽  
Severe Respiratory Failure ◽  
Aggressive Treatment ◽  
Lung Lesions ◽  
Pulmonary Lesions ◽  
New Treatment

Diquat is a widely used herbicide that is substituted for paraquat. With paraquat off the market, cases of diquat poisoning have been gradually increasing. The kidney is the most frequently impaired organ in diquat poisoning. Few cases of multiple organ failure caused by diquat have been reported. We herein describe a 30-year-old man who orally ingested about 160 mL of enriched diquat. Despite aggressive treatment, the patient’s condition progressed to multiple organ failure and death. The pulmonary lesions in this patient were different from those previously reported. This patient did not die of renal failure but of severe respiratory failure. He exhibited three different stages of pulmonary disease. The lung lesions in this case were unique. We hope that doctors will pay more attention to the lung lesions in patients with diquat poisoning in future and find new treatment methods to save the lives of such patients.

Endogenous digoxin-like immunoreactive factors: impact on digoxin measurements and potential physiological implications.

1985 ◽  
Vol 31 (9) ◽  
pp. 1525-1532 ◽  
Author(s):  
R Valdes
Keyword(s):  
Renal Failure ◽  
Liver Failure ◽  
Pregnant Women ◽  
Serum Proteins ◽  
Newborn Infants ◽  
Normal Subjects ◽  
Carrier Proteins ◽  
Third Trimester ◽  
Weakly Bound ◽  
Urine And Serum

Abstract Various laboratories have reported endogenous digoxin-like immunoreactive factor(s) (DLIF) in blood from patients in renal failure or liver failure, from newborn infants, and from third-trimester pregnant women. Similar immunoreactivity has been detected in amniotic fluid, in cord blood, and in urine and serum from normal subjects. The factor(s) giving rise to this immunoreactivity cross react with antibodies used in many currently available immunoassays for digoxin, sometimes causing apparent digoxin concentrations exceeding the therapeutic range obtained for exogenous digoxin, with consequent errors in measurement and in subsequent clinical interpretation of digoxin results. Here, I summarize findings in our laboratory and those of others. DLIF evidently exist in three states in serum: tightly protein-bound, weakly protein-bound, and unbound (free). In normal subjects, greater than 90% of the total DLIF in serum is tightly but reversibly bound to serum proteins and is not readily detectable by direct measurement of digoxin in serum with conventional immunoassays. However, there seems to be a redistribution of the more weakly bound and unbound components in patients with renal failure, pregnant women, and newborns. The increased values detected in these groups are ascribable to increased amounts of weakly bound and unbound DLIF rather than to increased total DLIF. Carrier proteins may play a prominent role in the transport of these factors in blood. I discuss the potential physiological and pharmacological implications of detecting endogenous immunoreactive factors that cross react with antibodies to drugs.

scholarly journals Simultaneous Occurrence of Choriocarcinoma in an Infant and Mother

2021 ◽  
Vol 18 (4) ◽  
pp. 1934
Author(s):  
Małgorzata Rzanny-Owczarzak ◽  
Joanna Sawicka-Metkowska ◽  
Katarzyna Jończyk-Potoczna ◽  
Ewelina Gowin ◽  
Patrycja Sosnowska-Sienkiewicz ◽  
...  
Keyword(s):  
Rare Disease ◽  
Organ Failure ◽  
Liver Tumor ◽  
Serum Levels ◽  
Simultaneous Occurrence ◽  
Positive History ◽  
Multi Organ Failure ◽  
History Of

Infantile choriocarcinoma is an extremely rare disease. We present a case study of a 1-month-old male with choriocarcinoma diagnosed simultaneously with his mother. On admission to hospital, the disease was very advanced and massive progression and multi-organ failure caused the death of the patient despite the implemented treatment. It was too late to save the child’s life, but early enough to save his mother. The authors believe that the serum levels of hCG should be determined in every newborn with anemia and liver tumor, especially when the mother has a positive history of miscarriage.

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